pluckyduck MSN, NP

Hi all, I'm a primary care NP (FNP) working in a small satellite emergency department for a larger health system. I've been working in ER for 10 months and was an ER RN at a level one trauma center prior to my current role. I'm interested in do...

Hi, I went to school in Ontario. There are 9 schools in Ontario that offer primary care NP programs at the Master’s level. Primary care in Ontario is equivalent to “family/FNP” in the US. A consortium of nine Ontario universities currently offer...

I did my master’s & FNP in Canada, where I’m originally from, at the same school I did my BSN at. My student loan was $18K Canadian. Part of the reason I chose to go back in Canada even though I live in the US is because the tuition was better an...

My employer mandates it, unless there is a medical exemption/documentation (and it usually has to be pretty legit—like anaphylaxis, for example). Otherwise, if you’re not immunized by December 1 you’ll be terminated. I get my flu shot every...

We use EPIC at work and we only call report to the unit when patient is going to step down or ICU, and then the RN brings them up on a monitor with a tech. Otherwise, our department has a quick text template that we use as a free text note that looks...

I placed EKG leads on an elderly lady in triage once. She came in for syncope. I put the stickers on and could not get the leads to pick up. I used two different machines and rebooted the damn thing and finally asked he tech for troubleshooting help....

We have high turnover in the ED because we hire new grads and after a couple years, they want to go to ICU to do CRNA, or they want to travel nurse. We are always short staffed and I’m getting tired. If I didn’t have a year left of school, I’d probab...

I worked in the OR of a level one trauma center/teaching hospital for 3.5 years after I graduated nursing school. Never did a day of OR in clinicals but wanted full time work, and they paid for my training and certification, and gave me an extensive ...

As a NP student, thanks for helping us learn. This is cool of you to do, especially donating back to PP. ??

I volunteer with an animal rescue group. I also went back to school for my master’s. this is an expensive way to “pass the time” though. ? If you like learning, look into studying for the specialization you work in—example, CCRN, CEN.

So a RPN in Canada would be an LPN (licensed practical nurse) in the US equivalent wise. The ADN is an associates diploma program but it is for RNs only —it’s an alternative to the BSN here because of the cost and time required to obtain a BSN, many ...

I can answer this because I am a Canadian working in the US. I’ve been working here for the last 4 years. The NCLEX-RN is the same test whether written in Canada or the US but you need to look at the individual licensing requirements for the state yo...

I was assaulted for the same reason—patient discharged from ED, had no place to go. So he punched me in the side of the head and he got an admission to a psych facility and 4 points. You better believe I pressed charges. I went with our department se...

All the major medical systems in southeastern Michigan are tobacco free and employees are subject to urine drug testing as a condition of their hire. If there’s nicotine present, they won’t be hired. If they drug test you at random, and they find nic...

Agree with the previous advice—I work days 6a-6p in the ED and when I do 3 in a row, I’m tired the first day off. But if you’re feeling exhausted, maybe you should see your PCP for a thyroid check, make sure this isn’t a symptom of something more ins...

We get residents in the ER all the time who order Lasix IV for our ESRD patients in CHF exacerbations. I ask the patient as part of my assessment from the get go, “do you make urine?” “I haven’t peed since 2002, toots. Are they trying to give me las...

We have one. I personally don’t like it because ours is on a wheeed stand and it’s big and bulky to cram into an exam room. I also don’t find it works for me. But some people love it. My preceptor when I first started taught me use to a hot pack for ...

We have a six bed secured area for mental health patients. Anyone who is actively suicidal, homicidal or having hallucinations or acute psychosis is assigned a bed there by the triage nurse, as long as they don't require any immediate medical attenti...

Thanks for the advice! I wish we could use lidocaine and I've brought it up to nursing education. I'm trying to get one of our ER ultrasound fellows on board with this too. I figured out the mayo stand after many failed attempts and awkward manoeuvri...

Hi, I work in a level one trauma centre in an area that sees patients with multiple comorbities and complex health histories. We have a lot of dialysis patients and IVDA patients, so plenty of hard IV starts. I took a course offered my hospital three...

Thanks for all the feedback everyone; I'm a year out now and I probably have about 90% success rate on first stick now. Sometimes I do go through patches where I have to take two attempts but I'm more comfortable. Figuring out how to position people'...

You did the right thing by reporting, monitoring and following up on lab results, and now that you've felt the horror that comes with a major med error you'll likely be way more careful next time. However, make sure you reflect on what happened contr...

There were a couple of phenomenal nurses who took care of my grandparents in LTC. They ran that place like a well oiled machine. I am eternally grateful for them. One RN took my mom's concerns about my grandfather's new symptoms seriously when she me...

We have management breathing down our neck about dispos and it's ultimately up to the ED doc to decide whether a patient is floor versus ICU. I have had several patients where I've had to cajole the resident and then the attending to rethink their di...

I budget aside if I have to. In Ontario this year it's going to cost $180 (per year) in addition to my state license (which is $60/two years). Which is annoying. But I need it to work, and don't want any marks on my record for failing to pay on time.