t2kck

Stay in nursing for two to three years before deciding on an advanced degree. Many things can happen with this economy and the health bill. You may find out by 6 months you can't stand being with patient who can't communicate because they have tube down their throat.

Nurses still need to know basic math. Get a calculator, asap.

You have 2mg in 250cc, therefore how many mcgs are in a mg? How many min in a hr? How many cc's in hr? How many in the solution.... It is basic math. It is not calculus. You are making it too hard. Your answer to #2 is wrong. Try again. Ask a student to help. You are going to slap your forehead when you get the answer.

A new grad in nursing who wishes to speed ahead into the MSN, NP program without clinical experience is unsafe. At the school I taught and the one I attended for my BSN, the theory was basically we will instruct the student in the basics. You will learn everything else once you get a job. In grad school it was the same. I learned the book stuff and experimented on patients in the clinical but it was not until I got my first job as a NP that my learning curve went into orbit. My friends who did what you wish to do did okay in the classroom setting but in clinical they were average or plain mediocre. The RN's with critical care nursing did the best. I think this has to do with the numbers of stable and critical patients they took care of on the floor. Med-surg floors don't often get patients with a trach or dopamine drips. If you choose to go the route of the ER, do not get the FNP. They are no longer being grandfathered in to critical care. Attend a critical care NP program. Georgetown University developed one of the first. However, I don't think that is where I would go. You need to look at schools. It does makes a difference in how you perform on the floor. I would suspect not one school teaches nurses like the next. Many schools are okay. Find how your nursing school is rated next to others country wide and grad schools. I preferred my MSN for NP to be affiliated with a medical school. I learned a lot more in class with doctors teaching who were in research than my PhD nursing teachers. Please think twice before enter graduate. You are too green for what happens in the ER as clinician.

I re-read your note regarding documentation for a patient or medical power of attorney who makes a decision for a NO CODE status (DNR). Inconsistencies in care may depend on the variation of Code Status from patient to patient. The doctor fills out the DNR form for Code or DNR status after an indepth conversation, full disclosure and all while assuring that the patient fully understands what they are agreeing. I have been involved DNR's status in which I had options. They are as follows: Full NO CODE: NO Defib, intubation or meds are to be administered when a patient stops breathing and has no pulse (dead); Partials code status 2. Administer meds, intubate, but no defib. 3. Meds only OR defib only OR intubate only. 4. Defib, intubate but no medications. Nurses must be familiar with each individual's code status. When a terminal patient is noted to be at the end of life, it is recommended to involve hospice if patient decides to be a full DNR or NO CODE. Please whatever you do, DO NOT ADMINISTER everything you've got on the crash cart to a patient who died and was a DNR. DO NOT withhold care and everything you have on a crash cart to a terminal or a patient who stops breathing and has no pulse but is a full code. Mistakes happen in Codes Blues mostly by nurses who don't know the orders. Familiarize yourself. You may get in trouble.

How does a nurse deal with family members grieving over the death of their loved one? I think you already answered the question. Grief is difficult. Allow the family the dignity to mourn. You are exactly what ICU nurses should be, empathetic. When you have the angry family member who wants to sue you for not doing enough, write again.

If in doubt, read the protocol for such a case. Ask the charge nurse what the definition is for cap documentation. Alot of liability can be prevented for negligence or malpractice. When nursing care is inconsistent this needs to be brought up to the charge nurse. Remember you are responsible for the DNR patient while they live. I agree with the writer who discussed briefly what DNR means and the use of hospice care. If the treatment is a capitated, then only so much money is available for treatment and care. Different bag of worms than what the writer and I are discussing.

I am an overeater, emotional and otherwise. I eat when I am anxious which is often. I eat when I am angry, feeling ugly and fat. After 30+ years I joined Overeaters Anonymous. I see myself as an addict. There are foods I have to stay away from, cheese, sweets, chips. I can eat the a lb of cheese at one sitting. It is so gross. In graduate school I had to complete a research paper on Overeating. I learned in my reading that much is genetic. i.e.if parents are over weight so will their kids. In the twin studies performed in Sweden alot research was done with both identical and paternal twins. My dad was an Alcoholic. I am a food-aholic. If I exercise, then I become an exercise-holic. Emotional eating is initiated from the inability to work out the problems that is the cause of stress, low self-esteem, depression. I need to go out for a walk or I will eat. UGH

We all feel anxious in NP school. It is exhausting. What people don't tell you in NP school is that you are learning to practice medicine. The learning curve is great. I had to turn off the nurse role and change gear to medicine. Study hard and arrive at your clinical 15 minutes early. This allows you to get relaxed, talk to people and read up on diagnosis d' jour. Now think what you would do if you did not have any nursing experience? Consider this, you have more knowledge and experience than a first and many second year medical students. Trust me, things start to click about 6 months after you start working. If you are in a clinical with a MD it can be awful. You are a coming threat. I found it easier in my training to have a NP as my preceptor. You might want to change that in the hospital setting. NP's are A+++ personalities. We hate failure. However, I willed myself in to practicing medicine. Nursing is a small piece of the NP training. Schools stick it in under community health and education. They want to keep reminding you that you are a nurse. Duh. Don't be suckered into this trick. NP has little to do with nursing except to get your job done you work with them. Once I understood my new role, I approached it differently. It also helped me understand why doctors get ******-off at nurses who don't get labs/lab results on time to their office. It gets intimidating but...darn it all it makes sense. Then when you do work in the hospital setting as a nurse practitioner you know the reality of nursing. You know to expect a nurse to turn a 300 lb person in bed every hour is not going to happen. You were there, done that. So your orders are more nurse oriented to reality. Turn the 300lb patient every 2 hours and get a clinitron bed. You order CBC qd. When the doc freaks because it was not done by 7am, you know the nurse has 24 hours to get done. You don't fret. You have been there, done that. You are enlightened with information that doctors don't have... You are the NP. You know both sides of job. Your are going to do well. Keep friends with the nurses, they are your best friends. They do not want you to fail. Let them help you with information regarding patients. LISTEN to them. Congrats.

Would an OB, mid-wife group hire you without nursing, other medical degree or association? Ask the people in your clinics that have a contract with your school? There was a time that nurse mid-wives graduating from Georgetown Univ. were not allowed to have practicums at Georgetown Hospital. Kaiser Permanente fired all their mid-wives. If they stayed it was for prenatal appointments and paps. Kaiser Permante is presently handing out pink slips or something to akin to this to all their nurse practitioners in the mid-atlantic region. The malpractice insurance required to hire you will be expensive. Therefore, will you qualify for malpractice? Find this out by surfing the web. If you are going to work overseas in a ministry position, than you are going to be better than no one. A mid-wife is responsible for the well being of mother and neonate. If something goes wrong you can and probably will be liable for up to 18 yrs after the baby is born. I would first find out what area you will be woking. This is the 21 century. There is the mind thought that if you regularly attend school, clinical and pass the board you will be qualified. I haven't answered your question but I think it is going to be very difficult for you to find a job.

My suggestion to the writer, it is extremely important to work at a hospital in a general med unit or cardiology unit (step down) for at least 2 years. Become proficient with physical exams, medication management and assisting the dying then consider NP school. Friends of mine after graduating from nursing school never worked as a nurse. As an NP for over 15 years, I still recall my first year after post graduate school. I can only say that had I not worked as a nurse for a few years prior to attending graduate school, I would have been out of my realm of experience. Nursing trains people to observe and experience first hand disease processes that one does not learn in nursing school. To think that one can jump from a BS nursing program without working with acutely sick patients and doctors who have not slept in 24 hours is dreaming. Nurse Practitioners are in a level of responsibility only akin to a physician. Any RN new grad who thinks they can leap in to the position in to a role as a professional nurse practitioner is nuts. I am also offended by the idea. It sounds that one role is an extension of the other by mere education. NOT. The role is entirely different from nursing. Consider medical school first. I love my career as an acute np. However, I really was fortunate. I had doctors who trained me in their private practice as though I was resident. Without my nursing background I would have been an embarrassment to my school, friends and family.