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Critical care
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J_W has 27 years experience as a DNP, APRN, CNS and specializes in Critical care.

J_W's Latest Activity

  1. J_W

    Alphabet Soup of a Title

    Just be sure to check your state BON requirements for what needs to be included behind your name. I'm sure every state is different.
  2. J_W

    Alphabet Soup of a Title

    I know in Texas there are rules regarding displaying credentials for APRNs and RNs... So, some of the issue is state boards of nursing rules/regulations. In Texas the nurse is always held to the highest certification, so if a person is an APRN then they are held to that standard regardless of what role they are functioning in. In Texas the APRN must have APRN listed along with the type of APRN such as FNP, AGACNP, CNS, CRNA, CNM, PNP, NNP...It would be Jane Doe, DNP, APRN, FNP or John Doe, MSN, APRN, AGACNP I do agree it would be nice to have a succinct title. Just not sure how it would work with the 4 APRN titles and then the different APRN recognition's that vary by state. So the state rules/regulations are the issue.
  3. J_W

    Future of the CNS

    I am a CNS with prescriptive authority (my Acute care CNS program allowed me to acquire prescriptive authority), thus I had additional options and can always move into a role in which I could utilize my prescriptive authority. So you might look at CNS programs that also include courses that would allow you to apply for prescriptive authority. The love the CNS role and it has been very beneficial to me and has allowed me numerous opportunities. This affords you additional opportunities for employment options. Doctoral studies can always come later. I just finished my DNP degree and thoroughly enjoyed the courses and feel they really enhanced and added to the knowledge I acquired in my MSN program. I am in TX and I can tell you that we are of course behind on the CNL role (some facilities are utilizing the role, but only a handful). And those that are utilizing the CNL role are not quite sure how to utilize the role. My thoughts are the CNL and CNS roles should work together in a collaborative manner to improve patient care and outcomes. JWRN, DNP, CNS
  4. Congrats to everyone going to UT Houston, it is a great school. I graduated from there, now so many years ago, 17 to be more exact. I thoroughly enjoyed it and had awesome clinical experiences. Hands down the best place for clinicals is the TMC. Good luck everyone!!!
  5. I can see the problem even if the identifying information was taken off of the x-ray...But you can google x-ray images and find many different unusual images some funny some not so funny... I guess I was thinking the identification info was still on the x-ray and that was posted along with the image. Most hospital's general consent for treatments include a statement about taking photos for educational purposes, but that all identifying info will be removed, so most patients/family never read these consents completely...Although these were not for educational purposes they were more likely to ridicule someone's personal life....
  6. J_W

    Nurses with a masters don't do beside nursing ?

    I have my MSN and though I do not work in direct patient care on a full time basis, I still work as I can in the ICU on a PRN basis. I miss patient care at times, but I also like my autonomy of my current position. I know more than a handful of nurses who have MSNs or PhDs and still work PRN doing bedside care. I had one faculty in my doctoral program who still worked PRN on the medical unit at the VA in San Antonio...Taking a full load of patients 8-10 per shift... Anyhow, I think everyone has something to offer in whatever position they are in, that is why they are there to begin with.
  7. J_W

    CNS vs NP?

    I am in Texas where the CNS is an Advanced Practice Nurse. Along with NP, CRNA, and CNM, these are the 4 APN titles in TX. I am a CNS in Acute care, but have always been employed as Critical care CNS, but my title with the BON is CNS acute care. I chose to take the CCNS exam offered by AACN, which TX recognizes, mainly because al of my experience has been in ICU settings...My CNS program automatically included the classes that allowed me to apply for and obtain perscriptive authority, however I do not need it for my job. I keep the hours current so I can keep it. The program I graduated from has changed since then, not sure how or what, just know they made some changes in the program tracks they offer. I like the CNS role, in my current role I use all that I learned in school. Not much staff education or research, but the other subroles of the CNS have been very useful to me.
  8. I am a APN in the state of TX. I graduated in 2000 from MSN program (CNS track), my experience has always been Critical care, so I took the CCNS exam offered by AACN. Texas recognizes it as path to Advanced Practice. My MSN (CNS) program allowed me to obtain prescriptive authority (I have a number with the board), however I do not use it in my current role and have never used it, but keep the Pharm hours update so that I may keep the authority in case one day I may want to use it. I am moved from traditional CNS role as critical care educator into a safety position (patient safety manager) for large acadmeic medical center. It was a complete turn around, totally new. I am still new to the role, so I am still learning. It is a side of nursing I knew was there, but never really thought much about it lots of JCAHO readiness stuff, etc... I would say look for a CNS program that offers prescriptive authority, that way you can have it if you ever work in a role that needs it.
  9. J_W

    anyone go to UT-H or TWU-H?

    I attended UT Houston...But it was long ago (13 years since I graduated)...I think both schools utililze facilities in the Medical Center, and that is the reason I chose UT Houston...The clinical experiences in the TMC were excellent and I learned so many things...Both schools are excellent I would think...So either one would be great...I know when I was at UT Houston, we went all year including the summer, so that might be something to consider...Good luck...I am sure you will enjoy it regardless of which school you choose...
  10. Actually, you should put your highest degree first, followed by your license, then certifications in the order your received them. Your degree is first because it is yours and cannot be taken away from you, your license and your certifications can be revoked and therefore are usually listed after your degree. You will always have your BSN but your RN and other certifications can be taken from you... So it would be BSN, RN, CCRN, so on... Hope this helps...
  11. J_W

    What role do you work in?

    traumaRUs...I have been busy moving into new house, new job...So I have not had time to post...I did resign my position as CNS for critical care, and have went into a staff position in the PACU (4 ten's a week) making more than I did as CNS, my base pay is only a couple of bucks less than my CNS base pay, plus I can get overtime, shift differential...I decided that 5 years as CNS was enough, I will look for a CNS role that incorporates more of what I learned in school, I mean I did learn how to do education for the staff and patients, but I also followed trauma case manager and followed trauma patients looking at outcomes...Anyhow, for now I am happy...Will keep you posted...
  12. How sad is this? In this day and age. I think I would like to start refusing to care for patient's whose religion goes against mine. It did say religious grounds. It should work both ways. Ex. Christian can refuse to care for a Muslim or Jehovah's Witness because their religions do not mesh. I should be able to refuse to care for a heterosexual patient because I do not agree with their lifestyle, whose to say that the heterosexual lifestyle is the norm.... This is just plan stupid, obviously people with nothing better to do than to think of ways to discriminate against a group of people...
  13. J_W

    How Long Did You stay at Your First Job as a Nurse?

    I stayed at my first nursing job for 2.5 years, then left to work in the ICU at a different facility in the same town. Stayed there for 3.75 years, started graduate school in there somewhere, then decided I wanted trauma experience, so went to the university hospital (used to be called the county hospital) and stayed there 2.5 years, then graduated from MSN program and started as CNS and was there at that facility for 3.5 years and things changed at that facility for he worse (it became for-profit) so I moved to a different city and have been in my current CNS role since 11/2003 and I love it, so I hope to stay where I am at permamently...
  14. J_W

    Precepting New ICU Nurses

    To truly give an a adequate orientation to a new nurse (especially a GN) the preceptor should not have any patients. I know this is difficult due to staffing, but if your hospital wants a quality nurse who can critically think through situations and intervene appropriately, then your orientee should have both patients or one challenging patient and you have no patients, then you could concentrate on testing/quizing your orientee about the meds/drips, pathophys, assessment findings, etc about the patients. The hospital I work at as a CNS is about to start doing this in March, I just hope that administration doesn't change their minds...This method of precepting comes from the PBDS model, I know some will not like this, I am not fond of it, but it is good tool/assessment to use on new nurses and experienced nurses, and the important part is that the preceptor have no patients in addtion to the orientee...
  15. J_W

    I have tinnitus

    I too have ringing in my ears, some days it is the left and some days the right, but mainly my left ear rings...I think in my case it has been Tylenol that has done it, though I do not take Tylenol much anymore except for headaches (which I only get when it is time to see the eye doctor), and I used to take a lot of APAP in cold medicines, etc because I have sinus infections usually twice a year with the cold weahter and warm weather changes...Anyhow...I have learned to live the ringing, there was one time that ir was so loud I was wanting to ask my roommate if he could hear, becaue it was that loud. It hurt so bad I could not sleep, this was when I was in graduate school so I had one of the NP faculty look in my ears, to no avail. no problems...Most of the time now it is not bad, though I would like to get rid of it for good...Good luck, please post more information when you can...
  16. J_W

    NCLEX: how much pharmacology?

    There will be more pharmacology on the NCLEX from now on...this started in April rougly 20% more than before.....With drug calculations and fill in the blanks....pretty much all I can say about it.....I was on the NCLEX panel last year....Hope this helps....

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