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traumaRUs

traumaRUs MSN, APRN, CNS

Nephrology, Cardiology, ER, ICU
Member Innovator Expert Nurse
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traumaRUs 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?

traumaRUs's Latest Activity

  1. traumaRUs

    NP vs FNP

    Moved to advanced practice forum
  2. traumaRUs

    Why Nurses Should Join the Gig Economy Right Now

    You should make your time count. Totally agree. However the reality of life is that most of will work a long time. Why not do something you enjoy? With decreasing pensions and 401k’s and the fact that you do t want to outlive your retirement options are always a good idea to consider. that’s all this is - an option
  3. traumaRUs

    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!
  4. traumaRUs

    Most important thing to look for in training/school

    Moved to SRNA forum
  5. traumaRUs

    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
  6. traumaRUs

    What should I do?

    Moved to student NP forum - congrats
  7. traumaRUs

    To retake chemistry for CRNA school?

    Moved to SRNA forum.
  8. traumaRUs

    RN --> CRNA or Law School?

    IMHO life is too short to do something you aren't passionate about. What do you LIKE to do? Have you shadowed or talked with any RN, JDs? That might be a starting point.
  9. traumaRUs

    Post-interview update

    Great - first hurdle done. I would be leery of the Friday call - sounds like it could really eat into your weekend unless there is a "night call" MD. In our practice our "call" ends at 5pm when the "night call" MD comes on.
  10. traumaRUs

    Reconstitution safe dosage calculation question

    Moved to pt medications forum
  11. traumaRUs

    Advice

    Can you be more specific?
  12. traumaRUs

    NP in genetics?

    Moved to APRN forum
  13. traumaRUs

    First official NP job interview

    Congrats on your upcoming graduation. 1. What is orientation like? Didactic/shadowing? Amt of time? Pay during this time? 2. Where will you be practicing? Hospital/office? If you are an FNP, do your local hospitals credential FNPs to see pts in the hospital? 3. How long is the credentialing process for insurances? Is there a dedicated credentialing person at the practice? This can be a deal breaker for me as credentialing, licensing, etc., can vary so much that it can be so time consuming and frustrating - I wouldn't take on this task alone. 4. Have they worked with APRNs before? Will you be the first APRN employed in this practice? Difficult place to be in IMHO - to be the first APRN they hire as expectations might not mesh with reality. 5. Who will be your boss as an APRN? As an employee? In my practice, we have an MD we answer to clinically but we also have a practice manager (non-clinical person) who we answer to as an employee. Best of luck - let us know how it goes
  14. traumaRUs

    FNP school-Georgetown vs USC

    Moved to student NP forum.
  15. traumaRUs

    Would you stay?

    After reading all the more recent comments I'm going to change my advice. Expecting a work family is not what being an APRN is all about. Its nice if you all get along but not necessary. The MAs need to do their job and you do yours.
  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.
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