PERSEPHONE01

Thank you BrnEyedGirl it helps to hear from someone who is making it happen. No chances to switch to a day position and mid shift would be a nightmare. As difficult as night shift can be I dont know if I would be able to give it up, I like nights and I have been able to figure out times that I should be able to work on class work and still get time for family. I have been an ER nurse for just over a year now...I have gotten comfortable with my role and have gained a lot of confidence. I have learned a lot about what is really an emergency and what is not. I want to get started on the FNP program now because it will take about 4yr part time and I know I will continue to learn a lot while I am back in school, and that what I learn will only add to my knowledge and performance as an RN. I look forward to having a deeper understanding of what is going on with my patients. Thank you all for your comments, they are much appreciated :)

It was my dream to work in the ER too! For several months after I started I just couldn't believe that I had landed my dream job. They didn't want to hire me at first because I was a new grad, but I was persistant and didn't give up. I think I will go ahead and apply, and wait to see if I get accepted before I stress too much about it. As much as I love this job, I never realized how much it would wear on me. I have only been a nurse for just over a year and I can already see how easy it is to burn out.

I have been an ER nurse for over a year now and I love it. It can be stressful, exhausing, exciting, all of the above. But I don't see myself working as an ER nurse 10 yrs from now, I just don't think my body can take it. I would love to continue my education on to work as an FNP here in our ER, something I have been stressing about almost every day. The admission deadline for the school I wish to apply to is coming up fast, but honestly, the closer it gets the more worried and indecisive I become. I love school, I love learning but I just don't know if I can do it. I will need to contine to work full-time as my family is dependent on my income alone, and go to school part-time. I remeber how exhausting my ADN program was and I just worry that I will start the program and that the added stress will be too much, or that I won't be able to keep up with the program. It has taken me a long time to adjust to 12 hr fast paced/high volume ER night shifts, but I still struggle with feeling weak, exhausted, difficulty in retaining new information and trouble getting my to-do list completed on my days off. I don't see things getting any easier if I try waiting to apply in another 6mos to a year. I am in my mid 30's and I am not getting any younger lol! I guess what I am looking for is a little encouragement, some advice, from others who have been there, have gone for it and made it through.

The Vet is in the building at all times but is not present for every procedure. I will use an example of a dental cleaning sense you mentioned it above. Prior to a dental procedure a pet would recieve a physical exam by a Vet and then while the Vet is seeing other pets or working on paper work, a Vet Tech would place an IV line, calculate the required pre sedation needed then administer it. With the help of other Vet Techs or Vet Assistants they would then take the pt back once pre sedation has taken effect and the VT would intubate, place the pt under general anesthesia then, while monitoring vital signs, the VT would perform the dental cleaning. Once completed the Vet would come in and check the teeth and remove any that need removed. Once cleared the VT would then stop the anesthesia and remain with the pet until they have woken up well enough to be extubated and then placed in a warm, quiet cage to recover. The same goes for surgical procedures...the Vet may only be present to do the incision, the surgical procedure and suturing, then be gone onto the next procedure. Do you feel that in the people world that pt's feel they do not "recieve their moneys worth" if everything is not performed directly by an MD?

By "under the supervision of" as a Vet Tech or an RN I do not mean they are our direct supervisors, I mean that we are unable to perform a function, such as giving medications or performing a treatment, that has not been first presribed or ordered by an MD (NP, dentist, DO etc) or Vet. We are under the direct supervision of our charge nurses, unit directors, etc.

Before you attempt to disparage a profession you know nothing about, you should first do your research. A Licensed Veterinary Technician is a professional that holds a minimum of an Associates of Applied Science obtained from a college/university that has been accredited by the American Veterinary Medical Association. Then in order to obtain their license they must pass the Veterinary Technician National Examination, which is a proctored exam of approx. 170 questions over 3hrs. After passing this exam and becoming licensed, they must obtain continuing education hours of approx. 20hrs every 2yrs through their state Veterinary Medical Association in order to remain licensed. A Licensed Veterinary Technician may then perform any duty required of them, under the supervision of a Veterinarian (just as an RN must be under the supervision of an M.D) as long as they do not diagnose, prescribe or perform surgery. So a Vet Tech can do assessments, give vaccines, draw blood, insert IV's, give IV fluids and meds, assist in surgery, perform and maintain anesthesia, intubate, perform Foley's and straight caths, do dental cleanings and so on and so on. Just as with the issues that RN's face, there are veterinary assistants, which are people who have been trained on the job, who will call themselves Vet Techs, however they are not licensed as stated above but as the veterinary world is not as regulated as the human side, those vet assistants can perform, under the supervision of a vet, the same skills as those supposed to be performed by a Licensed Vet Tech. I apologize for the unprofessional way that your pets care was posted on a public media site, but you should have addressed this with the veterinarian, who may have been unaware. Although there are no HIPAA rules in veterinary medicine most vets would find this to be unprofessional and would not allow it. As for the Vet Tech being called a "nurse", this misnomer is almost always done by a vet or a veterinary assistant, as Licensed Vet Tech's are proud of the title they have rightly earned and maintained.

Why the STAT CT? What are we looking for, even before the radiologist sees it? Looking for either a hemorrhage or area of ischemia If I could only get one tube of blood, run only one test, which would it be? Purple top for a pt/ptt, will help explain possible cause of a hemorrhage and/or whether the bleed will worsen. Also tPA in constraindicated with PT >15sec and Plt Why multiple lines? Why is large-bore (a) unnecessary and (b) even possibly even counterproductive? Never heard of a large-bore being unnecessary or counterproductive, we commonly use #18's, reserve #16's for traumas or the like. Will need multiple lines because this pt may require multiple infusions/meds at a time. Why the EKG and fingerstick? EKG to determine if the pt has afib which could have caused a clot, leading to stroke. Accucheck because hypoglycemia can mimick a stroke. And what about the blood pressure? Is it an issue at this moment? Why or why not? If so, what do we do? tPA is contraindicated with uncontrolled hypertenion >185/110 What one small, and often incidental, piece of information do we need about this patient? (that nobody has yet touched on) Are they on any "blood thinners", any LOC or recent head trauma?