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Advanced Nurse Practitioner in Intensive care UK looking to move to Canada
Hi, I'm currently in the NP program at UBC and have previously worked in Ontario as well. Aside from U of Toronto, there are no acute care NP programs and thus, most of the positions in Canada at the moment are in primary care. In BC at least, the direction is heading towards positions like ICU NPs. However, I don't think there would be a position as advance as the one you describe where you're intubating and inserting art lines. Particularly in BC, you will be required to do the OSCE (something not required by any other province) so choose wisely! Ontario's NPs enjoy the most scope of practice and are the role of the NP is most well known to the public there. BC is up and coming and I think the rest of the provinces are about the same as BC. So Ontario would be your best bet in my opinion if you're looking into an ICU NP role. Best of luck!
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ER RN NYC /Pt:RN Ratio
A newly vented patient shouldn't be 1:1? I'd disagree. If a person just got on a ventilator, they typically have much more going on than just airway issues so I would still argue that for a nurse to be safely able to care for a newly and acutely vented patient, they should be 1:1. Perhaps 1:2 if it's been a few hours and the patient is starting to stabilize.
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ER RN NYC /Pt:RN Ratio
Hey I'm an ER nurse in an inner city Detroit hospital and it is quite similar to what you have described. Management has instilled a "soft cap" which basically means when it gets busy, there is no cap. You have patients sitting in the chairs/waiting area because we don't have enough rooms to safely examine and care for people - even chest painers who should be on the monitor immediately. Our ED techs are always sitting with behavioural health patients and not used to their full potential. I am constantly doing task after task. It is truly unsafe and I fear for my license every shift. Even our traumas and vented patients do not get 1:1 or 1:2 care. With a vented patient I have had 3 other patients I had to tend to as well. Needless to say, I wasn't able to provide quality nursing care to the other 3 patients. It is quite mind boggling to think that these hospitals/healthcare corporations don't think long term because these are situations that are law suits in cue with potentially a lot of dollars on the line. I have some colleagues who have moved on to other surrounding Detroit EDs where ratios are 1:3 and 1:4 I am definitely trying to get my experience in the inner city Detroit ED and get out. Never working for a for profit hospital again!