LollygaggerRN

I've assisted with plenty of unsedated colonoscopies. It has always been the patient's choice. Sometimes the patient wants to be able to go to work afterwards or just doesn't like sedation. I've even assisted with a colonoscopy in which a physician was the patient. He rolled off the stretcher afterwards, got dressed and went off on rounds. If it is the patient's desire to go without sedation I truly feel it is the nurse's role to help them through, not try to convince them to have sedation. I talk with unsedated pts and try to distract them or coach them through Lamaze type breathing. I certainly don't feel as though as I am a bad or unethical nurse because I am assisting a doc with an unsedated procedure. On the other hand, if the pt desires sedation but we are unable to safely provide enough sedation to keep them comfortable I always step up and ask the pt if they want to continue or come back at a later time with an anesthesiologist. So far they have all chosen to continue and work with me on breathing, etc. Who wants to go through the prep again? Additionally, it has always been my experience that the docs prefer sedated pts. A napping patient makes it easier on the doc as well. I can't imagine why a doc would request no sedation. Makes no sense to me at all unless they fear the pt is too ill to tolerate the sedation- and why do a procedure on somebody that fragile?

At my facility we do both RN propofol sedation and fent/versed sedation. The RN procedures are different for each type of medication, but you seem to do only fent/versed so I will speak only to that. I work at an outpt facility. Our docs typically come in to the procedure room, do the time out and make a medication order. A typical order would be "2mg Versed, 50mcgs fentanyl". Some docs will ask us to repeat the initial dose at 2 minutes, some will not. After the initial order is given the doc leaves the room to document or speak to a patient and returns in just a few minutes. Some docs we do have to "chase down", but they are really only a few feet away at a computer station. After the patient is asleep/comfortable/calm- whatever the case may be we typically stop giving meds unless they express that they are in pain. We rarely end up giving more than 6/150 although I have given 10/200. The sedation RN is the only staff in the room with the doc for colonoscopies. The RN sedates and monitors the pt, documents, and collects and labels specimens. If there are many specimens or a pt requires intense intervention a tech or additional RN is just the push of a call button away. There are two staff in the room for uppers. The pt is wheeled out of the procedure room after the procedure as long as they are stable. We do an aldrete and it would be unusual for a conscious sedation pt to have an aldrete of less than 7 or 8. When the doc signs the electronic chart at the end of the procedure he is signing his verbal orders. I don't see anything too odd about your facility's practices. The ASA 4 is concerning, but I have sedated plenty of ASA 3s in a hospital GI setting- not at my current facility. Also, the three sets of vitals at the end before coming out of the proc room is strange. I can't see any value in the pt hanging out in the room for an additional 6 minutes or more when they could be moved to recovery and monitored by an RN in that setting. If the pt isn't stable that is one thing, but in my 4 years of GI experience it is very rare that a pt is not stable after a procedure. Six minutes is a long time when the room could be cleaned and turned over in about half that time.

I am an endo nurse. Started at an ASC then went to hospital. Hated the hospital. Sure, the procedures were more interesting, but being on call was awful!! Dragging my butt out of bed at 2am to drive in to retrieve chicken out of someone's esophagus was no fun. The on-call $ were awesome- but not worth it to me. I am back at my original ASC and am soooo happy. When I go to bed, I get to stay in bed. On weekends I drive by the hospital and am so thankful that I am on my way to my kid's baseball game or whatever rather than setting up for an ERCP. You certainly do have some additional considerations with daycare and whatnot- but, in general, the quality of life at an ASC is so much better than the hospital. My opinion.

Re: administering sedation I work in an outpt facility which utilizes anesthesiologists only one or two days per week. The other days of the week the RNs administer fent/versed for one set of providers, and do NAPS for the other. When doing the fent/versed the RN will also assist with bx, etc. as much as they are able. A GI tech is always available if necessary- if there are too many specimens to collect or the pt requires constant hands on attention. When administering Propofol that is all the RN does. No specimen collection. We are always right by the pts head monitoring airway at all times. I really enjoy both types of sedation. Though my RN job is easier when the anesthesiologist is present, it is also less interesting.

If tissue is routinely getting stuck on the forceps it could be the doc is taking too many bites. I work with one doc who tries to get 6 bites each pass with standard forceps. We use tweezers to pry off the "hangers-on". Doc just has to be patient while we work at it.

Really, Nurse Beth, a "death sentence"? Dramatic much? I was an older new grad five years ago. MedSurg is not for me. It would never be for me. I can't even imagine doing it for a day. Just not my thing. Five years ago as a new grad I took three PT jobs in three different cities in two different states to avoid the hospital. Fast forward to now and I am working in an outpatient procedure clinic...no nights, weekends or holidays and making $46 per hour. If that is a "death sentence" I'll take it. I know this post is old, but I hope the OP took the position that will make her happy and satisfied!!

The AER is in the clean room in the hospital I worked at. The scopes are also hung in closets in the clean room.

This is funny to me. "Vet nurse" is fine. Who cares???

OP- I was never a "floor nurse". Part of admission to my nursing school was obtaining CNA certification...and I detested every minute of it. I also knew that I could never take care of the same patient for 12 hours. I have so much respect for the nurses who do this, but it is just not my thing. I love procedures and got hired into an ASC right after graduation. I have done hospital endoscopy. I am now in outpatient endo and it is truly my dream job. It is very fast paced and routine. My skill set is much more narrow than a floor nurse: I admit and recover patients, start IVs, provide conscious sedation and assist the physician. We do have new grads there at times. They do well. There are always other nurses and physicians available so no one is ever, ever alone. Just something to think about. I never thought this is where I would be happy, but I truly do enjoy going to work. Don't be miserable. Not worth it. Not at all.

You can read the ASGE position papers. I found those fairly helpful. If you want to familiarize yourself with the processors, scopes, etc. you can Google Olympus and ERBE. Boston Scientific manufactures many endo supplies, they have a YouTube channel that can give you a basic overview of equipment and procedures. You can Google images of ERCPs which will help you get used to seeing stones and strictures using fluoro. I read a lot about patho of UC, Crohn's, polyps, Barretts, varices, etc. Medication wise there is not a ton to learn. Your primary drugs will be whatever is used for sedation (we use fent/versed and propofol). Other than that, zofran, glucagon, Indocin......nothing you're not already very familiar with. I hope you enjoy your new path!

New RNs in Portland,OR metro area hospitals start at about $35 per hour.

I know people who have graduated from each of those programs. All were satisfied, but totally overwhelmed with student debt. I was in a similar situation as you-kids, already a BS in another field. I went a different route. Earned my associate's degree from a local community college in the PDX metro area. Cost was under $10k- no loans. This was four years ago. I work for one of the multi facility health care systems in the area and will slowly work on my BSN online over the next year at a cost of approximately $6k with my hospital picking up part of the tab. Just something to consider. From the schools you listed I would go with Linfield. Seems the most economical and Legacy offers the most opportunity for new grad residency. Good luck!!

I am a school nurse in WA- where we are having the "epidemic". We are taking it very seriously, although, truthfully it is difficult to do much more than inform people and encourage them to get vaccinated. This particular outbreak also seems to be affecting people who have been immunized, which I find tragic. I personally have dealt with a couple of students in this situation- they do everything right and then....shazzam.....end up with it anyway. I am hoping maybe they just got a bad batch of vaccine or something..................

Gina- You can totally despise PCT work and still enjoy nursing and be a fantastic nurse!! In order to be accepted into nursing school we had to be CNAs. I took the course and hated every single moment of it. Truly. Got my certification and never worked a day as a CNA. I never want anything to do with ADLs....ever. Just the way I am. I raised three children and my days of toileting, bathing and oral care are OVER!! You DO NOT have to do these things in nursing if you don't want to. I work as both a school nurse and a recovery room nurse. Haven't wiped a butt yet and I don't anticipate having to anytime soon. If the need arose, however, I would take care of it with a smile on my face. For me the interesting part of nursing is managing care....which I do at the school. The recovery room is exactly the same, only on a very short term basis. Both of these jobs offer tons of autonomy without what I consider the "yuck" factor. There are tons of different things out there to do with nursing- not all of them are in hospitals. I think you could find something you would enjoy a whole lot!!

If this double-posts I am sorry. I thought I hit "post" but then it just....vanished. POOF! Actually, many nurses do belong to unions and nurses can get summers and holidays off. As a school nurse, I do! It can be hard for new grads to find jobs (I am a new grad myself), but if you look "outside the box" there are opportunities. My husband is a SpEd teacher and I would take my job over his any day. Good luck!!

I say go for it!! Why not?? I personally think you could use your Masters to your benefit. This is truly what I think.....education is very, very hard. Part of the issue as I see it is you have the same kids all day every day for nine months. You have to go and face them every-single-frickin-day. And, as a special ed teacher you could have the same kid for years! In my previous life I was social worker and had the same clients for years....couldn't take it. Decided to get a MiT, went through all the rigamarole to be accepted to grad school, scheduled my classes, ordered my books and then decided there was no way, no way at all I could do it.....so on on a whim I went to nursing school. Nursing can be pretty much anything you want it to be. I choose to work in a post anesthesia recovery room part time and have my patients for about an hour each. New patients all the time....recover them and send them on and get another...I think of myself as the grocery check out clerk of nursing. Your Master's could be beneficial. I am also a school nurse- and I know it is my psych degree and experience more than any mad nursing skills that got me that job. You could be a school RN (many require BSN- but not all- I am ADN). Group homes for MR/DD often hire nurses. You could probably make a case for being more equipped to handle psych nursing than other new grads. One of the other huge advantages of nursing over teaching is that you are much more mobile. Don't like the nursing job you have? Look for another! Don't like the teaching job you have? You are stuck in your contract until the end of the year. Do what you want and good luck!

I think my jobs are fun....I really do. Certainly not every moment is happy- far from it- but I actually enjoy going to work every day. I am a second career nurse....fell into it on impulse....and am so happy I did. Reading some of the posts I do wonder why some people continue. If your job is not fun, the hours are crap, co-workers are lazy, doctors are arrogant, you are understaffed and work too hard....then why do it? That was EXACTLY how I felt about my first career -social worker for state department of social and health services- so I left. Got a new career that I love. Having said that...the Yahoo article was just goofy as all get-out. But, let's also give some credit to potential nursing students. If you are with-it enough to get into nursing school and make it through the classes you are also probably smart enough to figure out that nursing isn't about rainbows, sing-a-longs, and golden unicorns.

I understand how the online application process is very frustrating. Nearly impossible to let the real you shine through!! So, my advice to you is to look to smaller facilities. They are much less likely to have an online application process that is pre-screened by an HR department. I am an older (43 yrs) new grad (Dec, 2011)and applied to at least a gazillion hospital jobs. No luck. Then I started prowling Craigslist and looking at other settings. Apply for the jobs no one else would want- you may be surprised! I applied for a few jobs that are only 10 to 15 hours per week....because who wants to work that little? Well, I got three of those and am now working 35 hours a week in an amazing variety of capacities. You can look at school nursing, small stand-alone surgical facilities, doctor's offices. There's a lot out there that is interesting and fun and a lot more personal than a huge hospital! Good luck!!

To answer your questions: I have an ADN and no prior medical experience, however....I have a BS in Psych (from the early 90s) and worked in casemanagement for a state agency for several years. I really think that is what helped me. It's not like I have mad nursing skills or anything. Also, I don't think it is that big of a deal, but I got a 4.0 in nursing school and made sure I bolded it on my resume. I don't know if anybody even noticed, but I figured it was worth putting on there. Also got my ACLS certification. I am a school nurse for a small school district, in addition to my other two jobs. I live in the Northwest. I really think I have a fantastic situation. Of course, with part time jobs there are no benefits, so that is something to consider. But I have great variety, don't get bored, and feel like I am gaining a lot of great experience. I refuse to go back to school for a BSN until someone absolutely forces me. Seriously....I am soooo done. I know that if I ever want to work in a hospital I will need that crazy bachelor's degree.....but there are very few areas of the hospital I would even consider. Oh.....and my dirty little secret is that I found two of my jobs off Craigslist. Take a look there....it can't hurt! Good luck! Pretty soon you will be turning down offers!

I worked from home for a while-not in nursing-but as a casemanager in a different area. I hated it and would never do it again. Part of it may have been the fact that I had a toddler at home and I depended on his nap time so I could make important phone calls and what not. If he didn't nap I was screwed. I hated the fact that there was no schedule and no separation between home and work. I felt that I could never get away from it. It seems to work well for a lot of people, though. Like the previous responder mentioned, it does offer you a ton of freedom and it is nice to be able to work in your jammies. Good luck!

It isn't easy. I am a new grad (Dec 11) and have managed to land 3 jobs that didn't require one year of experience. But, I had to be creative and look outside the box..........way outside. I have three part time jobs: one in a school, one in an ALF for individuals with MI (this is an assessment and consultant type position) and one in the recovery room of a small ambulatory surgical center. Use your past experience to sell yourself. Write incredible cover letters. My jobs all required something a little more personal than the online hospital application. It is nearly impossible to win over the hiring manager with those "fill-in-the-blank" kind of applications. If you can look for something smaller, more personal (if that makes sense) you may be able to get a foot in a door to gain your experience. Good Luck!!

It wouldn't be about modesty at all.....many babies are "delivered" by men. But, having a baby, as you are aware, is much more than the moment of the birth. I hate to say it, I really do, but I would not have appreciated having a male nurse with the births of any of my children. I don't know how to say it, really, but having a baby is such a uniquely "feminine" experience. I can't put it into words, but for me it would have just been awkward. Pelvic exams by a male? No problem? Breast exams? Walk in the park. But that relationship that must be developed between a laboring mother and her nurse? I can only see myself doing that with another woman. It would be interesting to hear what the dads-to-be would think of a male L&D nurse!

Hey, SoCal-It can be done. Maybe not in a hospital- but you said you didn't want that anyway. I am a new grad (Dec 11) and this is what I have put together: I work in a school two days a week during the school year, which is 15 hours per week. I am also the facility nurse for an assisted living facility that serves people with chronic mental illness. That job is 10 hours per week and I can go in whenever I want.....just need to get the work done. Also, I have an on-call offer on the table right now and am interviewing for a part time ASC PACU position this week. So, I will have three part time jobs. I think I am the luckiest new grad ever. My jobs are going great. I am learning a lot, have tons of autonomy and am getting some very diverse experience. But, I think it is also true that my bachelor's in psychology and background in casemanagement is likely what really got me my jobs and the reason I have been able to navigate through them rather easily so far. It will be interesting to see what you can pull off. When you start looking outside the box there is lots of part time work. By the way....I found all of my jobs except the school off of Craigslist! I never in a million years thought that would happen! Good luck!!