Guttercat

Fantastic article! Thank you, Linda!

Thank you so much for the insight, subee. The grass is not necessarily greener, as it is said. Sounds a lot like my gig. Yes, I loved what I did, but it was a love/hate thing. Many hours on-call, and getting hauled out of bed at 11PM when your head finally hits the pillow is a big fat drag.

Back in my Day: Reflections from a Crusty Old Bat Thirty-one years ago, I graduated as a baby-nurse and sat my boards. This was back when a graduate nurse actually sat boards with two or three hundred of their closest friends from across the state in one large hall, and testing took two full days. The camaraderie was intense; it was a right of passage. What's interesting is that in 31 years of continuous nursing in multiple environments, the ER is essentially the same, ICU is essentially the same, and med-surg is essentially the same. What hasn't changed is new nurses floundering and wanting to quit within the first seven years. Here's my suggestion to you youngsters either in school, or in your first few years of active practice: Pay very close attention to what tripped your trigger in nursing school, no matter how seemingly insignificant at the time. Think about it: there was probably one little moment in clinicals where something surprised you and made you curious, and that "something" felt natural, even if it felt alien. Follow that gut instinct. Thirty-one years later and my what I regret most is that I never became a CRNA. One of my fondest memories in nursing school was in OR. I thought I would be fascinated by the surgery itself, but, much to surprise, I instead pestered the anaesthesiologist the entire surgery. I eventually end up in a specialty that is somewhat closely related, but it took a long time to get there after I floundered around for several years. I am at the end of my career, now, and it's been a really great run, but it could have been so much better if I'd paid attention to that tiny little spark from so long ago. Best wishes to all the newbies, and, in the words of one of my professors, "go forth and do great things.”

There might be a correlation to a possible causation (which shall be unnamed). Maybe create a hypothesis based on observation, and do a little digging and data collection? Could be an interesting project.

First, is this an AV graft? Or an actual fistula? Where is it located, and what vessels are involved? Second, have you referred to your facility's policy regarding needle spacing parameters?

A few years back I gave the wrong med to the wrong patient. Thankfully there was no horrendous outcome, but there just as easily could have been. It was all on me, because even though I can cite how bananas the day had been (picture tossed salad being tossed for hours on end and then toss it some more) and I was already exhausted, the fact remains I took a shortcut and bypassed a safety measure and gave the patient a drug meant for the patient in the adjacent bay. I am to this day still haunted by the "what if's" if the med I gave had had a severely negative outcome for the patient. So part of me can understand how anyone, under duress, can have poor judgement, but another part of me questions why she would want to return to nursing after her poor judgement resulted in patient death.

To be an effective and trusted leader on the floor, you must be proficient in not only "sticking" patients, but you must also understand all the physiology behind what can go wrong with the myriad graft and fistula configurations in modern surgical techniques. Being assigned the "float" and "med" nurse position will turn you into a glorified CNA with awesome computer skills.

The "hot stove" topic. I am not surprised no one has replied yet; most especially as a 'forced retiree' (we are many). I have many thoughts regarding vaccination against a coronavirus in the young as well as the mass vaccination approach the world took against a coronavirus. But I am tired. The window of opportunity for putting the brakes on who should and should not be vaccinated occurred a year-and-a-half ago. The train left the station and we are all on it now.

UK is hot on their heels. About time.

Dr. Dhand is no slouch.

Sciencedude, I am glad that you are looking at all sides. Cooler heads prevail. You are not alone.

The level of disdain and utter lack of professional civility in your response to reasoned concerns with bona-fide references (not solely a Youtube video) tells me all I need to know.

I love my job role, I love my coworkers, I love my manager, I love the doctors I work under, and I love my patients. (Sometimes I even love the hospital system I work for. ? ) I've walked into many infectious fires both at home and abroad as an RN over a long career. This bug is different, though. This one has me nervous. I've decided I will stay on as long as I am allowed to utilise my own PPE in the absence of hospital-provided PPE (which I have purchased with much research into standards of application). If I run out of my own supplies, or the hospital runs out, or I am disallowed by administrative entities to use either...then it's time for me to go. I am not young, and I have a very high-risk adult living with me. I would like to see hospital administration nationwide do an about-face and work with us in transparency. This is not a time to "save face." These are extraordinary times, and it will take extraordinary cooperation, information sharing, and trust between us all.

Let's be honest. Newest data in strict testing labs have shown this thing hangs around in the air for up to three hours (burst-test--simulating aeorsolized particles from procedures and or strong coughs and sneezes). Similar to SARS 1, actually. Let's also be honest that hot spots like Italy and Wuhan have their frontline workers in full head-to-toe hazmat garb. Let's also be honest that the corporate model of healthcare in the US combined with decades of outsourcing the means of production have left our hospitals woefully understocked for PPE. It is what it is and we'll have to do the best we can to protect ourselves, our families, and our patients. I mean, we signed up to take care of people. That said, I know of no firefighter that signed up to rush into burning buildings in their underwear and a pair of goggles. Neither did we sign up to walk into viral plumes unprotected.. Health care workers are dying from this. Young, and not-so-young alike. We in the US are going to have to get veeeery creative until mass production of PPE begins.

vyecheverria, thank you. And yes, I am doing some research into the requirements for NZ RN license. Have also requested info from the immigration department. They have a very helpful website as well. That said, housing is an issue, and the salaries are less. I have been looking at Auckland and Wellington...oh my! Even rentals. As a single person with one income, it might be what kills my plans. But I haven't given up. In my specialty, I would need to be in a larger hospital, so moving more than 45 minutes out of the CBD will probably not work.

Truly appreciate the info, NZrnsoontobe. Thank you so much for the help.

https://allnurses.com/international-nursing/us-rn-planning-458374-page2.html Are there any expat RN's currently working/living in Auckland or Wellington? What has changed? Good or bad? Would love to go for a few years, or better yet even permanently. I am finding a lot of financial reasons *not* to make the move (salaries, rents, home prices). Is it as bleak for a single, working migrant without an enormous bank account as I am finding?

Do you really think that you would have a choice in the event RFID becomes the norm? How many employers offer the choice of a paper check vs direct-deposit anymore? How many employers offer the option of submitting an application on paper? Applications in technology start out innocuous enough, but tend to grow tentacles. RFID technology is about tracking and controlling the flow of data and commerce. That's pretty big.

TraumaRUs and StarBrownRN have already given great points to consider. The question to ask (at your grandfather's stage) is ...what does he want? It sounds like he is at the tipping point as far as his renal function goes, but to put him on dialysis now might not prolong his life with any quality. Indeed a tough question. Edit to add: patients with an ejection fraction such as your grandfather's often do not tolerate dialysis well.

Seattle is currently the fastest growing city in the U.S....at it's already enormous. And have you looked at housing? It's outrageous. So is the traffic in the greater Seattle metro area, especially in and out of that neighborhood. If you make the move, I'd recommend researching housing and commute times very, very carefully. You have to understand that the entire Puget Sound corridor is a commuter's nightmare. If you fly out, plan to stay at least four days to get a feel of the area.

What he said.

Is this for real? I've never heard of such a situation. I'm finding it difficult to believe. Get out of there.