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I'm a male nurse, work in an ICU, and graduated from an accelerated program. If you guys don't mind, I'll answer whatever I can.
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Nov 25, 2008 02:36
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| # ¿ May 1, 2024 23:28 |
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phatmonky posted:By NO MEANS, was anything I said meant to be a slight at nurses. poo poo, right now I can tell you pathway after pathway for drug usage, diagnose things by symptoms despite never seeing the disease in person, and tell you the physics behind all kinds of imaging. As an aside, this is a good reason to consider if you want to work in a teaching hospital once you have your RN. Especially in the ER and ICUs, you'll spend a lot of time babysitting interns for their first year or two. Even new nurses are expected to be able to do this because, well, that's what you signed up for. More autonomy = more responsibility. This is why a lot of people recommend that one year of general med/surg floor to get your bearings, but if your hospital has a good precepting program and you'll be working in a tight unit, gently caress it, go for it. He's right, we do get a lot more exposure to patients, even as students, than fresh MDs see before they walk out into the unit that first July in their new white jackets. Their heads are bursting with knowledge and diagnoses that are practically useless since the real world functions nothing like a textbook, the human body is squishy and unreliable, and the drugs they know may or may not be the drugs that hospital or attending physicians favor. They'll see muddled radiology images that they won't be ready to interpret, patients riddled with multiple diseases that can seem to create conflicting diagnoses or just make one big clusterfuck of signs and symptoms, and have to actually go through the daunting (no sarcasm) task of assessing a patient on their own with their own instruments and their own senses to guide them. They'll be working ridiculous hours with their residents and attendings constantly kicking them in the rear end. It sucks to be a new MD and at that point in their career they're not being paid poo poo for all the grief they have to go through. But they're still going to be giving orders and it'll be part of your job to keep them from loving up. Honestly, most of them will be really cool and ready to bust their asses, some will be terrified and drag their feet, and some will be pompous dicks who will wear that white jacket like a superhero cape and try to get someone killed. Whatever, they're new and you will be too. Know your poo poo, rely on your fellow nurses for advice, and trust your gut if it tells you something seems wrong. A lot of it will be pretty obvious stuff that they're overlooking because they're focusing so hard on something else anyway. Anyway, sorry for bringing some gloom n' doom into the thread, but I never had a clue about this and realizing it scared the poo poo out of me when I started as a new grad in an ICU. I'd still recommend it to any new grad though, ICU rocks.
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Dec 14, 2008 15:00
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Absolute Evil posted:Most places in this area (whether hospital or long-term care facility) are trying to do away with lpn hiring. They want aids or rn's. Suprisingly this hasn't lowered the wait time to get into the lpn program. Yeah I know the benefits of going straight to RN, but I'm paying my own way for at least the first year..and with CNA wages, I'm really stretching it to even get back into school at all. Are there any hospital programs in your area? For example, Bridgeport Hospital in CT has a RN diploma program that they offer free of charge... in return for a 3-5 (I forget exactly) year contract with them post-grad. Free degree + guaranteed job placement in a major hospital (they're also part of the Yale network) ain't a bad deal. Hospital diploma programs are becoming increasingly rare, though. Bridgeport's the only one left in the state at this point and I have no idea about other states.
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Jan 23, 2009 21:05
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b0nes posted:For anyone wanting to become a nurse and looking for schools, only 2 major things you need to ask. #1 Most states require 80% or above (CT is 90%, I believe) first-time NCLEX pass rate for a school to be accredited. The national average last year was almost 86%. If you can't find a school at least that good, move. #2 If they're accredited and have a good pass rate, who cares how long they've been in business? Nursing school doesn't teach you crap about how to be a nurse, just how to get your license. I'm not even exaggerating: not counting clinical hours, it literally teaches you nothing else. Speaking of crap they tell you in school, if you're planning to specialize and anyone tells you to work 1-2 years on a general med/surg floor before specializing into ICU/OR/ER/OB/etc so that you don't "limit your skill set" or whatever, they're full of poo poo. I've heard a lot of people say they were told that in school, I was too. Even if you do spend those two miserable years stuck there and wishing you were somewhere else, as soon as you specialize you throw all the irrelevant poo poo out anyway; all you're left with are the things you would have learned in basic orientation from your dream position's preceptorship right off the bat. Total waste of time, just go for the gold right out of the gate.
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Feb 3, 2009 14:44
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Fatty Patty posted:anyone a Nurse anesthetist or going through the CRNA program? I'm going for my BSN right now and am really considering doing the 1 year of ICU + CRNA route. What was your GPA upon graduating/being accepting into your schools CRNA program? Is the schoolwork more/less rigorous than clinicals? Just want to know what to expect as far as the school part goes. If you're already a nurse anesthetist, what's your salary like? I'm planning to do the same thing and am presently working on my second year in an ICU. I can't tell you much about the programs as I'm still looking into them myself, but I'd count on getting more than one year of ICU experience. It's possible, but unless you have incredibly competitive undergrad grades and can convince the interviewer you're ready with less than 6 months experience (you'll be interviewing at least that much earlier than the start of the program, keep in mind) it's probably not going to happen. Hell, depending on the hospital, you may not even be done with your unit's preceptorship until your 3rd to 5th month. Even knowing this I was still banking on being able to do it anyway, until I actually started in an ICU. Unless you're an immoral, completely self-absorbed prick, you'll realize pretty quick that there is no loving way your clinical, assessment, and emergent crisis skills are anywhere near ready for that sort of situation. That first week on the job is going to be a really harsh reality check, but in a good way. You'll realize just how little you know and how completely hosed any patient in your care would be. Then multiply that tenfold. Critical care nursing doesn't get much more critical than anesthesia and if you gently caress up it really is on YOUR head, so try to keep some perspective. Take the extra year, get your poo poo together, concentrate on building your skills and practical knowledge base. LEARN YOUR MEDS back to front, that's one of the biggest stumbling blocks. I've gotten this advice from almost every CRNA and instructor I've talked to and it makes a lot of sense. The salary is indeed loving awesome, easily over $100K to start. Compare that to an ICU RN's start at $55K-$65K (both of these are for CT and base, no OT included) and you should get a vague idea of how much more is at stake.
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Apr 28, 2009 21:11
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freshmex posted:Why not just go straight for a BSN? Even if you factor in the extra classes to go from ADN to BSN later, it's still cheaper than getting a BSN right off the bat. Especially because, as has already been pointed out, most hospitals will reimburse all or at least a significant percentage of the cost if you do it while working for them. Plus, if you're sure you just want your RN and never intend to go back for a Master's or try to break into management, there's no reason to get a BSN. There's no difference in pay, job opportunities, seniority, etc, and none of your coworkers will give a poo poo either way. And hey, if you change your mind later, there will probably be even more universities offering those ADN->BSN programs by that time. They also tend to be a littler easier and less stressful than their BSN counterparts. Not because they don't educate you as well (it's pretty much impossible to tell the difference between new grads when they're hired, and after a few months on the job there's no difference at all), they just throw less bullshit at you. About 20% of nursing school is teaching you basics so you'll be ready to learn REAL nursing once you graduate. The other 80% is getting you ready to pass the NCLEX, which in themselves have nothing to do with being a nurse beyond making sure you're not a retard and can actually think for yourself. So why get a BSN? 1) Master's programs open doors to the real money careers in nursing and 2) Four year universities are a helluva lot more fun than two year local colleges.
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Apr 29, 2009 12:45
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Yestermoment posted:I'm not positive if this is the best place to turn to ask, but I hoped this would be a good place to turn. There's no "specialties" in nursing school. Check the websites for local colleges and universities to see if they have programs, pick out some you like, then find out what their first-time pass percentage for the NCLEX. Other than some basic skills and fundamentals, that's pretty much all nursing school is for. edit: you want 98% or better. That suggests they're definitely getting the job done.
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Sep 10, 2009 23:42
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What degree do you have? AA, BSN, MSN? BSN Why did you go into nursing? Helping people and getting paid (pretty well) to do it, just without all the stress, financial cost, and lack of social/family life that plague doctors. Also, after witnessing someone collapse in a restaurant and being just another rear end in a top hat standing around not knowing what to do, I felt awful. I was embarrassed, ashamed, and felt wholly useless and spineless. It made me feel like I'd never really done anything for anyone that truly mattered (I realize, in hindsight, that it was a lot of emo waa waa self pity, but whatever). So I decided I was never going to be that rear end in a top hat again. Now I save lives every day. Or ease them into a death with dignity and as much comfort as possible. It's a pretty sweet feeling. Was it your first career? Nope, union politics. This is also why I'm incredibly cynical about all things political and avoid talking about them at all unless someone's REALLY annoying. What area do you work in? ICU. It's loving awesome for a whole plethora of reasons. Eventually going back to get my MSN for anesthetist, but I'm still a little "all schooled out" after that trip back for my BSN. On a scale of 1 to 10, how happy are you with your job on a daily basis? Once I'm there, 8-10. Getting up for work still sucks as much as it does for anyone else, but hey, at least it's only three days a week! (Soon to be two, and yes, it'll still count as full time  )
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Oct 14, 2009 19:31
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Ohthehugemanatee posted:I'm betting he's going to work as a bailer. Ours work Saturday/Sunday twelves and are paid as though they work 36 hours. They're the counterbalance to the nurses with enough seniority that they can work weekdays only. Bailer positions fill up very, very quickly. Wow, this is from a really long time ago but there's still some flesh on it. And yes, bailer. My hospital actually counts Friday night through Sunday night as the qualified shifts, so I work Friday and Sunday nights and get every Saturday off. Our hospital doesn't just pay us for 36 hours, they actually put a permanent increase on our pay rate (think "permanent overtime") so any extra shifts we pick up during the week are worth the bigger bucks as well. We don't get sick time, we don't get holiday time, but we're otherwise the same in benefits as everyone else. I realize this is really a best-case scenario, but if your hospital has a bailer program it's definitely worth looking into it just to see what's up. Also, chiming in as well to avoid med/surg at all cost. gently caress people telling you about "building your skills" first. It's a waste of time, few of them transfer and you're going to be retrained from the ground up anyway, and really, you're better than that. If you want that sort of action, ICUs are where it's at. 
Digger-254 fucked around with this message at 08:01 on Feb 18, 2010 |
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Feb 18, 2010 02:08
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It always makes me sad to hear how hard it is for new grads these days when just a few short years ago it was cake...  WhatDoTheyKnow posted:I currently work for a hospital in the Central Supply & Processing Department. I absolutely love the work environment, but unfortunately, its too busy there for me to get a chance to talk to the RN's and Surgical Techs there. I would really like to work in the OR and just have a few questions about the two positions. Surgical RNs are getting phased out pretty quickly. As was mentioned earlier, there's nothing they do that a Surg Tech can't do for half the price. Between the techs, the PAs, and the CRNAs, an extra RN has become redundant. If you want to assist without fearing for your job in the future, become a Surg Tech. Circulating OR nurses are pretty much glorified secretaries. Doesn't mean they're not vital to the success of the business at hand, they most certainly are, but that's pretty much the extent of it and most of them will tell you the same. It's a pretty chill gig, nothing wrong with that. But that brings up another problem: the OR is so specialized that once you're in, you're pigeon-holed. Not in the same way as say, pysch or maternity, but almost absolutely. You use almost zero clinical skills, unfortunately. It's a good "retirement without retiring" strategy or if you want a comparatively easy paycheck, though. If you're positive the OR is for you, Surg Tech would be cheaper, quicker, and have a more stable future. Or hell, just go for the gold and become a surgical PA or CRNA and really get your hands dirty. Now to sell my profession: I've been ICU for almost 4 years now. Two in a cardiology ICU, the past one and a half or so in surgical/trauma ICU, and I pick up extra in the ER. Got my CCRN and starting pre-reqs for anesthesia (bedside's been fun but it's time to move on). Anyway, this is definitely a biased opinion, but if you're not ICU or ER, you're a babysitter by comparison. A very well-organized, hard-working, intelligent babysitter, but still a babysitter. I'm not trying to be mean, sorry if that offends anybody, just being blunt and a little simplistic for time's sake. So don't let it intimidate you, no unit would ever just throw you in there! You'd be a panicking headache at best and a massive liability at worst. Actually, you'd be both, so an extensive preceptorship program is really in everyone's best interest. As others have mentioned in this thread, it's awesome. You'll do and see things no one else ever will, even within our own profession. And once you have a couple years experience you can get a job pretty much anywhere, go back for your CRNA or CCNP, or move up into any of the intensive, better paying (and extremely cushy) types of specialties (PICC teams, IR, cath labs, etc). Step up as fast as you can, you won't regret it! Also, pet therapy, music therapy, holistic medicine, etc are all perfectly fine and legitimate as long as they make the individual patient feel better (for whatever reason. It can be hard sometimes but try not to judge), don't encroach on other patients, and stay the hell out of the way. Digger-254 fucked around with this message at 18:55 on Jan 27, 2011 |
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Jan 27, 2011 18:45
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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. I've picked up in step down and telemetry when I'm desperate for cash and it's not panic-inducing, though it is annoying and frustrating and makes me miss my unit something fierce. Which sorta brings up another point: we can step down if we want to pick up some easy extra time, they can't step up because they'd probably get someone killed. Two patients is only a "light load" if they're not really ICU patients. I could agree with the technology and meds point, but again, it's all things we do that they can't. I'd wager it takes a lot more quick critical thinking skills in the ICU and more time management skills on the floors/OR. I'm not saying we can fly around and save the world outside those walls, but I am saying, for example, that since there's no dedicated code team at night in my hospital, if a patient crashes anywhere outside an ICU or ER we have to book it over there and run the code while the floor nurse records (on a good day) or stands out in the hall and cries (on a bad day). We can (and do, if we're broke enough) do their job, we have to fix their messes, and there's no way for them to reciprocate those roles. Of course, I'm only referring more to general med/surg, tele, etc floors. I don't think I could walk into the psych, pedes, or maternity wings and breeze through, those are specialties unto themselves that you have to really want and work toward. Hell, we never see pedes or moms and just sedate the hell out of any psych patient that gets unruly; we give him his meds if we can and he can go back to treatment when we're done with him. Most ICU nurses couldn't do ER because yeah, we admittedly do live in an ivory tower high above those messy trenches. It's not an attitude I like or a weakness I want to share, which is why I started picking up time in the ER rather than the floors. However, I don't kid myself, I'm ICU first and it shows. I take a good amount of flak for it but whatev, it's good-natured (and well-deserved) and I roll with it. They're pretty happy to have an extra trauma RN most nights, though. Anyway, I'm not trying to offend anyone or say such-and-such RNs are useless. Quite the opposite, we need all kinds to make this system keep limping along. And I would never expect someone to step up into a role they can't handle, that wouldn't be fair at all. But by the same token, I won't feel bad about not trying to equate better time management skills with more training, more responsibility, more knowledge, and overall better "keeping people alive" skills, either. They're just... not on the same level. If I'm wrong I'll be happy to admit it, but I've yet to hear a convincing argument other than the time management/patient ratio things. edit: Know what? Nevermind. I can't seem to express this without sounding belittling or hostile and I don't want to throw off an otherwise 100% positive vibe thread. I was hoping to attract some fresh new ICU nurses away from the whole "two years of med/surg to build my skills!" myth but I'm afraid I've come off as a snob instead. I'm gonna leave all that in the hopes that it explains my point of view a little better, but if not, I sincerely apologize for any offense caused. Congrats to all you new grads, hope you find the right fit for you
Digger-254 fucked around with this message at 05:48 on Jan 28, 2011 |
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Jan 28, 2011 03:01
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Silentgoldfish posted:As far as ICU goes, I remember working on wards as a student and having to deal with so many problems of ex-ICU patients who'd had their vitals sorted but were missing what seemed like all the top layers of skin from their backs due to absolutely terrible pressure care. I know it's hard to imagine this being possible if you haven't dealt with it directly, but when a patient is sick enough, we can't turn them. Because turning them would literally kill them. There's a ton of reasons why this could be the case, but suffice it to say that it becomes a matter of priorities. Skin =/= Life. We try to get them on a specialty mattress asap but even that's a dangerous maneuver that requires a few hours of restabilization afterward. In a Level 1 or 2 hospital it's pretty common. We don't take some sort of perverse pleasure in being negligent and we're very well aware that most floor nurses probably think we're awful, uncaring machines but that's not a priority to care about, either. You want unjustifiably bad skin care? A fresh admit from the majority of US nursing homes should fill that slot for you. (edit: Not by fault of the staff, but the administration. Too many patients, not enough staff isn't an acceptable situation in any institution.) These sorts of misconceptions are kinda what I'm talking about, but it's more than that, too. For example, an increasing number of hospitals are starting to require BSNs to work in their ICUs and ERs. We often get better pay. We have better upward mobility. ICU travelers get better assignments and compensation. We're in higher demand. A hierarchical view of our profession isn't some unique, revolutionary idea I'm proposing in this thread to put people down; it's pretty well accepted and acknowledged in the real world. If it makes it easier to label me a mean, elitist jerk for bringing it up, fine, I'll have to live with that. But just because things are different doesn't necessarily mean they're somehow equal. I've heard LPNs make similar cases against those dang high and mighty RNs but yeah, whatever. It's not like ICU is immune to this anyway; we get it from CRNAs and RNPs. Not in some hostile, in-your-face sort of way any more than we treat floor nurses like that; it's just an accepted reality that there's no point debating unless you're trying to make yourself feel better. This whole thing is like if I was trying to compare myself to a CRNA. Even after you toss out that they have an MSN, how could I? Sure they have better equipment, more knowledge, access to more drugs, more autonomy, more training, and are involved in significantly more acute situations than I can imagine. But... I have a higher patient load and do more bedside care? They're cheating because they have all that extra stuff? How could they leave this patient in the same position for more than 2 hours, don't they care about skin?? Well at the end of the day we're both nurses so we MUST be the same! ...ugh, I dunno, sounds like a lot of flailing around that I just can't do. I don't make excuses, I'm just not on their level. And that's not offensive to me. I take it as a challenge to do better. Anyway, at this point I feel like I'm just apologizing for hurting people's feelings over and over. Which seems impossible not to do in this sort of discussion but I'm probably just too blunt. Again, I apologize for that, I'm certainly no diplomat. It is what it is, wish I could have explained myself better. Digger-254 fucked around with this message at 22:32 on Jan 28, 2011 |
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Jan 28, 2011 19:21
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Ugh, an ER vs ICU pissing match is never pretty, you're right: better quit while you're ahead Zing! It was a joke, relax. <sigh> But alright, alright, I get it. I'm a condescending jerk who clearly has no idea what he's talking about. Like that other dude said, we're all nurses, it's all the same, join hands, etc. Moving on...
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Jan 28, 2011 20:24
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Anonymous Pie posted:I posted awhile back about a job shadow. I loved it! The nurse I shadowed was very sweet and patient with me. She showed me around her unit, and I learned a lot about hospitals and nursing. Of course. And I'm sure I still do, every day, subconsciously whenever it's not consciously. It's in no way consuming, but it's there. Even the most stable looking patient can decompensate or just flat-out crump, and often bad situations will get worse. But it's a job, and like any job, you can dedicate yourself to it, do the best you can, and succeed, or you can slack off, take your chances, and inevitably it'll catch up to you. I still get a big rush from codes. It's exciting, high pressure, fast, there's so much energy and adrenaline in the room, it's honestly one of my favorite parts of the job. That and really juicy traumas. But I'd be lying if I said I didn't still get that little metallic taste of fear in the back of my mouth when I first walk into one of those rooms. It's just part of the experience for me, though, and I embrace it because I feel like it keeps me sharp. You need to understand and accept one undeniable truth about almost any health care profession: people are going to die. At some point, everyone's time is going to be up. You, your parents, your friends, that patient in front of you with no family, the other patient across the hall with the big family, everyone you know, everyone you don't know, literally everyone on this planet is going to die eventually. Our job is to prevent the possible and ease the inevitable. Now, if you know the job and did it right, there's nothing to feel bad about; it was their time to go. If you screwed up or were negligent, well, yeah, you should feel pretty drat bad about that. This doesn't mean you don't care about your patients or just go through the motions like some sort of robot. Hospitals can be a very dehumanizing experience and trust me, patients deal with enough people like that breezing in and out of their room already. It's our job to care, we're the patient's advocate. But you have to keep it in perspective or it'll drive you nuts. Don't let that fear stop you. Nursing school will do almost nothing to prepare you for the profession, just accept that's it's just there to teach you the most basic knowledge, introduce you to the hospital setting, and get you past the NCLEX. Experience and your coworkers will be your best teachers. You'll probably freeze or freak out the first time something bad happens. That's ok, plenty of people do. These are some crazy situations, after all! Take a breath, shake it off, and get back in there. edit: erm, hope that didn't come across as too morbid and scary. It's not like you walk around thinking these things, it's just a perspective that clicks in the back of your mind. You care, you connect, but you have to be able to let go and move on to the next one as smoothly as possible, regardless of the outcome. Otherwise you won't be any good to anyone. "Cumulative grief" and all that. Digger-254 fucked around with this message at 23:59 on Feb 21, 2011 |
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Feb 21, 2011 23:50
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| # ¿ May 1, 2024 23:28 |
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drawkcab si eman ym posted:Can anyone comment on the job market for nurses? I keep hearing that the nursing shortage is only occurring in rural areas, and that in fact it's tough to find a nursing job. I want to work in the ICU, and live in southern California, if that changes things any. From what I hear it's getting tight or already is tight pretty much everywhere, but especially for new grads. Going straight into ICU, ER, or other specialty will take some luck and/or connections. The shortage is definitely hitting the MMAs as well, cities always have tons of people and most of the best hospitals. It's not nearly as bad as other fields, there's definitely work to be found. It's just probably going to be at an ECF/rehab center or a hospital with a high turnover (read: unhappy employees) rate. Still, a foot in the door is a foot in the door, give 'em a year then move on to a better place.
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Feb 28, 2011 22:43
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