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traumanightsRN NP

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traumanightsRN has 13 years experience as a NP.

traumanightsRN's Latest Activity

  1. traumanightsRN

    HPV TEST/positive results

    There are new guidelines from the ASCCP and they have an app you can use. It’s $10 but will be the best money you’ve spent. Go to your App Store and search for ASCCP Guidelines and download it. You put in the persons age and Pap results. You can put in their previous Pap results as well and it will tell you your next step. I use it all the time.
  2. traumanightsRN

    Which review course is the best????

    I did the online Fitzgerald FNP Review course and although I learned a lot, when it came to taking boards I do not feel it helped me at all. I did pass boards on my first try but barely. I felt completely prepared after doing the Fitz review and when I sat down and started taking the Cert Exam I was completely blown away by the questions, i.e. the content was nothing like any information from the review. There were questions that had information I had never even heard of. By the time I got to the end of the exam I felt it was 50-50 whether I passed or failed. I passed but when I got my score in the mail, the lowest passing score is 500 and I got 520. So yes I barely passed. I feel in general Fitz's review helped me understand things but it did not help at all for the certification exam. Just my two cents.
  3. traumanightsRN

    UVA FNP hopeful

    I sent you a PM.
  4. traumanightsRN

    UVA FNP hopeful

    I completed their FNP program this year and passed boards a few weeks ago (AANP). What do you want to know?
  5. traumanightsRN

    What's Burnout?

    Matt thank you so much for writing this article. It's like you wrote it specifically for me. I have completely burned out and I'm afraid I'm past the point of no return. I am an RN in a Surgery Trauma ICU at a Level I Trauma Center in a major metropolitan area. We are the number one trauma center in the state so we get it all. I've been working here for 8.5 years. Over the past few years I have felt I was starting to burn out. I spoke to one of our NP's who had just completed his DNP and did a lot of work on burn out and his suggestion was to read some articles on the AACN's website about it. Not the help I was hoping for. Fastforward to this May/June when the flame went out for me. There was a major trauma pt I admitted and who was there over 3 weeks. His wife eventually made him a DNR then she withdrew care and he passed away. One of the Trauma Attendings ended up starting a war with Nursing because she wasn't happy that the pt's wife made him a DNR and no one discussed it with her, even though she wasn't there because it was not her week on. (We have 10 Attendings and they each are on one week at a time and cycle through). Even though all these things were communicated with the Attending that was actually on service at the time all these things happened, this particular MD threw Nursing under the bus. I'm not going to go into details but it was really, really bad to the point Ethics and administration got involved. And this was something this Attending has done in the past and is known for. Of course nothing ever happens to her disciplinary wise. It was at this point where I was done. I officially burned out. That was this past June and things just keep getting worse for me. I get anxious every day that I wake up and I know I have to work that night. I am angry at work. I hate my patients and their families. I snap on almost all the residents. I hate my boss because she has not once ever spoken to any of us nurses about this issue with the Attending. I used to put my all in my job and would work tirelessly for some patients. Now, to be frank, I just don't give a f#$! I am sick and tired of our Attendings flat out lying to patients' families about the patient's prognosis or treatments. I'm tired of the verbal and physical abuse by the patients and nothing being done about it. I'm sick of the verbal abuse of visitors and nothing being done about it. I'm tired of being treated like a doormat. I'm done. Finished. I hate nursing and everything that is involved with it. I never want to work closely with patients again. If I could manage it financially, I would walk away from healthcare this second and never look back. I went to my Nurse Clinician asking for help for how I was feeling but got nothing. I'm at the end of my rope and I don't know what to do. No one seems to either want to help me or there is nothing at my hospital to help people who are going through this.
  6. traumanightsRN

    August 2015 Caption Contest. Win $100!

    What happens when nurses eat their young.
  7. traumanightsRN

    What did you do before nursing?

    Hey OP...love your profile pic although Bubbles is my fave! #knowwhatimsayin #JtothaROC
  8. traumanightsRN

    What did you do before nursing?

    I was a Division I college volleyball coach before I became a nurse. Talk about a major change! #noregrets
  9. traumanightsRN

    Anticoagulant Preventing CVC Insert?

    We're just going to have to agree to disagree lol.
  10. traumanightsRN

    Memorizing the Skeletal Muscles

    I suggest Googling anatomy flashcards. You can definitely find free ones on the internet.
  11. traumanightsRN

    Drawing labs from CVC locked with heparin

    If someone is going to be this worried about a contaminated sample then they need to stick the patient regardless of if the patient likes it or not. No one comes to the hospital for spa treatments although the new HCAHP sites would make you think they do lol.
  12. traumanightsRN

    Anticoagulant Preventing CVC Insert?

    Incorrect. You do not give a peripheral vasopressor in a small IV and yes you do give it through a big vein regardless of where that vein is, whether it's in the AC or an EJ. That's why central lines are put in....they are in big veins. I have seen what happens when you give levo through a 22ga PIV in a forearm vein that extravasated. Patient had to get a skin graft from the damage. Also, unless a central line is put in as a PICC or as a subclavian line, they are put in points of flexion, i.e. IJ (neck) and femoral (groin). To prevent a patient from bending the arm you just put a freedom splint on their arm. Safety first.
  13. traumanightsRN

    Drawing labs from CVC locked with heparin

    To make it plain and simple....if you're that worried about a contaminated sample do a peripheral stick and get the blood. Problem solved! 😉
  14. traumanightsRN

    Anticoagulant Preventing CVC Insert?

    In an emergency you can absolutely give pressors through a PIV. Neo can be given through a peripheral regardless of the concentration. If you need something stronger you can give Levo through a PIV but you need a low concentration such as 4mg/250mL until the central line is put in. I would not give a levo concentration higher than 4mg/250mL in PIV unless there was Regitine in the hospital and the PIV was at least a 20ga and in a big vein such as the AC. Regarding not placing a central line d/t VTE prophylaxis, that's just laziness on the provider's part. A patient is not at risk for bleeding from sub-q VTE prophylaxis; sub-q heparin, lovenox, or fondaparinox do not increase a person's INR because they are extremely low dose. Never have I ever seen a line not placed because of this, and every single patient on my unit is on VTE prophylaxis! Even patients on heparin drips get central lines if it's emergent. If a patient needs a central line (emergent) they will get one regardless of their coags; if needed they can get FFP to help with clotting.
  15. traumanightsRN

    Compact states for NP licenses?

    Well I actually found out some interesting information. According to the National Council of State Boards of Nursing, there is an APRN Compact since May 4, 2015! "The APRN Compact, approved May 4, 2015, allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states." (https://www.ncsbn.org/7405.htm) Very interesting!!!!
  16. traumanightsRN

    Compact states for NP licenses?

    Ok. Thanks so much!