bcjams

thats too bad

see next post

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!!!!

Please do not encourage her to apply for any RN jobs anywhere. We dont need any more Rns with this type of work ethic.

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

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

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.

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.

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.

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.

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.

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.

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.

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:

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

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.

Before I became a nurse I saw all the same problems yall talk about. I watched adults treated badly by others for things like the cost of cheese or who would pay for bushes damaged during a move...truly foul abuse. I became a nurse knowing that would not change but that it was worth enduring because I was helping humanity. I could go home and look myself in eye and know that the things that we said to me were not true. I was not an idiot becuase cheese cost exceed budget buy 1 %. Nor to do I allow the nutjobs at work tell me I suck. I look at my patients. And if they lived it was because I did it right. And if they died I know did all I could to prevent it. Let the small minded petty nutjobs be damned. I am nurse and God loves me for it.

5-1 o my god yall never quit moving at top speed do you. idoes that include a changeover 5-1 am and takeoff and 5 more on wow....

and icu acutes 1-1 inpatient 3-1 with 2 nurses present at all times or 2-1 but that situation always scared me there are no rules about double crashing while in the hospital it can and does happen...

I have 6 years as an LVn in dialysis my answer is during changeover 4-1 for techs 3-1 for lvns due to the added responsiblites of caths and meds for the techs. 8-1 during cruisetime for staff breaks RN charge no more than 15 alone 30 with a non charge RN backup thats about right and everyone has time to double check the work so no one crashes...one lawsuit r/t crash will eat up the profits of exceeding these numbers..imho also the RN needs an ICU background...things can get very hairy when you shift electrolytes and take 5 kilos at the same time...but still its amazing how many problems arefixed by a 500cc slow bolus of 0.9NS and putting the pt in Tberg

Call the board and ask to speak to their legal counsel. That should clear it up. I had a legal question about our NPA and they were very helpful.

did yall see that thread about changing the name of nursing to somthing else becuase of so many men entering the profession...what bs..i love being a nurse. . .

Is it me or what. I have a beautiful resume...nice fonts and setup But all the online applications say cut and paste your resume..and it completely wrecks the formating and then I have to input all the same info into their fill in the blank applications....what a waste of time. I know its just because by the off chance they hire me they dont have pay someone to type in the info...right....o well All that time wasted in class learning how to write a resume. Actually I just used a Word template but still...it looks good....and I want someone to see and go hey thats pretty cool lets hire him.

Pharm and Patho will save your behind almost every time but dont forget its the nurse who does a large part of the pt teaching about meds and side effects and when the pt should call the MD once they get home. So your RN program should concentrate on those 3 things...If they ask alot what is the best thing to say to a crying patient...run.....if they ask how different cardiac meds work and the different side effects of antibiotics and when the side effects need to be reported then stay. If the syllablus has disease process and pt teaching as the core material and very little on how mangaement theory then your getting your moneys worth. I never read one page of my transitions or management books...I memorized my pharm and patho books....I know how things work...I am still weak on pt teaching and that almost got me on my NCLEX last week but that will come with time...I blasted the pharm/patho type questions but pt teaching almost made me cry....it was and is my weakness...and now I think I really only have 2 legs on 3 legged stool....must read some now.....take care and good luck

Davis for nurses is a much better program than Epocrates in general but Epocrates has a very critical feature that Davis lacks and that is a drug compatiabilty function. you can put in upto 30 meds on epocrates and it tell you which are synergistic or if they decrease desired effects. But Davis is the bomb in all other areas. so buy Davis ($49)and get epocrates free version and that should do it.