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jb2u ASN, RN

ICU, ER, Hemodialysis
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jb2u has 5 years experience as a ASN, RN and specializes in ICU, ER, Hemodialysis.

husband of 18 yrs. father of 2 beautiful kids(1boy,1girl)

jb2u's Latest Activity

  1. "I believe that everyone should spend their first year in Med-Surg." These are the words as spoken by the Director of my nursing school. As one that has always liked a challenge, I made my case as to why one shouldn't go to Med-Surg. I am not against Med-Surg nursing as a profession. My belief is that you should only go there if that is where your heart leads you. Going into Med-Surg, if that is not where you want to go, leads to lost time, wasted money, and lost sanity. If you follow the crowd to Med-Surg post-graduation, you will find yourself with a lost year. The year will not be wasted. Med-Surg offers the new graduate plenty of learning experience. Besides solidifying your nursing skills, you will also learn invaluable organizational skills that will serve you no matter where you end up spending your career. So, why not just go to Med-Surg then? Well, it depends on where you want to work. You can learn invaluable nursing and organizational skills in telemetry, renal, ICU, or just about any floor that you go to. This proves that going to Med-Surg for your first year is not needed in order to learn nursing or organizational skills. So, why would the year be lost? Let's say you really wanted to go into ICU nursing. If you go straight into ICU, you now have one year of ICU experience. In your second year, you will be an experienced ICU nurse. If you had listened to those that say, "spend a year in Med-Surg," you would be an experienced nurse without any ICU experience. Also, you do not even know if someone has an ICU position for you after your first year. You may be spending another miserable year in a position that you did not want in the first place. In addition to losing time, you will also be wasting money. I am not talking about your money. I am talking about the hospital's money. It cost the hospital good money to recruit and train a new graduate. What do they get for their money? They get to train a nurse for a whole year. It will take you a good full year to really get comfortable in nursing. After your first year, you should be able to take on any assignment. You should be able to organize and plan your nursing care without having questions for the experienced nurses. At the time when you are really ready to function, you are now telling your manager, "I'm sorry; I did my year in Med-Surg. I am off to the ICU." Now, the manager has to spend more money to recruit and train another nurse. Time and money may be lost, but you can always find misery. This one does not apply to everybody! I do know some Med-Surg nurses that love it; however, I have seen many new graduates, as well as experienced nurses, in Med-Surg in misery. I have witnessed several new graduates on Med-Surg crying. Nursing school prepares you for the NCLEX. Nothing prepares you to have 6-10 patients with 20 medications a piece, complex wound care, total cares, angry doctors, and short staffing. I would not want to put myself through all this just to get some nursing skills and learn how to organize my day! To truly enjoy your first year, I say go into the field that interests you most. You will spend that first year learning the medications that you need to know. You will learn how to care for the types of patients that you are interested in caring for. You will learn how to organize your day for the type of unit that you are on. I went straight into ICU. While my peers from school were running up and down the halls of Med-Surg, I was studying my two ICU patients. The first year I learned about vasopressors and advance life support. I learned the skills that helped me succeed and better contribute to my unit as I went into my second year. Learning is easier when you are interested in the subject. I really wanted to learn ICU; so, I got more from my first year. But most of all, I spent my first year happy!!
  2. jb2u

    Fluid Restriction on Dialysis Pt

    Fluid restriction is because, as madwife stated, they do not urinate or very little. They come to us to have it taken off. No that does not mean on dialysis days they can drink more before going or during. And yes, some patients come back and request more fluid to be taken off because they want to drink more. I'm not sure about the diabetic one. There is glucose in our dialysate, so blood glucose levels can actually go up, if they are low on HD. I know some have to eat because they received coverage by the floor nurse anticipating that the patient was going to eat. I wouldn't do it, but I've seen it happen.
  3. jb2u

    Acute or Chronic Dialysis Nursing?

    I only work acutes, but.... Pros of acutes... 1. You see a lot of the same patients, but you also see some new ones. 2. You actually get to see some pt's recover kidney function (acute kidney injury). 3. 2 to 1 ratio or 1 to1 ratio..baby!! 4. Good working relationship with the nephrologist. 5. You pretty much know what the orders are going to look like day to day. Cons... 1. Being on call. 2. You never know how many patients you are going to have day to day. 3. Stat orders when everyone is already on the machine. Now someone has to come off. 4. Not getting your hours during the slow months, working over on the busy months?? 5. You can get tired of seeing the same patients coming in time and time again because they missed their dialysis appointment, ate and drank what they wanted and now you get to come in in the middle of the night to save them from themselves. 6. Being called in in the middle of the night for a "stat" overloaded patient, only to come in and find them being wheeled back to dialysis, smiling, no O2, and asking "when am I going to get something to eat?". Chronics (from what I hear)... Pros... 1. You get to know your patients. 2. Repetition. 3. More controlled schedule (ie: you know who's coming, or at least who is suppose to come each day. 4. No call, holidays, or Sundays. 5. Get out of work with enough time to do other stuff. 6. I'm sure there are more, but like I said...I've never done chronics. Cons... 1. A lot of repetition. 2. Same patients all the time. 3. (Don't shoot me, this is just what I hear) Some strong personalities from (many) Techs. 4. Early, Early mornings. 5. Higher nurse to patient ratio...but you do have techs running patients. Keep in mind, one person's pro may just be another person's con or vice versa!! I always say it is worth trying out. You never really know until you do it. I love doing acutes. Yes, I wished I had a better idea of how the day will go, but I wouldn't trade it for a floor position even on the worst day!!!
  4. jb2u

    KSU accelerated RN program Spring 2012

    According to the owner of this site, you are not allowed to use initials. The terms of service state that you may not use anything that could identify someone. In this case, initials could identify someone, as in everyone would see j.s. and say oh that's professor john smith. You may identify yourself at your own risk, but you may not identify others.
  5. jb2u

    Can you have RN certification in more than one state?

    Well you would just need to look at the website for the board of nursing in the state that you would like to work. For GA the BON states... If applying by endorsement, the applicant must be licensed as a registered nurse in another jurisdiction and must have graduated from a nursing education program prior to passing a licensing examination recognized by the Board as valid for licensure as a RN. The applicant must submit the following: A completed application with a fee of $60. A completed criminal background check. Provide verification of current RN licensure in another state. Provide verification of original licensure obtained by NCLEX-RN in another state. A verification of employment as a RN documenting (3) months or 500 hours of licensed practice as a registered nurse. Any additional information requested by the Board as needed for licensure. This is just an example of what you need for GA. If we are talking about another state, then see that states board of nursing website.
  6. jb2u

    Can you have RN certification in more than one state?

    You can..but you need to get a PA and a NJ license. Compact states are states that have agreed to accept a multi-license compact, but you must be in a state that is in the compact state agreement, PA and NJ are not.
  7. I think you will be fine. They should really give you more than two weeks though!!! We give our experienced nurses at least 6-8 weeks. I did not find dialysis hard to learn, but you do need to learn the policies for that particular facility!! That alone can take more than two weeks.
  8. jb2u

    Job outlook for RNs

    you're welcome and good luck!!
  9. jb2u

    CNA very upset

    :redlight: Reminder: No one here is allowed to give legal advice!! :redlight: I will leave it open so that you can vent, but if people start giving legal advice..the thread will need to be closed.
  10. jb2u

    I am officially a CNA

    :pntrghi: :ancong!: :pntlft:
  11. Home hospice care and Home health are one to one. ICU and Acute Hemodialysis nursing are normally two to one. I guess you can go under the specialty tab here on allnurses and read about these to start yourself off. Best of luck to you.
  12. jb2u

    Job outlook for RNs

    Well, I think the shortage exists in some areas and not in others. Yes, hospitals are trying to run as lean as possible, but they have to weigh that against potential lawsuits due to not having adequate staffing. My point is, they can only run so lean. Most of the nurses having a hard time finding something in my area are new grads, but new grads are still getting jobs. Experienced nurses seem to be doing fine. I have two jobs and just accepted a third after turning down two other offers. Pay is low in Georgia, but so is the cost of living. And, I would not even consider a job offer of 18/hr, even when I was a new grad. "You" will pay me what I am worth or someone else will, doesn't matter to me!! For me, I'd say I make great money, like 4 times the amount of money I made prior to becoming an RN. I would hate to even think of where I might be had it not been for my decision to go to nursing school. If the op is willing to move anywhere, I'd say the outlook for nursing is bright. If they live in an area with 6 nursing schools in a 10 mile radius, and the op refuses to move out of their area, well then I'd say the outlook for them would be dim; however, like I said earlier, no one knows what the future is going to hold.
  13. jb2u


    I would not want to recommend a certain company or association because I am not familiar with any of them, but if you google "doula certification", you will find what you need. I hope that helps.
  14. jb2u

    Job outlook for RNs

    Well, if you want to work in Georgia, then this is the right place to post it. If you are interested in working anywhere you can find a job, then I'd say post it in the general nursing forum with a generic headline like "job outlook for new grad RN." However, no one can really say what the future holds. What I do know is people are going to keep getting sick!!! If the economy really tanks, even more so I guess, then people will not be able to afford nursing school and banks won't be giving loans. What does this mean for nurses??? They will be even more in demand!! Hope that helps!!
  15. jb2u


    Being a CNA is hard work...being a new CNA is even harder!!! If you know you want to do this, then stick it out. I never worked in maternity, but sometimes you need to get experience first (take what you can get) and then go for what you want. You can look into working as a CNA while you get certified as a doula. If you never heard of a doula, just google "doula" and you will find plenty of information on it. Being certified as a doula and a nursing assistant may get your foot in the door to work as a CNA in maternity. The point is there is more than one way to reach your destination, but sometimes you have to take a route that you don't like to get to your destination!!
  16. jb2u

    Any ideas on ways of making extra money as an RN?

    Well phone triage normally requires experience in peds nursing. I do know some RNs that work in Dr.'s offices doing conscious sedation. Ever thought of just working PRN in a different nursing area? Legal nurse consulting is an option...I guess. Get certified to instruct CPR classes?