isis73

hehe...me too! told my hubby i was going to get a journal and fill it with my name, rn--just for practice!:dncgbby:

congratulations, vballman, rn!!!

[color=deepskyblue]congratulations, inthehomestretch and dazeylpn2b!! :ancong!:

Thanks, guys! I look forward to congratulating you tomorrow, vballman!

[color=deepskyblue]i passed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! look out micu, here i come! wahoooo!:anpom:

Almost time! Good luck to everyone and post when you find out!

Drinking husband's conconction of a wine/fruit smoothie...does make the wait easier!

I took mine yesterday and I have no idea how it went. Except for med calc, everything was just best guess...and it stopped at 75. Good luck to everyone waiting! 24 more hours.....:anbd:

i just wanted to post an update...i'm going to the mccu! i just graduated, and now it's off to kill the nclex dragon...thanks for the advice and encouragement!

Thanks to everyone for their helpful advice and encouragement! I am in my senior semester, about to graduate in May, and my biggest fear is time management. I feel slow and all thumbs, and I tend to proceed cautiously until I am sure of what I am doing...I know I will get faster as I get used to different tasks and gain more conifidence, but my attention to detail and hesitancy has resulted in one instructor telling me that I was very slow and sure to have a very hard time in my final semester. Our last round of clinicals start next week and I really want them to be great! Thanks for the help!

Had the case study today, and you're right--pt had a temp of 96 and with everything else we were trying to think of and work on, we didn't catch it right away. Pt had 36% BSA burned.

Thanks to both of you! Great advice. And you're absolutely right ukstudent--my teacher's two loves are critical care and psych, so I'm sure she will be interested to know what we are doing to care for the wife and two daughters who are on the way. And thanks for the warning on fluid volume overload, trauma_burnout71. Why are they at such risk for fluid volume overload? Trying to think that one through...they could go into shock, but then their BP would drop...After being a little burnt on nursing school (the end is finally in sight!), I love all the thinking and learning involved in critical care. Feels good to know I may have found my niche (it was definitely NOT OB-Peds...) So the biggest priority is airway, and likely intubation since their airway may be irritated and swell secondary to smoke inhalation and the possible loss of consciousness. Second is fluids and establishing an IV to maintain BP and prevent dehydration, being careful not to overload pt (indication for hemodynamic monitoring?) And once these are established, with pt on spinal precautions and heading to x-ray and CT, a call to the hospital chaplain for family support. Thanks again! (And who wouldn't be enthusiastic with the end of nursing school just around the corner!)

Yes, that is extremely helpful. I had forgotten about the Parkland formula (having only recently learned it). I think the focus is mostly on assessments, but also on prioritizing care, and your suggestions are all very helpful. (How is your first year as a nurse going? How was the transition from student to nurse?) Thanks for taking the time to respond and offer the voice of experience!

I know it is extremely vague, and I do apologize for that--that is all the information we have been given to work with. More info will be given when we show up for our case study and we will have to know how to respond--we have just finished covering increased ICP, cardiovascular and emergency nursing, so the idea is that anything goes and we will need to be able to think on our feet and prioritize care quickly...I am loving the critical care aspect (and hope to work in critical care after graduating in May), but I like to be prepared. Thanks again for the help, if it really is possible with so little to go on...

There is no teacher like experience, so I'd love to know what those of you with years of experience make of our class case study...Thanks for the tips and advice! 39 year old truck driver, male, admitted to the hospital following an accident in which the cab of his truck caught fire. He was freed from the truck by a passing motorist, who stayed with him until the rescue team arrived. The rescue team decides to call Skycare to transport him to the regional trauma center which has a burn unit. His wife and two daughters have been notified. How do you stabilize the patient and maintain airway and ventilation while also assessing, stabilizing physical trauma and the degree of his burns?

Yay! I'm so glad to hear that it's okay to not start in Med-Surg, especially if my heart isn't in it. I really liked and respected the Surgical unit manager, but I felt it would be unfair to her as well to take a job I felt no enthusiasm for. Thanks so much for the advice--I'm going to try for MCCU first, ICU second (it may be available before May), and IICU third. I'll let you know what happens!

First of all I just want to say hi! This is my first post here(*I was wrong--according to allnurses, this is my 7th post!* :Snow: ) , though I have been reading posts for advice and encouragement for the past year and a half of nursing school--I love allnurses.com and really appreciate being able to come here. My question involves where to start as a new grad when I graduate in May. I spent all day yesterday shadowing on four different units at a big hospital within an hour of home. It is a small commute (35 miles) but well worth it for the great experience. The hospital is a heart hospital and is a faith-based hospital. I loved the hospital and would gladly work there--the problem is deciding where to start? I am deeply interested in critical care and have worked as a tech in the local ED. The hospital I shadowed at let me spend time on IICU, Telemetry, MCCU and Surgical. Everyone working there seemed to really enjoy their job and take pride in their work, and all the unit managers knew each other well and had an obvious respect for each other. All four units are hiring new grads and the critical care units have a very intensive and thorough six month orientation (part of the attraction). Here's the pros and cons in a nutshell: IICU (ICU step-down unit)--small, 3:1 ratio, great learning environment, the nurse I shadowed was extremely friendly and described their unit as being "very laid back" with a certain level of indepedence and a great starting point before going to a more specialized unit like ICU or MCCU. This was the first unit I shadowed on and I left there very encouraged and sold on the idea that it was a great place to start. Telemetry--I'll be honest, I did a rotation on Telemetry in clinicals and it wasn't my favorite. Though the unit manager was very nice, she and the preceptor/nurse educator (esp. the nurse educator) did a hard sell, and I don't like being pressured. I also tend to be suspicious of someone who is too eager to hire you and wants an immediate verbalization of interest or commitment... MCCU--This one is complicated--I LOVED the unit manager (who did not try to sell me on the unit at all) and I loved the obvious intensity of the floor. She made it clear that the last thing they want is someone who doesn't want to be there and that in terms of critical care, especially coming in as a new grad, you have to WANT it. Seeing her in action was inspiring and the depth and breadth of her knowledge and experience was obvious. I want it, I do, but it is also a terrifying prospect! I will only be a new grad--can I learn enough in six months of orientation to deliver safe care? She emphasized that I will never feel truly ready or that I have mastered everything (and that no one there does), but that they will know when you are ready, even if you don't realize it yet. Surgical (5:1 ratio--which is really good compared to the local hospital) You know what I'm going to say...everyone says do your time in Med/Surg first. The unit manager is obviously skilled, and expressed interest in hiring me, and a willingness to prolong the 12-week orientation if I felt I needed more time. Concerns: According to the nurse recruiter, when she came to the unit two years ago there was only one staff nurse and all the rest were travel nurses--even so she cleaned house and rebuilt the unit from the ground up. That is a major accomplishment, but the day I was there they were short-staffed one nurse and they have one nurse that is moving to another state. Other concerns: My heart isn't in it. I know I would learn excellent skills, time management and organization, but would I dread going to work? My coworkers will all have been there for less than two years (with one exception) and the one I spoke with was only there for the extra paycheck (PRN--works FT at a diffferent hospital). They are short-staffed. What to do? I love the hospital and everyone I met, but I want to have a great first year learning. School has been rough and stressful, and some of my instructors have been cold and unsupportive, making it hard to have self-confidence in myself. I know the first year is bound to come with it's share of stress, but I could really use a supportive learning environment. All that being said, I am not afraid of hard work. I am dedicated, concientious, detail-oriented and eager to learn. I WANT to be a great nurse, I do. Any help in making the right decision in where to start would be greatly appreciated (and thanks for reading the small novel!).