Nurse & Nursing School Megathread: The NCLEX is the spookiest test you'll ever take

The Something Awful Forums > Discussion > Ask/Tell > Business, Finance, and Careers > Nurse & Nursing School Megathread: The NCLEX is the spookiest test you'll ever take

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Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

side_burned posted:

I guess I just thought if someone where to work as nurse for a while that they should be able to substitute that experience for portions of med school. Sorta like giving nurses the option to go into some kind of pseudo apprenticeship to get their MD.

Just out of curiosity will any of your nursing school class be transferable to Med school program?

No not at all. Med School is post graduate. Nursing school is undergrad.

The best it would do is make some of the courses easier since you already should have pathophysiology down pretty well and have probably seen and treated half the poo poo they talk about in school.

You'd also be a lot more confident shoving tubes and needles into people once you got into your clinicals.

Other than that it wouldn't help in getting in or shortening the load.

# ¿ Dec 9, 2008 07:20

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# ¿ May 1, 2024 18:26

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Mr Tweeze posted:

Little thread resurrection here. I'm graduating with my BSN in like a month but now I am insanely worried. When I was 19 I got charged with a DWI with like a .03 BAC because I got pulled over with a burnt out headlight, and being the retard that I am got an underage about a year later. I'm 23 now, completed ARD for the first offense, haven't had any troubles with anything since then, live in PA. Did I waste 4 years of my life doing this or will I still be able to be licensed?

Yeah you'll be fine but you really should of submitted some form of declaratory order before hand. You may get your letter of permission to take the NCLEX and work as a Graduate Nurse delayed. So basically in Texas you really should of cleared this with them ahead of time. They went over this our first week of orientation to school. You could end up having to wait a month or two after you graduate to start working or take the NCLEX.

I got a DWI when I was 17 after flipping my SUV. I knew it wouldn't be a problem but I made sure about 7 months before graduation to fill out the board of nursing declaratory order paper work and send them court paperwork and whatnot so when the time came for them to get my notice of graduation there wouldn't be a delay in them issuing me the NCLEX permission.

# ¿ Apr 20, 2009 07:18

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Datsun Honeybee posted:

What I mean is, does one have to be overly resilient to put work behind them when they're at home so they can relax and enjoy hobbies?

Dude it's just a job. Yeah you feel lovely the first few times some one dies on you or you have to withdraw care but seriously. You will be working in a hospital not at a gallows. Most people do pretty well, and if not hopefully they get transferred! For example I work in SICU, we get the most acute about to code patients, but luckily once they're remotely stable we ship them off to one of the less acute ICU's like Cardiac, Neuro, or Medical. So if there is a slow downward spiral I don't see it.

Trust me after busting your rear end for thirteen hours, when you get home you'll barely remember the day. You also aren't going to magically deeply care about every patient either, don't get me wrong you'll do your drat best to keep every last one as well and comfortable as possible/their condition allows. But there is so much documentation to do some days you'll come home bitching about how your patient wouldn't leave you alone long enough to get your hours of charting done on time. It sounds hosed up but it happens. Most days are not "I hope Mr. Soandso pulls though" but "God I hope I charted everything perfectly to cover my rear end if he goes down the tubes."

Iron Crowned posted:

Would it be a good idea for someone to become an LPN, then study for an RN after completing that?

Don't do LVN, it's a waste of a potentially good RN. You'll be wishing you had a larger scope of practice and RN's you work with will wish you did too. Knock it out, get your RN, you'll be happier and independent in your practice.

Bum the Sad fucked around with this message at 04:34 on Jul 14, 2009

# ¿ Jul 14, 2009 04:23

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

miso posted:

I had problems, especially when I first started, where even when I was home I would think about all the things I'd done wrong at work or worrying that I didn't chart everything or do everything I was supposed to do in the shift. I think that kind of thing is fairly common, especially with new nurses.

From what I have heard from older nurses that poo poo will still happen on occasion. Just much less frequently.

# ¿ Jul 14, 2009 04:49

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Fatty Patty posted:

lately I've heard about a lot of people who are graduating with degrees where they can't find jobs then heading to their local CC/back to school to get a nursing/similar degree. How is this affecting the job market?

You can always find a good paying job as a nurse. It may not be where you want it though. Like if you want a job in San Francisco or San Diego or some poo poo you may have a lot of trouble. But if you're willing to movie it's not hard.

Not to mention there aren't enough slots in the academic programs to glut the market.

# ¿ Jul 14, 2009 05:06

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

AquaVita posted:

I find this is overblown. Older nurses piss and moan about this all the time, but it just shows that they completely forgot what school was like.

It takes years in most cases to get into a nursing program. Most people who want to switch careers just to get something easier are not willing to go through the absolute hell it takes to get into a nursing program.?

Does it? I keep hearing this from people. I just got my pre-reqs done at a CC then applied to the University and well got my BSN.

I don't think the UT system wait-lists or any of that poo poo. I think they just give their slots to the most qualified who applied that semester.

# ¿ Jul 14, 2009 05:25

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Doppelganger posted:

our pulse ox monitors seem to be designed for comatose adults. These kids' sats plummet every time they twitch!

Give the kids more drugs.

# ¿ Jul 26, 2009 19:19

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Ohthehugemanatee posted:

Come to the ICU. The ventilators alarm, the beds alarm, the telemetry monitor shrieks and the feeding pumps cry out for attention. The uncanny bit is how your brain gradually filters them until you can blissfully ignore thirty different alarms and spring up when you hear the thirty first that signals an actual emergency.

Oh, and we routinely offer to staple leads to our patients as well, even if the suggestion isn't usually accepted. Although with enough tape you can keep almost anything on someone...

That super strong weird striped paperish tape we use to secure ET tubes in place is loving fantastic if you need something stuck. I don't know if you have the same stuff though. Just see what RT uses.

# ¿ Jul 27, 2009 05:07

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

qentiox posted:

To contribute to the thread: is it naive of me to assume that I'm going to be able to get a job in the unit that I think I want? Obviously I haven't done any clinicals so I have no real world idea of what goes down, but from personal experience I feel drawn to the L&D or NICU. Those areas just seem like they would be some of the more popular ones.

Depends on where you live honestly.

As far as L&D goes, I hope you like lochia!

# ¿ Jul 29, 2009 23:46

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Solaron posted:

I thought you basically had to work med-surg for a few years before you could move to ICU/ER etc?

Nope, that's how it used to be.

I went straight from Nursing school to the Surgical Intensive Care Unit, where the fresh heart surgeries/transplants and the likely to code folk go. They throw you into an internship(full salary) though at my hospital where for like 4 months you have one day of week of class and you work with a preceptor though.

Also it helps to get an externship. Try to get one during your last year of school, because if you have one you are pretty much guaranteed a job where you externed.

The last semester of school I work one night a week in the SICU then like 2 months before graduation they called me and asked if I wanted the position when I graduated because they were receiving a crapload of apps about the internship and wanted to know.

# ¿ Jul 31, 2009 03:57

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Ctrl_Alt_Delete posted:

I've been interested in being a Nurse for years now. I recently completed my CNA, and still love when I will be doing. That being said, money is tight, as I'm sure it is for many people. Those who I know who have gone through a program say that it is near impossible to work to support yourself and get in the time to study effectively. Does anyone know of anywhere that will pay for your school and enough to live on in exchange for working for them or in a certain area for X amount of years? Ideally I would like to not have to work while going to school, while living in an environment where I could study. I know it's a long shot, but I'm willing to move anywhere and try anything if it means that I can be a Nurse! I am currently in a community college with a 3.5 GPA, and have a lot of other classes from a University with a horrible GPA, I also have horrible credit. If anyone has any ideas or suggestions, I would love to hear them

Go for the VA then. They will pay for your school and throw money your way in exchange for working for them for a few years. They pay well when you get out as well. I know several people who did this route.

The only downside is that all your patients are crotchety old veterans. And you might not have as much of a choice as to which unit you want to work on when you graduate.

# ¿ Aug 3, 2009 23:55

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Solaron posted:

Wow... that's really good to know. I'd love to try ER or ICU (although I don't have my RN yet, so maybe that will change as I get more experience in a hospital).

There's a VA hospital near me - I'll have to give them a call since I can't seem to find a website with jobs, and see if they offer that deal you mentioned. That would rock!

Yeah I think my friend got the equivalent of like $40,000 from them in two years. When combining the stipend and tuition.

Anyway I don't know the specifics but call them and ask.

Bum the Sad fucked around with this message at 04:01 on Aug 4, 2009

# ¿ Aug 4, 2009 03:50

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

a handful of dust posted:

I'm curious what the work environment's like for guys, mainly. Especially more ah...traditionally male guys. I'm 6'1" 200 lbs and I have a shaved head and a bunch of tattoos , am I going to be judged negatively for this in interviews or have trouble fitting into a female dominated workplace?

Not at all. Especially in the ICU. Employers like male nurses. They can actually lift poo poo.

# ¿ Aug 19, 2009 03:04

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

a handful of dust posted:

Cool. I've gotten poo poo for it in a few office job interviews; I was hoping nursing wasn't the same way.

You know I've noticed this. For some reason even though this is a professional field with strict licensure requirements. No one seems to really give a poo poo about tattoos. I think once you have gone through nursing school, passed your boards, and passed your background checks for your license it's kind of assumed you aren't a sleazebag. Plus nurses can be pretty oddball anyway, the thirteen hour shifts and constant death can do that. I'm pretty new and I walked into a room a few doors down that I had to ignore because I was admitting at the time and the room was just covered in blood and vomit(patient had aspirated after some kind of throat surgery and was impossible to intubated. I said I was sad busy because I was busy and it looked like fun. The response was "It' a lot of fun unless it's your patient and you have to chart it all afterwards."

# ¿ Aug 19, 2009 06:09

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Snord posted:

I'm starting a 1 year accelerated RN program in September to get a BSN/MSN after I had no luck at all finding a job with a MS in Healthcare Management. Most people I talk to say I will end up doing nursing administration in a few years, considering my previous degree and experience. Will that end up helping me find a job right out of school?

I would also like to try working in the ED instead of the floors (I'm a man), but I was told that I should work at least a year before transferring.

Don't listen, find a preceptor/internship.

# ¿ Aug 25, 2009 18:12

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

asbo subject posted:

nobody gives a flying gently caress what sex you are.

Except for other male nurses. loving human being rear end murses.

# ¿ Aug 29, 2009 00:13

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Datsun Honeybee posted:

I want to ask some peoples' thoughts on this...
So far, this semester, I've found my experience at clinicals to be kinda awkward. Not sure how else to describe it.

Our group is 10 students, and everyone else got divided up into pairs and one group with 3, to each take a hall. I was the odd one out and got placed in a hall all by myself with no other students, and to boot it's the hall where the nursing home has all the patients with severe dementia & alzheimers.

I've been getting through the days OK and being there and working with the people doesn't so much bother me, but it just feels sorta odd being dumped off into water like that all alone, just me and 2 LPN's who don't really seem to like students. I feel like it wouldn't make me as nervous or hesitant if I had another student there with me.

Is it unreasonable of me to think that as a brand new student I shoulda been partnered with someone -- or at the very least if I had to be alone, not on a floor like that? It just strikes me as odd, but maybe I just had a different idea of how it'd be. I want to stress that I'm not complaining, the situation just seems strange.. but maybe it's more common than I think.

You got screwed, you got a lovely assignment with minimal learning opportunities. It happens, keep your head up and keep a low profile. Just suffer through.

By the way first semester is always poo poo. It gets better when you get real responsibility and higher acuteness.

# ¿ Oct 7, 2009 07:13

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Totally Negro posted:

Yea I understand that, but no other health professional goes out of their way to make it that clear, even the "mean old" surgeons I've worked with.

Nurses care a lot about their patients they are with them 13 hours a day instead of just popping in for 14 minutes once a day and receiving a couple calls during the night when they crash. We really just don't want you to gently caress anything up too much.

# ¿ Feb 5, 2010 00:48

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Axim posted:

I'm a psych RN, used to be telemetry.

Being a psych RN is cool, less physical work, more observations and assessments, but when poo poo hits the fan, its rough, you can be assaulted and hurt, and don't ever think it can't happen to you, its happened to some good coworkers of mine. Even if you do everything right, some patients can snap.

But I love it and don't want to go back to the medical side ever again.

As a CV/SICU nurse mad props to you psych nurses. When my patients get feisty I just up the propofol and slap on restraints. More respect if you don't end up hating your patients day after day. Psych nursing is loving difficult, I can wean my patients off the vent, yank their patients swanns and chest tubes after two days and ship them out to tele, you guys don't have that luxury.

By the way I have read studies and psych nurses are way more likely to be assaulted than police officers.

science pole posted:

No love for psych nurses? I just graduated with my BSN and I am working a hospital psych floor. I love it but is this going to make a transition to ED or more medical floor difficult? We don't do much medical stuff. I know it may make things more difficult but please elaborate.

ED sucks. It's either tooth aches or car wrecks. At least where I was at which was our county's level I trauma center. If you were ED you rotated. You spent like 3 days doing stubbed toes and then 1 day in trauma to make sure everyone didn't get stuck on stubbed toe duty. So it's days of assigned boredom, with fun interspersed. You'll do fine and most likely if it is a level I trauma center med students will do half your job. If it isn't a level I you'll likely dick around and arrange transfers.

Bum the Sad fucked around with this message at 16:31 on Feb 6, 2010

# ¿ Feb 6, 2010 16:22

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Doppelganger posted:

Why do so many adult nurses seem to have such a disdainful attitude towards pediatrics? It seems like every time I get floated to an adult floor and they find out I'm from peds, I have to hear the same "Oh my God I could NEVER stand all those kids!" song and dance from at least one nurse. Is it really that much better having to work with confused, cranky geriatrics?

It's not then kids. It's the parents.

# ¿ Feb 7, 2010 12:47

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

McJogurt posted:

Med student here. If I walk into a room and the IV pole is beeping while I talk to the patient, should I attempt to turn it off? Or does that interrupt your workflow if you don't hear the alarm?

Don't ever turn it off. Tell the nurse. Maybe it's just a small air bubble alarm and you just need to advance the tiny air bubble a little bit. Maybe the volume to be infused amount was set a little low to alert the nurse when it was time to order a new bag. Maybe it was an antibiotic infusion that wasn't being piggybacked because the patient had no maintenance IVF ordered so it's just going to beep when dry. Could be a bag of amiodarone that needs to be be fiddled with because amio likes to cause air bubbles like a motherfucker. Or maybe it's a vasopressor that needs to be fixed NOW.

Then again of course it depends on where you are at. If you are on my unit which is a Surgical/Cardiovascular ICU we only have 1-2 patients tops and our patients are in glass rooms where we are right outside the entire time so it's not going to be an issue because the nurse will be right there. On a floor they aren't going to be on anything too vital. They don't usually let patients on titratable important vasopressors leave the ICU. Although they may go down on fixed rate Milrinone or something similar to that which could be very important.

Basically trace the line up from the pump to the infusion bag/bottle. Then use your judgment whether or not you should give a poo poo.

Bum the Sad fucked around with this message at 20:16 on Mar 1, 2010

# ¿ Mar 1, 2010 20:14

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Danksauce posted:

That being said, I'm looking for people's opinions on FOOTWEAR. What did you wear to work today?

Nike Shox, they aren't that comfortable for your feet but they are loving great for your knees. I'd much rather have a little foot discomfort at the end of the day then limp half of my last shift.

# ¿ Apr 22, 2010 15:50

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

SICU is best. You never go above a 2:1 patient nurse ratio. Usually it'll be something like 13:8 patient:nurse ratio and a unit clerk, no PCA's because they'd probably break some one. Hell we've had some night when we had two 1:2 patients, two unstable fresh VAD's both ran with a two nurse team for about two days till they stabilized.

Of course even 2:1 can get loving hectic. This week I had a fresh CABG who was 1:1 and I got him extubated and stabilized and then BAM, rapid response overhead, and I get a call that I am getting a patient. Because bed control seems to believe that as soon as you get your fresh heart extubated they are fine. It ended up being a post ORIF of the hip who had some kind of coagulopathy and was dumping blood all over the bed and I spent all night slamming in PRBC's, Platelets and FFP to keep his pressures up, while running back to my other patients room to wean his levophed and dopamine and record his chest tube output. I'm lucky my heart "fine" that night. I still ended up staying over an hour late to finish charting. I had far worse teams though.

# ¿ Apr 26, 2010 00:10

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

RogueTrick posted:

I'll be starting up with our Community College nursing program for the fall semester. I was wondering if you guys have any recommendations regarding stethoscopes for a nursing student. From what I've been hearing, a nursing student is much better served by an expensive stethoscope so they can more easily learn to distinguish particular sounds.

Buy a Littmann Classic II S.E.
Here http://www.allheart.com/2200-16.html it's a nice middle of the road high quality scope

# ¿ Jun 3, 2010 10:46

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

mason likes onions posted:

mine wears a wristband with my name and pager number, and has always found its way back to me.

Which kind? Fall risk, Allergy, DNR, Limb Alert?

# ¿ Jun 4, 2010 14:54

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

XausF1 posted:

Anyone know any RNs that walk around with calculators?

You kind of need one for titrating your vasopressors, or calculating your I&O's.

# ¿ Jul 30, 2010 03:36

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

otter space posted:

And calculating AVO2 differences and modified Fick equations for cardiac output.

My calculator gets stolen a lot.

FICK's are a pain in the rear end I am glad we have CCO monitors on my unit. The way it works at my hospital is that we have a Cardiac ICU which is all like STEMI's and post Cath lab crap. Then across from that unit is mine the Surgical ICU which takes the post op CABG's, Valves, and Heart Transplants, along with every other surgical train wreck. Anyway the CICU side doesn't usually have the fancy CCO swanns w/ SVO2 monitoring and they do FICK's all the time, our post ops always have the fancy Swann's with the digital crap.

# ¿ Jul 30, 2010 04:41

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

otter space posted:

Most of our patients are swanned up, but not all. It depends on the surgeon. I'm kind of surprised that your SICU takes on all the post-op cardiac cases; my (now former, I guess) cardiothoracic ICU is strictly an open heart/lung unit, and all the other surgical train wrecks go to the SICU side. Each ICU is managed completely differently. It's the most dysfunctional place I've ever worked though, which is why I just bailed for a new job.

Yeah our hospital is a little odd according to all the travelers that have come here in that we don't have a Cardiothoracic ICU. Yet strangely enough we have a Cardiac ICU for the MI's and post Cathlab crap.

quote:

edit: nm, saw in one of your previous posts that you never go above 2 patients per nurse. We get tripled assignments ALL THE TIME. Our manager, who is a dialysis nurse and never worked a day of cardiothoracic ICU in her life, thinks that once a patient is extubated they must be stable. Some seriously unsafe poo poo goes down in that unit on a daily basis.

Bed control does that poo poo to us some times at nights. I'll get a heart extubated and then an hour later they tell me I am getting an admit and who knows if this admit is going to be some ER trainwreck who's septic and coding en-route. But yeah we ALMOST never go above 2:1. The only time I've seen 3:1 is when we have teamed two patients with full orders to transfer to medical just waiting for clean beds teamed with a legit ICU patient and even then that is rare.

# ¿ Jul 30, 2010 10:26

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Start with the dorsal penis vein first

# ¿ Sep 30, 2010 00:03

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Chillmatic posted:

Just tried this, didn't work. Got punched in the face. Lost license. Homeless now.

thanks

Goondolences.

Corn Thongs posted:

My fiance is in his third semester (out of four) of the nursing program. He's doing fine but seeing how stressed and how little sleep he gets makes me very worried. Also this talk about the job market being tough for ADNs...

Did you guys have good support while in school? Was there anything they did that made it easier? Oh and if anyone wants to comment about the job market, we're in Southern California.

Nope, nothing makes it easier. Although pre-exam boning always made me feel more confident going into exams. Seriously, that's all you can do, it's going to suck, the only thing that makes it slightly tolerable is boning.

Bum the Sad fucked around with this message at 15:25 on Sep 30, 2010

# ¿ Sep 30, 2010 15:22

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Mrs. Orgasmo posted:

I have not read this whole thread but I just wanted to say that a ICU nurse is an amazing type of nurse. You all are truely dedicated to your job and care about your patients. My husband was in ICU intubated for 14 days. The staff there was AMAZING.

I hope your patients appreciate you as much as I appreciated my husbands nurses. I can name every single one of them that took care of him. The male nirse spent a half an hour shaving him, it was just unbelieveable how much they cared.

14 days? Jesus that's about the time we trach some one. Did he go into ARDS? And no it's not that we care about our patients, we just care about doing a good job. Trust me we'll talk poo poo about the ventilated jerk who won't stop bucking the vent that we can't sedate enough or crazy grandma who we need to get the gently caress out of SICU and over to MICU or stepdown the second you leave. But drat we'll fake it though.

# ¿ Oct 21, 2010 22:57

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Ohthehugemanatee posted:

Heh, I was going to say she definitely must have skipped a few posts in this thread.

Yet I'd argue we do care, in our twisted and sociopathic way. After all, we went into this for the warm and fuzzies and it isn't our fault that we're now neurotic adrenaline junkies entirely devoid of empathy. We're no more malicious than paramedics or contract killers. It's just the job that does it to you.

But yes, he's mostly right Mrs. Orgasmo. ICU nurses are pretty terrible people. We do care, and every now and then a patient or a family does get through and remind us of that. It's just that if you filmed us chatting at two thirty in the morning most Americans would vote to have us incarcerated.

It's not our fault we just have to deal with terrible poo poo some times and if we were the face we put up we'd be loving neurotic depressed messes(although at least half of us are anyway despite the job.) But anyway at the end of the day it's still a job, we're still showing up those three 12-13 hour shifts a week to pay the bills.

I mean for the past few nights and then a night before that I have had a woman who gave birth to her first child, had an MI 5 days later, got treated medically, went home a few days later had some syncope, EMS'd to the hospital, went to cath lab, taken to an ICU post cath lab ruptured her LAD and Left Circumflex shortly after, coded, went to CVOR emergently, had a triple bypass, landed on our unit, coded before the OR team and surgeon even left, back to OR she had ruptured her RCA, had that bypassed, and is now day 7 post op, on a balloon pump, and not responding to commands moving wildly non-purposefully, we even had her extubated for a few hours two days ago she still thrashed about crazily and then developed laryngeal stridor and had to be reintubated(probably from trauma from her thrashing while on the vent.) Her pressures look better, her ABG's look great, but still no following commands and I'm guessing anoxic brain injury. Her husband is there often, he has a new baby at home with a wife/new mother in a world of poo poo and it's a sad sad horrible scenario.

But have I left depressed? No. I leave work thinking god damnit I wish she would stop bucking the loving vent and setting off peak pressure alarms and trying to bend your legs to gently caress up my balloon pump, and stop forcing urine around your foley when you gag/cough on the ETT. And being pissed that her pressures weren't high enough to give enough morphine and versed to slam her. Now does that mean I haven't worked my hardest? Hell no I have worked my rear end off to keep her alive and grasp at any chance to get her better, have not slacked in the slightest, I have my eyes and ears tuned to where I know what her waveforms looks like when she farts. I have poured my sweat into this case and given nothing but 100%. But when I am driving home I am thinking about that bitch who dinged my Caddy and what questionable pornography I will download.

Ohthehugemanatee posted:

It's just that if you filmed us chatting at two thirty in the morning most Americans would vote to have us incarcerated.

Ah fellow night shifter, you know that makes a difference as well. I think more of the day shift nurses genuinely care, or at the very least aren't as blatant about their sociopathy at work. But still regardless of shift we see horrible trainwrecks all the time and you can't emotionally invest in all of them. Ventilated crashing patient 432 is the same as Ventilated crashing patient 128, Crazy grandma who should have been left to die in peace isn't much different from the last one.

But I do get warm fuzzies every now and then when you get a CABGx4 with a valve, get extubated in a timely manner and they turn out to be an awesome likable person, you wean them off pressors, ship them off to tele in a couple days and say get out and don't come back with a smile.

Bum the Sad fucked around with this message at 16:18 on Oct 22, 2010

# ¿ Oct 22, 2010 16:10

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

mboger posted:

Informal poll to help me decide where to specialize:

ED nurses: How often are you assaulted by patients?

OR nurses: How often are you assaulted by surgeons?

If you haven't already, go read the "Surgeon threw something at me" (or whatever it was called) megathread in the OR section of allnurses.com. It's ridiculous what some hospitals are willing to put up with.

Surgeons don't assault people, they just assault walls and equipment with other pieces of equipment usually. Or if they hit you you have bad reflexes.

# ¿ Oct 22, 2010 17:07

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

mboger posted:

I'm not sure if you're being sarcastic or not, so here's the link: http://allnurses.com/operating-room-nursing/has-surgeon-ever-16747.html

A few of those posts are definitely accidents, but "bad reflexes" doesn't explain getting squirt gunned with a blood-filled syringe.

You know those days are mostly over. Docs get their privileges revoked over poo poo like that and I have seen it happen.

# ¿ Oct 22, 2010 17:19

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

I forgot, best part about nursing

Free shot glasses

# ¿ Oct 22, 2010 18:04

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Mrs. Orgasmo posted:

I totally get it. The day they reduced his sedation to wein him off the tube they wouldn't restrain him through the night. Instead I was instructed to keep him calm. That was the longest night of my life. He was such a pain in the rear end. He kept trying to take the tube out. At one put I had to call the nurse in (male) and asked him to please yell at my pain in the rear end husband.

I learned that it wasn't really his fault. He was under sedation for so long that even though they had reduced it to almost nothing he still could not remember what I told him 2 mins ago.

I have to tell you though that when they finally did remove the tube which he was fully awake for and now does not remember, he was so loving out of it. The poo poo that spewed out of his mouth was hilarious. The nurses assured me it was normal.

Yeah extubating patients is a pain in the rear end for everyone involved but luckily the sedation we keep them on while the tube is on has heavy amnesic effect. Being intubated is miserable, it feels like you are breathing through a straw and are choking. Anyway it's not their fault, they are doped up as all hell, and yeah it's normal, like I said we keep you on such heavy narcotics to keep you from remembering being intubated acting a little wonky is to be expected.

Edit: Oh Mrs Orgasmo I have a funny loving story. I recently had a bypass patient who was a paramedic and he was a loving wild rear end in a top hat while intubated, I mean just thrashing, he was a big guy, I mean he followed commands momentarily, nodded, did what you asked, responded appropriately, but then went right back to thrashing. Anyway due to my experience I got the feeling that he would do fine extubated and was just pissed off he was tubed. Anyway I called Anesthesia and said hey this guy is acting like a crazy rear end in a top hat, his blood gas results are marginal but he is strong as hell and just looks pissed off and I want to extubate. Anyway anesthesia asked if I wanted to sleep him over night or extubate, I said extubate and he said go ahead, I pulled the tube and he was fine and instantly normal anyway later he said to me about the whole being intubated experience "Is that what I've been doing to people? that was loving horrible."

McFlurry Fan #1 posted:

The things that you'd think might help these patients don't. We suppress the immune system but it doesn't make any difference. We used to crank up the ventilator pressure to over-ventilate the good areas of the lungs but it turns out that did more damage than good. Same thing for upping the oxygen levels. Since nothing works very well and mortality is sky-high, we end up throwing a whole bunch of pseudo-science interventions at these people. We even sedate them, paralyze them and flip them upside down and rotate them for days until they either get better or die.

It all looks very technical and awesome until you look at the research and realize there's no evidence for anything beyond keeping ventilator volumes low.

I'm guessing Bum asked about it because it's one of the few reasons to keep someone ventilated for that long.

Yeah true gently caress you ARDS isn't pretty and you are right about the throwing pseudeo-science at them. Anyway just to anybody reading this, if any family is ever on a paralytic drip; they are going to die. Although I have heard some few decent stories where the patient was placed on CPS/ECMO and lived. Anyway the crazy support McFlurry and I are talking about is true gently caress you ARDS.

Bum the Sad fucked around with this message at 05:45 on Oct 23, 2010

# ¿ Oct 23, 2010 05:19

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Chillmatic posted:

Whoa. Are you talking about stuff like sux?

No I'm talking about a continuous infusion of something like a vecuronium drip to decrease oxygen consumption consumption by the tissues. To clarify I am talking about a continuous infusion, not a quick bolus.

# ¿ Oct 25, 2010 20:20

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Ohthehugemanatee posted:

I'm an ICU nurse too, and I hate this kind of attitude. We're pampered specialists who are completely dependent on our technology. Take that away from us and we'd poo poo ourselves faster than our patients do. Don't knock the folks who work in the lower-tech fields, and don't call them baby sitters when most ICU nurses I know panic at the thought of having more than two patients. We can only handle the critical stuff because we have the luxury of technology and the lightest of patient loads.

If I don't have an Art line, a continuous 12 lead, a Swan-Ganz with a CCO/SvO2 Monitor, and as many ABG's as I can through at the machine I'm loving lost.

# ¿ Jan 28, 2011 15:47

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

Baby_Hippo posted:

Things I've HEARD....

L&D preceptorships are pointless because you're not going to be hired straight into L&D (could be wrong)

Mangue posted:

I know this was from a while ago but I just wanted to say...I did an L&D preceptorship this spring. While I knew it was essentially useless in getting me a job once I graduated

Preceptorships(we called them externships) worked great for me. And are useful if you want to work where you extern/precept.

I wanted to work in our CV SICU(we land heart transplants, VADS, in addition to the valves and cabbages, and weird congenital fixes like Fontan procedures now and then) and snagged a externship while I was in school. And then hired onto my Cardiothoraic Surgical ICU immediately, as a new grad as soon as I finished my boards

But my hospital has a new grad preceptor program(where you are now an intern(full RN) where you work paired with one of the experienced RN's for four months before you start taking your own you also go to critical care classes like once a week on like EKG's, pacemakers, advance hemodynamics.

Anyway it was great, for example I came in Wednesday night next thing I know I was called to the ER for a patient with a malfunctioning driveline for her Heartmate II LVAD(it kept resetting and stopping and she could feel it rattling and winding down in her chest). Got her to the unit on the systems monitor, watch the pump totally reboot and stop again(not a suction event.) Plan was made to lets replace that faulty thing(first time we had done it.) I was in CVOR by 3am manning the heartmate until 9 in the morning as we explanted her old pump and reimplanted her new Ventricular Assist Device.

Pretty fun poo poo.

They should hire new grads into OH poo poo areas. Just get them a long preceptorship when they're licensed. For one it teaches them THIS IS HOW YOU DO IT HERE, and they don't come on with a bunch of stupid floor nurse baggage and preconceived notions of being safe. When we got four nurses hand squeezing in blood as fast as you can while cranking the levophed up to 30mcg/min, while we're giving repeat doses of novo-7. You don't need some being like "Oh transfusion reactions, and shouldn't you give those over an hour with lasix inbetween" and "isn't the dose higher than max shouldn't you titrate up slower" No gently caress that baggage, get them young and smart and mold them into a SICU machine.

Bum the Sad fucked around with this message at 15:03 on Sep 10, 2011

# ¿ Sep 10, 2011 14:54

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# ¿ May 1, 2024 18:26

Bum the Sad: Aug 25, 2002; Can't post for 6 days!; Hell Gem

somnolence posted:

How do you specialize in to a particular medical field once you finish school? I've just started college and probably won't have my degree for about 5 years, but I'm interested in knowing how you end up in say, oncology, versus becoming ER/trauma nurse.

Get hired.

# ¿ Sep 29, 2011 20:58

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