GenaRN

I applaud your turn around and tenacity to overcome your hardships. And getting a 4.0 in your prereqs shows that you are determined. I just want to warn you to check VERY closely with your state's nursing board - each differs broadly on what requirements persons with mental health diagnoses require. Here in TX, there are restrictions and stipulations put on nurses in recovery and with MDD, it's pretty rough. Nursing school is hard to finish and then not get a license at the end of it. Be careful, I have seen it happen.

I don't know where you live, but not having clinical experience is going to hinder your ability to get a decent job, as more people take the same route you are. Believe me, in Texas there aren't tons of openings for NP and you don't see a lot of independent practitioners, so I actually have 3 advanced practice RN's working for me on the stepdown unit I supervise. Two are CNS's and one NP, all went straight through RN-grad school, but have no clinical experience, so the can't find jobs in their advanced practice roles. It might be very different where you live, but it's something to consider. They'll eventually get jobs, once they get experience, but had they gone the "traditional route" they might have been more satisified, not working "beneath" their level of education. This isn't usually a problem with CRNA's because they still require 2 years, as far as I know, of critical care experience and the world needs more anesthesia :) !!

Always go with A - as a ACLS instructor you will never get knocked for chekcing the airway and "hypoxia" is totally one of the "h's" of reversable causes of PEA. =DustinRN]This question is from the ACLS provider manual. In case you don't have the manual I will write the question out. You have to have the ECC guidelines 2000 manual to get the answers to these questions and I don't have that manual. I'm going over case 4 PEA and I'm not sure what the right answer is for this question. Thanks You are called to the ED to assist in the attempted resuscitation of a patient in pulseless cardiac arrest from unknown causes. When the patient arrives in the ED, chest compressions are being performed, and the patient is receiving ventilations through a tracheal tube placed by EMS personnel in the field. The patient is transferred to a gurney; you confirm that chest compressions are producing palpable femoral pulses, but no pulses are palpable between administered compressions. The patient is attached to a cardiac monitor that confirms the presence of organized QRS complexes. What is the first thing you should assess in an attempt to identify a reversible cause of cardiac arrest in this patient? A. check tracheal tube placement with primary and secondary techniques and evaluate breath sounds to rule out tension pneumothorax B. check arterial blood gases C. check serum electrolytes to rule out imbalances D. obtain a serum sample to identify drug overdose if anyone has the ECC guidelines 2000 it says the answers will be on page 151. My first guess for the FIRST thing you would do would be A, but I'm not sure if that's the answer or not. I have no way of knowing unless one of you can tell me. Thanks!

Gack, I hate that. We had a family the other day that brought their literally 10 grandkids not just to see Grandpa in the ICU (which is a request we accomodate, but not the norm) but stay all day in the hallways, running up and down with no shoes on. I told them to stop running in the halls (this kids were 8-10 years old, old enough to know better) and they dissappeared. Then when I transfered a patient to the 4th floor, I found them up their, riding on the dirty linens carts like scooter. I mentioned it to the charge nurse, who told me later she had already spoke to them about the complaint and they told her "They were bored so we let them play on the elevators!" Holy crap, I think Carlos Mencia is right...

Because I have been a nurse for several years and I do "dirty work" every day- does she work in an OR or Cath Lab, because patient care outside of places like that is "dirty" for everybody.

That's a totally valid point, actually reminded me of an instance where I specifically DID NOT speak to a brain dead patient. We had a 40-somthing man who died from an ICH and was on the vent pending organ procurement as his sister (presumed next of kin) had consented to organ donation. In comes father (possibly estranged but certainly vocal) who despite protracted efforts of coordinator in counseling him, refused donation, stating that the hospital was "trying to make money by selling his son's organ". His father wanted to know what we would do next to "cure him" and the intensivist said "your son is dead", we then extubated him and allowed time for the father with his dead son. I remember thinking that I was compelled to tell the man that I would be taking out the ET tube, but stopped myself so as not to muddy the issue in the fathers mind.

But I don't recall talking to brain dead patients. It seems odd, I wouldn't talk to a dead body, it seems disrespectful to say "Mr So-So, we are going to turn you now" to a dead body, just a it would be to not say the same thing to a comatose patient. It's an interesting topic of discussion for sure.

The facility where I work has a fairly aggressive one for critical care and the goal is BS 80-120, with hourly titrations and boluses. I haven't had any problems with hypoglycemia using it, but like I said, it's really closely monitored. I wouldn't want to use it on the floor, and we don't at our facility.

Most of the schools in Texas have waiting lists too, although they mostly base the wait on your GPA. It's common to "rank" applicants based on their GPA's to ensure a higher graduation rate. So if anyone tells you to blow off Human Growth and Development because the "C" you get won't matter, they're only half right. I know of people who've waited 2-3 years to get in after finishing their prerequisites.