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bugya90 ASN, BSN, LVN, RN

Ambulatory Care-Family Medicine
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bugya90 has 10 years experience as a ASN, BSN, LVN, RN and specializes in Ambulatory Care-Family Medicine.

bugya90's Latest Activity

  1. bugya90

    Leaving before 1 year? Don't know what to do..

    It depends on your long term career goals. Since you say you want to do ER or ICU in the future, I would recommend you stay or try to find another inpatient job. Though other inpatient units may require 1+ years of RN experience and/or BSN. However 10-12 patients at night is a bit extreme. Are all the units in your hospital like this or just the one you are currently on? How is the management, do they help at all? I was similar to you. Had been a LVN in ambulatory for several years and went to inpatient when I finished my RN. I knew right away inpatient was not for me and went back to Ambulatory after 10 months. I will probably never be able to go back to inpatient but that is fine with me as my heart is in Ambulatory.
  2. bugya90

    LPN to RN woes

    I have been in your shoes. I took the scenic route to my BSN. Graduated with LVN in 2011, RN in 2017, and BSN earlier this year. My advice: Get it over with! I regret waiting so long to finish up. It is mentally exhausting and frustrating no matter if you wait or go straight into it. However, now that I am done I have free time again and it is so nice not having school hanging over my head.
  3. bugya90

    Quit my CNA Job ???!

    I second the scribe in ER if you are able. It will help expose you to more of the provider side of healthcare and show you more of the duties you will be performing as a PA. Depending on the ER schedule, it may even allow you to continue to work some during PA school (some ERs have staggered start times instead of just 7-7). You could also apply to be a tech in the ER. Sometimes ER techs have very different duties from the CNA duties on the floor. I would try to stay in a healthcare related field if you feel like you can't keep the CNA job until next Fall. It will look better on applications in the future as a new grad to show you do have X years of experience in healthcare and that your are not a "job hopper." Good luck and Congratulations on PA School!
  4. bugya90

    R.N. debating to pursue BSN

    You are still young and hopefully will have a long career ahead of you. the current trend is pushing for more BSNs (rather it is warranted or not). With that said, it may be mandatory for you in 10 years to get your BSN for your employer. I am 30 and just finished my BSN a few months ago. I'm still in my same job (that I love) although I did get a small raise for the BSN. I don't want to go back into management at this point. However, I know I still have 30+ years of working ahead of me. I got my BSN now so I wouldn't have to do it later basically. I'd rather suffer through school now than when I'm in my 50's/60's when it could be come mandatory if the current trends hold up. If you were older and closer to retirement I would say the BSN is not worth it. However, like me, you probably have 20-30+ years ahead of you. Yes it is a lot of research papers and can be mentally exhausting. However, most online programs can be completed in 1 year or less if you go full time. Many employers offer tuition assistance and some schools offer discounted rates if you work for an a partnered institution. Check with your employer and see if you get an education assistance and also apply for FASFA. Being a single mom you may qualify for aid.
  5. bugya90

    Nurse Managers: Showing initiative, or being creepy?

    As a manager I never used Linked In or any other social media/networking platform. Our recruiters would sometimes look up a person's social profiles as part of the vetting process but I personally never did. However, our recruiters vet the person and do a phone screening before I ever received the application so I had no reason to dig into their social media accounts as the recruiter had already provided me with any of that information. I cared more about their resume, the person showing up on time for the interview, and being dressed appropriately.
  6. bugya90

    Large numbers of prescriptions are being lost!

    This happened frequently with our old EHR system. Is still happens occasionally now with the new one (Epic) but no where near as often. Majority of the time it is a computer or internet problem, sometimes on clinic end and sometimes on pharmacy end. Keep a log of which pharmacies are not receiving the Rx. If there seems to be one pharmacy (or one chain) that is standing out, your manager or medical director may be able to set up a meeting with the PIC to see if they can find the issue.
  7. Speaking from manager experience, no your manager does not have to work around your school schedule just because Suzie from the next unit did so for her employee. Every unit and every manager is different. The best thing to do is find out what your actual school schedule will be (don't base it off someone else's, get your schedule from your advisor) and then go talk with your manager. The worst thing she can do is say no in which case you can start job hunting or start asking your co-workers if they would be willing to trade shifts with you. Scheduling and staffing was one of the hardest parts of that job. No one fully understands the headache that a manager goes through until you get handle it first hand.
  8. bugya90

    Seeking advice for possible position change

    RUN! I worked on a M/S Renal and Cardiac overflow unit for a while. We maxed out at 6 and our Charge usually did not take patients but on the rare occasion she did she was maxed at 2. It was tough but manageable most days. Our unit management would come help out during the day shift when needed (especially at med pass times) and at night the hospital supervisors made rounds on all the units to help as needed. I promise not all M/S units are bad. If you truly love being a M/S nurse there are plenty of hospitals that would love to have an experienced nurse like you. However if you are tired of M/S and the high volumes/acuity there are tons of other specialties out there. You could also look at the outpatient world too. I am now in ambulatory care and loving it. The hourly base pay is more for my ambulatory job than it was hospital but I don't get any shift differentials and rarely have OT so I don't bring home as much most weeks. Have a long discussing with your wife, look at your budget, polish up the resume and take the leap of faith. With your experience, I don't think you will have a problem landing a new job. Research the places you are applying to and ask around about their reputations. Nursing is a small world and you most likely know someone who used to work there 🙂 Good luck!
  9. bugya90

    Diabetes Care Standards

    We have a protocol for lab order for DM. A1c every 3-6 months depending on previous result (if above 8 then 3 months, if below 8 then 6 months), Micro albumin yearly, BMP/CMP and Lipid screening every 6 months. We can also refer for DM eye exam yearly. We can refer to Podiatry for a yearly DM foot exam as well, however most of our PCPs will do the foot exam in office at the follow-up. We do not have protocol for initiating any medications as that requires prescriptive authority and evaluation by a provider. Keep in mind there are many different statins and there are risks with any medication. Our providers use the AVSCD risk score to determine statin appropriateness. For nursing to order, the patient must be an established patient at our clinic, brand new patients must be seen by PCP prior to labs. The patient must have been seen within the past 6 months or have an upcoming follow-up appointment scheduled with our clinic. We require our patients with DM to be seen every 3-6 months so it is usually not an issue.
  10. bugya90


    I started out with the classic III. I used it through nursing school and my first 6 years of practice. The tubing finally wore out 2 years ago and I had to get a new one and opted for a lightweight classic II which is more than adequate for my job now. The classic III can be a little heavy around your neck so I would suggest cargo pants so you aren’t having to wear it all the time. I would also suggest having your name engraved on it as stethoscopes tend to walk away. Ive used a cardio one and an electronic one before. Both are really nice but I wouldn’t suggest either for a student. They pick up every little sound and as a student it can be hard to distinguish what you are actually hearing. The Classic III is great for a student or a nurse on a general med sure unit. Once you finish school you may need to upgrade if you end up on a specialty unit like ICU, Peds, etc
  11. bugya90

    Where were you...9/11

    In middle school walking from art class to algebra when all of the TVs in the school turned on to the news (they were all connnected to the office). Walked into algebra just in time to see the second tower get hit. My aunt picked us up from school not much later as our whole area was going into lock down (we lived not far from President Bush's ranch in Crawford). They had thought his ranch and the schools near it could be another target.
  12. bugya90

    Non-licensed staff documenting in Code Blue/Trauma Code

    On our floor typically only licensed staff are in the room during a code (our rooms are small so not a lot of room for extra people). Because if this it is typically one of the floor RNs documenting, rapid response nurse or provider running the code and primary and charge nurse assisting with whatever. Our aids become runners and get anything that we need that is not on the crash cart already and are taking care of the other patients on the floor. All staff are required to have BLS certification so if for some reason there are not enough RNs our CNAs or even our housekeepers could step in to help CPR until our code teams got to the unit.
  13. bugya90

    Pharmacy Stocking during MedPass

    Ours stock at odd times (0500, 1030ish and 1400). Their big stock time is the 0500 and the others are small fill up and last minute order items. The 1400 can sometimes mess up the 1500 med pass if they are running late (they stock all the units on the same run so if your unit is past on the list then the tech may not get there until close to 1500).
  14. bugya90

    Number of Lymph Nodes Removed?

    Interesting. I'd love to bring this up to our policy review committtee to have them look into the evidence (or lack there of).
  15. bugya90

    Number of Lymph Nodes Removed?

    The surgeons in my area just tell patients which arm they can use for IVs, BPs, etc. Many patients have bilateral mastectomies and lymph node removals so we always just ask which arm their surgeon said could be used. I don't think we have a written policy for a specific number of lymph nodes though, just whichever arm the surgeon put on the chart to use for access.
  16. bugya90

    Texas nurses i need advice

    If you have both in Texas you are forced to renew both. When you go to renew it doesn't give you an option to just renew your RN, it automatically puts the LVN on there also and you have to pay the fee for both. Your CE hours count for both so you only need to do 20 total, not 40. If this is your first time to renew your RN you're not required to do any hours for that one but you still have to do the 20 for the LVN. Keep your license active while on maternity leave. It costs to put it in inactive and then back in active. I've never known anyone who put it inactive just for maternity leave.