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myoglobin

myoglobin ASN, BSN, MSN

ICU, trauma, neuro
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myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

"When the mob and the press and the whole world tell you to move, your job is to plant yourself like a tree by the river of truth, and tell the whole world "No you Move"...

myoglobin's Latest Activity

  1. myoglobin

    What's the least saturated specialty in APRN?

    The difference is that in my (limited, but still somewhat long) experience is that there is an opportunity for a variety of personalities, and sexes to work in the ICU (I don't believe that CRNA school's should only take or even prefer CVICU which I've been told many do). I actually don't believe now that I think about it that CRNA schools should necessarily require ICU experience (again it should certainly be a strong factor in favor of admission). I know that at my hospital a 600 bed facility the NICU doesn't have any males. I also know that Methodist (in 2008) in Indianapolis (the largest NICU in Indianapolis at the time) didn't have any males. And I know that I was told specifically by my instructors that males were simple not hired into NICU's so I could forget about an internship there (again we did these over the last six to eights weeks of our program in the areas where we had the most interest) Perhaps that has changed and perhaps it is somewhat regionally based. Still, one does not need Psych experience to apply into a psych NP program, nor does one need "primary care" experience to apply into an FNP program, and at many schools one does not need critical care experience to apply into a ARNP program. also at many schools one does not need geriatric experience to apply into that specialty.
  2. myoglobin

    What's the least saturated specialty in APRN?

    My point is that there are gifted people from a plethora of backgrounds who would make good NNP's. To limit the opportunity to only those with NNP specific experience is to lose many, if not most of these people and to create a less diverse workforce. Maybe things have changed (since I graduated in 2008), but at that time I wasn't aware of a single male working in NICU at Methodist or anywhere in IU Health. Also, I was specifically told that I need not apply (by my nursing school) since males simple were not hired into this specialty (or OB). Now in my case this is no longer relevant (I am a Psych NP). I would like to believe that men and women who have good nursing backgrounds would at least have the opportunity to apply into these programs.
  3. myoglobin

    What's the least saturated specialty in APRN?

    And yet as an FNP (which I am not) I could manage that same infant when they went home and as an ARNP I could manage a critically ill adult in the ICU? I was a 4.0 student in nursing school and have 12 years experience in the ICU and yet have met many first year nurses far more equipped both intellectually and emotionally than I will ever be. Medical schools don’t require specifically defined experience and neither should ARNP schools. Doing so artifically restricts the range and talent entering the profession.
  4. myoglobin

    PMHNP

    I was thinking of scenarios like my significant other experiences in tele-psych treating mostly Medicaid/homeless clients in rural Arizona. Many of these patients don't have a regular primary physician or NP and when they do there is little (or not) coordination/communication with these providers. Thus, in my scenario you would "own" the clinic and have providers who were psych and medical (also in my scenario there would be robust support for CAM interventions both in psych and primary).
  5. myoglobin

    Who wants to hire a graduate nurse at 55?

    I always think of an article that I read back in nursing school (when I was in my late 30's and feeling old) about a nurse name Peggy Morris working in a medical floor in Nevada in her early 80's. She didn't start nursing school until her late 50's or 60's because she became "bored" after her husband died (I believe she had been a waitress before that). After reading about Peggy I felt slightly less sorry for myself. Still, now that I'm 50 and a new PMHNP, I'm feeling sorry for myself again!
  6. myoglobin

    PMHNP

    I was thinking of a scenario where you aspire to "own" a clinic in an IP state. It would be a theoretical advantage to be able to manage all of your client's needs (both medical and psych) at the same location. This would be facilitated (in part) by having both certifications. Such integrated, holistic care could have advantages for both clients and providers. Of course once you have the ANCC psych certification (or FNP certification) the question become whether it makes sense to go back to school at all or if one does go back to school whether to pursue an FNP post masters (to sit for the FNP ANCC exam) or to simply get a DNP and stay pure psych. Alternatively, since I am 50 I might start a PhD with the goal of transitioning to "teaching" as an adjunct professor around the age of 65 or 70 as a form of "semi" retirement.
  7. myoglobin

    ANCC EXAM REVIEW TIPS PMHNP exam

    Not sure about the "yellow" book, but I found the "purple/orange" cover book by Kathyrn Johnson and Dawn Vanderhoef very helpful especially when paired with the "Pocket Prep" application (since PocketPrep references many questions from this book along with Sadock). Thus a good study approach is to do 20 study questions from Pocketprep and then read all of the citations (the whole page including the ones that you got correct). In this way you will expand and reinforce your knowledge base with every group of questions.
  8. myoglobin

    PMHNP

    I think that FNP and Psych are a good combination in states with IP practice since you could efficiently run an integrated care clinic that offered both medical and psych management.
  9. myoglobin

    PMHNP

    I can do 12 hour shifts as a PMHNP in Wash. working outpatient since my primary job is staffed from 0800 until 2030. The problem is that I used up my savings and credit in school so I’m working seven days per week between three jobs. Plus they all pay a flat 70% so I don’t get paid until the insurance pays. Thus, I’m likely to earn 300k this year, but have to sleep in my minivan and shower at Anytime fitness. At least I’ve gotten my alternate day fasting up to only eating once every 48 hours (sadly Seattle doesn’t have cheap buffets where I can gorge every two days).
  10. myoglobin

    ANCC EXAM REVIEW TIPS PMHNP exam

    Here is a link to where the questions can be purchased https://www.nursingworld.org/continuing-education/online-courses/certification-practice-questions---psychiatric-mental-health-nursing-8ed8a40b/.
  11. myoglobin

    PMHNP

    Also, one of the potential "downsides" of ARNP is that you may end up working "six on and six off" that is the way all of the PA's who work for the Trauma team at my hospital have to work (we do not currently use ARNP's in our hospital). To me that would be a nightmare considering the never ending stream of procedures that they must perform ranging from central lines to assisting the MD in surgery (and most of the trauma MD's are pretty far towards the type A personality style).
  12. The rad techs at my hospital make about $22.00 per hour compared to around $34.00/hr for nurses. Plus they have to work "on call" and mandatory overtime (if needed). Your aversion to body fluids can be minimized with exposure/CBT therapy. Also, there are nursing jobs (such as psych) which minimize this compared to something like say ICU (where it is much higher). There are even positions such as management where this is minimized even further. You could even become a "direct entry" psych NP or DNP and teach online (or do a year or two as a case manager, or work in a MD's office where again body fluid exposure is less).
  13. myoglobin

    Just Say “NO” to Nurse Staffing Laws

    Here's the thing I support both measures (billing that reflects nursing care and staffing ratio's). However, from a "political" standpoint staffing ratio's can be passed easier as evidenced by the fact that California has implemented this policy, and other states have come close. Perhaps, that is because "nursing care billing" (for lack of a better term) faces greater opposition from the government both at the federal and state levels (where Medicare and Medicaid are already heading towards trouble) and ratio laws face most of their opposition from hospitals (and the ANA). However, on both issues the ANA should be on the side of the nurses, a when they are not they should be called out for it and face "competition" from advocacy groups that better reflect issues that most nurses support.
  14. What is wrong with the term "prescribing clinician(s)"? It describes the role without casting aspersions.
  15. myoglobin

    The ICU sucks sometimes

    Yes, but if you were convinced of the eternal nature of the "soul, spirit, atman" whatever, you would likely be less "sad". That is because you would have some confidence that you might see them again in the future. It is my hypothesis that a materialistic, reductionist world view makes it harder to avoid depression as we get older and face devastating life circumstances (however, even someone who is a strict materialist might ponder that we are probably less than a few hundred (thousand?) years from being able to essentially confer immortality via technological approaches).
  16. myoglobin

    The ICU sucks sometimes

    Well, with regard to making Medical Surgical suck less my advise would be California where at least the ratios are set by law to no more than four to one (3 to one in PCU). Also, their mandatory lunch breaks probably help in ICU. Someone above commented at the challenge of "eating lunch" after cleaning a body. Well, in the ten years I've been at my HCA facility I've been able to take maybe 10 lunch breaks (although we must clock out) since there is no one to safely watch your patients. Rather the routine is "patient dies, rush the family through the mourning process... move the body, so that you can get another body in the room". No to turn this into another "need for mandatory staffing ratio's thread", but California's law is the answer for many of the problems that you face. Only someone who is a sociopath, or very disassociated can not be emotionally disturbed working in the ICU where I work (in my case most people including my significant other say I have Asperger's so my manifestation of emotions and social interaction(s) may be blunted, but I certainly feel them).
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