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CONGRATULATIONS!!! gOOD Luck in your new role! Jen:balloons:

Mave A JP is a drainage tube that is generally placed in a patient's wound during surgery to help facilitate any drainage from collecting. Good luck with nursing. It will be the biggest adventure in your life. My advice to you from having been an ED nurse for 20 years would be for you to keep a journal of those exciting, tragic, confusing, frustrating and exhilarating events. I can recall those events but I really wish I had thought to journal them. Take care Jennifer

"Old outdated physicians that need to go"--AMEN!!!! I have a couple old nurses that need to go too!! Living on the mexican border, we donate old equipment, outdated supplies to one of the community ems staff. If you have old wheelchairs, suction machines, cables---try calling large equipment distributers or manufactures. Many of them like wheelchair vendors take a truckload of old equipment to third world a couple times a year where the equipment may not be at our standards but useful there. Happy New Year!!

I had RNY gastric bypass in November 2001. I was one of the smaller people the surgeon did at 5'8 & 350lbs. I lost 155lbs. I did end up in the OR again on day 2 for wound dehisence but it was the best thing I ever did in my life and I would do it again. 5 other staff at our facility had it done also. The only unsuccessful person was someone who chose to go to a non-bariatric certified physician because she could get in sooner. Right from the beginning, she was overeating Go to http://www.obesityhelp.com From there, you can chat with others contimplating surgery, check out different procedures, surgeons, and facilities and find out if your insurance company covers the procedures. HOpe that helps. jen

check out 4nursemanagers.com They have some policies and procedures available to share we follow the chest pain protocols of 30 minutes door to drug by the ama and the american heart association. check out ENA-www.ena.org for policy books. Most ERs now refer to specific books for protocols and procedures rather than reinventing the wheel. Jen

Just address a letter stating that you are giving 3 weeks notice and your last date of employment. Thank your boss and the facility for the opportunities they have provided you to enhance your skills, etc. Don't burn bridges. Don't bring up issues of inappropriate patient safety etc. If you have not presented these issues before now, you are only opening yourself up to questions of your ability to cope & do your job. Many times issues of staffing, patient safety are related to changes in administration, finances etc. You are going to a place you feel has better opportunities and care. Leave on good terms and look forward to the changes in your life and new job. You never know when you might want to return to the current hospital Jen

It sounds like you gave more than appropriate notice and explaination for your decision. You are not obligated to give them more than the 2 weeks notice and it sounds like the manager is trying to make you feel guilty. You should stand by your resignation letter and contact the HR department as this is creating a hostile work enviornment and if your work record is fine in the department, stating that you would be a no rehire is a threat. Jen

For those of us working in small rural hospitals, we are ER nurses and the Trauma team as well!! Ours is a 7 bed ED on the mexican border, off the 1-10 highway in the middle of nowhere. While we are still working on our level 3 trauma designation, the level one center in El Paso calls us Little Sariavo!! A few bus accidents on the highway and shoot outs at the border make you have to be a trauma nurse.

I moved from Canada to New Mexico first in 1997 and requirements were a job confirmation, $56.00 and copy of your license to obtain a TN visa. I only needed to cross the border each year to have my Visa renewed. Since 1997, they have been talking about foreign nurses requiring the CGNSF validation. Well, as of July 2005, the CGNSF has been legislated as required for foreign nursing entry. That is why some people are being told it will now take 3-4 months. I have worked in the US for 8 years with a yearly visa. I went home to Canada for the summer and have moved back to New Mexico and the US immigration won't renew my TN unless I have the CGNSF. I called them which they are a credentially service that validates that foreign nurses have the equivilent education and English language skills of the US. They want $350.00 & you need to send them everything since high school for them to validate and provide you with the necessary visa screen now required for Canadians. They state it will take them 4-6 weeks to process this information For me the problem is that I was credential by another service a few years ago and in fact have finished my BSN nursing components in the US and am short 2 general electives to finish. CGNSF still requires me to pay them for the Visa screen I have a few weeks to decide what to do. I only live 20 minutes from the Mexican border so I am going to try to get the renewal without the CGNSF because I have also written NCLEX. This time I am applying for US Citizenship because I am unlikely to return again to Canada to nurse. The positive side--I have been an ED nurse for 20 years all over Canada and the US. The US provides you with better opportunities for advancement, better staffing, education funding etc. I went home for 8 months and decided I prefer US health care. Hope that helps. Jennifer Well, as of

PPP-Piss Poor Protoplasm HBD--Has Been Drinking PSCS-Positive Suitcase Sign--(meaning they arrive in the ED with suitcases packed as they plan to check into the Hospital "Hotel" no matter what) STAL--patient has a Sub Therapeutic Ativan Level Jenny