guest957671

Truthfully, I'm still waiting for a counter argument that doesn't imply that i'm anti-nurse, or not experienced enough to understand, or in some way am demeaning and personal because I'm making points that aren't exactly popular among nurses, or pointing out arguments that are just factually incorrect. You said to be more open minded. I'll challenge you to do the same.

No, but in the United States it is, and any meaningful change towards something better in the near future is highly unlikely. Also, let's not pretend that other countries deliver healthcare without being cost conscious. Any time there are finite resources such as beds, staff, equipment, etc, there's a degree of awareness that we need to have in our utilization of those finite resources.

Yes. Run along now.

I like how quickly this turned into being for or against nursing. Such a typical reaction. So isn't touting 19 years of experience as a justification for not being able to back up a claim. That aside. I'll say again that the reason nursing gets stomped on when it comes to budgeting is because few nurses actually want to learn about how the budgeting works. When I say that getting involved with cost savings and having strong nursing leadership can help bring money for continuing education and reinvestment back into nursing like staffing, equipment, etc, I'm saying it because I've seen it work in my, granted, humble **ten** years of experience in multiple settings ranging from large academic tertiary centers to small community hospitals. Oh, and my work on my PhD in **Nursing** and **health policy** where I actually studied nursing budgetary patterns and staffing trends. Fun fact: There's a difference between 19 years of progressive evolution in a profession and just doing the same thing for 19 years while the world around you changes. My argument remains that there should be nurses at the bedside and in the business office, and that nursing should be the ones dictating budgetary constraints and needs, not some finance guy with an MBA and a finance degree. But in the absence of nursing doing its part as the largest healthcare group, guess who takes on that role? The finance guys and MBA types fill that role. Nursing remains its own worst enemy on this one, as it tends to do.

I think a 24-48 ICU stay is called for, and agree with the posting above saying that the dopamine is kind of just a bandaid. He'll definitely need more of a work up, and more intense monitoring in the meantime in case the dopamine needs to be titrated or a pacing wire needs to be floated emergently. The only other thing that I can think of is that it was his first HD treatment, maybe he was experiencing dialysis hypotension that can elicit a vagal reflex causing bradycardia and hypotension. Either way, an ICU stay is probably still called for if that's his response to a preliminary HD treatment.

citation to support this claim, please. hospitals that are non-profit status can use their profits for capital improvements to get tax breaks. Claiming that "a large part of the health care budgeting crisis" can be attributed to this is spurious at best. Here are a few examples of mechanisms for hospitals to obtain grant monies or tax exemptions for capital improvements Federal Resources for Capital Financing

Get the vaccine. Every employer that I have had has not only required documentation of having been vaccinated, but did blood work to make sure that I had the antibodies and was immune. Plus, with everything you'll be exposed to as a nurse, you'll want all the help you can get.

So, the question is really of overdose vs adverse drug effect then. Two different concepts. An overdose implies a toxic state affecting actual organ function. Most drugs have a LD50 scoring (median lethal dose) and many researchers have tried to find this number for marijuana, but they just couldn't give animals enough THC to kill them. Though at those doses, I'd imagine it would be quite.....unpleasant. So let's put aside the idea of overdosing on marijuana and focus on adverse drug effects. Someone can get a bad high, or just be sensitive to the drug, or just smoke some really potent product and have a strong reaction, or they got product laced with a different chemical like cocaine, meth or god knows what. Adverse drug effects are the inherent risk in anything from an energy drink to an aspirin to giving TPA for a stroke in an ER or ICU. Beyond marijuana being illegal, I hardly consider it to be any riskier than most other drugs. I would dare argue as to its safety comparatively. I don't think I understand your comparison of alcohol and marijuana as comparing dilaudid and tylenol, however. They're different drugs, but do serve as an interesting example of how one legal drug could potentially be more damaging than one that was made illegal under less than forthright political interests and spurious claims by "experts" at the time. Also, the estimated LD50for alcohol in a 75kg human at one time is roughly 14 shots (40% ABV), give or take.

Some of the studies being cited here actually makes me nervous about the amount of misinformation nurses could be giving their patients. I'm all for caution, but a few cross sectional studies, even if well designed, don't justify the definitive causal links that are being suggested in the above posts. Marijuana may be associated with mental health issues, but associations aren't causation as anyone who has taken a research class at any point will have heard, hopefully. Reason being is that the mental health issues could be underlying issues not caused by the marijuana itself. Using could be self medicating, or maladaptive coping like with other illicit drug use. So blaming marijuana use is kind of a stretch. But back to my original point of vetting your articles and at least learning what makes for a good study before posting something claiming it as evidence. This may be a whole other debate, and sound incredibly elitist, but this is why a BsN should be entry to practice because you at least get some exposure to research methods and what makes for a good study vs a poorly designed one. Otherwise, who knows what other misinformation nurses are giving their patients on a variety of things based off some "study" that they read.

Thanks for your input! Some of my friends there in public health circles have suggested I try working with NSW Health, so it's nice to hear that it's an option.

I'm hoping some of our Aussie nurses can help me out on this one. I am finishing up my PhD in Nursing later this year, and I will be moving to Sydney mid 2017 to live with my partner. I've been a nurse for ten years in critical care and trauma, with some management experience as well. I'm in the process of figuring out applying for registration, but had some more general questions about nursing in Australia, and more specifically, Sydney. Does anyone have any insight into things like what to expect from the job hunt once I have licensure there? I will be applying for permanent residency at the same time, so I will be eligible for most employment I think except for government jobs reserved for citizens. Having a PhD will open up some doors for faculty or administration roles, but I feel as though I should work at the bedside for awhile at first to get a feel for nursing in Australia. Having been back and forth between the States and Australia a fair amount over the last few years, I've met a few nurses in Sydney who all love what they do, and my overall perception seems to be that nursing there is very similar with some key differences. So, any insights or words of wisdom would be greatly appreciated.

I'm hoping some of our Aussie nurses can help me out on this one. I am finishing up my PhD in Nursing later this year, and I will be moving to Sydney mid 2017 to live with my partner. I've been a nurse for ten years in critical care and trauma, with some management experience as well. Does anyone have any insight into things to expect from the process of applying for endorsement? Or what to expect from the job hunt once I have licensure there? I will be applying for permanent residency at the same time, so I will be eligible for most employment I think except for government jobs reserved for citizens. Having a PhD will open up some doors for faculty or administration roles, but I feel as though I should work at the bedside for awhile at first to get a feel for nursing in Australia. Having been back and forth between the States and Australia a fair amount over the last few years, I've met a few nurses in Sydney who all love what they do, and my overall perception seems to be that nursing there is very similar with some key differences. So, any insights or words of wisdom would be greatly appreciated.

With your varied and extensive experience, have you thought about clinical consulting or even global health? I'm in a similar boat, though in critical care where the stressful part isn't necessarily the job, but the politics and personalities of dealing with coworkers and administration. I'm looking at biotech companies and clinical education which definitely comes with its own issues, but at least they'll be different issues. If you're really wanting to shake things up maybe working for a global health organization that provides mental health services in underserved countries might be something new while still utilizing your skill set. There's also flexibility with some groups of doing 6 month to a year contracts. Definitely take time to regroup and consider what you would like to do because you might be surprised at what doors are open to nurses with your experience. It's not all clinics and hospitals for nurses anymore. There are opportunities in global health, biotech, government agencies, teaching, and basically anything related to health so it's just a matter of taking stock of your skills and what yore looking for in role and then going for it.

For day to day stuff, I really liked critical care made incredibly easy. It helped a lot with understanding the basics and is a really easy read for learning waveforms and blood gas interpretation and whatnot. For the more nitty gritty stuff, I still refer to The ICU Book by Marino. It's a thick, kind of intimidating book that goes into a lot more detail on just about everything. When i had a really specific question about, say vent mechanics, that's the book that I would go for. Hope that helps!

I was taught that it depends on the situation and that it's your highest degree earned. So BSN MSN DNP is rather redundant and looks a bit silly. DNP would suffice. I only use my CCRN-CMC-CSC when writing from the perspective of my critical care role. PhDc only comes out in my academic role when I'm writing a grant or submitting abstracts. The only place where my full credentials are listed at any one time is my resume/CV. It is still striking to me how much nurses like to put each other down though whether its for having certifications or for not having certifications. I'm in the minority that thinks that we should take after some other countries and require specialty board certification to practice. For example, requiring every ICU nurse to sit for the CCRN within a certain time frame of beginning their career in critical care. It sets a national benchmark for knowledge and practice within a specialty much like board certification for physicians. Again it boils down to the fact that if we want to be seen and treated as professionals, we should probably seek to uphold the highest professional standards.