MatthewSN

I spent the first year and a half of my nursing career as an LTAC nurse. After spending the last 3.5 years as a critical care nurse, I consider my LTAC experience to be on par if not harder than step-down level care. Our patient/nurse ratios were creeping up and we hardly ever had even one PCA which was why I left. 5 was standard but it was more becoming more common to take on 6-7 patients. The majority is as you described- trach to vent, restrained and total cares. More than 3 is to me unsafe- you can’t even meet your patient’s basic needs much less meet their clinical needs and provide a safe environment. It’s incredibly discouraging and not to be overly dramatic, has given me a touch of what could be termed PTSD like symptoms. On the positive side, I felt like it gave me a very strong skill set and made my transition to critical care fairly smooth. It is an incredibly busy environment to practice in. LTAC nurses do not get the credit they deserve.

I'm in an ADN program, I took a year of Anatomy and Physiology and a year of pathophysiology so what was it you were saying about an "increased knowledge" base? I've compared my program to BSN programs, the major difference was the BSN programs had a lot more nursing research, nursing leadership and health care informatics classes while the ADN had a lot more in the way of in the hospital, on the floor clinical experience. Will I get my BSN- yes but will it dramatically change my practice, Nooooo. I also plan on getting my DNP.

I'm in an ADN program- it's the 300 level nursing class. The main focus is peds and OB with a sprinkling of Med-Surg. I've always been told med surg makes or breaks nursing students however most of my class loved last semester (all med surg) and did very well including myself. This semester sucks- tons more paperwork, idiotic concept maps, reflection papers and basically just busy work. I actually don't mind writing linear care plans however OB had been a challenge, I feel like most of the nursing diagnoses are hard to apply. It feels like OB nurses follow a more medical model vs the nursing model and that's cool and I'm pretty good with both but trying to write a nursing care plan that is halfway decent blows. The tests this semester have been a lot more brutal as well- ive scraped by with a B however i know a lot of people that consistently get A's that have failed these tests. The questions are very poorly written questions, a lot of them you read 5 times and still have no clue what it's asking. So I totally sympathize with useless paperwork and the all around increasing brutality.

Sometimes I feel like my school relies too much on ATI. I like certain things about it....the books for instance are like the readers digest version of the huge textbooks. I don't feel like the modules are very helpful. When I know I have a ton of homework to do, the last thing I have patience for is watching a "perfect world" ATI skills module.

LMAO- I hatttttttte ATI, I feel like my teachers rely on it way too much. Has anyone had to do the C-Diff clinical reasoning scenario????

In KY PA's cannot prescribe controlled substances- they can however prescribe anything else. I am a pharmacy tech and am familiar with prescription authority. NP's do have a DEA number and as was stated can write for limited amounts of narcotics. That being said, in many other states NP and PA prescriptive authority is the same and they can both write for narcotics. I honestly think the roles are very similar and the preparation and schooling is the big difference.