mrphil79

Union or not... if you give 5 months notice, they need to figure it out. How can they not figure it out with 5 months, but they can cover your entire job if you give 2 weeks notice when you quit? THIS crap is why I won't go back to staff - I'm a grown a$$ man and I won't be told I can't take a vacation that I planned out responsibly.

I'm offering an actual fact in response to the original question about why anesthesiologists can prescribe most meds, whereas CRNAs can't... But for some reason you seem to be hearing my words as "CRNAs are undereducated cavemen" and want to be defensive about it. I'm fully aware that people in a specialty are familiar with their common drugs, and I never disparaged CRNAs in any way whatsoever in my response. Not sure why you want my words to be a pi$$ing contest, when I'm really doing nothing but stating straight up facts. Kind of an odd response, really...

Yeah... perhaps my point is being a bit twisted here... I'm not arguing that anesthesiologists should be regularly prescribing all kinds of medicines or that they in fact do - I'm just stating why they have the ability to do so compared to a CRNA, which was the exact question I was responding to. At the end of the day, the anesthesiologist (just like a psychiatrist or radiologist) has the education and training to prescribe basic meds like that if they so choose - the CRNA, unless they're also a NP, doesn't generally get that same training.

Well to be fair, the anesthesiologist went through the entirety of medical school and years of residency that include multiple specialties -- the CRNA has been trained specifically to focus on anesthesia and anesthesia related health issues/procedures (pain management, blood patches, etc...). The CRNA's scope of training doesn't generally include the use of augmentin or terbinafine outside of the basic pharmacology class that all APRNs have to take. The anesthesiologist, however, did have to learn all of that to make it through residency before starting to specialize in anesthesiology.

Seriously... nursing students need to be taught the realities of the profession... Specifically that patients aren't always rainbows and sunshine and so happy that you're helping them... Sometimes they literally bite, kick, punch, spit, scream, etc... Nursing school instructors tend to "Florence Nightingale" up their ideas of what it's going to be like. Then when we get new nurses, they are paralyzed the first time someone yells at them - they literally think they have to take it and back away pleasantly with a smile and an apology because Mrs Collins in nursing 2 said so... That just ain't real life. They need to know that this is common - not to scare them, but because they need to know how to handle it. You can absolutely tell a patient you won't be talked to that way. You should absolutely set limits with these patients. You can absolutely protect and defend yourself. You can absolutely press charges. You can absolutely file an incident report. You can absolutely refuse to clean a 97 year old dementia patient who bites and hits until you get a second or third set of hands. And you can ABSOLUTELY refuse to continue employment at a facility that refuses to take these problems seriously.

If you only had 47, who had the rest? Things like this are exactly why I can't at all understand why people are OK working in these facilities - you had 133 patients and didn't even know. The fact that this could even happen in the first place is insane - why does anyone work in a place where this even has a chance of happening?

NOT coffee - for the love of god NOT COFFEE. Because then you end up with a room that smells like C Diff flavored coffee, it doesn't cover the smell, only adds another layer You should throw 2-5 drops of peppermint or lavender oil into a nebulizer with like 5ml from a flush - run it at like 1LPM. It works quite well

But you have no real justification for saying this other than someone told you this a long time ago. You can't justify being SUPER specific about every microscopic thing we are expected to chart (gave a warm blanket, flushed IV, clipped right thumbnail, 16 BMs with peri care each time, Tylenol at 16:13 due to pain level of 3 with complete relief of pain within 35 minutes, etc…) and then suddenly say "oh except names, those must be top secret only available by subpoena.” It makes no sense.

This is a great answer.

There's a ton of state schools that don't charge out of state tuition for their NP programs no matter what state you're from — many of them range in cost from $15,000 to $25,000. total, For the whole shebang. when you Google NP programs, your top Google hits are gonna be the schools that charge 40,000, 55,000, or even 65,000 or more for their programs. Dig deeper. If you really want to be an NP, it's worth spending some considerable time finding the best school for you, not just looking at the top 7 that come up on a Google search. The public (far more affordable) schools aren't gonna advertise and pay for those Google spots...

First thing - and sounds like you're already addressing it - is to get off that floor. Those people sound terrible. The people you work with DO make some of the biggest differences in your day. I've never understood why nurses stay on a shift/unit or in a specialty/hospital that they literally cry about on the way to work. There is no award at the end for staying in a miserable job. Move floors. Change specialties. Change hospitals. Go to school again to learn informatics. Become a midwife. Teach. There's LITERALLY more than a thousand things to do that aren't on that ortho floor you hate - both bedside and away from bedside. So, look forward to this move - don't go in to the ICU with these thoughts and feelings, rather go in fresh and ready for a new challenge that you might love and learn as much as possible in your experience.

Especially in a code, narcan has no downside. Only a possible upside. Bicarb actually is really important because you need to help the body keep at least a normal-ish pH because it goes acidic during the code from, among other things, buildup of co2. Generally I'll give it every 3rd or so epi - unless I know low ph is the problem then they're getting more. Calcium can help with possible hyperkalemia, hypocalcemia, hypermagnesemia, or OD from calcium channel blockers. While there are not specifically in the algorithm, remember that the algorithm includes finding and fixing the H's and T's - and that's what these meds attempt.

If you're considering a MSN or NP - use the down time at work to study and do school work.

I'm currently traveling to a very small rural hospital. we all get report in huddle on all of the patients, because at any point during the day you may be helping someone to the bathroom, passing meds, or doing any one of 6000 other things that require you to know about the patient. In big hospitals you get report on your patients only usually, so if you're trying to help with vitals or give meds or do a discharge for a busy nurse or get someone to the bathroom or tell the rounding specialist some obscure lab value, you're gonna need to get in the chart. HIPAA allows you to view a chart if you have any work related reason to need the information. So when 107's nephew comes out and says she has to pee - I need to know if and how she ambulates, if I need a urine sample, if they're on chemo meds that require precautions when I flush the toilet, if they need orthostatic vitals that I can knock out while I'm there, etc... Now if they need help with the TV or closing the blinds, I've got no way to justify opening that chart.

It's been my consistent experience that the people who refuse the vaccine due to stated fears of it being new and untested and unknown side effects are the same people who aggressively seek out anti-viral drugs for Covid the second they get sick. For some reason those fears vanish when it's for treatment with drugs that are far newer, can be pretty darn hard on your body (liver especially), and at one point seemed to be changing every 2-3 months during the height of Covid. So, ask yourself if you'd take paxlovid if you got sick, and if you say yes to that then your fears to justify not getting the shot are probably not valid.