NYCRN21

Hi mbaseyscott, I passed the PCCN in May this year. I used the book PCCN Certification Review, 2nd Edition by Ann Brorsen to study, and took the practice test from the AACN. I found the questions in both the book and the test to be very similar to the kind on the actual PCCN. I took the practice test from the AACN (the SAE) about a week before the actual PCCN and it indicated that I wasn't going to pass the PCCN test, but I did so I'm not sure how accurate the test is. But it was good practice! No vent questions that I remember and like tcvnurse said, its VERY heavy on cardiac/pulmonary. I would recommend spending a good chunk of your study time on that. Know normal lab values and ABGs too. Good luck!

I was just hired at NYU after having a year and a half of acute care nursing experience. Feel free to PM me. Best of luck!

Hi everyone! I'm about to start a new job in an orthopedic critical care unit. I'm really excited about this new job, and wanted to ask some experienced ortho nurses what I should know about starting in ortho and what to expect. My nursing background is in surgical step down- I've taken care of some ortho patients (THR, TKR) but not too many, and know that pain control is a big part of patient care. Any tips and advice would be appreciated, thanks!

Hi IHeart BSN RN, BSN Ive been a night shift step down nurse for a year and a half and I still break down crying every now and then, especially if Ive made a mistake that I know is a stupid mistake (I hope that doesn't sound like I'm making mistakes all the time, but mistakes do happen occasionally!). Nursing is hard! Honestly, Id say youre very lucky that the doctor didn't give you an attitude because I know that mine would have haha. Never be afraid to ask questions and always make sure that your patients are stable! Find your resources on your unit and never be afraid to ask them questions! Nurses and doctors are always telling me you know more than you think you do”, you have to trust yourself a little more, which is super hard to do as a new nurse. i still have trouble trusting myself all the time. This mistake is something you will learn from and won't let happen again, and remember, ALWAYS trust your gut! You said you felt like something wasnt right because you couldnt release the order...you were right! Trust yourself and always follow up if you have ANY concerns- the confidence will come and the tears will become less frequent :) Good luck!!

My favorite schedule to work is two nights on, one night off, two nights on and then usually I end up having 5 days off. That night that I'm off, I stick to a night schedule and just use the time to catch up on tv shows, laundry, household stuff and just hang out at home. I don't feel tired going back to work the next night either since I stayed on the night schedule, and usually I know at least some of the patients on my unit since I was only off for one night. Sometimes I do three in a row, but only over the weekends when we are a little bit slower (I'm only 23 but I still feel wiped out by 3 nights in a row!) It all depends what works best for you, I had a really hard time adjusting to a night schedule. But once you figure out what works best for you, it'll be fine! Good luck! :)

Hi maaadddzzz, I'm a new nurse too (started working in November 2015). I work on a surgical step down unit and I agree with adventure_rn, BSN, RN, I think it's a great place for new grads to start if they want to be an ICU nuse but can't get in to an ICU as a new grad! I love the balance of med-surg and critical care that I get; I get between 3-4 patients, my patients are on tele monitors, I get experience with medicated drips, a-lines, and other kinds of invasive monitoring but without the same intensity of an ICU which personally I did not feel like I was able to handle as a new grad still learning the ins and outs of how to be a nurse. (I know a lot of people who started in an ICU though and loved the intensity!). You also get to know the staff of the ICU's because you accept report from them often, so they would be able to give you insight on when positions open up. I haven't decided if I want to make the jump to an ICU just yet, but the MICU and SICU managers both reached out to me and said they would take me on if I was interested. I feel as a new grad having the step down experience would definitely make an easier transition to get in to an ICU than if I had been going from a med/surg floor. Good luck!

As I said, I am a new nurse. I did the best I knew how at the time to help a patient in need. It was not my patient and the doctor said not to give the medication, so Been There Done That, it was not appropriate. I gave the Tylenol because the doctor did not order any thing additional and that was the only prn medication that he was ordered for. The nursing supervisor was aware of the situation, and the doctor had seen the patient at the bedside. But thank you so much for putting down a new nurse coming to this site looking for supportive help on how to handle a problem...

Thanks everyone! I know it's hard to give advice based off what I told you but what you all said helped. The nurse I was referring to is very bad about giving patients pain medication when they need it (we work on a surgical step down unit, so that's pretty much all the time!) I'll definitely be able to advocate better for the patients next time a situation like this presents itself!

Hi everyone, I'm a first year nurse and I have a question about Dilaudid administration. Is it necessary to hold Dilaudid pain medication for an 84 year old patient with low blood pressure? Another nurse on my unit refused to give her patient Dilaudid 0.5mg IVP ordered q3h because his blood pressure was 90/60, it had been hovering around this for the past two days or so. He was an average sized man (not a frail elderly man but not large or obese), very distended abdomen that was firm due to fluid build up, it was a monitored step down unit where he was on tele (history of controlled a fib), we could closely monitor his blood pressure and respirations which were about 30-35 because he was having difficulty breathing due to bilateral pleural effusions, fluid buildup in his lungs, was about a week post chest tube removal, and was suffering from a lot of cancer pain- he was screaming out in pain all night. She adamantly refused to give him any pain medication and I felt it was extremely inappropriate to not give him pain medication- he had not had any pain medication in 6 hours and his respiratory rate was not depressed. I sat in his room with him for a most of the night holding his hand while she sat at the nurses station texting. Because I did not know whether it was appropriate to give him the Dilaudid, I eventually gave him a prn order of Tylenol 650mg PO after she went on her break while I was covering for her. She had told the doctor that she held the Dilaudid because his blood pressure was too low, but never actually told the doctor what the pressure was. I didn't think that a blood pressure of 90/60 would be too low to give someone who was not having any respiratory depression. Would it have been contraindicated for me to have given him the Dilaudid 0.5mg IVP order with a BP of 90/60? This situation happened a few weeks ago but I haven't been able to shake it and it has been bothering me for a long time- to be honest I think she was just being lazy and didn't want to get the medication. Please tell me how to best a situation like this should it ever happen again. Thanks! - frustrated first year nurse

No problem! For MedSurg 1 and 2, the best things you can do are to realize you have no life for the 2 months you have those classes, study 24/7, and get a good study group. And buy an NCLEX review book, I did a ton of practice questions when studying for exams and I feel like that made a huge difference. The CPR you need is BLS AHA CPR, the other Certified Background stuff I'm not sure about. Your best bet would be to go to the school and talk to Dr. ******, the coordinator of ABSN and she should tell you what you need

Hey Andy1415, for MedSurg 1 and 2 which you'll probably take in October and February, I DEFINITELY recommend the most up to date textbook. That thing is going to become your Bible haha. For some of the other classes I got an edition older than the one recommended and still did well in my classes

Hi sarsoora8, I'm in the last 3 weeks of my 12 month ABSN program now, and I can tell you, it's a LOT of work!!! Having said that, it's completely doable. There were a few times where I was really stressed out, but overall it wasn't as hard as I anticipated it to be. My first piece of advice is don't let the stress psych you out!!!! It happened to me a few times and it makes you worry about getting through the program more than you need to. Like a lot of people said, I would suggest making sure you have a good grasp of your anatomy and physiology, since I assume you've already taken that class. It's important to know what is normal functioning before you learn how to take care of abnormal functioning! Also make sure you have a good pair of shoes for clinical because you will be standing a lot and doing a lot of heavy work...if you're going to invest in anything, have it be your shoes! I honestly don't think at this point it's worth learning lab values and things like that because if you're anything like I was before I started my program, you have no idea what they mean anyway! It's great to know that the normal Na level is 135-145, but if you don't know what that means, there's no point in spending your last available few weeks memorizing values that have no significance to yet. And in about 6 weeks you're going to know them all like the back of your hand just from studying and being in clinical. Really try and relax the next few weeks with your family and friends because you're not going to see them a lot until next year. It will be worth it in the end though, I promise! The year will go by so fast, I can't believe that I'm just about finished now. There were a lot of parents with young kids in my program and they were able to make it through, so you will too :) Best of luck!!

Hi @tiprizzo, I'm in the absn now...I can't remember how much the uniforms were but I would recommend getting 2 uniform tops, you never know what's going to get on you during clinical! A couple of penlights would also be good to get, I dont don't remeber being told we needed them but youll use it once you start doing assessments (I only say to get a couple because I would lose mine all the time) The program is very demanding and you have to be willing to put in a LOT of work on your own time, there's not much room to slack off! Find reliable people to study with in your class, I think that was a huge factor in my success in the program. It's a tough program but definitely possible to get through. Good luck! If you have any questions, feel free to private message me

Congrats, @nayesab24! Feel free to private message me and I'll give you my name & add you on Facebook

Hmmm, it won't let me private message, can you guys private message me your name, then i'll add you?

Congratulations to both of you @Pookie89 and @emilydanz!! So exciting! I didn't set up the exam yet, but that's the first thing I'm going to do, I'll let you know when I schedule it. I'll private message you both, feel free to add me on Facebook :) Are you guys going to orientation?

Scratch that...I just got home to find an acceptance letter!!!!!! Wooo! How about anyone else?

I haven't heard anything yet, have you? I ended up not taking the English placement test yet, it really doesn't make sense to take it until I find out if I'm in. Have you heard anything yet?

I'm worried too, waiting to hear is the hardest part! I didn't apply anywhere else, my issue was that the programs are so expensive and since I still have to pay off my 1st bachelor's degree loans, I can't justify paying the $60,000 price tag that most other schools have!

Considering the minimum GPA was around a 2.7 to apply, I think you should be fine! I'm around the same, my graduating gpa was a 3.33 with mostly A-'s and B+'s in my pre-reqs. That's a good idea about the placement test, I'm gonna call the advisers and make sure that it's okay not to take it until after getting in and I'll let you know what they say. I know someone who took the course back in the 90's...I know that the program has changed since then but she said that while it's really, really tough, it's definitely worth it. She also said the advantage of doing the program accelerated is that you don't have as much time to forget stuff for the NCLEX :) Hopefully we head soon, should be in about a month now, can't wait! Let me know if you hear anything too; good luck and hopefully see you in May!

I haven't heard anything yet, I'm pretty sure they said we should hear back sometime in March though. I was talking with one of the advisers and she said over 100 people applied for the accelerated program and 40 get in...and usually after the first few weeks about 10 drop out because it's so much work! I'm taking Biochem and Patho this semester, I finished my other pre-reqs too. I have to take an English placement test though, did you have to take that/any idea what might be on it? I hear that placement tests aren't usually that hard but I'd hate to not get in over a placement test haha

Hi everyone, just wondering if anyone here has applied to the Accelerated BSN nursing program at Dominican College in NY starting in May 2013?