intothecosmos

I was wondering if anyone had been admitted into the spring PNP program for 2018. I wanted to know what the booklist was, can you send me an email? [email protected]. I know the book list will change, but I wanted to start reading ahead and I don't care if a book I'm just going to be pre-reading is not the exact one used. I start in the spring of 2019.

Hi, I was just excepted into the Peds NP program in spring of 2019. Was wondering about the book list. I wanted to get ahead in my reading. I'm going to send you an email...oh and I'm from the DFW area. I work in Fort Worth, live in Crowley.

Snot rocket was my favorite answer. If you've ever been hit by wads of phlegm, you know exactly when you should suction, or duck. :) And I agree with everyone else. Wheezing is associated with constriction of the bronchial passages, what every person with asthma will attest to. Crackles is the moist sound of mucus being rattled around when the patient breathes. A person with a trach most likely can cough up the secretions from the lower airway, but they usually can't clear the secretions from the larger passages, which is where a good suctioning comes in. If it sounds wet in there, and they are having trouble clearing it on their own, suction. If they sound wheezy, they don't need suctioned, they need a respiratory therapist (who presumably has an order for bronchodialators on hand).

I went to the ER once for the worse abdominal pain I had ever had. Felt like someone was stabbing me in my right ovary. I thought maybe I had appendicitis. I was at work at the time of the initial pain and my supervisor told me I needed to be seen. As I was bending over to get my things to go to the hospital, it felt like something popped and a feeling of warmth spread through me. The pain started to diminish some but at the thought of having a possible ruptured appy now, I still went in. There were only 2 people in the ER, and I had to get a male nurse who put in my IV. The doctor decided to give me morphine even though my pain was tolerable (4/10), and a CT scan. About 2 hours later, the nurse comes in and rips out the IV, saying, 'you can go home, you're JUST constipated. Gas pains can be painful.' I looked at him and told him what I had felt wasn't gas, and he shrugged and left. Doctor walks in right after him and told me there was free fluid in my abdomen so he thinks an ovarian cyst ruptured which caused the extreme pain. I wanted to strangle that rude nurse for trying to belittle the pain I felt. I guess it can be a two way street, and we need to remember that.

My favorite was when I was walking a woman to the bathroom to collect a urine sample, and she decided to "pass out" directly in front of the nurses station on our way back to her room. It was all I could do to catch her, the urine and her IV bag.

One of our main water mains broke in a hospital I used to work in, so we had to fill up a bunch of urinals with water for the employees to drink from while they fixed it.

Sometimes death is hard to deal with. When I was in school for my paramedic license, I was on a call that involved a drive by shooting. The teenager was flailed out on the couch with blood coming out of his nose and mouth, multiple gunshots to his entire body. I had nightmares that night because of it and sometimes I still think about the look on his face. Since then, I've categorized deaths as good deaths and bad deaths. Not that any death is good, but you have those that die peacefully (good death) and those that turn purple when their bodies clench and vomit up everything in their stomach before they die (bad death). I'm sure there are more categories other people have made up, but death is never easy and takes a while to get used to. Once you work in a hospital, you will witness dozens of deaths in your lifetime (I know I have already and I've only been working for 15 years in the medical field). It's best to figure out how to deal with it before it happens.

Heh, I bought Girl Scout cookies from one of my co-workers. I bought 5 boxes and somehow only got 4 and a half. Seems her kids got into one of the boxes and ate half of it before she realized what they had done. I let it slide, but I did have a good laugh about it.

I worked in a clinic once and there was a traffic accident in the parking lot that dumped 3 teenagers out of the bed of a pickup truck. Most of the employees ran outside to help so of course it stalled the people who had come to the clinic to be seen. One of the patients in the clinic was heard to have said, "Maybe I'll be seen faster if I go lay out on the sidewalk." Some patients understand that others will need to go first and that is always appreciated. We had one woman come in who was having an allergic reaction to something and literally couldn't stop sneezing. One nurse asked the people ahead of her if they would mind letting the woman go first and no one cared. They saw the trouble the woman was in. But it is annoying sometimes to work triage in an ER and constantly be harassed by parents as to why one patient went ahead of their child when they got here first. We always have to explain that some patients might go ahead based on the nature of their illness and it never seems to satisfy. In their eyes, their child is sicker than everyone else. We eventually had to separate the waiting rooms for those that were considered "green" care (colds, runny nose) and those that needed more immediate care "blue" (asthma attacks, abdominal pain) just to fight off those parents who were always keeping an eye on who came in when. In the green room, they went by time because everyone was at the same level (they also went to a different part of the hospital than the regular ER, seen by a NP or a physician). In the blue room, it mostly went by time, but we could upgrade people as we saw fit. No one really got upset because they didn't see others go ahead from the other waiting room. It was frustrating when the green section moved faster than the blue section though. Sometimes the colds got seen before the asthmas because of that. I don't think there is any tried and true way of dealing with situations like that. We are trying something new again in our ER. Let's hope it works out better.

There's tons of reasons he might not show up in registration... misspelled name, changed his name, he goes by his middle name but registered under his real name, etc. For awhile you couldn't find me either because I had gotten married and it took them awhile to get my name changed on the license. Maybe he didn't get his license in your state yet but has a national registration. And unless you call human resources, how do you know he doesn't work at the same hospital. Not everyone knows everyone else. Truly, if you could go so far as looking him up on registry and calling human resources, you sound like you are making this a personal vendetta against him. There's nothing illegal about what he is doing. Especially if you have already confirmed he doesn't work at the hospital you work at. He's not working as a medic, flight or otherwise, so who cares if he calls himself one. But if you decide to call him on it, do it in private.

Not illegal for him to call himself a paramedic or even a nurse for that matter. It's only illegal if he tries to work as one when he's not. Since he has a job as a medic he most likely is a medic. You can't just get a job anywhere without showing your license. You have to show that license every 4 years because that's when you have to resubmit. (I know because I'm a paramedic and work in a hospital.) There's a website you can check if you are THAT concerned if he's legit. You can look anyone up by name and last name to verify licensure. Different website for every state though. I've known a medic or two that likes to talk out of their rears so you just have to take it with a grain of salt. He's not doing anything wrong unless he's working as a medic with a suspended license.

I used to work for a nurse manager that had everyone do this. If we sat down for half a second, she would find something for us to do. It was torture. I can understand productivity, but to force people to rearrange the supply room or get on all fours to clean the bottom of the cabinets with cavicide wipes because they have nothing to do for ten minutes is a bit overboard.

Definitely, as someone said, making a bad grade on a test will light a fire beneath you. :)

RobtheORnurse, you hit it exactly. I work in peds, and if they come in with infection, they will most certainly have an IV running for at least most if not all of the stay. For one, infections can go septic fast in kiddos and you want to always have that access to give them meds. Also, a lot of the meds given via IV are very caustic to the vein, so having fluid running behind it helps keep the line patent. Lines tend to clot off faster without that extra fluid running TKO. Plus, the kids do get dehydrated quickly, especially if they are running a fever. If they are sick, they also don't want to eat or drink as normal, so extra help needs to be given to keep them from getting dehydrated. For the other kids, like sleep apnea, you want to have that line in just in case. I also wanted to chime in on that other question, because we had something similar in our PICU. We had a kid who had morphine going and narcan at the same time. Both are antagonists of the other so we couldn't figure out why they were both running together. I did a little digging and discovered that for children receiving morphine, there is a high risk of infection associated with the pruritis caused by the side effects of morphine. Especially if children scratch at themselves, scratch until they bleed, scratch at the tape holding the IV in place, etc. Plus, it's just annoying to be itchy all the time. Narcan given in small doses can inhibit the pruritis caused by the morphine while not having any effect on the pain control action of the morphine. Maybe the two medicines listed were the same. They were both titratable to keep the BP from going out of control by working on differing parts of the vascular system. Just a guess.

Good luck guys! 39 y.o. with 3 kids and a half-time job in a hospital. I'll be graduating in August with my ADN! It can be done!