NYNewGrad

I agree with CraigB - yes, the more years you work, the more opportunities you are exposed to, however some people make every single patient interaction a learning experience and become great nurses/NPs that way. I have 2 more semsters left before graduating an FNP program. I've worked adult med/surg and PICU/NICU for a year and change each. That kind of gives me a diverse background. I aced the peds component of the program and did well in the OB/gyn component by studying hard. I think adult primary care should be comfortable enough for me given the med/surg experience. (The FNP program is focused primarily on outpatient primary care so although adult ICU experience would've been nice, I don't think it's crucial...) If there's one other area I'd choose to work it would definitely be ER. Either way, it's not like once you become an NP you stop learning. Any field that you're interested in is open to you.

I'm starting soon in a Peds Resource Team position where we rotate every 2 months between Peds, NICU, PICU. I have a year and a half adult MedSurg experience and am so desperate and ready for a change. Critical Care really excites me and I have always wanted to work with kids, so I am thrilled with this job. We get about 6 months training throughout. Anybody here have positive experience with this type of position?

Hard to give you a clear answer as you have SO MANY options! Off the top of my head, in nyc - NYU, Mt Sinai, Columbia, Beth Israel, Lenox Hill, Bellevue... (prety sure each of these have NICUs). Your best bet - go to their websites and find the number to recruitment. If you're ready to work nights you'll get a job anywhere. Days is also possible though a bit harder to come by. If you want to go to Brooklyn - Methodist, Lutheran, Maimonides is opening an extened Babies Hospital, Brooklyn Hospital, Downstate, Kings County...

I sent you a PM. Oh, and I wont be seeing you next semeser, as I'll be right here at my computer

I live in NYC and attend StonyBrook's online NP program. Being "young and single" I know I have the flexibility to relocate at any time without school commitments. I can even do the program from Alaska... And I also get to work full-time.

So far so good with SUNY Stony Brook's online FNP, also part time or full time

I'm doing FNP online, though I haven't started clinicals yet. Our school gives you a list of all places where students in the past have had success with preceptors, and at the same time you are free to set up your own if its more convenient. They seem to be very on top of the situation and organized about it, but I guess time will tell. I like the online aspect that allows me to contine working full-time, but at the same time I wonder if I would learn more face to face in discussion. The school has a great reputation so it must be successful some way. For now I'm studying and studying and studying... and I enjoy it!

It's not like you have no experience - If you're a good medic with strong assessment skills and diverse healthcare exposure I think you'll be okay. Maybe not first pick over a NP with 20 years RN experience, but probably on a fair playing field with NPs that have 3-5 years RN experience.

Funny how this thread was revived... Either way, my original question still stands. You write that you attach NS with primed tubing to the nearest port in case of reaction. Logically, thats how I agree it should be. However,with the standard blood Y tubing that we use, the bag of NS and the blood come together at the top of the tubing, which means they share a several feet of common tubing. In case of reaction, when you open the bag of saline which is connected at the top, you'd still be infusing all that tubing with the blood inside. I still think you'd be safer just piggybacking the NS to the port closest to the pt...

Thats my understanding too. AD only occurs after the phase of spinal shock, in which reflexes return. Do you have any more background info on this pt? Vitals? How much time s/p injury? Other s/s?

Sorry, but as soon as I read the question I thought - ok, CS. You have to answer the question with the info they give you. Here, they're saying - 1) Cast was "just" placed 2) they got pain meds and pain is "worse". Let's say maybe the pain meds weren't enough, or it was PO and maybe didnt kick in all the way, you'd still have to wonder why the pain is "worse" as opposed to not relieved. The answer may be a little intimidating in that it says "send for the cast cutter" (i.e. making you the authority) as opposed to call MD and if ordered, then call the cast cutter. Either way though, the pt needs to be thoroughly assessed by the MD/PA/NP. Obviously, if there was a choice to check neuro/circulation I'd do that first. But thats not a choice. All the other choices are simply ignoring the fact that the pain is worse, and no choice says anything about getting medical attention.

SUNY stony brook

I'd LOVE to do ER but everyone tells me the ER in my hospital is a complete zoo, with ratios easily exceeding 1:10 at times. Hallway pts are the norm and critical pts stay back against the wall hooked to cardiac monitors, leaving them 3 rows deep. If they code everyone first needs to climb over the 2 rows of stretchers in front.. Yes, I'd love ER but not enough to kill myself (or my patients). And I'm also not ready to switch hospitals... so that will have to wait.

As much as night time is quieter and thus more *time* maybe to learn, I think you learn way more on days. Thats when docs round and discuss plan of care, procedures are done, specialists come on by (OT, PT, SLP) etc. It's much busier b/c theres so much more going on and thus much more opportunity to learn. My opinion.

No one needs the EKG flat line printout?

SUNY Stony Brook is another good one.

BB should tell you if that bag contains the ordered 10 units. When I have an order for 10 units of platelets, BB often sends up one or two bags total. I then call 'em up and specifically ask if there are 5 units of platelets in each bag. They make the bag, they have to be able to answer how many units are in the bag.

We run FFPs pretty frequently on floor. And yes, blood bank will often combine 2-5 units of FFPs in one bag and we still run it over 15 - 30 minutes. Sometimes it says on the bag how many units and other times I would call them to clarify. How else do you run 5-10 FFPs with 6 other pts?!

Finished Advanced Patho couple of weeks ago...Woopee! Next thing you know and its time for Pharm!

2005 ACLS algorithm (took the course yesterday) - stable vtach - amiodarone 150mg over 10 min, repeat as needed to max 2.2g/24hrs. And prepare for synchronized cardioversion.

About 6-7 months after starting as a new grad on medsurg, I was assigned charge with full pt assignment. Its the kind of role you grow into as you're given that responsibility. If theres major issues you dont feel comfortable with dealing with on your own, then there's usually a more experienced nurse around to guide you, or theres always (at least in my hospital) a nurse manager somewhere in the house. Use your people skills, common sense. etc...

In grad school, the public library and Barnes & Noble have become my favorite hangouts. No phone calls, internet or other such distractions... Just straight studying for a few hours.

1.Type of nurse? MedSurg 2. How many hours u work per week? 40 3. How many years of nursing? First year 4. What Shift: Day shift 5. City and State: NY 6. Average 2 week gross pay Take home after deductions: approx $1800 after maximum tax deductions for being single with no dependants...

Yup, I agree that Narcan *was* the right choice to give an older lady with recent narcotic use. Depending on tolerance, body wt., etc. I think the dose you quoted here may be to the high side. On another note, I gave Narcan once, as a brand new grad still on orientation. Pt was a LOL who got morphine 5mg IVP 3 hours earlier, and now had RR of 4. New interns on the floor were mostly clueless (and so was I) and said push the full dose of Narcan = 2 mg. OUCH! I hadnt even finished pushing the dose when the pt woke up SCREAMING! Let's just say it worked, probably too well. I was too new and inexperienced to know to dilute the drug and push it very, very, slowly and only give as much as needed to wake her. About calling a code, my hosp would be entirely annoyed if you called a code on a/o with a pulse! ;-)