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FurBabyMom MSN, RN

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FurBabyMom has 8 years experience as a MSN, RN.

FurBabyMom's Latest Activity

  1. FurBabyMom

    Career Existential Crisis

    The thing about nursing and health care - all types are required to "make it work". There is really no specialty better or worse than another, nobody more special. I left the OR recently and am in a vastly different kind of role. I love what I'm learning. But at the end of the day, a part of me misses surgery. I'll be back to periop eventually, but I don't regret trying to learn something new. In my new role, a lot of my coworkers and others I encounter do not believe I know anything - how could I as an OR nurse? All I ever did was sit around and chart 😉 I refuse to perpetuate that kind of BS in nursing and healthcare. I have just as much (very likely more) to learn as I have to share. I know all about all of the drugs anesthesia gives, the drugs given from the field, positioning, lines/tubes/drains, procedures, way more about anatomy than any of my coworkers... Some have started to listen as I explain some of the drugs used and things from the OR. ECMO has been a popular topic lately, I've been able to educate my new coworkers about that. My coworkers are amazed how calm I remain during the emergency situations I am present for. Once you've lived through some of the things experienced as an OR nurse in a Level 1 trauma center...very few things excite you (and even if you are nervous it's internalized and your approach is methodical). You're mindful that the situation may escalate, but it just doesn't top your worst day or worst emergency. The skills ARE different. But no set of skills is bad or wrong. Do what you like. When you don't like it or feel the need to move on - do it. Try something else and decide if that new something is for you or not. You can learn to titrate drips easily, IVs and art sticks are just skills to learn.
  2. FurBabyMom

    new circulator, but want to scrub too

    I have to agree it depends on facility and staffing needs. In general, surgical techs are "easier" to find and hire than OR Nurses. I was taught to scrub in my hospital's new to OR program. Historically, our staffing has been about or greater than 50% RN. I personally love scrubbing. Getting to see and touch things so closely - that's so cool to me. In general, most of the time, neither RNs nor STs function as a first assist in our ORs - we have surgical residents. When the residents are less experienced, they are their attending's assist, but often towards the end of residency their attending is their assist. We have a few providers who use an NP or PA as a first assist, some of the time, but not consistently. Our staffing has shifted some, with STs easier to hire than RNs, RNs are overall scrubbing a bit less (but not never by any means). I think that RNs scrubbing adds flexibility that you do not have when your RN staff does not scrub or is not expected to scrub. There are more options to move staff around if necessary than there are if half your staff flatly doesn't scrub.
  3. FurBabyMom

    New grad only night shift available

    My first nursing job I was on days. The only non 0700-1930 shifts I worked was a holiday shift where I worked 1500-2330 Christmas eve and then 0700-1500 New Years Day. With that said, that specific hospital was not a good environment. My next job was rotating day/night. I'm in periop - specifically the OR. While having a typical schedule of 0700-1530 or 0700-1730 may seem nice - the call can be very difficult on those with kids. Not only that, but if staffing scheduled at a specific time is less than needed for cases running, you may not be able to leave (without relief one can't just leave a surgery). Your childcare plan may have to be a bit fluid and flexible. Healthcare is difficult on childcare arrangements...
  4. FurBabyMom

    bring back diploma they can function on graduation

    Some states DO publish clinical hour data. I completed my BSN and was originally licensed in Ohio. I haven't looked lately but at the time I was attending college this was all published. I think this conversation needs to address a more complex issue which I didn't see while skimming the discussion. Nursing schools can WANT to increase clinical hours or change the format of what clinicals have evolved to become. However, nursing schools do not OWN this. There are extremely specific and complex contracts and requirements from hospitals and other clinical site locations that have helped to make clinicals what they are not as opposed to what they used to be in the "good old days". I would argue that there are more restrictions on students of all varieties and disciplines due to organizational desires to limit liability and mitigate risk. This is of course, compounded by the fact that even if a school has a contract with a hospital, that does not mean the staff is open and accepting of having students. While I was in my MSN program, I was a BSN tutor and TA for several BSN classes. You cannot imagine how many times, from the number of students myself and other class faculty heard that (insert unit name / insert facility name / insert info about primary preceptor) is not open to having students, it's a second thought, nobody is willing to teach during clinical time. We are not helping this problem any. Clinical nurses, management and leadership own a part of this. Nursing schools own part too. But the students also own part. Another part is that even when I was in school (~10 years ago now) the quality and competence of our clinical instructors varied greatly. That's on us - those of us practicing clinically - to be willing to help change things. We can be part of the solution or part of the problem...but we shouldn't be complaining if we're the ones unwilling to teach students. Not to mention, the regulation of clinical facilities is vastly different than it was many years ago. All of these comments referencing the 1970s, 1980s, 1990s - have we forgotten that all of those situations predate this focus on patient safety, morbidity and mortality? Just because most students and many patients survived doesn't mean it was actually better. As for the comment about working doubles regularly as a student (or otherwise): there is a TON of data and literature that shows that the potential for making an error vastly increases after 10 hours of work. I have worked my share of 16's, been on call for a week straight in addition to working my regular hours, have worked easily 80 hours in one week regularly... Just because we accept it does not make it right or best, and it actually tends to hurt our argument for "better". I greatly benefited from being a nursing assistant during nursing school. I was in the float pool at a large university hospital - I learned time management, to advocate for myself and to trust nobody. I had to unlearn that last part - about trust - to a healthy level of concern in my current job. I love the team I'm part of now, but wouldn't value it without what I experienced as a float nursing assistant. I had to learn time management - the float was ALWAYS given the worst assignment (save for a few select units who treated us well) and my assignment often changed q4 hours. Having learned time management and some other key skills, I was in a better place as an RN. As an OR nurse who frequently precepts our new hire OR nurses and surg techs - I have to endorse the comment shared earlier that the task skills can be taught and refined. The bigger picture issues take much more work.
  5. FurBabyMom

    Facing my second major cardiac surgery in 3-years :(

    I'm so sorry you have to have an additional surgery, but grateful that you're getting the answers and care you need. Will be keeping you and your coworkers in my thoughts and prayers. Yes, I've cared for coworkers before and imagine I will again.
  6. FurBabyMom

    Sequential Concurrent Surgical Fields - Trauma

    Yes, this type of situation happens from time to time. Usually we know, we may need to run concurrent procedures, but sometimes we don't. That's the nature of some of our most critically injured patients, and we are a trauma center with everything that goes along with it. I've actually seen it play out the opposite way - where a patient is having an ex lap and then has to have a decompressive hemi crani added.
  7. FurBabyMom

    Bedside / ICU Surgery (Decompressive Laparotomies)

    Sending you a PM
  8. FurBabyMom

    Bedside / ICU Surgery (Decompressive Laparotomies)

    We sometimes do a laparotomy in ICU - commonly STICU, PICU or NICU. From time to time we do open the chest in our ICUs. Our most common bedside "OR" cases are peripheral cannulations or decannulations for ECMO. We do not have a specific team for any of our ICU cases, all of us are expected to be able to do those cases. We're not that far down the hall from our surgery ICUs. We send an ESU and a neptune to ICU when we do cases there. We have travel carts for our ICU cases. We get sent to other non-ICU outside locations too...
  9. FurBabyMom

    MSN Leadership - Is it worth it?

    Yes, my program did. I very creatively arranged my work and school schedules. Took work with me for any down time between engagements with my preceptor which couldn't be filled by practicum project hours. I had a few weeks where I flexed and worked Saturdays to make up for my missed hours due to school.
  10. I work in the OR of a Level 1 trauma center. There is no safe time. With that said, we generally don't get called in between 0600-0700 at the end of call leading into day shift - people are arriving for days and can be asked to clock in early for an emergency if needed. I've been called back after leaving less than an hour prior (from either a scheduled shift or my first call back). I've seen it all, early in a shift, middle of a call shift, later in the shift. I've been called in multiple times in the same call time (ugh - specialty call over a holiday weekend (puke)).
  11. FurBabyMom

    MSN Leadership - Is it worth it?

    I think it's worth it. I finished my MSN this year and will probably ultimately end up with two masters degrees and a DNP (I'm still young...and will be working for a LONG time would rather just get the DNP soon-ish). I THINK my ultimate goal is going to be something senior executive level...so...as MSNs, MBAs, MHAs, MHSAs, etc become more common, I MAY need that DNP (and don't want to be forced to hurry and obtain it ASAP due to a role change). I'm more than qualified for a unit manager job. I'm actually being considered for an operational management position that otherwise would not happen without my degree, my clinical experience and method of problem solving. I'm being considered over people with much more experience... I went to an excellent school, but I went part time and made full use of the academic assistance my employer provides.
  12. FurBabyMom

    OR nurse vs. PACU nurse?

    Good luck! What is meant to be will be! Other than that, it's a total crapshoot. Some people say you don't/can't learn critical thinking skills in the OR, but I think it depends on the person. I started neuro stepdown then went to the OR after a year. There are some things that you don't so much of in most facilities as an OR nurse (same is true for PACU). But despite some folks saying you gain/use no skills as an OR RN, that's wholly untrue if you're doing your job correctly. Regarding MSNs in OR and PACU - some are APRNs. We have some APRNs with our anesthesia group who mostly do pre op stuff. We have some APRNs with our surgery groups who mostly see patients in clinic and some round in house. Very few APPs (PA or APRN) scrub and first assist in my facility as we have surgical residents. MSNs also show up in admin roles in perioperative services. Magnet facilities prefer a BSN or higher for managers, MSN/equivalent or higher for director or senior admin roles. In addition, we have MSNs or equivalents in education, informatics, quality, etc., roles. My role is part admin part clinical. Paid more than before, mostly due to experience level not so much degree. Got my MSN so it's out of the way, and I don't need to be time pressured into obtaining later on based on a position's requirements. However, I got my MSN the cheapest way possible (spreading tuition reimbursement out as long as possible) so there's that...
  13. FurBabyMom

    When should I ask my nurse manager this?

    This could go either way. I can see, as a manager, why having staff for 6 months then losing them would suck. On the other, I value honesty and transparency. I think your manager probably knows that people *want* to transfer to the ICU from the floor. Internal turbulence is not generally a surprise - staff leave less desirable positions for more desirable positions. The part I'm stuck with is thinking that *because 6 months is the minimum you are required to stay that that is all you should stay*. You're not worth anything as a nurse to a unit until after 6-12 months when you're independent and possibly able to start precepting. Two years is a better commitment - you're able to help train your replacement by then. Sorry, from a manager/admin perspective, it's true. Orientation is a huge financial burden and nurses only staying the minimum required time is frustrating to the bottom line. It's also incredibly inconsiderate to the people precepting and orienting you. Working short staffed is no fun. Also - consider what you may not appreciate when you shadow in the ICU. And why the ICU nurse manager is ok with a floor nurse with only 6 months of experience going to straight nights? I'm guessing the grass may not be greener...
  14. FurBabyMom

    What did you get with your relocation package/assistance??

    I moved from several states away, and was eligible for "expenses up to (x amount)". The amount varies based on position - we pay techs and nurses less to relocate than we do providers or senior administrators. During orientation, I signed an agreement to stay until a specific period of time was over. At the time I believe it was 2 years, or I owed the money back. I submitted my receipts, they paid me everything as my amount was lower than expected.
  15. FurBabyMom

    Should I disclose my current job to interviewer?

    Nursing is a small world. Especially within some specialties (ex for those of us in the OR - everyone knows someone who knows this other person (or knows someone who does). I would be honest. I'd be surprised if there isn't a statement that says something along the lines that failure to disclose relevant information is considered falsification of your application and punishable up to/including termination. VERY common in most community hospitals and health systems. While you CAN explain that the information about your employment at Health System A may not have existed at the time you submitted your application to Health System B...completely omitting it and hoping for the best would suck. PS - I completed a MSN program within the last year. Someone from EVERY health system in a three state region was in my classes. Even outside of specialties that are so small/everyone knows everyone, it is possible for this to backfire on you if you are not transparent.
  16. Our facility allows for: (given name - first and last), (degree 1), (possible degree 2 - if non-clinical and relevant to role), professional licensure (if applicable). Example: (given name), MSN, RN Certification is handled with an optional tag that is put behind your badge and displays the certification credentials *below* your photo ID badge. The certifications that my employer buys these tags for are certifications that count for ANCC Magnet...so things like CCRN, RNC, NE-BC, CNOR, etc. We don't get to display any "course certifications" (ACLS, TNCC, etc). The show off thing shows up (lol) more in email in our institution. Some people list everything in their email signature when we have a "uniform signature format" template.