loricatus

Agreed. Just trying to show that patients should be given full information from a variety of perspectives so they can give informed consent to whatever they choose to do.

You have to keep in mind that cancer cells require more nutrients than normal cells & when nutrition is supplied the cancer cells feed first. Less nutrition can amount to slower growth of the cancer cells, in some cases. Cancer cells literally steal the food away from the body's normal cells.

Add Nursefinders to your list.

There is an AAS in Dallas-think it is in Irving to be precise. Avoid Favorite because they are known to say there is work and cancel right before the shift.

The criteria for hospice is that two physicians must cerify that if the condition runs its normal course they estimate a six month or less prognosis for the patient. In addition, there are disease specific guideline, called LCDs, that can be used to qualify the patients terminal status. Here is a link to get an idea of what I am talking about http://www.cms.gov/mcd/viewlcd.asp?lcd_id=13653&lcd_version=29&show=all

Don't think the CEN without the experience will help you get the job. Joining the ENA would probably do you better when looking for an ER job because it will demonstrate an genuine interest in that specialty. Try to go to chapter meetings and make your face known. It wouldn't hurt to show up to at the ED where some of those nurses work (the ones that you meet at the chapter meetings) and find the back door approach to landing a job in the ER.

This is more common than you might think. The only hope would be to talk to the Nurse Educator for the floor and ask the N.E. to talk to the manager. Have been in this position and started looking for a new job as soon as the mention of going it alone 4 weeks after graduation from school was made-my preceptor went on maternity leave on week 4 after orientation started. And, it was a Neuro ICU floor where I was expected to take 2 patients on my own. Had no problem finding a new job just telling the truth of what was going on. FYI: High employee turnover ratios don't look good for a manager at their review time-----hint, hint

With minimal regulatory control over the healthcare insurance industry, maintaining employer-based healthcare insurance (reducing personal options for chosing one's supplier of healthcare insurance coverage), eventually being financially penalized for opting not to feed the healthcare insurance industry & not providing a public option (buying in to the same coverage as congress has), I cannot see how the Obama Bill is going to produce positive outcomes (as it relates to improving healthcare for the American people).

Try calling level I or II trauma ERs and ask to speak to the Nurse Educator. That is the person who can fill you in on the training given. I would not recommend going to anything less than a level II is you want to get to see the good stuff. A level I would be ideal but having an ER medicine residency program would be even better because you get to interact with the residents who are in the training process, also.

You misunderstood what I meant about changing priorities. As you must know, ICU changing priorities are no where near the complexity found in a busy ER, where there can be more than six beds (filled by more than 6 patients in a shift). ICU is more focused and the prioritization found there do not involve a multitude of patients.

You will have to be able to have the ability to constantly change your priorities. Lists of things to do (per patient) are OK, but you may have to juggle about 6 of those lists at one time. With what you describe yourself to be, I would suggest critical care nursing. There you can give the patient more focus and not have to be juggling 4+ patients who all need something done at the same time.

Based on my experience in the PACU, I would say no because the other forms of general anesthesia are more easily reversed if the need arises. Propofol was generally reserved for the quicker procedures like EGDs & or spinal injections for pain patients.

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Having transplanted to the DFW area from a major NE city over 14 years ago, I think the ONLY thing that can make you love Texas more than Chicago would be the lower cost rent. Be sure to visit in August before you make your final decision-if you can survive the heat (and it ain't a dry heat), you might do OK. One word of advise is to not burn your bridges when you leave.

The only ones that ever know that I am a habitual gum chewer are the people that see me pop the gum in my mouth and the ones who make it a point to complain on how much they hate gum chewers. I once proved a point by showing how gross it was to put a half a box of tic tacs in my mouth-one piece of gum was nothing in comparison. Seriously though, I have chewed gum undetected in every place that forbids it since I was in grade school. Let's start complaining about all those people that can't keep their mouths closed when they chew food. Now, that is really gross!

There is a decent one in the Stonebriar Mall in Frisco-Preston/121. I have been told about a good one in the Grapevine Mills Mall, too.

Although I am not familiar with the new format, the CEN exam had minimal invasive motoring questions, if any. What I remember is more of an emphasis on trauma and stabilization. You can always go the http://www.ena.org (emergency nursing association website) and find out specifics on the test. You can also order study material from them & would be the best source for you, since they are the ones that oversee the CEN exams

It would depend on what you are looking for. Parkland is a county hospital with a world class rep. If you what to learn hard core nursing, then this is the place to go. Not a designer hospital and a lot of poor clientele. What you will learn in two years there, might take 5-10 elsewhere. Plus, you can write your ticket anywhere else if you have Parkland on your resume. Baylor is more of an upper crust type of environment. There is a saying around here about the Baylor Hospitals: "It's the Baylor Way or the Highway." My BIL works for them in recruiting, so I do know some insider things; but, as a nurse, you can thrive if you fit the mold. You will learn a lot if you are going to Big Baylor (Dallas); but, the other Baylors are more like a community hospital with all the politics that go along with small town thinking. I did clinicals at their (Big Baylor) NICU and enjoyed it. You will get congierge services and great dining options at Baylor, where the most gourmet thing you will find at Parkland is a Big Mac. Why don't you take a weekend and come to Dallas to just look around at both hospitals, then decide.

Ohhhh, do I know where you are coming from... Thought that travel nursing and agency would be different and it oonly got worse because I became the scapegoat for the very thing i thought I would be getting away from. Changed specialties to PACU and things were worse, if you can believe it! Now, I have been working hospice as a case manager and things are more tolerable because I lead a team, can set my own hours, deal with patient & families one-to-one and limit my time at the office where the same old, same old takes place. I never thought I would enjoy traveling by care patient to patient; but, it actually makes things more tolerable. And, most of the nurses cover each other's back, instead of stabbing each other's back. The ER assessment skillls are invaluable in hospice-both nurses and docs have shown respect (shocking word to use) because of things I brought into the job from the ER world.

Trust me. You will not regret your decision. I started as a hospice Case Manager a little over a month ago & don't regret it one iota, even though I probably work for one of the lower quality hospices. Once I get enough experience and pay my current hospice back (speaking in terms of labor and effort for them for the training they have provided me), I will move on to a place that does it right. What I think I am trying to say is that the worst hospice is far better than the best staff job because no one can dictate what you do for the patient and their families-you will understand what I am talking about once you get your own caseload. BTW, at one month into this, I already have a caseload of 6-8 patients and have had to train newer hires, without even really knowing what I am doing, myself. Be sure that you don't let them rush you because that is the only stress that I feel now. No more conflicts with other nurses because most of us watch each other's back and pick up another's slack. No more having management breathing down my neck, micromanaging because, all that matters now is that I submit the paperwork so the hospice can get paid their per diem. No more threats of getting fired because the hospice NEEDS nurses and is more afraid that I would leave to go to a better position. Bumping heads with other disciplines is over-I now lead an interdisciplinary team and collaborate with them to optimize patient care. But, most rewarding is that I can get to know a patient and their family to treat them in a holistic matter---although, I find myself sometimes being more of a psychologist than a nurse. And, I get to wear normal people clothes (using the scrubs for house clothes now). Enjoy, you won't regret it even if the hospice isn't one of the higher quality ones.

You said that you are one of many to resign. That says to me that it is an 'it's either you or me' attitude & you are one of many that become the scapegoat under this manager. It is a shame; but, there are many places like this. Hoping someday, somewhere, someone, will realize the problem lies with the management and not the worker in the pit.

So happy for you. Wishing you the best. You certainly deserve it.

Fot two places I worked that had them, they were a glorified holding unit where admitted patients could be discharged from. The ER nurses that that floated through there had to learn floor nursing to function there. Orders will be received from the floor docs, since the patient is no longer considered an ER patient. Ratios were a bit higher than in the ED. I hated having to work at them since it was all 'holding-type' of tele patients.

I agree with you.

The OP may not be able to cut it there, either. May not require wiping asses; but, to be successful there, you certainbly have to kiss them.