NYRN05

hey, first relax! secondly, what "JJHC2006" says is true or was true for many ADN programs. When you are enrolled in a ADN program sometimes after you have taken fundamentals, med-surg, psych-they will let you sit for the NCLEX-PN or apply to get a limited permit as a GPN. You are on the pathway to obtaining your RN but I assume at one point in time it helped those going through school get experience and work as GPN or LPN's. When I first was going to school in NY state 2003-2005, thats what I did, I was a CNA prior to getting into nursing school and after I completed fundamentals/med-surg/psych, I applied only for the limited permit and in my nursing home the DON allowed me to work under her license as a GPN and I had orientation and never took the NCLEX-PN because I was graduating the following year. So if you think about it LPN/RN training is not much different clinically except for some things, so maybe your friend has it a bit confused, and heard she was doing clinicals that could count toward LPN license, because it CAN! or did at some point in time. Although in the last couple of years I know in NY state has done away with this because they state you are in a RN program and working as a LPN would somehow alter your sense of your scope of practice. But I think most people would know they are not RN's yet...who knows. Also when you would apply for the GPN or LPN, you would be missing OB/peds....which the LPN program students have taken and been tested on to sit for the NCLEX-PN. So maybe this is helpful to you or not. just thought I would chime in. As others have advised just call the school directly or go to an open house session and ask your questions. Best of Luck!

hi, so i currently have 5 yrs-nights exp under my belt. med/surg, cardiac stepdown, ccu. relocated and now in new hospital, now 5 months in open heart unit. honestly i don't love open heart, prefer my medical cardiac patients any day, but wanted to see the surgical side and management. there is a cath lab job opening-same hospital. thinking of applying. any info or advice from cath lab nurses? now that the opportunity is here i would like to see if it could happen. how is taking call? it is a days/eve position which will be so much better for me than day/nights rotating that i'm doing now. the only factor is that is about 40 min to get to work and i'm not sure if that will be against me, b/c i know they would want you to the lab w/in 30 min. thanks to all who reply !

yep it is. i believe sotalol is one if you've ever given that...its non FDA approved. given for arrythmia prevention-afib patients. don't know where it would be documented but its been done. thats the only 1 i can think of at the moment.

just being acls recertified...survey says...its always epi 1st...then spent some time with my educator last week going through the acls pretest...rhythms....always epi 1st...i once too thought atropine (in that particular situation) but it is epi all the way first and then you can give other meds. i'm sure that you could give the atropine but if the epi didn't work i doubt the atropine would...remember atropine is a weight based drug, and although we commonly give it...we are max'd at 3 doses for a reason. epi has no max...you can give as much as you want...well until they call it. as a acls certifed nurse, i think you would be held accountable if you did deviate away from the algorithm, if it was ever questioned or investigated. hope it helps...and correct me if i am mistaken. side note: remember epinephrine is a vasoconstrictor and positive inotrope. increasing BP/HR atropine-muscarinic antagonist...affects HR, little effect on BP.

well i worked for 2 yrs and went back and completed my bsn-online...now in bridge bsn-msn online. what about working per diem/ part time. is your school onsite or distance learning-online? if its online its totally doable while working. personally i just wanted the break from school, and wanted to apply theory to practice, and not worrry about much while working the first 2 years. i think that after passing the boards and waiting 2 yrs, and not working, that most employers will wonder why you didn't do some type of work. i'm sure its been done before. but with the job market like it is, i think it would be better to have your foot in the door someway. well i hope that it works out for you either way. just my thoughts :rckn:

i agree with the first poster...stay where you are...then take a long vaca-well enough for training...try to orient to an ICU job if it works out that way. so you can moonlight on the side, and gain the experience you want. if you are happy than stay where you are for now, and hope it all works out !

thanks for replying....no prob about the post. awesome for him !

i disagree with you on so many levels....but answer me this...if you don't like nursing so much. then why are you here posting about it? are you a nurse? then i ask again why? go be a "professional" somwhere else...just my opnion ! maybe whatever job you have encourages this mindset....and if you accept it...then you own it. you will make your professional career what you want it to be. you want to be the burned out bitter soul that puts down their own profession (yes thats what i call it)....then do. if you think cna's can learn nursing in a few years then i think by now we all would have been out of a job-heck i would have never went to nursing school then-i could've stayed a nurses aide according to you and would have known it all-your rationales make no sense. if you are so much better than you know where the door is...like my gma said...and on your way out...don't let the door hit you where the good lord split you ! and that's my true colors for you.....i know people like you who just want to get people all in a tizzy....its how you get your kicks. but i still love what i do each and every single day...its my profession...its my job....its what i was chosen to do. maybe you weren't...and you chose it instead. there are a lot of people like you who should have never became a nurse. it is for people like you....who just want to keep the profession from advancing with your negativity.....well i guess you could always flip burgers then right!

respond to facility A, and tell them yes. and then if facility B offers, then politely send a email or letter to the manager explaining, and phone call-recruiter to let facility A know that another opportunity has presented itself...blah blah blah...you get the picture. thats what i would do. best of luck !

well i don't know where you work, but i definately don't write out nursing diagnoses from the textbook, and i don't go to a physcian with one either. as for what you said about seizures. yes of course you want the RN to take action and get the seizure precautions established but then tell me where will you write that you did. where will you document your action, and plan of care for the patient=care plans=diagnoses-risk for injury secondary to seizures. are you going to write nursing notes every single time for every single issue with your patient. if in a court of law how will you document that you were aware the patient was at risk injury from seizures and that action was taken to prevent injury from occuring. i understand what you are trying to say, but you have to understand that this has been studied long before our time. i know there was a time when this was not being taught. is it wrong...is it right. well its here now. i guess it can change and probably will in the future. but what i do know is that yes i use them to a certain degree, until practice changes. thats all i will say about it. thanks for the post, always interesting in reading what other nurses are saying best of luck to you !

as julie stated, they help the student, learn why we are doing what we are doing. not just carrying out tasks. yes the wording may be fluffy and beating around the bush. but like you said we are not physicians, therefore we can not use medical diagnoses. if you look up your scope of practice by state, and nurse practice acts, you would then know we cannot use the same language. the AMA will never allow it. if you are so concerned with the way nursing education is being taught and nursing diagnoses. then make education your passion, and do something about it. don't get me wrong, i didn't love writing care plans or pulling out my nursing diagnoses book. i think they are valuable, to the student and towards learning. i may not write exact care plans they way i did in school, but i do write patient goals for the plan of care focused to my specialty and patient diagnoses, so did writing those care plans help me...you darn skippy they did ! oh and as a registered professional nurse....i definately know that i am not insecure, and i don't think having to learn nsg care plans or write that funny language for a few semesters in nursing school, makes me any less of a professional than they are. everyone is entitled to their opinion...so i guess things will carry on as they do by the people who implement the change into practice and theory.

not sure about the child abuse-haven't taken it again since i graduated....but infection control is mandatory every couple of years-i just updated that. other than that no ceu's are required here in ny. just pay up to the office of professions. correct me if i am wrong.

i agree....its a bunch of crap !

i second that nurse mike....seriously ! going on vaca...had to change planes...boyfriend woke me up 3 times....there was a radiologist, a emt, and myself. 1st flight diabetic didn't eat....and falling over out of seat. other diabetic passenger had glucometer and all it read was LO, thank god he was able to swallow whatever we could give this guy. he came around. and then another hour passes and some guy passes out next to the bathroom, syncope. 2nd flight.....lady walking to the bathroom and then has chest pains and dizzy and lays next to bathroom. said she was supposed to follow-up with her cardiologist. what the heck...all i wanted was to relax and sleep on the plane and not get involved in the drama, at 30,000 feet or higher. and honestly there was limited resources except a small emergency bag they flight attendants had. what could we have honestly done if any of them coded....nothing. well of course CPR and emergent landing when possible. i wouldn't have gotten up on my own-sleeping with my ipod, except my loud mouth boyfriend saying, "shes a nurse" "baby go help" "hey whats going on, my girlfriend is a nurse" "hey i think someone needs your help". i know there a good sam laws but i rather not get involved unless i absolutely have too gggeeezzzz and then i would've looked like a horrible person if i didn't. not a good way to start out vaca.

it is an incident. so you should have written it up, because the resident did touch the floor. it can get very technical for these things. and although a pain....its just better to do it than to not. i don't think you didn't write it up purposefully, because you felt as if you were there and you were able to prevent it from actually being a unwitnessed fall. and you never know who will say what, so just cover your a** always...its your license girl. the resident sustained no injury as far as we know, so just learn and grow. just explain the situation to the sup, and then maybe they could offer an inservice of what counts as falls, incidence/occurences, so that its clear.

i think that it's totally absurd. i still work per diem as a supervisor from time to time in a facility where i worked as an aide. anyways...the night shift should collect the laundry...yes. but how can they adequately care for the residents and maintain safety of the unit when they are washing laundry. i'm guessing no union. i know that during the day where i work the aides do take turns rotating through the day room with recreation to help out for 30 min at a time but they don't just stay there. i find both of the situations to be a safety issue, and a issue with the level of care. if they are hired to provide direct care, then thats what they should be doing. laying in a wet diaper or having a patient sustain an injury b/c they were doing laundry or an activity is just setting themselves up for the dept of health to have a field day. well just hope it doesnt continue for much longer. hang in there !

an idea to the OP get certifed and take the PCCN, and you could put the title after the like so.... RN, PCCN....it may help. it shows that you are comitted to excellence in progressive care-a lot of the content is cardiac. or become board certified as a cardiac vascular nurse. which would give you the title RN-BC. i would do either or, but not both. its not cheap. well best of luck !

where i work...its about twice for policy...i will try a third time only if i am 99.9% sure, but i am a pretty good, and i usually go on the back of the forearm....there is always a nice fatty waiting hehehehheeeee. if all else fails then i call someone else.

well i didn't keep my patient cooled for 72 hours...i think the whole process is 72 hours cooling...rewarming....maybe it's done differently? anyways he was cooled for 24 hours and then passively warmed. but it was pretty cool...pardon the pun lol....interesting stuff. that's why i love cardiology

Well I honestly have been in your shoes...worked on a cardiac step-down before going to the cardiac ICU. It was on the step-down that the patient was ordered for coreg and lopressor. Kudos! to you for questioning it...who cares if they have kittens, let them have 2 litters! More than likely it was some little resident who was in the ICU ( I assume-if it was the attending then shame on them) and not the attending, who didn't really understand that the Attending Cardiologist wanted the patient to get 2 B Blockers. When I questioned it, they had the exact rationale for it....although I cannot remember now lol. But as a Registered Professional Nurse, these interns and residents still don't know it all, and neither will you, so you learn together and from eachother. To try to make you fell inadequate is totally uncalled for. I don't think it is entirely up to the doctor to manage those meds, because they make mistakes as well, and sometimes pharmacy does too, so who is the last person the medication goes through before the patient gets it, THE RN ! So to say we are not responsible is crazy, just because something was ordered by an MD, and delivered or entered into the system by the pharmacist, DOES NOT MEAN YOU DON'T QUESTION IT. Even more so in the ICU, you have 1-2 patients for a reason, so knowing each and every little detail is necessary. It is within our scope of practice to educate and advocate for the patient, which first includes educating ourselves and standing up for our own thoughts and concerns before just following through with an order by an MD. I don't know where you work susuana but I have yet to see a MD do ANY patient care, they round, discuss the plan of care, course, medications, treatments, tests, but never have I seen them perform patient care-except for doing procedures at the bedside, but where you work may be a totally different place. It is their responsibility as the MD to justify the course of treatment to all disciplines, we have a professional job and taking a backseat or subserviant role to the MD is what will keep nursing behind in my opinion, keep on questioning to the OP. If the attending explains it clearly to a resident, or charge RN, or the nurse who is providing the care to the patient, that information can be passed along, so you won't have to keep "bothering them" so to speak. I work in a university teaching hospital-for a reason, and I question them all the time-remember they are learning. They are there for a reason as well. In the end, in court, it's my license, not some resident who is no longer there. Thats my 2:twocents:

hey all well i have narrowed it down to 2 units in one hospital. the ccu and the csicu. i got to interview with both nurse managers and spent time on both units 1-2 hours each unit with a staff nurse. overall i think the interview went well. i of course was home in the ccu, since that is where i work now. it would be an easier transition for me since i will be new to the area. the csicu really took me by surprise how intense it was on another level, and i enjoyed it. there is alot to be learned there. the only down part of the csicu is that they have 6 nurses leaving to go to anesthesia school in the fall, when i will be starting. but they are actively hiring to fill the positions, which is good. also they csicu is offered an additional 20% on top of the base pay, i'm guessing to aid in recruition and retentment of the nurses. anyways, i'm not sure what to do. the recruiter will be contacting me shortly i hope, and i don't know what the decisions will be, but if it is for both, what should i do. i guess i can only make up my mind and what feels right, but i would appreciate the input from others. thanks !

well yes i did take a general college chem, but not what is required by the schools that i have looked into. so in regards to that i would need more chem or bio. yes i got into a program and i do plan to continue it and finish. yes i know that there is a post-masters if i choose to continue on. thanks! i see this has caused quite a stir amongst the people.

gerry, i am not sure if i will really do nurse anesthesia....it's just a thought. i would like to but it may or may not happen depending on what i make priority in my life when i complete NP school. i could continue on or i could try to start a family and wait several, several years until i decide to go back. anyways, maybe i worded the post wrong, but i am just thinking about it in the distant future, and was wondering if anyone was or has been in a similar situation. i will most def work as a NP, i wouldn't put the time and money and all my efforts and sometimes frustration into something that i wouldn't use, now that would be the high road traveled and a big waste of time. thanks for your support !

well to answer your question 1st don't get snobby with me because I love learning and I love education, those seeds were planted a long time ago since my mom was a teacher-who's now resting in heaven :redbeathe 2nd who says that I didn't want to be an NP, obviously I wouldn't be as you said "taking up a seat" in the program if it wasn't something I could see myself doing. You don't know me and don't know my future, I have to have many roads to go down and can have as many choices as I want. As a nurse and as a woman, I can wear as many hats as I choose ! So I wasn't asking for people who were NOT supportive to reply for whatever personal reasons they have, I was asking for NP's first and foremost who saw it as an advantage or disadvantage for them IF ...any of them have gone back to school for CRNA. Not saying that I will and not saying that I won't but my options are limitless and your life and career are what you make of it. So don't try to put me down. I love advanced practice nursing. I continue to learn everyday at work and in school and that will only shape me and mold me into a better person and nurse. That's the best thing about nursing. If you try something and it's not for you you can continue on to do something else in another specialty....so many roles in one profession. I strongly advocate for nursing and nurses ! I don't put them down for asking questions and having goals and dreams and their accomplishments....just my thoughts about your post...thanks anyways...

hi i recently applied to ummc, so far haven't heard a response. if you don't mind me asking when did you apply? are you a new grad or experienced nurse ? what unit will you be working on? it's been pretty difficult contacting them, and you can't just walk-in to HR, i tried lol....appointments only ! well i'm hoping i get a call-back soon, i would really like to work there. if you would rather pm me thats fine. thanks