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Rob72 ASN, RN

Infectious Disease, Neuro, Research
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Former EMT, Corrections Officer, Phleb, lab tech, current Research RN

Rob72's Latest Activity

  1. Rob72

    What do you like about being a research nurse?

    If you are in Oklahoma, PM me, and we'll see if we can get you hooked up with a job. There is little in the way of non-OJT training for research. Oklahoma City Community College is one of a handful of CCs in the country that started an Assosciate Degree in Research program. Pre-reqs are the same as the RN program, with the core courses being research specific, with 2 final semester internships. Do you need another degree? I would say not. From the nursing perspective, Research is a whole lotta documentation and record keeping; beyond that, as a Coordinator, you would have responsibilities including drafting study documents, contract and budget negotiation, invoicing, data collection/entry, report filing, etc.. As an ADN you can apply for a Coordinator, Research Assistant, or Research RN position, generally. Pay varies, depending on who you work for, and experience. Edit: Generally, the best places to start looking are state universities; you can also look up "Research" in the yellow pages, and start looking at websites & making calls.
  2. Rob72

    Seizures real vs fake

    Oh, Lord, sis, you are innocent! Probably the easiest "tell" for seizure activity, whether absence or GTC, is the pain response. Use a Bic pen (tail or cap), and press it forcefully into the cuticle area of a fingernail. If they withdraw, they're faking. If they are playing GTC (generalized tonic clonic) with flopping, shaking and foaming at the mouth, they may continue with this, but the limb receiving pain will be rigid, attempting to minimize manipulation which would cause more pain. For an absence seizure (staring spell) you can flick at their eyes, and they won't blink. Again, risky in that they may alledge that you hurt them, they may injure you, using sx activity as an excuse, etc.. I say this with the obvious caveat that you may have someone take a swing at you, and say they were, "out of it". Either get a CO to do it for you, do it only under very controlled circumstances, or just let them flop(probably safest). For your experience level, and being female, I would probably simply say that if they display a post-ictal state, they had the real thing(confusion, discoordination, lethargy). Anything else is faker-faker. Edit: Probably waaaaay more than you want to know- http://www.ilae-epilepsy.org/Visitors/Centre/ctf/reflex_seizures.cfm Quick & dirty worksheet: http://www.ilae-epilepsy.org/Visitors/Centre/ctf/documents/ILAEHandoutV10_000.pdf and the abstract: http://www.ilae-epilepsy.org/Visitors/Centre/ctf/documents/ClassificationReport_2010_000.pdf
  3. Rob72

    Stuck in the rumor mill at work...

    Men and women are very different in this area, and that is most of what creates the problem. As a male, I'm always friendly with my co-workers, but there are some conversations from which I simply excuse myself, and some comments to which I just smile politely. Most healthcare folks interact (in every sense of the word) with others in the field, and generally in the same facility, so the basis for gossip is readily available. Best suggestion: avoid even the appearance of evil. Tone the "flirtation" waaaaay down. A male NM/CN should alread know this and be doing it, which gives me pause. In any event, if nothing is going on and if you are called into HR again, the phrase to use is, "malicious prosecution". Someone is using the administrative body to harass you for personal reasons, and it is a civil (and past a certain level, criminal) crime.
  4. Rob72

    Tattoo cover up

    Most of mine are chest work- I have one visible bracelet on my forearm. If you are applying at a corporate hospital (part of a multi-state/large corporation chain), rule of thumb is cover when interviewing, don't worry about it after you're hired, unless it is specifically addressed prior to your signing your employment papers. Corporate facilities won't risk the discrimination suit, unless your ink is "distasteful". I.e., a grim reaper and dancing skulls on your forearms will, in fact, get you transferred/fired from the oncology/peds/etc., floor. Private facilities generally have more site-specific discretion, applying to their code of conduct/professional standards enforcement. If you're applying to a private- what they say goes. Some have taken offense to what I've said in other posts, but if you're fairly discreet you generally won't have a problem. If you like to push limits, you're likley to meet someone who's happy to set them for you.
  5. Rob72

    Drug Screen question

    Contact your BON via email, and telephone(as in , "get the response in writing..."). On a personal note, you might want to investigate non-narc migraine tx (e.g., triptans obviously, topiramate prophylactically, etc..)- see what your doc/neuro suggests. Narcs tend towards severe rebound, over time, and you won't have the legal concerns over impairment.
  6. Rob72

    What's it like working on neurology unit?

    Interesting. I would guess that that is based on a given population- do/will you have more epileptics, strokes, or...? Neurology is similar to orthotics, in that you tend to have significant levels of depression, new learning, coping issues, altered family roles, etc.. As my wife has noted (an RT)- Neuro is nuts, Pulm is phlematic, GI is FOS, Ortho is hardheaded... Tends to be fairly true.
  7. Rob72

    Neuro Integrated Care Unit vs Intensive Care Unit

    Becoming more common. Most typically, you'll see subdivisions, such as the "stroke unit", or the "epilepsy unit", and these may each be 6-10 beads on the same floor, all part of the "Neurology Unit." They are patients with special needs, but whose care does not qualify for ICU billing.
  8. Rob72

    Time Management in ER

    True "ADD/ADHDs" don't do well, and I've worked with a few. Invariably, they loose the trees for the forrest. Developing a high level of compartmentalization helps- being able to quickly find a stopping place in the immediate task, switching tasks, and coming back to what you left. This is where the Strong Personality comes in- sometimes you have to tell others, firmly, "Not now...I'll be with you in a moment." Clustering is another biggie. As soon as you open a med/device/etc., throw the wrapper away immediately. Trash is in the trash before you do anything else. Push a med- while waiting 2-5 minutes in the room to observe your pt., do your charting. Most of this falls under developing a practice framework, or an abbreviated decisional tree (heuristic). Once you find an operational model that you are able to consistently follow, you are more capable of "switching gears" because your interventional processes are more efficient. As a tech, you'll learn that individual nurses have different heuristics, and learning these will allow you to anticipate their needs- it becomes an X=Y formula. E.g., Nurse Kathy + Chest pain= EKG, IV, Labs in that order. Once your interventions are done, you know that labs need to be tubed/called/whatever, so you step away from the immediate process, and on your return, you re-evaluate what is going on in the room, and what your next pathway will be.
  9. Rob72

    what do you do during a tornado?

    Move in, move down, lockdown & cover is the rule of thumb. Move patients towards the core of the building; move to lower floors, when possible; close all blids/windows/doors/etc.; provide blankets/pads, etc., for shielding. Interestingly, a co-worker completed his BS-BSN two years ago, and one of his leadership essay assignments was to formulate a plan for dealing with delegation and staffing during a complete loss of power in a small hospital. Not a huge problem for him, as a former Ranger/ED tech, but it knocked quite a few of his classmates for a serious decisional loop.
  10. Rob72

    MA working beyond scope of practice

    Most things are knowing how and what to document. Policies (who does triage, who reads TB tests, etc..) must be within the scope of practice of the staff. When they are not, the Medical Director who signed off on the policy is liable as are the managers/supervisors. Bottom line, if an unlicensed individual is trying to tell you what to do or make a clinical judgement, it is always valid to state that they are not competent to make that decision. DVRs are your friend, especially if your state is a single-party-knowledge state.
  11. Rob72

    Mean coworkers?

    Sort of... Corrections is its own animal. General suspicions: 1) they are afraid you're a "goody-two-shoes" who will blow the whistle for negligence/malfeasance in care delivery. 2) they are afraid you will interfere with their dope-dealing business. 3) they are afraid they may be fired, should either of the above come up, and they really would be unable to function in "the real world". For the most part, most of your co-workers are not much different than the inmates- they will never progress above "Safety" in Maslow's hierarchy, or Industry vs. Inferiority in Erickson. This results in some dysfunctional retarded s***, in every sense of the phrase. To put it bluntly- you are concerned about your profession (theoretical), your co-workers are concerned with not getting killed/fired, or getting high/getting laid after work(carnal). CAVEAT!!!: certainly, this does not apply to everyone in Corrections. However, paying minimum wage to people to watch over those whose primary language is violence and graft does not draw the "best-of". God bless those who do the work because they want to make a difference.
  12. So, of course, the question is, "Why?" I heard this from peers, when I was in high school. I heard it from students when I was working as an EMT. I've heard it from my own kids, by now. For most, it is an issue of personal identity. If you really aren't sure of who/what you are or will be, being able to say, "I'm going to U of X," is comforting. Of course, there is also the arousal motivator- we make "excessive" decisions when what we reallyreallyreally want is within sight. In practical terms, and having worked at 3 teaching hospitals and 2 Universities, I will say it is very unlikely you'll recieve $65,000 more "value" in attending TCU. In some rare instances, the social contacts may be worth it (i.,e., your parents/grandparents are alumni of TCU, and are friends with the CEO of a local hospital, or something similar). Otherwise, you're paying $80K to support your instructors in the style to which they have become accustomed, and it will be (on average) another 10-15 years before you will be able to approach that level for yourself. Conversely, if you begin with a small investment (ADN), and gain experience while working as an RN towards the BSN/APRN, generally you will step out at a much higher standard of living. The BSN from a Big Name U is an attempt to buy SES that only works if you're fairly well off to begin with. Good luck!
  13. ...and are SCDs a popular item with patients? (Compliance)
  14. ?? What are your 3-4 options? Your topic here is a good one, there is a bunch of literature related to it, and I can think of 1/2 dozen nursing interventions, off-hand...
  15. Rob72

    Doll's eyes reflex...

    There is absence of the fixed & dilated gaze, indicating cessation of brainstem function, i.e., at least on a primary level, "somebody's home". You have some unclear statements in the text. In a conscious, but aphasic, patient, DE may be consciously maintained. This can be further evaluated by watching their ability (or inability) to track. The second part of the unclear statement- in this instance, the pt's gaze is "fixed" because they have localized their gaze, but are not doing so in conscious mechanism. Basically, you are testing for attention and tracking- if the patient appears able to do both/either, the brainstem (at least) is functional. XB9S, neither of those mention what I have heard to be the most obvious sign of brain death- election to Parliament.
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