Nurse_Ratched

Anyone working in an ED OBS / ED Clinical Decision Unit? I recently accepted a position in CDU & would like to hear from you! Tips & tricks, common pitfalls & frustrations, your favorite reference (hardcopy or phone app), and what you w...

Thanks Youtube, I am on the east coast, in Delaware. Where did you go from CDU? What drew you back?

Try major private insurance companies - many have positions for NPs doing pre-insurance physicals, as well as chronic disease follow-up. Definitely look into the healthcare provider shortage areas (HSPAs) as often that results in loan repayment.

Thanks Youtube, I was hoping to use that time as my practice with a collaborating physician, since I need X amount of hours working with a collaborating physician before practicing independently. I don't mind "following" protocols in the beginning, ...

I have been investigating the possibility of a job as an NP for an ER Clinical Decision Unit after graduation. I currently work PACU (close to 2.5 years by the time I am done with school), and prior to that I worked for 5.5 years in various ERs (ped...

Hello all, I am an RN with almost 8 years of critical care experience, and I am 10 months away from my AC-AGNP. I am trying to decide on where to go from there. My interests include, in no particular order: - ICU NP - the hospital closest to my hou...

Does anyone have any policies to share for how they manage post-op HTN? What are your cut-offs for "abnormal" vital signs before the patient has to be transferred to step-down? I am a PACU nurse and we are running into roadblocks trying to get orth...

RainMom, we've tried, all of those suggestions, but we are still butting heads with the floor. No there is no actual numbers in the policy. Strangely enough we only have this problem with the ortho floor, which is managed by an RN who oversees the ...

The PACU nurses seem to be the only ones sharing this concern "my facility is more concerned with dropping them too quickly,". The floor nurses want them picture perfect or off their floor (to the point where they tried to tell me to take my patient...

Hello everyone. I work for a medium sized Magnet health system. We are 4 days away from a new EMR launch (switching from McKesson to EPIC). Does anyone have any suggestions, tips, tricks, etc. for making the transition smoother? I am a super-user ...

I LOOOOVE paper (no sarcasm, I really do). It's short, concise, and there is a strange sense of nostalgia and peace in the unit when we're on paper. But so far it's been a decent launch, the EPIC trainers are very helpful.

I'm considering marketing myself out as a Nurse Consultant. Basically I'd love to do business by providing recommendations and education to "clients" (patients, families, organizations) based on their individual situations. For example, Mary's elder...

I've been in the AG-ACNP track for the last 6 quarters. I have no complaints. Do not expect any help from advising, especially for finding preceptors. Know your deadlines and give yourself 4 extra weeks to meet them: my paperwork for clinicals is ...

I thought nurse-to-nurse report was part of EMTALA law for inter-facility transfers. I also agree, that nurse-to-nurse report, with adequate time to ask and answer questions, is the professional thing to do. That being said, unless the reporting nu...

Does anyone have any "success stories" regarding what works well for pain management for anterior cervical discectomy and fusion (ACDF) procedures? Almost all of the ones I've seen come out rocking and rolling in excruciating pain, requiring the kit...

Exactly! All the more reason that long-acting narcotics should be given intra-op, instead of having the PACU nurse playing catch-up.

I hope I'm not coming off as calloused when I say "rolling around in pain", while many ACDF patients were previously chronic pain patients, I am not trying to say they are faking their post-op symptoms. Coming out of anesthesia after a procedure tha...

Thanks, azhiker96. Lately I'm finding more and more of these cases coming out with absolutely no Dilaudid or anything else long-acting on board. Our CRNAs tend to run them on a Remifentantil drip and give additional Fentanyl and Ketamine if they se...

Thanks SubSippi. Besides Fentanyl, we can give Dilaudid, Morphine, Robaxin, Phenergan as an adjunct, and Toradol (only with the surgeon's okay - Neurosurg usually stays away from it due to bleeding risks occluding the airway, certain OB-GYNs also re...

Hello all, hoping for some advice. This may be more of a management/HR type of question. I was approved for a $3600 masters class last year. Class began in Dec & ended in March. I submitted all my paperwork, was approved, and then submitted m...

I do not expect to be reimbursed in 3 weeks, I expect an answer to my email that I sent 3 weeks ago. The actual paperwork for reimbursement was submitted 2 month ago, and still no indication whether or not I will eventually be paid for this. In eve...

Just accepted a PACU position at a Level II Trauma Center. Coming in with 5.5 years of ED and critical care transport experience, lots of autonomy. Looking for tips, suggestions for orientation, and general knowledge! Feeling pretty good about this...

Also, I'm curious what do you all carry in your pockets? Being a PACU environment, the scrub options are obviously only hospital scrub machine, so pockets are limited. All the bedsides look well stocked, but I'm very used to my Aviator scrubs with ...

Oh stop! I already learned 2 new things during a shadow experience: Decadron for nausea prevention & Quease-Ease aromatherapy for nausea relief in the PACU environment. I'm researching the Decadron further, I had never heard of that use. Anyone...

Now that I wrote that, I'll actually have to double-check the way the order is written when I get back to work. We set the pump to 17 mL/hr which comes out to 10 mcg/min. But I think the order may have been written start infusion 0.125mcg/kg/min up...