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Uroboros APRN

Advanced Practice Critical Care and Family Nursing


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Uroboros has 17 years experience as a APRN and specializes in Advanced Practice Critical Care and Family Nursing.


Uroboros's Latest Activity

  1. Uroboros

    Nurse Practitioner -FNP

    Apologies no one has responded to your common question. I'll crack the ice as simply as possible. First, I'd suggest you do your research regarding where you want to live and practice as FNP may not be the way to go if jobs are unavailable. From experience I would also recommend multi-certification to cover you in a time of APRN credential amalgamation. For example I have post-masters certs in adult acute care, family, and occupational health, with PhD in progress. The ACNP has afforded me numerous hospital based positions during my career. FNP, along with the occ med cert, has provided options for community care, whereby I have practiced in urgent care, DOT, and rural clinics. I plan to use my PhD to finish my career teaching and lobbying for future APRNs in my state. I currently co-manage a high volume urgent care that went urban pre-hospital COVID triage and collection center overnight. We are also adjunct to a large teaching system where I am among academic faculty. We work off 40 hour weeks, with varying day flex shifts. Teaching hours vary with class size and enrollment, along with online options. Pay is all contractual, but I'm 50 and debt free so it's been good to me. Best advice I can give you is think in terms of liability. Always ask yourself if called to court, does my cert cover me for this, no matter what. For hospital jobs, you'll have to have some form of acute care training to be fully covered. That's a hot debate that's getting hotter as jobs become more competitive between acute care and family APRNs, which is partly why I got both. Nevertheless, we work in an equal opportunity environment for litigation, it's simply a matter of what personal risk you are will to take. Really wish you the best. Hope you get some more good feedback than my rant here. Godspeed.
  2. You do realize we are all anonymous here for good reason?Truly, just a friendly warning.
  3. There's a quote here from the end of my posting, followed by an editorial that has little if anything to do with the citation? Respectfully, rather than an ongoing litany of emotions run rampant, can you relate your ideas to the Matthew Effect or Pareto Lines in current economics that I did mention? Given your financial concerns this would provide an objective thought process and discussion. Espousing derivations regarding health effects from merely two months of mandated social isolation is echoing more personal concern, and understandably, rather than evidence based community medicine. If anything the consumerism behaviors are more apparent during social lockdowns, since Amazon recorded an all time high in sales some 75 billion, yes billion, with 60% of that in America alone. Hardly an economic crisis wouldn't you say? So our system is hardly in the financial dire straits just based on Amazon, eBay, and general auto sales alone. An idea the "world will starve is our system fails" is hardly the case. Made in America is an idea that died in the 60's, along with the steel and coal industries. This is finally beginning to effect big oil. Simply put, America is a consumer nation, and supplies little if anything apart from financial support to international economies. Read up on The Club of Rome, a social justice league from the 70's that broadcasted similar fears of world starvation and over population by the year 2000. They included the likes of Rockefellers, Morgenthau, and some 75 of the supposedly most brilliant philanthropists, scientists, and economists of the time. Obviously they were all quite wrong, and did not accurately account for epochs of technology advances since then. It's quite self evident that America needs to, and is reopening. Any base or lay person would agree. Tension between my nursing optimism and pessimism often gets the best of me, but hope remains as the thinking gate keepers to healthcare we use hints and hedges from our history, rather than fall prey to current anxiety and fear which simply are byproducts of the unknown. And it's just that we should argue the most against, while protecting at risk populations. The idea that these people groups should simply fend for themselves with hygienic methodology such as face masks and hand washing is a bit preposterous. After all, without severely diluting the issue, failure to adhere to those menial tasks is what leads to pandemic events. Exposure therapy is well proven in clinical psychology, but should hardly be the technique applied to a novel virus, with however varying mortality rates. Would any right minded parent think to throw their child into the dark unknown, simply to overcome the fear faster? Continuing to predicate our derivations in archetypical comparison traps by citing influenza trends or Great Depression similarities is misleading ideology. Keep in mind, COVID did in a few months what those historic issues took years to inflict. Look I'm not here to deflate anyone's position in the interest of pretention, and we all have the sovereign right to opinion. And were this issue a simple arithmetic equation there would be no discussion to be had either. Yet I do believe the APRN is in a unique role of separating good empiric science from existential fodder for ourselves, family, communities, if not now more than ever. Appreciate your efforts in fighting the good fight.
  4. We stand at the precipice of this issue, especially those of us on the front lines of COVID testing and treatment, as I wind down my day at a high volume urban COVID center. Comparing this to the seasonal flu is rather spurious and grossly misunderstanding the clear difference. However, in four short months, coming this October, when our friendly regular flu is here we will see the two in action together. Personally and professionally I fear for the worst. Common flu statistic left out is some 40 million catch it in America even with decades of vaccine and treatment. Now imagine that same 40 million this fall with COVID still lingering, with no vaccine, and little to any proven treatment. IMO the most serious blind variable which remains a real wild card are pediatrics. We are just now seeing cases of SIRS nearly one month post COVID in this age group. I'm surprised there is so little mention of the some 150 pediatric cases in NY alone under current review for this syndrome. During peak strep, myco, RSV, and influenza, which are all well on the way, what grim statistics will we be debating concerning our children this fall concerning COVID? People seem to easily turn a blind eye to literally dump truck loads of adults dying in these novel times, calling it a hoax or conspiracy. But when kids are affected even the hardest, most apathetic among us capriciously sing a more sobering tune. I'm not virtue signaling here, and I haven't wore my pink hat in a while. And I'm also no economist but I do have a business degree as well. There's something called the Pareto Rule that really applies here, meaning nothing is 1/1 in financial principle, and most causes come from the smallest means. Helps to put all this into better perspective, since after all we closed the economy, hence we can reopen it. Businesses can bounce back, or be reborn. The people who have died from COVID do not have that luxury. And no one would agree we can put a price tag on the life of one single child. Godspeed sincerely to all.
  5. Uroboros

    Valid Covid19 Dx?

    Nothing has copyrights here my friend. Glad it helped.
  6. Now I'm fairly uninformed on Canadian employment law, but I do believe the idea of "at-will" does not exist there, as mentioned initially by NunNurseCat in Florida and the state law there. This is fairly common in the US, especially in the southern states. Which is part of why I think we see weaker nursing lobbying in the regions. Just my lay perspective. My best advice is to know the employment law, and I think it differs from province to province in Canada. But from what little I've read the legislation is highly in favor of the individual employee, since some 90% of the system is regulated by protective labor associations. Good nursing conscience is a given, but when combined with soundly informed judgement, now that's someone to be reckoned with. Wish you the best.
  7. First, it's quite admirable or even noble you even have the presence of mind to consider ongoing social isolation beyond our present day to day circumstances, but maintain a healthy self awareness of the lasting health effects of that even. My spouse and I currently work in high volume COVID testing centers as well. In fact my site was the first one in a very large urban county and part of a chain of the initial drive through options state wide. We continue to relentlessly test daily, especially now that rapid antibody testing available, with walk in and drive through options lining the street it seems. My spouse works in a free standing ED part of the same system, where like you, there is confirmed critical COVID daily. Needless to say, we have installed an airlock adjacent to our Tesla powerwall in the garage, or so it seems. We have not physically visited our extended family in months, nor plan to, until the data is more clear. But we are wearing out some ZOOM meetings, with the occasional amusing hacks. We were off nursing websites like this for years as well, but recently rejoined to cyber-social in some down time. Point is you find a way to stay connected. Really the decision is yours to make. Just like we are taking it week to week with extreme caution. Do what's best for your family, because that's all that matters. You'll get a profundity of recommendations and additional personal experiences to follow. But in the end, decision is yours and yours alone. But I sincerely empathize with your position, and commend your efforts to be as informed as possible. Trust facts, trust data, trust patterns, least of all trust people.
  8. Uroboros

    How do you do lab work on patients while maintaining social distancing?

    The hierarchical de facto system of governing these threads continues to make the best power point material for my courses. I mean seriously, you cannot make this kind of whimsical stuff up. I recently revisited T. S Elliot's "The Cocktail Party", and what a masterpiece. "It will do you no harm to find yourself ridiculous. Resign yourself to be the fool you are... ...We must always take risks. That is our destiny...” ― T.S. Eliot, The Cocktail Party- Without sounding too capricious I say take a risk, draw your morning labs, go test yourself or someone else for COVID today even, but I'd also suggest wearing a mask, with or without eye contact.
  9. Making an existential experience out of every discussion seems to be a real reoccurring trend here. My comment was directed to provoke some legal-ethical thoughts beyond the surface ideas of charity gifting or free lunch. Truly, it was not intended to make you feel guilty about your free McChicken and fries, so for that I apologize. However, have you ever known anyone who took a little too much of anything? While a major overdose may be the first witness account we acquire, the perilous journey to those disasters begin with very minute, insidious, what we convince ourselves to be "gifts" along the way. I'm going to show my age here, but there's an old 1930's business adage, "there is no free lunch", I'd be interested to hear your take on that in relation to this thread. Cheers.
  10. That's a great point, as does nearly every alphabet soup of business associations, because they are all founded on loose ethics? Why don't you share specifically with us which code you are referring to? Although, quoting even the ANA won't save anyone in front of their respective BON if there is conflict with practice wording in that state. What state do you work in? Does your BON say anything about nurse gifting?
  11. Uroboros

    Executives Receive Bonus, Staff Asked to Sacrifice

    I don't see an issue here either. It's simply contractual and money owed from 2019. Now, they have the option to give it or a portion back in an act of benevolence, like many of the corporate bailouts have demonstrated. But it's their choice alone. Really what's worse is the myopic scrutiny select businesses face when they prosper in times of international economic crisis. I mean if something is illegal or immoral that's one thing. But to simply benefit from good front end business decisions? For example, no one is yelling about the record 75 billion (yes that's billion) in sales Amazon made so far during the COVID crisis.
  12. Uroboros

    Nurse Practitioner Safer than bedside nursing?

    Difference is when patients assault nurses at least now there is some litigation in place to protect the nurse, often allowing charges to be filed against the patient. But when nurse practitioners are attacked (especially by fellow nurses, cough, cough) or patients even, a complaint is usually filed to your not so friendly BON during the process, who will consider you guilty until proven innocent beyond an exponential-irrational-irreasonable doubt, and only seek to make an example out of you. They do so to show the public (like your assailant) how hard they work to protect the good citizens of the state like them. So, as a bedside nurse, you may actually profit from being attacked. Paid time off, rehab, lose some weight, get a new wardrobe, heck maybe even some free Botox if injuries are facial, all at the expense of your employer per se. As an APRN, it's going to cost you. Your malpractice will go up (because hopefully you're smart enough to have some) attorney fees, stress eating, lost nights of sleep, et cetera. And trust me you would rather take a pro bono assignment in a wilderness Wuhan nursing home before going before the BON for anything short of misspelling Florence Nightingale. Point; there is a lot of satire in what I'm saying. Truth is an RN should never go into advanced practice thinking anything about nursing is easier or avoided. Everything is harder, more serious, with bigger consequences. And it should be. "anyone with the right why can face just about every how.." -FN-
  13. Uroboros

    Bill Approved to Limit Treatment for Transgender Youth

    What's more absurd is this issue has required multiple bills to block the malpractice for now. Most forty-year-olds are suffering an identity crisis of some variety however large or small. So you are willing to allow another human being, with (debatabley) a brain that will not fully develop for at least another decade, during the most hormonal time in their life, make a critical decision that will effect the remainder of life? Interesting how supporters will evade the strong neuroscience with weak social justice arguments, whereby "parents should be able to make this decision for their children". However, up to that contradictory statement the claim is all about autonomy, individual rights, and the axiomatic charade of "allowing people to be who they want to be". Yet in this instance, even something so critical to all levels of human development, they find it acceptable to hand the bleeding heart rights of the individual over to guardianship authority. How anyone with the slightest healthcare education, or conscience for that matter, could support this, sleep at night, and even worse dare make a buck doing it and call yourself a professional anything, is impossible.
  14. Uroboros

    9 Types of Manipulative Patients

    Great post! Good psych nursing 101 here.
  15. Uroboros


    That nurses spelled backwards "ses run". "When you stare into the abyss long enough, the abyss begins to stare back." -Neitzsche-
  16. Purely another example of left-right political socialism in countries like Canada which unfortunately often get what they asked for in the end. Yes the remaining few democracies like America should take note, although the world-wide policing of social media has already clearly begun. Canada has much greater woes with respect to speech restriction, with more recent forced gender identification and personal pronoun assignment (Bill C-16). Personally, I identify with the late great Michael Jackson, and prefer "Hee-Hee". Less I too, be offended.