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WestCoastSunRN BSN

CVICU, MICU, Burn ICU
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WestCoastSunRN has 20 years experience as a BSN and specializes in CVICU, MICU, Burn ICU.

WestCoastSunRN's Latest Activity

  1. WestCoastSunRN

    Liability issues

    If you are not credentialed by an institution as a provider, I don't see how anyone can hold you liable for not writing/changing orders on a patient (which no one can do unless they are credentialed/privileged by the institution) -- and this is really the crux, IMO. Any good RN should question something that is not right - and this includes APRNs who may be working in an RN role (and who will probably have deeper insight into appropriateness of medical orders). So I suppose we can all be held accountable for what we should know - but that has always been the case for every level of licensure. Now, I have heard that some states forbid APRNS to work in an RN role. I do not know which states these are, but I have heard this, and this is different. In this case, an APRN will not be offered an RN job in the first place (except in the unlikely scenario the hiring organization does not know the law -- so know your state's laws).
  2. WestCoastSunRN

    Question about hospital privileges

    If you are really interested in this job, contact the medical staffing office to see what the process is for an NP to get privileges/credentialed. Then you can follow up with this potential employer about what the process is. It sounds like this particular hospital is not NP-friendly. So could present an uphill battle, but one that the hiring clinic will need to fight if they don't already have a credentialed candidate. I think it's fine to ask them if they already have a credentialed candidate.
  3. WestCoastSunRN

    What should I do?

    You have many years of clinical experience. Plus, unless you are going for acute care NP, I don't think you need to stay in acute care. You will benefit from your past clinical experience, for sure (don't let anyone tell you you won't -- even as an FNP -- sorry, tangent. It's a personal pet peeve). I don't see the convent job hurting you. Sounds like a dream! I'd take it.
  4. WestCoastSunRN

    Do you scrub the hub of a PICC between each medication?

    Yes scrub the hub. It's the right way to do things and there is a reason for it (takes less than 5 seconds for bacteria in air to get onto hub). That's why the oncoming nurse said something. You should also know your policy, but if your policy doesn't call for this practice, it should.
  5. WestCoastSunRN

    FNP in Hospital Setting

    You will be responsible for writing orders to wean patients off vents? Is there a residency that will be preparing you for this kind of work? With FNP cert in the new age of Consensus Model, you may be walking a dangerous line, here. Look carefully at your state board of nursing law for APRN scope. If something goes wrong you are going to have to defend that you had the training/education to manage care for critically ill patients. You have not worked in ICU, or even acute care before this, so you cannot even claim relevant RN experience. If you went to an FNP program, you did not receive this preparation. Thus my question about a residency (which still does not meet Consensus guidelines, but at least would give you some defense). Is it possible for other team members to cover the ICU and you round only on ward-status patients?
  6. WestCoastSunRN

    What happened to the post masters certificates?

    there are plenty out there. Keep looking -- with consensus model, I bet you will see more and more of these as APRNS will need them for their populations of interest.
  7. WestCoastSunRN

    Regret Becoming an NP

    See, I think I'd LOVE working heart failure, but I hear you -- the team you work with makes ALL the difference. Truthfully, it's one of the reasons I love my RN job -- the team is amazing. I agree one NP job is not like another. As a soon-to-be CNS, my schtick is not likely to be primary care. And while I know you can work your tail off in specialty, I know I don't want to be churning patients out to meet quotas. It's one of the reasons I chose, CNS -- I want options (but full-disclosure -- CNS can limit folks in the direct-care arena). What I'm seeing, though, is a variety of ways to use an advanced practice degree -- there are NPs doing education and professional development, management, admin leadership, and so on. If direct care isn't working for you there are other options.
  8. WestCoastSunRN

    Everyone is white?

    Yes, one of things I love about Florida, BUT.... the east and west coasts do have different demographics. I don't think what the OP is seeing is discrimination, but I do think it *could* be a bad sign. I totally understand wanting to see diversity in a system and it's leadership. I'd want the same thing.
  9. WestCoastSunRN

    Age range Adult-Gerontology NP

    My state's NPA also doesn't say. I am finishing up my ACCNS-AG academic prep. In practice I find the ages to be 13 or 14+, but I don't see hard and fast rules for this published anywhere - even in the certification materials. This is an important issue for me, as I may need to obtain additional cert for the younger peds.
  10. WestCoastSunRN

    NP still working as a bedside nurse on the side...

    I mostly respect your postings, but this ^ is beyond dismissive and condescending. How many times have I witnessed a physician, with much more education and training than you, flub an intubation or central line insertion (shoving tubes as a previous poster put it)? Fortunately it doesn't happen very often, but when it does I am there to help stabilize my patient, even though I am apparently not smart enough to do much more than what someone tells me to do with a wide-eyed, deer-in-the-headlights expression. Give me a break. I am an APRN student -- almost done with my program. As far as critical thinking goes, I agree, diagnosing and prescribing requires high-level critical thinking. And, although I have always sought to understand the pathophys, diagnostics, and rationale behind any treatment plan, I have a renewed respect for the responsibility of the providers to manage a patient's care. So to the OP, I agree -- you will have plenty to occupy your mind with in becoming a good PCP or urgent care provider. If that is what you want to do. Don't worry about losing skills unless you are not sure this is what you want to do.
  11. WestCoastSunRN

    New grad no preceptor.

    I am astounded. This is just wrong. Are you willing to share what state you are in? (just curious). You do need to speak to your manager and STAT. Forget about the complaining thing.... you need to speak up, and if you need to leave this situation then do so. I'm a veteran nurse, didn't have a great orientation, but I don't condone that now. This is the day of nurse residencies and things done right, with regards to orienting new nurses -- as it should be.
  12. WestCoastSunRN

    RNs giving patient lab results.

    I'm confused. Are nurses not supposed to understand lab results? And who does the patient education? Nurses do it. It is our job to do it. I don't deliver devastating news (if at all possible) without a plan and support to do so. Most times that includes the provider doing the delivering and me doing the damage control. The providers I work with would sigh and roll their eyes if we acted like pansies about stuff like labs and the plan of care, etc. We are a team and operate as such. The "gatekeeper" business is disrespectful to both nursing AND patients.
  13. WestCoastSunRN

    Any nurses that love nursing and love their job??

    Love it. Life is hard, I don't expect work-life to be any form of escape from hardship -- especially when my chosen career is specifically taking care of those dealing with great hardship. Here's something I think is key -- you need to be the sort of person who knows how to be satisfied in your life -- both personally and professionally. Much of this has to do with expectations and perspective (and boundaries!). Honestly, if I didn't have my faith, family and friends (and boundaries!), I would probably be pretty traumatized by the work I do. People ask me, sometimes, why I do this work -- it's because I can, I am equipped, I like having a physical job that requires I use my brain. I like life-long learning. I like being a part of someone getting better, or someone dying well. I like doing things that few people in the world do. I like being a part of a team. Not everyone should do this job, but if you are cut out for it, it's a great career! Oh -- and part of my boundaries involve being choosy about who I will work for. Granted, sometimes that is a luxury that is earned over time -- with experience and developing a valuable skill set, but that investment in your practice is worth it on all accounts.
  14. WestCoastSunRN

    Advice From Season Nurses

    Well. This post got me fired up. I'm ready to show up to your unit and open up a can of whoop-@$$ -- what you are describing is despicable and I do not know how such a Lord of the Flies culture has been allowed to ferment in your institution. That said,...... Everyone has given you great advice. Make record/report this stuff. You MUST talk to your management. As for the mean girls,... Look people in the eye and force them to deal with you directly, right there, on the spot -- call them on their behavior on the spot, not a second later. Your attitude should be one that it is clear you expect the utmost professionalism and teamwork from them. When a patient goes south, you make it clear you expect them to do their jobs, as you do yours. This is going to sound strange and stupid, but learn how to strut. I don't mean really 'strut', but pay attention to your posture. Back straight, shoulders relaxed, head high, and don't forget the eye contact. None of this should be necessary, but until you figure out how to go forward in this situation -- whether that means changing units or staying, or whatever, you need to put an end to this nonsense. Like I tell my kids, "never, ever start a fight, but you'd better be ready to finish one".
  15. WestCoastSunRN

    Exhausted; I want a way out.

    These ^ are such wise words. To the OP, my heart goes out to you. You are experiencing a great disappointment. This is hard to put in words, but being a parent is fulfilling, but in a very unexpected way. Your thoughts right now are very focused on how you are not fulfilled. As it turns out, parenting ends up not at all being a way to fulfill the parent. I quickly realized it is not about me and my happiness at all. I would not trade my children for the world, I am just saying they are not what you will find fulfillment in. In fact, it is not fair to put that responsibility on any other human being. I have someone very close to me who has experienced MUCH of what you have and are. She made all the right decisions in life, but they did not end up being conducive to starting a family, even though she wanted it with all her heart. That ship has sailed now, but over the years I have watched her blossom into one of the most giving, self-less people I know who has impacted far more young lives through her work and lifestyle than she could have as a mom to one or three kiddos. Things didn't turn out according to her grand scheme, but she has a loving partner and a full life and they do good things together. I am pretty sure she would now say she would not trade that ... even for the chance to have had her own kids. I second or third the suggestion that you get some counseling, as you sound defeated and stuck -- no shame in that -- we all need help sometimes.
  16. WestCoastSunRN

    Leaving the OR/management for a major icu

    I echo everything @JKL33 said. You are an experienced nurse coming from a very different specialty and discipline. No ICU nurse in his/her right mind is going to have high expectations for you from a clinical perspective. Congratulations on your new job!
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