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bcjams

bcjams

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bcjams's Latest Activity

  1. bcjams

    What's your story? Why did you take up nursing?

    i was in real estate sales back in the 80s and 90s and one day i woke up and realized the only reason i had to get out of bed was to find someone...anyone..and take their money. I got up but i never sold another house. i went to lvn school then rn school and the funny thing is i now make more money than i did in real estate and most days dont feel like im working. im just doing what i love to do...saving peoples lives...its really like that since i do hemodialysis...i show up...do my thing ....they live...its great..and they pay me ....whata deal!!!!!!woohoo!!!!
  2. Please do not encourage her to apply for any RN jobs anywhere. We dont need any more Rns with this type of work ethic.
  3. bcjams

    waiting for full time

    You need to move to where the jobs are even if that mean leaving the state.
  4. bcjams

    BP dropping at beginning of tx=need help

    there is a 10% increase in return bloodflow to the heart while on treatment. It sounds like her cardiac status has changed and is unable to tolerate the increase in bloodflow. the aortic baroreceptors are sensing the increase in pressure and is signalling systemic vasodilation. Thats why the ns bolus is not working..more volume exacerbates the problem..she needs a cardiac workup and a switch to pd....i think she will probably show a severe left sided ventricular hypertrophy...if you have a 12 lead check leads v5 and v6 and see if they are larger than her baseline 12 lead...but really you need to consult a cardiologist on this one... and start with a slower QB rate and increase slowly....like up by 50 every 10 minutes with a max at 300
  5. bcjams

    Help! RN who does not like nursing!!

    I just turned down a job that was a ccu step down/medsurg overflow/pediactrics unit. When they asked how I would handle this situation I responded I would not allow myself to be placed into that situation.
  6. bcjams

    LPN's in CCU, a vent

    Here is the file from the Texas BNE... ftp://www.bne.state.tx.us/lvn-guide.pdf The is RN vs. LVN Chart is about half way down the page. it all really comes down to three words. "Unpredictable Health Status". We had some long discussions on this in my school....ie. if you know some is going to die anyway can you assign an ICU lvn to their care..yes...but if they might live then it has to be an RN. I can tell you now there are definitely some LVNs I would prefer over some Rns if my life was in the balance.... but I think its pretty clear that the ICU LVn days are numbered if not already done....its just one big lawsuit away.
  7. bcjams

    New Graduates In The Icu?

    I can see why an absolute newbie should work med surg for a year. However I have been an LVN for 7 years and feel more than ready to go to ICU....i hope that clears it up.
  8. bcjams

    New Graduates In The Icu?

    I can see why an absolute newbie should work med surg for a year. However I have been an LVN for 7 years and feel more than ready to go to ICU....i hope that clears it up.
  9. bcjams

    LPN's in CCU, a vent

    I was an LVN and I went to RN school to be able to work in ICU. I have seen some great LVNs in ICU. But the fact is I invested 5000 hours of my personal time to meet the state requirement to be able to take care of the critically ill. And they should too. Our new Texas NPA specifically states LVNs can only take care of "stable patients with a predictable outcome" and that pretty much precludes the vast majority of ICU patients I have seen in my 7 years of LVN experience. They are still there but I think that will end once a team of attorneys explains it to Mgt on behalf of a dead or disabled person because an LVN was involved in the care. And no doubt the RN charge who assigned said LVN will be working at Walmart. btw I went to RN school because I got tired of being beat up for being just an LVN. and to be clear I respect the LVN. they are valuable in many areas I still have my LVN license But the ICU should be an RN only area...because thats what the law says and for no other reason.
  10. bcjams

    New Graduates In The Icu?

    I think you need to be a great ICU nurse before you can be a great med surg nurse. You still need all the critcal thinking skills and nursing knowledge in either area and med surg doesnt have all the infomation readily available..you have to just be able to look at the patient and know when something is going bad....I am going ICU first...then Med surg...it safer for everyone.
  11. bcjams

    New Graduates In The Icu?

    I think you need to be a great ICU nurse before you can be a great med surg nurse. You still need all the critcal thinking skills and nursing knowledge in either area and med surg doesnt have all the infomation readily available..you have to just be able to look at the patient and know when something is going bad....I am going ICU first...then Med surg...it safer for everyone.
  12. bcjams

    1950s nursing

    I am still amazed at the lack of computers in hospitals for nursing staff to use. We had them ten years ago at my hospital and its wonderful to be able to read all relevant information without trying to decipher bad handwriting...I am looking in Austin texas for an ICU gig and so far 2 of the places I have interviewed still paper chart...I wonder where they keep the box of rattles to shake at the patients if they spike a temp.:rotfl:
  13. bcjams

    Differences Between LPNs/LVNs and RNs

    I agree. I was an LVN for 7 years I just passed my Rn boards But basicallyTexas Rn's are allow to work with more medically unstable patients. Most of my Rn transition courses were a review of what I learned in Lvn school with an emphasis on the patho and chemistry of the body. and mgt ..yawn
  14. Nurses who talk about their patients for any reason should be givien applications for Domino pizza. They talk to us becuase its private...that is the social contract.