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traumaRUs - Judy MSN, APRN, CNS

Nephrology, Cardiology, ER, ICU

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traumaRUs - Judy has 27 years experience as a MSN, APRN, CNS and specializes in Nephrology, Cardiology, ER, ICU.

I have a total of 27+ years of nursing experience; including 10 years as an RN in a level one trauma center ED. Now, I'm an experienced (13+ years) nephrology APRN. In my spare time, I volunteer on my rural fire department as a licensed Pre-Hospital RN. I'm also a proud USN veteran. 

Presidential Executive Order about Kidney Care - July 2019

UCSF Alarm Fatigue Study

Are We Too PC?

Assistant Community Manager. Please let me know how I can help make our site enjoyable.

traumaRUs - Judy's Latest Activity

  1. traumaRUs - Judy

    what's the least saturated specialty in APRN?

    Hmm...do you mean FNP, ACNP or do you mean pediatrics, family practice, dermatology? Can you clarify a bit?
  2. traumaRUs - Judy

    Best States for RN's and NP's both in terms of pay and practice?

    I consider CA and MD to both be very high cost states and I have lived in multiple states all over the US. I currently live in IL (central IL, rural area) and my pay is excellent for this area with 13+ years APRN experience. A very nice 2000+ sq foot house will run anywhere from $150 up. And I take exception to your statement that " High quality food - most of the nation's fruits and veggies are grown here." Most of the corn, wheat and dairy come from the midwest. Iowa produced the most corn in the United States in 2016 followed by Illinois & Nebraska. Iowa and Illinois both produced over 2 billion bushels in 2016. Four states produced over 1 billion bushels of corn in 2016: Iowa, Illinois, Nebraska, & Minnesota https://beef2live.com/story-states-produce-corn-0-107129
  3. traumaRUs - Judy

    Georgetown AGACNP Program - May 2020

    Moved to student NP forum
  4. traumaRUs - Judy

    NP vs FNP

    Moved to advanced practice forum
  5. traumaRUs - Judy

    Happy Veterans Day 2019

    I just wanted to wish all my fellow military veterans a wonderful, peaceful day. This is a day to honor all veterans and active-duty military. Many businesses honor us with discounts today. However, more importantly, is our country recognizing our commitment and sacrifices. So many veterans have returned from military service disabled either physically or mentally. allnurses.com salutes our veterans! Veteran's Discounts Thank you for your service to our great country!
  6. traumaRUs - Judy

    Advice needed for Military Spouse

    I'ma military spouse, hubby did 23 years. I did L TC, medaling, & ICU without problems . I did MSNafter he retired and haven't looked back since,BTW we moved 3 tines while I was in NS
  7. traumaRUs - Judy

    How to "calm" down autistic pediatric patient?

    STAFF NOTE - several posts have been edited in this thread due to debating the poster, not the topic. There are many of us with autistic family members so this can be a sensitive topic. However, please be polite and courteous when disagreeing with others. Thank you
  8. traumaRUs - Judy

    Board of Nursing Complaint

    Yes, I would definitely consult an attorney. I would be glad to remove this post too if you are concerned with your privacy.
  9. traumaRUs - Judy

    Prescribing new medications?

    I work in nephrology and many of my pts are on max doses of 4-5 anti-HTN meds. I use UTD but I also use National Kidney Foundation guidelines as well as the ACC/AHA 2017 Guidelines.
  10. traumaRUs - Judy

    Email from dfpr??

    I'm in Illinois - all nurses received it as near as I can figure out - I deleted it and no biggie IMHO
  11. traumaRUs - Judy

    Illinois Diazepam

    What about schools without nurses?
  12. traumaRUs - Judy

    Most important thing to look for in training/school

    Moved to SRNA forum
  13. traumaRUs - Judy

    RN. BSN

    We are going to need some more info - what kind of experience do you currently have? You need to choose a specialty in order to decide on NP track?? FNP, ANP, ACNP??? Moved to student NP
  14. traumaRUs - Judy

    Presidential Executive Order about Kidney Care - July 2019

    Here's an update - practices have until January to submit an application to CMS for the new payment model. https://www.beckershospitalreview.com/finance/cms-taking-applications-for-2020-kidney-care-payment-models.html
  15. traumaRUs - Judy

    RN in Medical School -Should I keep this to myself?

    My feelings exactly. I worked with two fantastic ED MDs who were RNs prior and they were easily the most awesome ED MDs I've ever had the privilege to work with. Congratulations on your success!
  16. The Emergency Nurses Association's Annual Conference was held in Austin, Texas recently. With almost 200 presentations, the 3800 attendees had the opportunity to learn much and network among colleagues. One of the interesting presentations involved complications of the legalization of recreational marijuana. The presenter was Lisa Wolf, PhD, RN, CEN, FAEN, ENA's Director of Emergency Nursing Research. allnurses.com was able to interview Dr Wolf. First, we asked what types of complaints do you think will be more commonly seen in the ED due to legalization of recreational marijuana? Hyperemesis syndromes - one of these is cannabinoid hyperemesis syndrome (CHS) which according to Cedars-Sinai hospital is a condition that leads to repeated and severe bouts of vomiting. It is rare and only occurs in daily long-term users of marijuana Pediatric ingestions of edibles (brownies, cookies, and gummies) - According to a Journal of Pediatrics article, "Unintentional cannabis ingestion by children is a serious public health concern and is well-documented in numerous studies and case reports. Clinicians should consider cannabis toxicity in any child with sudden onset of lethargy or ataxia" Geriatric ingestions can also result in a myriad of issues; Acute asthma exacerbation Pneumomediastinum and pneumothorax suggested by tachypnea, chest pain, and subcutaneous emphysemas caused by deep inhalation with breathholding Occasionally angina and myocardial infarction We discussed the possible increase in MVAs associated with the legalization of recreational marijuana? Dr Wolf stated that this would be difficult to discern as "edibles have a delayed onset of effect, and people may misjudge." Drugged driving is being addressed by state legislatures; "Detection of marijuana in drivers involved in traffic crashes has become increasingly common. According to the National Highway Traffic Safety Administration, 12.6 percent of weekend nighttime drivers in 2013-2014 tested positive for tetrahydrocannabinol (THC), the component that gives marijuana its psychological effects, compared to 8.6 percent in 2007." Some of the first states to legalize recreational marijuana are on the forefront of developing tests to determine impairment: "In Colorado, the first state to legalize marijuana use, the Colorado State Patrol (CSP) includes specialized drug recognition officers. Any driver arrested after a trooper observes signs of impairment is given a blood test. “When driving a motor vehicle in Colorado, any driver has given their consent to submitting to a chemical test if they are presumed to be under the influence of drugs or alcohol,” Sgt. Rob Madden, a CSP representative, told Healthline. “Drivers can refuse a test, but that leads to an immediate revocation of their driving privileges.” Madden also noted that the CSP is entering the final phase of testing of new “oral fluid” devices. California, where the recreational use of pot became legal on January 1, also has specialized drug recognition officers and rules stipulating drivers arrested for driving under the influence are required to take a blood test if marijuana is the suspected intoxicant. That suspicion is formed during a 12-step roadside evaluation process that includes some familiar elements — walking in a straight line, standing on one foot, touching fingers to nose — as well as checking pulse rates at three different points in the process and checking pupil size in ambient light, near-total darkness, and direct light." We then shifted to what ED complaints are being seen in states where there is legalized recreational marijuana. Dr Wolf does live in a state, Massachusetts which has legalized recreational marijuana and she reports the most common complaint they see is hyperemesis. As more states move to the legalization of marijuana, I asked if she had any tips for those EDs in states where recreational marijuana will soon be legalized to prepare for this suspected onslaught? Her comments included these tips: Educate the ED staff Push for good community education in the same way we educate about alcohol Access protocols for managing cannabinoid hyperemesis (Colorado has some good ones) Thank you Dr Wolf and ENA for facilitating this interview. Has legalized recreational marijuana impacted your ED? Please share.