Fortunately so far I was usually home when a storm hits. But not this time. On Sunday, the news started to spread that there was going to be 20-30 inches of snow across NYC and Long Island from Monday until Tuesday midnight. And I was scheduled for both Monday and Tuesday.
So I got myself ready… Just in case I was going to stay over. Another pair of scrubs, toothbrush, toothpaste, other toiletries, and pajamas.
I went to work Monday. Watching the news, I saw the weather get worse. I probably would make it home but my small car probably wouldn’t be able to make it back to work. My nurse manager asked if I was going to stay. I said yes– I just need a sleeping area. She said she would arrange one, don’t worry.
After work, I went to the cafeteria. They were nice enough to give out sandwiches, cookies and water for those staying over. Many of my coworkers came in early the night before. Dedication!
I went back to my car to drop off my lunch supplies and pick up my bags. I was considering sleeping in the car but by the time I got to my car, I thought it was way too cold. I headed back inside.
When I was working the night shift, we put sleeping mats in the shower because we didn’t have anywhere else to store them. I thought that the shower was pretty useless and nobody was ever going to use it. Funny how I ended up using it that night. I just wish I brought my sandals!
I slept on a mat in the conference room. It wasn’t too bad, except that the ground was hard so I had to reposition myself every few minutes haha. I put my phone on airplane mode to conserve battery.
It was actually kinda nice not to have to travel to and from work. Extra sleep time. It was nice to wake up and find out that four other nurses also stayed overnight. One patient care assistant (PCA) worked the 3-11, slept, then 7am-3pm. Another PCA did 11pm and ended at noon. Another one did 3pm-7am. Thank goodness for them!!
They offered a $2.50 credit for breakfast. So that was nice.
But we started with 7 nurses when we usually work with 10 so it was a rough start to the morning. Most of us started with a triple! As the morning came, two more nurses came in so it felt a lot better.
Anyways I am glad that there was a mandate for no cars on the roads overnight so the trucks could plow most of the snow away. And I am glad that I didn’t have to drive through bad weather by staying inside.
We don’t have mandatory overnight stays so we don’t get paid to sleepover. I believe that at some other hospitals that in a state of emergency that they do this to keep enough staff on duty. Do you think that nurses should get paid to sleep overnight or during the day or that it’s a waste of money to do so? Or does short staffing cause unsafe patient situations? What is more important?
I finally finished my essay after several drafts so I submitted my grad school application online. It really makes you think about why you want to go into a career and forces you to be certain about what you’re going to do in the next few years.
I did share my blog in the personal statement essay. In this 21st century, I hoped that was ok. After looking at Twitter, I found that the school also had a WordPress blog. Perhaps they will see what blogging can do for someone… And help many people!
It’s been somewhat of a relief to finally be done with applying for grad school. I went to two information sessions, studied and took the GRE, took the PALS classes, studied and passed the CCRN, made sure recommendation letters are completed and in (and thanked those who’ve helped me), got my Michigan license… It’s been quite a few things to coordinate. Having a timeline helped but it’s mostly been studying, studying, studying. While I welcome the break, I know that I’m going to be itching to do something again.
It’s really tough to decide the best course of action for someone who is dying, especially in our society where life, any sign of life, is prized, and not necessarily the quality of life. It’s truly difficult to make a decision for someone’s life especially if you love them.
But the better question is, would you want to live in that fashion?
Talk about death decisions with your loved ones so they know what to do in case something happens. This will save time and grief among the family and friends. The health care proxy doesn’t have to be guilted into making that hard decision that no one is willing to make.
As for organ donation, if someone willingly signed up to be an organ donor, I would assume any organ is ok as long as it’s usable and that I don’t look completely mutilated after the process. I mean, in the end an organ is an organ. If it can help save another life and I’m already dead, why not help out someone else?
I passed the CCRN last week! Yay!!! The CCRN is a certification exam for critical care nurses. It basically verifies your knowledge about critical care concepts after working 1750 hours in the last two years. The benefit of getting the CCRN means getting a pay raise or a bonus. Or intellectually, it solidifies your basics. But if you’re reading this, you probably already know that. You have the more important question — how do I pass the CCRN?
Before I studied, I also searched the internet for the best way to study for this difficult exam. There were two things that stood out to me.
I got all of the material from a friend, from another friend.
I listened to all of the videos and wrote down notes the first time around so I wouldn’t have to listen to it again. It meant I had to pause the video sometimes to write notes. There were 6 videos about 2 hours long. So roughly 12 hours. I did 2 videos each week while working full time. It took 3 weeks to complete.
Then I did all of the questions from Pass CCRN. Don’t read the book. Doing the questions will inadvertently make you go through the important concepts and details. I gave myself the goal to complete either a complete section (for shorter, easier sections) or a certain number of questions each day. Cardiac (20%), pulmonary (18%), and ethical (20%) are the most heavily weighted sections. For the cardiac and pulmonary sections, it initially took me about 2-3 hours to complete 30 questions because I would read the rationale and write a flashcard for the material. There are over 300 questions on cardiac alone, and there’s a good reason for it.
I felt the most important things about cardiac are:
The different medications (pressors, vasodilators, diuretics, beta blockers, calcium channel blockers, ACE inhibitors, ARBs), how it works, side effects, and how it affects afterload, preload, and contractility (which comprises of stroke volume (SV)).
How does SV and heart rate (HR) affect cardiac output (CO)?
In different disease states, what is lacking, and what do you need to fix the problem?
How does the intra-aortic balloon pump (IABP) help? Complications?
What does the pulmonary artery measure, what do those values mean, and what do you do when you see a value out of wack? What are physical assessments would you find?
What are the different types of murmurs, where do you listen, what typically causes stenosis vs regurgitation?
Different types of chest pain, MI.
12 lead EKG — this took some time for me since at work it’s only required to know how to read a lead II EKG. But since I started studying, I’d look at 12 lead EKGs at work and it’s kinda fun.
ABG interpretation (compensated vs uncompensated; what would breathing too fast or too slow cause? How would you treat different values?)
Ventilator settings – which ones affect respiratory rate? What does PEEP do? How does that relate to the V/Q ratio?
As I did the questions, I used a flashcard program called Anki. It’s a fantastic memorization tool using the concept of spaced repetition. And the best part is that it’s free to download on the computer or laptop and to use over the internet. It’s $25 to download on your iPhone or Android but it’s worth it.
Basically, I did the questions on one side of the screen, and had Anki opened on the other side. Anything I didn’t know or wanted to review, I either copy and pasted questions or answers, or paraphrased the concepts. It’s easy to put too many things to memorize on one card and that’s the last thing you want to do. When you’re reviewing the card, you don’t want to think, “oh I got half of the card correct… so do I choose that I got it right or wrong?” You want to be decisive and pick whether or not you got it correct.
I have the flashcards that I created for the CCRN that is easy for you to download, although you should probably create your own or edit mine to make it easier for you. Updated December 16, 2016: these flashcards can only be used with Anki on a computer or phone. If you are thinking about downloading the flashcards, please download Anki first and make an account. Also, please do not download these flashcards unless you will use them right away.
Updated August 3, 2015: I’ve given the CCRN Flashcards to many people who have used them and passed the CCRN. Since it is time consuming for me to email everyone who asks and I’ll have no income for the next two years while I’m in school, I’ve decided to sell them to help me pay for food during school. People have said that it’s worth $50 but I won’t charge that much for it, especially since I really want you, as my reader, to pass!
And good luck in your endeavor.
Just 89 out of 150 questions to pass. So you can do it! 25 are for research. Only 125 actually count. You have up to 3 hours to take the exam.
The exam is $225 if you’re a member of AACN. You’ll go to goamp.com to see the test sites and register for the exam. You’ll get 3 months to take the exam. Once you pick, you can change the test date once for free. Majority of the test sites are in the HR Block. How nice of them!
I took mine in Astoria, NY. I was the only one and it was quiet. Good experience.
And the best part is that it’s free to download. Unless you decide to download it on your phone (iPhone / Android).
You know how you cram everything in for an exam, only to forget in a few hours or days later? Yeah, that won’t happen anymore.
This flashcard system is based on science of how people remember and forget things. It uses a spaced repetition system so that the card shows up right before you’re about to forget the information on that card.
The great part about these flashcards is that you won’t have to review every single card every single day to remember. It spaces itself out depending on how well you’ve remembered the card. You will look at the card, decide on an answer, click on the card and see the answer. You will choose whether or not you got the question wrong (leading you to seeing the card sooner), or right. You can pick how easy or difficult it was for you to remember the answer. If it was easy, then the card will show up days later. If it was difficult, the card will show up sooner. If it was ‘just right’, then the card will continue down its algorithm.
While initially the Anki was created to remember languages, it can also be used to memorize nursing concepts. I used it personally to study for the CCRN, the certification exam for critical care nurses. So I know that this works.
It may look seemingly difficult but it’s actually easy to use.
You have to commit to it, and Anki will be there for you.
People should not think that it’s ok to hit anyone, especially nurses. Even if you’re mentally crazy or angry or whatever you’re feeling, it doesn’t give you the right to hit nurses. Violence is not ok and should not be tolerated. Hospital administrations should support nurses and those closest to the patients.
I can’t believe that it’s been 2 years since I became a nurse. I remember 2 years ago, I was looking for a nursing job, and it was so difficult as a new graduate nurse. Nearly every posting I saw, it stated, “2 years of experience, preferred.” But at that time, I thought, how can I possibly get those 2 years experience if no one gives me a chance?
Somehow, I got lucky. Relatively, it’s been a relatively smooth career. I would say that NYU nurses work are all over NYC and wherever they decide to go (back home to their home state — New Jersey, Michigan, Texas, California, Oregon, etc) or they’ve gone back for their Master’s (I personally don’t know anyone who’s gone back for a doctorate degree yet).
By June this year, it’ll be the first time I renew my license. I’ll let you know how that goes.
In 2014, there has been more readers than ever — so thank you for reading my blog! Here are the top 5 posts in 2014.
For those looking for their first nursing job — my take on it is that any nursing experience is better than waiting around for the ‘ideal’ experience. Just keep in mind what you really want (where in nursing do you want to end up?) and keep heading in that direction. Opportunities open up for those who are ready and looking for them.
This year, I want to go over one evidence-based practice each month. Unfortunately, the conversion rate from science to real practice takes an average of 10 years (WHAT??). The goal is to reduce this rate and start practicing new findings sooner in practice.
For the last 2 months, I’ve been studying for the CCRN, which is a certificate offered by the American Association of Critical Care Nurses (AACN) that reflects the dedication you exemplify as you provide direct bedside care to acutely and critically ill adults. It can be taken by those who’ve practiced in critical care for 1750 hours within the last year. I’ve definitely learned a lot from it, especially things that I don’t use as often. It’s been great to incorporate what I’ve learned from there into practice.
The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog.
Here’s an excerpt:
The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 34,000 times in 2014. If it were a concert at Sydney Opera House, it would take about 13 sold-out performances for that many people to see it.
You either get the flu shot or you don’t. If you decide not to, you must sign a waiver and then wear a mask at all times once you’ve stepped inside the hospital… At least until the flu season is over, usually sometime in the beginning of April.
This requirement is so serious that if you didn’t comply, you’d end up with leave without pay and eventually fired within a week. So hop to it!
Most people don’t want to get the flu shot because they feel more tired and ill afterwards. They fear getting the flu from the flu shot. But people are much more likely to get the flu from the community than from the flu shot.
Some have an egg allergy, or a family history of Gullian Barre. In this case, definitely don’t get it. Or if you’re body is immunocompromised from another disease. Then adding a dead strain of the flu to your body is probably not a good idea.
Anyhow, wearing a mask all the time isn’t so bad. In fact, in Taiwan majority of hospital workers wear masks, partially due to the H1N1 and SARS virus that broke out a few years ago. The only annoying thing about it is if you wear glasses, it sometimes fogs up the glass or if you have an allergy to the mask material and you break out from it.
I never got the flu shot prior to 5 years ago. I was at Employee Health to get cleared to volunteer at a Cancer Center. The nurse asked if I got the flu shot. I said no and I didn’t want it.
What she said next changed my life. She said,
It’s not just about protecting you; it’s about protecting others.
Cancer patients are definitely immunocompromised. The radiation and chemotherapy is killing off good and bad cells, unfortunately. If I got the flu, my body may be able to fight it off easily but if I cough on someone else (by accident of course), it’d be much easier for them to get the flu.
That day I didn’t get the flu shot because I had a certain pride of never getting the flu shot.
2 days later I got the flu shot. I didn’t want to be that agent to pass on the flu.
For my boyfriend, I encourage him to get the flu shot. Last year we were at a Breast Cancer event in October in Providence, Rhode Island. There, Walgreens was offering free flu shots. So he got one.
This year I encouraged him to get the flu shot again. He didn’t want to because it’s an out of pocket expense. However, at his work they were doing an experiment on ways to encourage people to get the flu shot. They offered it for free. So he got one.
Cost and fear of getting the flu are the 2 major barriers for not getting the flu shot. Protecting yourself and others are my reasons for getting it.
What’s your reason for getting it or not getting it? Comment below!