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Love the title. Those poor, poor law students. I'm not sure the detoxing alcoholic I had hogtied last week will love me forever though. Anyway, thought I'd tackle some negative myths. Nursing School isn't really that hard. People just say that because nurses don't know any better... I went to nursing school with a previous degree in bacteriology from probably the most renowned public university in the field. Before that, I switched out of mechanical engineering because I thought it was too easy and I was getting bored. In micro bio we did all that lovely O-chem and genetics work that everyone enjoys so much. It wasn't that hard, but it wasn't something you could just wing either. A few years later I went to nursing school. It was the hardest thing I've ever done academically. The courses were brutal - they involved more hours both in and out of the classroom than any program I'd been in before. The expectations were higher and more immediate. You had to know lungs by Tuesday, and you had to know the physiologic effects of the antidysrhythmics by Thursday. Classmates dropped like flies, and those who stuck around were as bright a group of people as I've ever been around. That's not to scare anyone away - if you work hard and want it, you can do it. I'm just amazed that people are meh about my nursing degree and wowza about my infinitely easier BS in a hard science. It's like being in the marine corps and having people gloss over that to swoon over your collection of boy scout badges. Nursing school is as hard as any hard science, and it tops that off by also demanding practicality and an ability to adapt. You don't get to walk away from things with a fuzzy understanding of them. A fuzzy understanding of anaerobes will screw up your experiments. A fuzzy understanding of the effects of ACE inhibitors can cripple or kill a fetus. But your job sucks! You just do what the doctors tell you! In a word, no. I can't speak for all, but I'm in ICU. We have a close working relationship with the doctors because we're at the bedside and they aren't. Our patients are in critical and often declining states, and if the MDs didn't trust us, they'd be in every fifteen minutes to fiddle around with things. When I see a troubling cluster of new symptoms, I page some poor bastard and explain what I see and what I want to do about it. The poor bastard gives me his code and either backs me up on what I want to do or decides to go with something different. So far my "yeah what you just said" rate is about 99% and I get overruled about 1% of the time. The job of the MDs in the hospital setting is to devise a plan. They diagnose and establish a list of meds to use regularly and a list of meds to use if the situation arises. My job is to get the patient through my shift. If the plan is good, my job is easy. If something comes up and the plan is no longer good, it's my job to recognize that and act accordingly. That may mean bending the rules a little bit, or it may mean going the direct route and paging some poor guy at 3am and telling him I now need a central line and an order for pressors. Things are very different from the TV shows. Our medical system has its eyes focused squarely on the dollar sign, and MDs appallingly high salaries mean they are rushed through absolutely everything they do. The good news for nurses is that it means we get a lot more autonomy than we probably did before. The bad news is that with that autonomy comes a lot more responsibility. But I could never do that, it's ICKY! Hah, I remember when things used to disgust me. Those were happy days. To be honest, you get desensitized quickly. The human mind adapts wonderfully, and whatever you might think holds you back from entering health care isn't nearly as important as you might think. I've seen vaginas that would drive legions of heterosexual men straight into frenzied buggery. I've seen mucus, blood, feces and vomit, and as many as three of those at the same time. They aren't the fun part of my job, but they're a small price to pay for the cool things we get to do. Ohthehugemanatee fucked around with this message at 03:45 on Nov 25, 2008 |
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Nov 25, 2008 03:43
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sewersider posted:On paper its something that isn't very desirable, bodily fluids, bitchy docs, long hours, usually subpar pay compared to amount of effort you'd puit in any other field. Bodily fluids don't bother me much, my doctors aren't bitchy and I started as a new grad at $34/hour with essentially free health care, a pension plan (ha, like that will last) and a 401k. Overtime pay is always available. If I was truly desperate for money, I could hop over to legal consulting or one of the other sub specialties where you can make $100/hr or so. We do work hard, but the era of nurses working insane hours for chump change is dying.
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Nov 25, 2008 04:10
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oddkoiout posted:I also, hope that if I do land a job as a BSN Nurse, that I'll be able to branch out to different fields of my choosing like ER, or Psychiatric, and not be locked into basic nursing work without the ability to verge to a different specialty since I have a foreign BSN nursing degree. If you sit for the NCLEX and pass, you're a nurse and no one gives a crap about what kind of degree you have. You can almost certainly get a psych job (mostly because none of the rest of us want them...) and while ER is competitive for new grads, your BSN will put you slightly ahead of RNs when it comes to interviews. Internships and your final clinical rotations will be what really set you up to walk into a certain branch of nursing. Worst case scenario you get stuck in med-surg for a year until you've got enough experience and your hospital's ER will let you transfer in.
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Nov 26, 2008 15:08
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Christoff posted:Have made up my mind. Either want to get my Associates or Bachelors in nursing. Leaning towards my BSN. I'd like to go to University of Hawaii or Portland State for it. Assuming I can get in. Plus I'll be doing Air Force ROTC most likely. Usually you can only jump into BSN as a junior if you have a previous degree. That's what I did. Perhaps some of the prerequisites you've taken will allow you to skip a semester or two. One option you could consider is getting your ADN and then going somewhere for an RN->BSN program. They tend to take a year or two with about one class a semester and they're usually designed for people who are working at the time. The extra courses aren't very clinical in nature so they aren't really that bad.
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Nov 27, 2008 03:40
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BeeZee142 posted:I'm currently a nursing student(woo!) but I was wondering what jobs would be good for me to get on nights/weekends/etc while I have the time(my spring semester classes are pretty easy, and I need to earn some money in the new year). I figure that experience in a hospital setting will be useful down the line over working at Starbucks. What can I do in a hospital considering I don't have a degree in anything, and am basically the same as a high school graduate? Nurse's aide is traditional. The downside is that it really isn't much at all like real nursing. You'll get a chance to see interesting things and ask questions, but it's not the same. Everyone should work as a lifter/asswiper for a bit so that you have respect for those who do it every day, but you'll probably get enough of that in the beginning of nursing school anyway. I'd personally hold off and wait for an externship. It's better paying and more interesting. Another consideration is that health care tends to overwhelm people's lives. When I went to school I made a point of finding a job that had nothing to do with nursing. It meant that 20 hours a week I didn't deal with sick people. It was wonderful. I think if my life had been school, clinicals and working in a hospital I would have gone insane. I just tutored high school kids, made twice as much as I would have made as an aide and had an absolute blast.
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Dec 6, 2008 00:05
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phatmonky posted:He's on to us. He must be destroyed. quote:The same nursing unions do the same thing doctors unions do - lobby for a limit on the number of schools, extremely high requirements for accreditation, etc. to safe guard existing jobs, foreign graduates, and quality.Some of the shortage is for quality, some is protectionism. The Nurse practitioner was made to be a mid level provider to allow a more efficient system. In reality, nursing unions have fused the role into patch working the broken primary care role in many cases, which only exasperates the problem, but is very good for the nursing industry and nurses themselves. We learned it all from you guys.  The NP thing is actually pretty frustrating from our side. Many states put inane restrictions on what we can do, and many hospitals shuffle us into uninteresting jobs. Acute Care Nurse Practitioner sounds really fun until you realize you're going to be in the ED getting every case of "my kid has had this cough for two days now..." The much vaunted autonomy of the NP is often the autonomy to do the jobs the MDs don't really want to do. We also made the crucial mistake of loosening the experience requirements and over saturating the market with inexperienced prescribers no one really wants to hire. There are happy and incredibly successful NPs who have challenging and interesting jobs but most I've talked to went in thinking they'd found a shortcut to being a doctor and found out that really wasn't the case. Oh, and while you guys do have appallingly high salaries, I never said you didn't earn them. I'm pretty sure our critical care fellow's active/on call schedule guarantees that he hasn't slept more than three hours straight in the last month. Whatever he gets paid, it can't be enough. Mangue posted:In my opinion the only way wait lists could be eliminated is to open more schools and hire more educators...but phatmonky is right, nurses do get paid well and most enjoy their job so why the heck would they want to take a major pay cut just to teach someone else to do the job the teachers really want to be doing? It amazes me that I make significantly more starting than any of my instructors did teaching me. How the hell can anyone run a decent school when the system you create sends the ambitious people fleeing from academia?
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Dec 9, 2008 02:33
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Kimball_Ninja posted:So are the shortages for nurses that I've read about because there aren't enough nurses, or not enough GP's out there to handle the usual mid level cases? It's something I should ask my father, as he's an orthopedic surgeon. There are two shortages that are unrelated. First, we're losing GPs because any physician in his right mind doesn't want to be one. The money, respect and babes all go to the specialists. While many people start out wanting to go into primary care, by the time they finish med school they look at their debt vs their salaries and do what anyone else would. The shortage of RNs come from heightened requirements, the fact that hospital based RNs require a lot more training than a 2 year degree can give, and the massive attrition that has always defined our field. A lot of people go to school, start work and leave the profession forever within six months. It doesn't help that there aren't enough schools and few qualified teachers. The teacher problem is compounded by internal weirdness as to what our Masters/PhD candidates actually do. If they're doctoral level they need to be researching something, and that's the rub. Their research has to be "nursing" related which leads to highly educated people researching what is essentially meaningless fluff. I have zero interest in models of caring or therapeutic communication. Neither do they, to be honest. Yet we're way too hesitant about letting our research cross over into "medical" territory and as a result, no one, least of all nurses, cares about nursing research. It's also one of the problems of nursing school in general. 25% of it is "nursing theory" which everyone ignores. The other 75% is Med School: The Abridged Version. That's what actually matters, and it's what we actually use when we work. No one really wants to admit that though, and it's why our post graduate programs are so screwed up. The result is that if you're a nurse who wants to learn things, you go play in whatever specialty interests you and learn while you work. With a few notable exceptions, there are no reasons to go for Masters or PhD unless you want to teach since the research options are incredibly limited. You're also guaranteed a lovely pay cut. Hence why no one does it, hence the shortage of teachers, hence the shortage of schools and thus graduates. Ohthehugemanatee fucked around with this message at 06:07 on Dec 9, 2008 |
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Dec 9, 2008 05:51
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side_burned posted:This may be a weird question, but is it common/possible for some one who has worked as an RN for lets say 10 to got medical school and become an MD? Possible, not incredibly common. Once I finish my third year in the ICU I'm going to probably either go for Flight Nurse or, failing that, MD. It'll mean starting out just like anyone else in med school, but I'm young enough to get away with it. What you describe in your second paragraph is what the Nurse Practitioner was supposed to be. It tacks on 1-2 years of education and gives an RN the ability to prescribe and act as a quasi-MD. Depending on your area of interest, the "quasi" can mean no functional difference (family practice) or a complete deal breaker (critical care).
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Dec 9, 2008 06:12
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Subliminal Squirrel posted:And to all male nurses: do you find you deal with a lot of "you're a guy, so you are doing task X"? I know this in particular would annoy me greatly, as I dealt with it at my last job and the management did nothing about it. Never really been an issue for me, but things vary depending on where you work. Guys are really common in the ICU or ED and no one really notices your gender. Expect more awkwardness as you move away from critical care and the female/male ratio skews further. quote:And to everyone: how often are you puked/poo poo/pissed on? Serious question. They make contact about once a month but I'm pretty good at dodging. I'd say about one near-miss a week. Honestly though, you won't notice after a bit. Gross sort of loses all meaning. quote:And! You say the autonomy of nurses is increasing. But do you still get a lot of "well, you're not a doctor, so..."? I think being polite to those people would be annoying. The only place I've ever gotten that is outside the hospital, and usually from people who know nothing about health care. They don't really bother me much because everyone I know who has seen an ICU nurse in action has the same "Woah... I didn't know you guys did that" response. People in the hospital have never really given me any crap. They tend to be completely bewildered by all the numbers, machines, vocabulary and sounds. Nurses are usually their source of information about what all these things actually mean. If you walk them through those things, they tend to trust you and your coworkers. The only nurses I know who get their competency questioned are the ones who give the impression that they have no idea what they're talking about.
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Feb 18, 2009 01:49
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DigitalJesus posted:I have a few questions I would like to go ahead throw out there. 1) To the best of my knowledge, pretty good. But be warned that there's a reason for that. Drug/Alcohol rehab is incredibly frustrating to deal with and medically very uninteresting. Decide if you really want to work on the nursing angle or if you'd rather be in a counselor position. Regardless, if you have any illusions whatsoever about convincing folks to give up their destructive ways, bail out now. Much of what we do with drug addiction is simply soften the impact when they finally crash and burn. Then again with the current economy, all bets are off. I only barely slipped into my preferred specialty before most institutions laid down hiring freezes. Nurses are the last group in my hospital to get laid off but the axe is coming down in a week or two. Expect a lot of job competition over the next year or so. 2) I can't answer from experience, but I can pass on what I've heard: Tricky, possible and usually not worth it. Nurses in America have a sweet gig. Other countries are often behind the times in pay scales and work environments. Nurses here are professionals and are usually treated as such. Not so much elsewhere. 3) What kind of MSN? There are really two categories. One type makes you an "officially" specialized nurse. These are MSN programs that focus in areas like critical care, cardiology, pediatrics... They all offer minor increases in independent authority. As an example, a psych MSN I knew in Georgia could place 72 hour holds on people in the same way an MD could. In general though, I think most of these degrees are kind of pointless. You learn as much or more by just working in your specialty and the authority you're granted is usually just to do the things an MD would happily ok you to do anyway. All the degrees really allow you to do is teach and I think we've covered in this thread why that's not really as cool as it sounds. You may also get a slight raise from your employer but it's rarely anything major. I'd love to be corrected if someone has one of these degrees and found a meaningful use for it. The other type of MSN degrees radically change what you do. We're talking Nurse Practitioner/Nurse Anesthetist programs. Nurse educators also probably fall into this realm, as they take on more of a research/protocol focus and have next to zero patient care. These degrees have "nurse" in the title but have essentially jack to do with nursing. NPs function as physicians with restrictions that vary state to state. Nurse Anesthetists work with surgeons and also respond in hospital when people crash. Their job is simultaneously awesome and incredibly repetitive. These are jobs where your degree really matters.
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Apr 22, 2009 21:50
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Silentgoldfish posted:In regards to going overseas with nursing ohthehugemanatee is wrong. It's a pain in the rear end, sure, but the hardest transference is from anywhere else to America, mostly due to your maternity requirements. Canada, too actually. I have to go work 3 months of full time maternity if I want to work in North America, which is why I haven't tried. But other than that, passing an exam is usually the biggest headache. That's really good to hear, actually. I've heard a lot of people complaining about incredibly paternal physicians and a real lack of respect for nurses in other cultures. I've heard awful things about Britain in particular and it's nice to know it isn't that bad.
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Apr 23, 2009 04:28
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Hughmoris posted:I'm thinking about starting an RN program at my local community college here in Florida, but I know that once I would graduate the program I'd want to find a job in a different state ASAP. Could someone explain how it works as far as finishing an RN program in one state, then turning around and trying to get a job in another? What type of licensing/testing has to be done? I really hate Florida, but I can't afford out-of-state tuition. Thanks! It's a pretty common practice and relatively easy. I finished school in Atlanta and then ended up working in Minneapolis. I had the option of taking the boards in Georgia and then getting my license transferred over or simply traveling to MN and taking the boards there. I took the lazy man's option and waited until I was in MN to take the NCLEX. Nursing degrees and licenses are very portable.
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May 17, 2009 06:58
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Hughmoris posted:Thanks for all this. Nursing school and nursing are two very different things. Nursing school was frustrating for the inanity of half the material and the incredible difficulty of the other half (really as difficult as you make it, but I tend towards being a perfectionist...). My only advice is to suffer through the stupidity and hold out for the meaningful stuff. You'll pick up the difference quickly, although that first semester is usually pretty awful. Actual nursing on the other hand... drat. I think I spent my first few months in the ICU constantly asking, "Wait, we can do that?" It got even worse once I got on night shift and we no longer had a Fellow around to bounce questions off. At nights we're expected to be independent to the point of questionable legality and the hardest part for me was learning to dance on that line. It's also somewhat sobering to figure out that we're the end of the line in critical care. There have been multiple nights when I've realized I'm taking care of the sickest guy in a 400 bed hospital. It's fun as hell though. My only advice to someone starting a program though would be to find things in your life that don't involve health care. It's easy to get sucked into that world and it's a good way to get burned out. You'll need non-health care buddies and activities where there aren't sick people everywhere. That, and whenever someone mentions "nursing theory" reach up and turn off your brain. But that comes naturally I think.
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May 17, 2009 23:50
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Baby_Hippo posted:Why can't I find a loving decent watch for nursing school that isn't over two hundred dollars?! I have freakishly tiny wrists (otherwise I'd buy a man's watch) and can't find a women's watch with a) a face larger than a dime AND b) a second hand. SO FRUSTRATING!! Dude, go to target and buy the cheapest waterproof one you can find. We are not a field conducive to wearing expensive accessories.
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Jul 14, 2009 21:13
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Solaron posted:When you say 'any RN can get a decent job' what are we really talking here? I'm transitioning from IT, and by the time I finally get into the program and have to stop working at my current job, I'll be at ~40k per year. Will I be able to start at least somewhere close to that after getting my RN? This depends greatly on region and workplace. As a hospital based nurse in the Twin Cities, I made $60k starting as a new grad. At a clinic I might make $40K or less, and I'd make somewhere in between at a nursing home. Things get even weirder once you factor in shift differentials. I get about an extra $5K every year for working night shift. Some of my colleagues in Atlanta started out closer to $40K in hospital based positions. Then again their night shift differential was ridiculous and tacked on a little more than $10K to their salaries. Nurses in New York can pull in 100K. Starting. If you're trying to get a feel for your area, call up some local hospitals and ask them what they offer new grad nurses. A lot will depend on locale and whether your nurses have unionized. Ohthehugemanatee fucked around with this message at 13:42 on Jul 16, 2009 |
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Jul 16, 2009 13:39
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Doppelganger posted:I've been meaning to ask this for a while now for any nurses. What are the monitors like where you work? I'm a clerk in a pediatric unit, but our pulse ox monitors seem to be designed for comatose adults. These kids' sats plummet every time they twitch! Either that, or we have magical children in our city who can drop their O2 sats from 98% to 73% and back to 99% in the span of four seconds. And the telemetry monitors? I have Office Space fantasies about those loving things at least once a week. 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...
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Jul 26, 2009 23:34
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Shysty McShysterson posted:I'm a college student in Australia (which I think is the equivalent of high school, I'm 17) and I'm currently doing all the prerequisites for Nursing at uni. Found the whole 'doctors are better than nurses' conversation earlier in the thread interesing because I totally understand the feeling. It sort of sounds like you know some twits. Also, beginning med students tend to go through an embarrassing phase where they manage to exude more arrogance than an entire surgery department. Law students go through something similar but fortunately the vast majority of both professions get over themselves by the time they graduate. Go look up the Student Doctor Forums some time if you want your jaw to drop in horror. For great fun, start a thread about nurse practitioners and ask how people feel about the evolution of that role. Prepare for a lot of fury preceded by the phrase, "Well in my opinion as a LIKELY FUTURE MED STUDENT nurses are SIMPLY NOT MENTALLY CAPABLE OF..." There is no greater hive of asinine circle-jerking on the internet. Once everyone gets beyond their schooling things calm down and most folk work really well together. Don't let the idiocy get you down. Doppelganger posted:In the interest of keeping a good thread above the water, what are your unit clerks responsible for in general? I only ask because there's a major inconsistency among clerk duties where I work. This usually means that when a clerk from another unit is floating over to mine, they're not even aware of half the poo poo we do every single night. Some units seem to only have their clerks handle doctor orders and answer the phones. I do that, plus about a dozen other daily tasks, plus about another dozen miscellaneous, de facto clerk jobs that might pop up randomly. Unit clerks have that unfortunate characteristic in that some times we really need them and other times there's really bugger all for them to do. Occasionally some idiot manager sees them chilling by the phones and decides to triple their workload in the name of increasing efficiency. Sigh... Sounds like you've got one of those. Ohthehugemanatee fucked around with this message at 09:53 on Aug 11, 2009 |
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Aug 11, 2009 09:49
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Chiken n' Waffles posted:I'm looking for a bit of advice. It sounds like she just got really unlucky with her timing or, more likely, she'd pissed someone off without knowing it and this was an excuse. But it happens. It happens in all fields and no one's career is ever ruined by it. Tons of new nurses start out on crappy floors and quit before they make it to even six months. They go on to have fine careers and it's generally expected that people will have trouble when they first enter the field and may well bounce from job to job for a bit. All she needs to do is to roughly outline what happened and say what she learned from it. Datsun Honeybee posted:Another thing I thought I'd mention -- I forgot the URL, but someone showed me a website that was dedicated to burnt out/pissed off nurses ranting on about how being a nurse is terrible and that they recommend no one does it, ever. it wasn't just venting, they were trying to lay out the idea that the field is, in general, a poor career choice. It varies a lot from unit to unit. Some places fuel those attitudes because their nurses are heinously overworked. I work in ICU and I get two patients. In the last year I saw someone asked to take three patients once. And I mean asked - it was both corporately and personally understood that saying no was completely acceptable. We will move heaven and earth to keep our 1:1 or 1:2 ratios. Contrast that with my girlfriend who works Med/Surg nursing. She usually has five semi-mobile patients, and while mine are sicker, hers are infinitely more demanding. She basically zips around all day putting out fires. When her unit was understaffed she was simply given eight patients with no say in the matter. Where I work we've got an elite thing going and the culture is focused on safety and job satisfaction. It's wonderful and we have very few burnouts. Where she works the nurses are considered to be workhorses and it's almost an assembly line for sick people. Places like that produce the sort of bitter, pissed off nurses that lurk on internet forums. The mistake those nurses make is trying to scare people away from the field when it's really just a tiny portion of the field that's hell on earth.
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Sep 18, 2009 14:36
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Jesus, that defense of med surg makes it sound even worse than my repeated attacks on it. You could get an entire class of nursing students to bail from the program by delivering it at orientation. 
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Sep 21, 2009 05:20
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Axim posted:Are you going to do a 24 hour and a 12 hour shift weekly? Are you sure you can handle that? 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.
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Oct 17, 2009 00:23
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leb388 posted:This. Even if they SEE their kid trying to punch/kick a staff member for no reason, they insist their kid is a sweet little angel, and that the staff is at fault. I'll never understand it. It's fun and very different but it isn't really any more fast paced than anywhere else. For every exciting moment in Labor and Delivery there's the staggering dullness of Postpartum. I also found it much easier from the medical angle because your population is almost entirely young and healthy. There are only a handful of drugs you need to be familiar with and most of them won't be necessary anyway. My only tip would be to check out NICU if you get a chance. It's like ICU except your patients are adorable and about ten times as hopeless. Very interesting though. It's one of those areas like flight nursing where positions only open up when nurses die of old age and I can completely see why.
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Feb 9, 2010 00:35
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chisquared posted:Does an RN-BSN program degree work for getting into more advanced degrees and certifications, or is it a black mark when you're going for those? I know they're extremely competitive, and I want to give myself the best chance I can. Anyone else go this route (getting the nursing education part time), and any advice on pitfalls/good paths? Not a problem at all. Nurses are very familiar with the weird ways people eventually make it to BSN degrees and no one gets looked down on due to the path they took. One of my colleagues was just accepted into a CRNA program and I'm fairly certain he went from Tech -> LPN -> RN -> BSN. Getting your RN first will also allow you to start getting experience and building up the critical care resume you'll need to apply to a CRNA school. Ultimately being able to say "I worked X years in an ICU" is infinitely more important than the course you took to get your bachelors.
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Apr 20, 2010 23:47
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mizbachevenim posted:Passed with 75 questions in 30 min. Job in MICU starts next month. Oh hey, it's me from two years ago!  If I were you I'd go do something awesome until next month. Your studying will be your on-the-job training. Nothing you read is going to really prepare you for the practical realities of taking care of ICU patients. Go do something fun because in about a month's time you're going to come home shaking and hearing sirens in your sleep. The desire to kill yourself or quit fades about six months in and after about a year you'll be truly competent and start having fun. Around this time you'll develop a sense of humor so pitch loving black that the only people who will laugh at your jokes are other ICU nurses, serial killers and paramedics. Totally worth it though. Ohthehugemanatee fucked around with this message at 05:14 on May 3, 2010 |
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May 3, 2010 05:02
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Farcus posted:I hate to be the dick here but OP, I'm quite sure you're not supposed to use any ACE-I or for that matter any drug altering the RAAS when your patient is pregnant and with HT. I'm not a nurse nor a nursing student. That bit was cribbed from my post, actually. The OP added it later. And I'm a bit confused because I tossed that out as an example of something you need to know not to do. I can't tell from your post if you didn't pick up on that or if you're somehow bothered that the bit of trivia I tossed out wasn't properly esoteric enough. Ohthehugemanatee fucked around with this message at 14:08 on May 4, 2010 |
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May 4, 2010 13:59
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Anatomy and physiology were starting points but I don't think I really had a solid understanding of either until I'd covered a lot of pathophysiology. Learning how things went wrong is how I learned how they really worked. I wouldn't be too hard on yourself if it seems like everything isn't quite coming together yet.
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May 24, 2010 05:38
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Giant Wallet posted:Starting Med/Surg 2 tomorrow, learning how to start IVs on Monday. Anyone have any hints that might make it a little easier? Stab, stab and stab some more. More than anything, IVs require practice. If you're lucky, you can work on them in clinical. When I rotated through ER I made sure I did every drat IV start in that place for two weeks. Don't expect it to come quickly. But, some technical tips: Don't dig for veins. It loving hurts and it doesn't work. If you don't get it in on a pass, withdraw almost all the way out and try again. Hold that skin tight. It hurts less and it is easier to insert if your patient's skin doesn't move as you go in. You're aiming for a little shy of a death grip. One mistake I made when I started was to hit the AC. It's big and easy but it's worthless on any patient who can bend their arm since the site will occlude every five minutes. That said, it's a wonderful site if the patient is going to be immobilized or you need large bore access. Really though, IVs are not something you're going to do well without a hell of a lot of practice. Most nurses never get enough practice and they're never very good at it. It's why a lot of hospitals have IV teams and even those that don't often have some unofficial go-to folk for difficult starts.
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Sep 29, 2010 23:06
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mason likes onions posted:A BSN and a few years of experience. And 30 to 80 thousand dollars. That's one way to describe grad school, yes. NPs are BSN nurses who go on to graduate programs where they take what is essentially 75% of med school. They graduate as nurses who are almost-but-not-quite physicians. They are limited in that they're all specialists, cannot do surgery and, depending on the state, require varying degrees of physician oversight. The requirements vary vastly from program to program, but there are enough schools out there right now that getting into some sort of program is not necessarily that difficult. Getting a job, however, is. We're closer to the law school model of "gently caress it lets train anyone who can pay" than we are to the med school model of "keep a death grip on the number of admissions to prevent flooding the market."
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Oct 6, 2010 01:47
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Iron Squid posted:What exactly does a NP or physicians assistant do, generally speaking (and in California, specifically speaking.) That's an amazingly difficult question to answer. In theory, they do all the things a physician can do but they boot the complex cases to the physicians. In practice, physicians boot the complex cases to specialists. Those physicians employ specialist NPs who in turn see the complex cases while the specialists look for the really weird poo poo since they long ago got bored with all their patients having the same three loving illnesses. Things vary from that model based on your practice and your level of competency and trust. A PA or NP who demonstrates competence and reliability will be given an incredible amount of autonomy. A lovely one will be fired or be kept on a tight leash. There are practices where NPs function as glorified nurses. One NP I know was hired by a neurosurgery ICU team. When she was hired they asked her to write her job description because she was the first NP they'd ever hired. She wrote out her dream job and that's what she does now. A PA I know was hired by a neurosurgeon who absolutely hated doing his job. The PA was tasked with preventing the neurosurgeon from getting called at all costs. Everything went through him. Every complication, every choice about whether to take a patient to surgery, it all went through this PA. He could do whatever the hell he wanted as long as the surgeon could sleep in. Functionally speaking, he was our neurosurgeon for two years. A new neurosurgeon took over for the old one. That same PA was fired within two weeks for overstepping his authority. The new neurosurgeon was loving furious that his PA was deflecting calls and not relaying information to him. The remaining PA on that service now does basic assessments, simple procedures and is terrified of doing anything on her own volition. There are ICU NPs and PAs here on the East Coast that essentially run the ICUs. They do the procedures and they see all the patients regardless of complexity. It's not only what they're trained to do, they're great at it because it's the expectation and it's what they have experience doing. Were I to go back to the midwest and pull that, people would go ape poo poo. So I guess the short version is that it really depends. It depends on your region. The coasts are sweet. The midwest is alright. gently caress the south. Great place but their medical associations are obstructionist asses determined to fight tooth and nail against anything remotely resembling progress. It depends a lot on your personality. It depends on the personality of the physicians in your practice. A midlevel can be anything from completely autonomous to a permanent med student. I told you it was a difficult question to answer. I wish I could be more specific to California but my guess is that even there you'll find a huge variation between the autonomy of midlevels at metro hospitals, research hospitals and rural centers. Ohthehugemanatee fucked around with this message at 03:09 on Oct 6, 2010 |
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Oct 6, 2010 03:02
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sewersider posted:Just finished up 6 months working at a prison hospital it was one part eye opener and one part boring as hell. Aged Care nursing lifers was certainly interesting though. ICU is wonderful. It's also very aggravating at first because the alarms take some getting used to. There will be horrific shrieks coming out of equipment and no one will care and then an IV pump will beep in just the right way and people will sprint into the room. Similarly the vents have graded alarms from "The patient is coughing" to "The patient just self extubated and is about to choke to death." At first it all sounds the same and then some part of your reptilian brain figures out the difference and you'll be capable of casually ignoring the 99% of noises that don't really matter while catching the 1% that mean you have at most a few minutes before the patient dies. Until that time though you're pretty much always in a state of shell-shock. Also, the best place to be in a code is to be the dude doing CPR. Why? 'cause it's loving easy. Having a simple repetitive task to do in a high-stress situation allows you to sit back and watch the more complex things going on around you. You're also doing something helpful instead of being one of the wallflowers that get in the way. Get involved though and ask questions. And don't be surprised to find that ICU nurses aren't too welcoming to new folk. New ICU nurses are loving dangerous. It's easy to make a small mistake and kill someone. Even those that are aware of the potential for mistakes waste hours combing over meaningless issues while they miss the major problems. I wouldn't call any ICU nurse remotely competent until after they've worked a year full time. Give them two years and they'll be acceptable. Get used to being a newbie, and remember you'll spend a longer time as a newbie because you have so much more responsibility. It really is fun though. I'm in school now and I miss it. They kept calling codes during my clinicals today and part of me jumps each time and wonders what exciting sort of patient I'll be picking up shortly. But no, I'm doing an HPI on some perfectly healthy dude. Sigh...
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Oct 18, 2010 19:55
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Bum the Sad posted: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. 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. Ohthehugemanatee fucked around with this message at 00:36 on Oct 22, 2010 |
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Oct 22, 2010 00:32
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Mrs. Orgasmo posted:What is ARDS? ARDS is Acute Respiratory Distress Syndrome. Given any sort of insult to the lungs it's always a risk. Pneumonia, drowning, vomit in the lungs, simply being on a ventilator or almost anything else you can think of can trigger it. Something gets into your lungs and your immune system freaks out and decides to kill it. That's all well and good, but your body's immune system tends to fight infection by sending in suicide bombers. They wipe out the intruder, any of your cells that were nearby and any cells that happened to look funny at them on the way in. It's a fine system when you're dealing with replaceable tissue. Not so good with things like lungs. The lining of the lungs gets absolutely shredded to the point that the lungs inflate with air but the cells that shuffle oxygen to the blood are toast. The few functioning parts of these patients' lungs are rapidly overwhelmed or flooded with debris. You can hook these patients up to ventilators and give them 100% oxygen but only a trickle of it will get into their blood stream. 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. True ARDS patients look like this. If you squint you might see the patient. Even the patients who live often end up with scar tissue in their lungs and a nasty predisposition to go into ARDS over and over again. 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.
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Oct 23, 2010 00:57
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I'd heavily dissuade anyone feeling "meh" about medical school from leaping over to nursing. The two are worlds apart. At least in the hospital setting, MDs largely make a plan and walk away. Nurses execute the plan. There can be a lot of creativity and autonomy in the execution of the plan, but carrying out a plan is not the same as designing it. Which would you rather do? There are upsides and downside to each role. Making the plans is actually pretty boring most of the time. It's also frustrating because rather than do what you would like to do, you're often constrained by the way things are done at your local institution. You're also going to have your plan overwritten by other practitioners, and sometimes the people carrying out your plan will end up mangling it so badly you won't even recognize it. You also won't be there when things happen. You'll have to trust that other people are monitoring, and that those people know how to respond appropriately. Executing the plans is fun because you get to deal with the immediate problems that crop up. You have to prioritize and anticipate, and in a true crisis you get to make the really quick decisions that matter just as much as the overall approach. The downsides are that it's frustrating when you get stuck with a lovely planner. The job also becomes terrible when you are so overloaded you have to mentally shut down and just leap from task to task. Of note, the people executing plans are usually the ones who get covered in disgusting bodily fluids. The best advice I can offer though is to get out and shadow people. Call up your local hospital and ask them if you can tag along behind someone in the ED for a day. While you're there, try to talk to people in different roles and see what they do, how happy they are, and try to decide if what makes them happy would make you happy. Also, look into Physician Assistant programs. Midlevels do 90% of the cool stuff MDs do while dodging 90% of the awful poo poo MDs have to put up with. If you're looking for something close to being a physician, Nurse Practitioner or Physician Assistant might be more up your alley. Of the two, PA is probably the better option for someone without a nursing degree. Ohthehugemanatee fucked around with this message at 04:04 on Dec 5, 2010 |
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Dec 5, 2010 03:36
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Digger-254 posted: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. 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.
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Jan 28, 2011 00:35
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Enigmatic Troll posted:Awesome rundown of psych I did a student rotation through the kind of facility you work at and that's pretty much the read I got. Glad to know that my desire to run screaming from psych as fast as possible was merited. As to the question about being a guy, just like in most fields, guys often have an easier time of it. I'm most grateful for it when things get heated and disagreements get nasty. No matter how strongly I'm clashing with someone, things always stay respectful. There's that line between disagreeing and belittling, and most folk just don't cross that line with guys. I have, however, seen tons of asshat nurses, paramedics and doctors tear into 5'2" females, presumably because you can tower above them and be relatively sure you aren't going to get the poo poo kicked out of you for being a douchebag. Just like all fields, there's some bullying in health care. There's a lot to be said for being just intimidating enough that the assholes of the world don't see you as their punching bag, and being a guy does a lot for that.
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Feb 2, 2011 01:40
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Digger-254 posted: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. I'd say we're all emotionally dead on a certain level. I still care, but I'll never care the same way I did when I started health care. The knowledge that you may inadvertently harm someone is always there. Somewhere out there tonight, a rookie nurse is trusting a rookie resident and about to gently caress their patient up something fierce. You have to trust yourself to use the knowledge you have to make the right decisions, and you have to hope that when you run into something you don't know about, one of the checks in the health care system catches you and saves your rear end, whether that's an experienced colleague stepping in or a pesky computer system that won't let you put in that order for 100mg of fentanyl. Mistakes happen though, and it's how we learn. I go to morbidity and mortality conferences with my surgical team every week and it's an hour long talk about all the cases that went badly, why they went badly, and how those mistakes can be avoided in the future. The more responsibility you take in health care, the more certain it is that your actions are going to harm someone at some point in time. Ohthehugemanatee fucked around with this message at 02:45 on Feb 22, 2011 |
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Feb 22, 2011 02:43
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Man this thread turned ugly quick. Bree, you seem a little pissed off at nursing in general. You should also know you're coming across as that guy who is king of mediocrity mountain and wants to poo poo all over everyone else while remaining oblivious to the very modest nature of his own achievement. You work in acute rehab, dude. Most nurses would rather fellate a shotgun than set foot in your unit. That doesn't make you a badass - it makes you a dude working where most nurses would never even send a resume. Congratulations on being (in your own estimation) the best of the desperate. How you've convinced yourself that you're qualified to sneer at ADNs is completely beyond me. Ohthehugemanatee fucked around with this message at 09:03 on May 23, 2012 |
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May 23, 2012 08:24
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Weebly posted:Hey, I work acute rehab and aren't an rear end in a top hat. Sorry, was only trying to make him feel like one  .It was his attitude that annoyed me, not where he worked. Acute rehab is a less competitive branch of nursing with a reputation for being task oriented with most of the difficulty coming from a time-management standpoint. For the non-nurses, that's code for: "endless back breaking labor." A lot of folks run screaming away from it for exactly that reason. If you're lucky enough to work for one of those units in a place that's fun, well staffed and doesn't work you to death, that's awesome. There's actually one of those at my hospital, and it was the first I'd ever seen like it. Most that I've seen have real trouble keeping people on and end up having to hire a lot of nurses and other staff that would not be hired elsewhere. It's just a weird platform to stand from if you're going to post like he was. Ohthehugemanatee fucked around with this message at 21:11 on May 24, 2012 |
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May 24, 2012 21:07
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A Sleepy Budgie posted:I have a question for you nursing/nursing student goons- what is the difference between a nursing degree from a community college and one from a university? I am seriously considering changing my career choice from veterinary technician to nursing. The answer here is complicated. Sorry. There are 3 categories of nurses. You've got your Licensed Practical (or Vocational) Nurses or LVNs/LPNs. These are the nurses with the least training and have several restrictions on what they can actually do. LPNs and LVNs used to be everywhere, but they're increasingly being relegated to nursing homes and doctor's offices. This program is offered at a number of community college programs and in general is the degree you do not want to get unless you really need to be out and working in a year's time. Then there are Associate Degree Nurses or ADNs or as everyone refers to them, RNs. This is the basic 2 year nursing degree. It's offered at all sorts of institutions. RNs work pretty much everywhere but one HUGE caveat is that getting hired as a new ADN is getting more difficult. Your average experienced RN can get hired nearly anywhere, but the new grad ADNs are increasingly finding hospital positions closed to them. To further confuse things, this is a highly regional issue. The Bachelor's of Science in Nursing or BSN is the 4 year degree version of nursing. It's what you get at a university. To make things confusing, these people are also called "RNs" and are paid almost exactly the same as ADNs. The degree is essentially an RN degree with the addition of a liberal arts degree, some fluffy leadership classes and a tiny bit more practical theory. It's the required degree to move on to Masters or PhD programs, and increasingly it's being required to be hired at hospitals in metropolitan areas that can afford to be selective. So roughly, community colleges tend to graduate LPNs and ADNs, while universities tend to graduate BSNs. ADNs and BSNs are functionally identical in practice, pay and responsibilities, but the latter option makes you slightly more likely to get hired and is generally required for advancement in the profession. The hiring thing is key because while experienced nurses can just walk into jobs, new grads can have an incredibly difficult time getting hired. If I were to advise someone, I'd say go with the BSN. If you're hurting for cash or don't want to end up in debt, go with the ADN and work as an RN for two years or so while you complete your BSN part time. And to think some people consider nursing to be the most ridiculously alphabet soupy of all professions. And I didn't even touch what happens when people start getting masters degrees. EDIT: My spelling and syntax go to poo poo on overnights. Christ. Ohthehugemanatee fucked around with this message at 07:49 on May 27, 2012 |
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May 27, 2012 06:59
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Fromage D Enfer posted:What do you guys think about Kaplan or similar NCLEX prep programs? Did you find them helpful or a waste of money/ time? Should I even bother? The salesperson came by our class the other day and scared us all into signing up for the course, but I'm not sure I will get much out of it. I'd just buy a book and flash cards. The NCLEX is pretty gameable if you just remember that they have a raging hard-on for Safety and Assessment in that order. They also love open ended questions, which makes any "what would you ask next" question a gimme. Any book you buy will lay that stuff out for you in the first few chapters. The flash cards will let you identify trouble areas and address them. They also help you get used to how the test takers think, and once you get how they function, the test gets a lot less scary. The courses are best for folk who won't be able to muster the motivation to drill that stuff into their heads. As long as you're capable of working on your own you should be fine.
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May 30, 2012 07:18
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Hughmoris posted:How difficult is the ACLS qualification? It's doable as a new graduate but it's really designed for folk who have a decent amount of bls experience. You have to be able to quickly identify rhythms and it's nice to have been in a few codes so that things stick a bit better. I took it six months into my first job and it was easy. Had I taken it right away it would have been much harder and I would have retained less.
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Jun 1, 2012 06:41
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