adversityjane  asked:

Hi Gary! Hope everything is going well. I am in my last year of my BSN and I'm really interested in doing ICU straight out of school. My question is: how soon after graduation am I supposed to get my ACLS certification? I'm assuming it's required to be hired in an ICU, but is it too advanced to do right out of school? I've heard people say that it's helpful to "witness a few codes" before getting it in order to understand the concepts better. Thanks!

Hello there!

Having your ACLS before you start applying for ICU positions will certainly help you, but it’s not necessarily a requirement. If you don’t already have it, and most new nurse grads probably do not, the facility that hires you will have you take it during your orientation. Even if you’re on the unit and one of the patients codes, you can still do CPR. Doing CPR is an excellent way to ease into codes. Once you do your two minutes, you can step back and observe the rest and learn from it. Also, after the code is over, ask questions. Why did we give mag? Why didn’t we give mag? Do we use the AED mode or manual?

I wouldn’t go and spend your own money on getting your ACLS because 1) it is expensive and 2) your future employer will pay for you to do it.

The ACLS class is not too advanced for a new nurse grad. My buddy @rumurse and I both had our ACLS before we started our senior year and before we’d taken our critical care courses and clinicals. It’s a lot of information at once, but it’s manageable.

Yes, seeing codes will help you get a better understanding of what’s going on. However, I’m a tactile learner so I prefer hands on. If you want to see what an ideal mega code looks like, go to YouTube and search for ACLS Megacode and watch the videos by Simple CPR. Those are the exact same videos you’ll watch in the AHA’s online modules, which you’ll likely have to watch when you take the class. I have personally never seen a code run that smoothly, but whatever.

Last bit of advice. When you’re in a code, be careful what you and others say. We had a code in our ICU not long ago in which a nurse from the ED who responded to the code said something off the cuff that offended the family. The patient died in front of their family and the family’s loss was magnified by what it felt was an inappropriate comment from a nurse.

Yes, we see death so regularly that we sometimes build up walls to help us manage the stress. But we must remember that these are real people with real friends and families and we should be professional and respectful during such a horrific scene.

I hope this answers your question! Thanks for taking the time to ask it and best of luck to you in your final year of nursing school!

Sincerely,
Mursenary Gary

(PS - Answered from my mobile, so if there are misspelled words, meh.)

anonymous asked:

Hi there , I recently just found your blog. I am interested in pursuing a career as a registered nurse but I'm quite lost as to where I should start. I graduated high school a year ago and took a break but I am ready to go back to school. I've look up the Lpn program at my nearby school and one of the requirements is taking a pre-nursing exam but I've never had experience. I don't know what course to take to start. I just need a little guidance

Dear Anon,

Good for you for taking a year off and not going to college before you felt ready. Too many kids go straight to college after high school and for some of them, I don’t think it’s the right move. Many could benefit from a year off. I went to college right out of high school and was not ready for it. I survived, but that first year was pretty rough. So, good on ya, mate!

Now, to your question. There are several routes you can take toward becoming a registered nurse. You could go the associate’s degree route, usually a two-year program. You would still be a registered nurse, but depending on where you work, you may be better served getting your BSN (bachelor of science in nursing) degree, which is a four-year degree.

Obviously the associate’s degree will be cheaper and faster and you can always go back and do an RN-to-BSN program later. Associate’s degree programs are usually offered at community colleges, which have flexible course schedules.

If you choose to go to a four-year program, you’ll have to gain admittance to the college or university first, which means you’ll need to take your SATs (if you haven’t already) and/or your ACTs, depending on each university’s requirements. The top nursing schools will be highly competitive, so it will be very important to make good grades in your first year of college. My alma mater gave priority to pre-nursing students who maintained a GPA of 3.5 or better and had zero code of conduct violations.

Originally posted by so-fancyyyy

Another option would be to get in touch with the university you’d like to attend (if you’re going the BSN route) and ask about taking all the pre-requisite courses at a community college (and save tons of money). That’s what I did at Radford University. I had a previous degree from Virginia Tech and a lot of my credits transferred to RU, but for the ones that didn’t, I was able to take a comparable course at the local community college (for about one-fifth the cost). RU’s nursing school admins did a wonderful job of guiding me along the path and told me exactly which courses to take at the community college. Hopefully the university or college you choose will be as helpful.

And before you can be accepted into a program, you’ll need to take a pre-nursing exam. I took the Kaplan Nursing Admissions Exam, but there are others such as the TEAS and HESI. All of the aforementioned exams have prep books that will help you study for the tests. Being relatively fresh out of high school, you’ll be better prepared for it than I was at 39.

So, that’s a lot of information, but where do you start? I think you call the undergraduate coordinator of the nursing program you’d like to attend and explain where you are in life and what you’d like to do and ask for their help. They do this for a living and they will guide you in the right direction.

Every nursing program is different. Some programs incorporate nursing-specific classes over four years and others, like RU, make all their nursing-specific programs “upper division,” which means your junior and senior years. That means your first two years (freshman and sophomore) you’re taking all the courses that most other college students take such as psychology, statistics, English, biology, chemistry, etc. You just have to make some calls and ask.

If you have questions after having made those calls, come right back here and I’ll do my best to help you through the process. Also, by answering your questions publicly, we’ll be able to get feedback from other nurses and nursing students on Tumblr.

Best of luck with your nursing education! We’re here to support you along the way.

Sincerely,
Mursenary Gary

tips & tricks & i’ve learned in 21 years as a human girl who has adhd

some of these i’ve learned on my own, or from family/friends, or reddit/tumblr/pintrest/facebook. but i’ve compiled a list that has helped me remain focused, organized, and not having my mind go all over the place. some of them are just good to know.

1. don’t put it down, put it away (helps immensely with clutter)

2. use a planner for everything, not just school (i use an actual planner because writing it down actually helps me remember it better, but an app can work too)

3. color code class materials, use a different color for each subject (i’m a nursing student and i’m always running around like crazy, my binders, folders, and notebooks for each class each have their own color. ex: bio=green, chem=blue, psych=pink. that way if i’m in a rush, i never grab the wrong stuff.)

4. rewriting class notes, memos, important dates, & anything else worth remembering helps to engrain it in your mind 

5. meal prepping twice every week helps to save time & money & also helps to keep your meals nice and healthy (it also helps me remember to eat because sometimes i have a hard time doing so since my vyvanse suppresses my appetite. it also helps to eat before i take my meds because then i have a more normal appetite and i’m not cranky. i’m also someone who would rather just not eat because i get stressed if i have to cook something, so having something all set and ready to go for each meal is such a huge stress relief)

6. do some sort of exercise for 30 minutes at least 4 times a week because it gets rid of excess energy, helps you to focus, & look & feel great (i do 45 minutes of cardio every other day on the stair-stepper & i’ve just gotten really into weight lifting. cardio definitely helps me A LOT to not be so cranky or all over the place)

7. pick out and get your outfit for the next day, every single night (i pick out EVERYTHING from the actual clothes, to the underwear, socks, bra, shoes, & accessories. this helps because i also have a weird thing about how clothes fit over undergarments & i also have a weird thing about matching clothes with undergarments, socks, & shoes)

8. pack your backpack and whatever else you need the night before (i put all my class materials, snacks & drinks, chargers, gym clothes, etc in my bag every night before i go to bed so i don’t rush or forget anything in the morning)

9. have a bag full of essentials that you take everywhere (i have a purse that i keep my wallet, keys, a protein bar, a water, my iPad, a back up charger, pen, small notebook, planner, gum, & hand sanitizer that i take with me everywhere. everything has it’s own special pocket & i never lose track of the things i need)

10. make lists of “to’s” (to do, to remember, to buy)

11. go from room to room whenever you leave someplace to make sure you haven’t left anything behind 

12. use post-it notes in visible places as reminders

13. set aside one day per week to do stuff you need to get done (cleaning, schoolwork, chores, grocery shopping, etc)

14. have a “time out” for yourself every other day to relax and recharge (i set aside an hour or two every single day to read or watch a tv show or do something that doesn’t require too much thought or energy. i don’t answer calls or texts, and i try not to browse social media. this helps me relax and not feel overwhelmed throughout the day or the week)

15. set alarms for waking up, tasks, & cooking fro better time management (i use a great app called 30/30 thats a great task manager. it lets you set up a list with a set time for each task. the timer starts and you go about your task, once the time is up, it lets you know you should move onto your next task)

Nursing Facts (that didn’t make any textbook cut)

1. Instinct will save your patient, it will save your coworker’s you’re covering for, and it will save your own ass.

2. If a doctor asks you to do something and it feels wrong, it probably is. See #1.

3. Patients lie, families lie, everybody lies.. sniff out the truth with your detective nose.

4. If you even mention you hate taking one type of case to a charge nurse you don’t get along with, guaranteed you will see nothing but those cases once word gets out.

5. Some of the strongest nurses, the people you would inherently trust with your patients, your family, your loved ones, yourself with - aren’t preceptors, they aren’t charge nurses, they are likely the neighboring nurse who never gets the unit award, but everyone wishes silently would be the nurse if they were to ever look up frightened from a stretcher.

6. Half the shit you do in Nursing school isn’t reality, and you won’t always have time to do it in the same way; but that doesn’t mean you’re compromising care, quality or integrity of your profession. It just means you’ve found a more proficient, effective, and just as safe way to do it that textbook authors won’t admit to.

7. You do actually have a choice to speak up when someone is intensely rude to you, despite what surveyors, management, and all the circus of politically correct people will tell you - there isn’t a law or standard of practice in nursing that says take all the crap from people and stay silent. Setting boundaries with patients, families, and coworkers doesn’t mean you’re disrespectful, it means you respect yourself and your place in this profession.

8. Protect your patients, but protect your license just as hard - you can’t protect anyone if you’re not protecting yourself.

9. Nursing management often complains the loudest about things they’ve forgotten how to do themselves.

10. You can make mistakes, have a snitty day, be off point, miss all the IV’s, miss a subtle sign in diagnosis,  and wish you’d chosen another career - but it doesn’t take away from the days that you’re the one to catch someone’s error before it harms their patient, or their license, it doesn’t take away from the days when you sort of think in the back of your mind, I simply love what I do,  it doesn’t take away from the all the times you snagged an impossible IV, but no one really needed to see it for it to feel good, it doesn’t take away from all the moments you caught subtleties that made you remember why nursing is a vital piece of hospital function, and it doesn’t take away from the moments you reminded yourself that hey, it’s a good thing to stick with this profession that you never quite know what to expect of next.

And none of that will ever make any textbook.