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Family photo! #statement #packpics (at Carter-Finley Stadium - Official Home Of Wolfpack Football)

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Look what came in the mail today!

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  • Question: What is nursing like? Like what do you actually do as a nurse? What would be a typical day for you? Did you ever consider being a doctor? I think nurses are really underrated and I'm thinking about being one! :) - Anonymous
  • Answer:

    cardiacattack:

    Wow, what a question. That’s actually quite difficult to answer, as nurses can do so many things! I’ve worked in three areas since I graduated (pediatric med-surg, pediatric emergency and now pediatric cardiac ICU) and each one has been vastly different. I’ll try to sum up the most common avenues of nursing, then talk a little about what my specific jobs have been like. I can go ahead and answer that last question, though: No, I have never wanted to be a doctor. :) I wanted to be a dentist in kindergarten, but that was the first and last time I ever considered being a doctor haha. My brother and sister are both in med school. I have a very similar educational background to theirs and perform just as well (if not better) academically, so I’m sure if I had wanted to pursue medical school I could have (I hate how every nurse has to preface with the whole “I’m not a nurse because I’m dumb!” spiel). Medical school has never been on my radar, though, as the job description of a nurse truly appeals to me much more. I don’t even want to be a nurse practitioner. I just literally have no interest in diagnosing and prescribing at all.

    Alright, now, onto nursing. 

    Outpatient

    Most people probably see nurses in outpatient settings more than inpatient. Outpatient nurses work in doctor’s offices, as school nurses, home health nurses, infusion clinics….anywhere people in the community access healthcare. I’ve never worked outpatient, so I can’t speak much to what these nurses do on a daily basis. It can be anything from paperwork and minor procedures, to blood transfusions and administering chemotherapy, to providing daily care to medically fragile people in their homes. Just so many possibilities. You don’t even have to do patient care: a lot of nurses become pharmacy reps, go into medical equipment, case management, IT, teaching….so many more. I don’t know as much about non-clinical nursing (as I’m a clinical nurse), but it’s another huge world!

    Inpatient

    Inpatient nurses work in hospitals. These are more the nurses you see on TV and are probably more what everyone’s idea of a nurse is. There are so many specialties of nursing, and what you do on a daily basis depends on what kind of a nurse you are. Adults, pediatrics, OB, medical-surgical, psychiatric, rehab, ICU, emergency, OR, PACU, oncology, cath lab, GI lab, dialysis, etc. etc. etc. (there are so many more)….then a lot of places are divided up by diagnosis. Like I’m a pediatric cardiac ICU nurse. There are just pediatric ICUs, neuro ICUs, surgical, medical, technology-dependent, neonatal (etc etc!)…and what each of us does is different. I’ve barely touched the surface on the types of nurses there are. The possibilities for a nursing degree are just so extensive, I can’t emphasize that enough. 

    Ok, so what do these jobs look like? I can only really speak to my personal experience and what I personally have done. This even varies state-to-state and hospital-to-hospital, so someone else working as a pediatric ED nurse may not have the same responsibilities I had in my peds ED, for example. But here’s basically what I’ve done: 

    Pediatric Med-Surg

    This was my first job as a new grad. I worked a med-surg floor, specializing in orthopedics, urology and surgery. We took care of many diagnoses, especially if other floors were full, but we most commonly saw: spinal fusions, fractures, compartment syndrome, appendicitis, pyloric stenosis, spina bifida, bowel obstructions, tumor excisions, limb lengthenings, osteomyelitis, testicular torsion, osteosarcoma, hip dysplasia, SCFEs, cholecystectomy, spontaneous pneumothorax, neurogenic bladder, kidney reflux….that’s just the stuff I can think off the top of my head, there’s way more. 

    What did a typical day look like for me? Arrive on the floor, receive report from the off-going nurse about my patients (I would have 4-5 of them), then get started by assessing my patients and taking vital signs. From there, I could do a variety of things depends on what kinds of patients I had. Administer pain medications if needed, administer antibiotics, all kinds of different medications. IV pumps, syringe pumps, PCAs, PO, push….so many meds. If a dressing needed to be changed, I would change it. Start IVs. Irrigate bladders. Place or remove foleys, place or remove NG tubes. Administer feeds (NG, NJ, G, GJ tubes….TPN/lipids…etc!). Set up traction, help kids in and out of bed. Administer IV fluids. Care of different kids of casts. Continually assess my patients for things that might be changing (does their arm seem more swollen? Are their changes to their hand’s color or sensation? Let’s call the doctor and split this cast! Is their blood pressure lower? Do they seem septic? Are they needing more O2 than they needed before? Is their heart rate changing? Am I worried about this patient? Maybe I should call rapid response!). I would update parents over the phone, update parents in person, explain things the doctor told them that they didn’t understand, answer their questions, educate, educate, educate. I would call security and handle social situations (usually a problem when the parents are in a custody battle or there’s abuse). I would prepare patients for surgery and watch them afterwards. I would admit patients to the hospital and discharge them home. 

    Emergency Department

    In the emergency department, you see everything. Everything! Sickle cell, cancer, fevers, seizures, broken bones, trauma…just seriously everything. I can’t even start to list all the diagnoses, as it’s all of them hahaha. In the ED, I cared for 3 patients at a time. I did lots of the same tasks (start IVs, NG tubes, give medications, foleys, urinary catheters, etc), but I also did some new things that I didn’t see on the floor. I assisted with procedures (reducing fractures, I&Ds, lumbar punctures, etc), helped to sedate kids, gave respiratory treatments, drew labs, EKGs, helped during traumas (intubations, chest tubes, massive transfusions…anything and everything you might see in a trauma room). The way I started my day was much different than the floor, though: if I was getting report from another nurse it would be extremely brief. Just summarizing why they were here, what had been done and what needed to be done still. Sometimes I would be opening up new rooms, though, and wouldn’t get a report at all, I would simply start bringing patients back. You might also be working in fast track (for patients who don’t need many resources), in assessment (you’re the first person to assess and interview patients before they go back to the actual ED), triage (assigning acuities to patients and determining how quickly they need to be seen), or sedation (you draw up sedation meds, assist and chart during sedations). ED is much faster paced. You will see dozens and dozens of patients in one night. My ED saw about 90,000 patients a year (yea, you gotta move fast!) You provide care, then admit or discharge. No one sits around (expect maybe like a psych patient we need to find placement for). You do a lot of coordinating in the ED, lots of education, work a lot closer with doctors, paramedics, social work, translators, etc. 

    Cardiac ICU

    Currently, I work here. We see patients with congenital heart defects. We treat them in the OR or the cath lab, for the most part. Some examples of diagnoses are tetrology of fallot, pulmonary atresia, coarctation of the aorta, SVT, Ebstein’s anamoly, transposition of the great arteries, aortic stenosis, Shone’s, hypoplastic left heart syndrome, interrupted aortic arch, truncus arteriosis….more, lots more. I start my day more like I did on the floor by receiving report from the off-going nurse, then assessing my patients and taking vital signs. I’ll also print off my EKG strip. I will only have 1-2 ICU patients (depending on how sick they are), or 3 step-down patients. Some patients are so sick they need 2-3 nurses just for them. I’ll do tasks as they need to be done: suction patients, monitor and change drips, administer medications, change dressings, care for ventilators, perform dialysis, give blood, draw labs, care for lines (IVs, arterial lines, umbilical lines, central lines, RA lines, etc). Pace patients. Administer feeds. Patients can be on ECMO or CPS (bypass). We assist MDs at the beside, opening chests or closing chests. Caring for chest tubes (yes, we can strip chest tubes :P). Caring for patients immediately post-op. We do lots of bedside imaging (echo, ultrasound, xray, etc). 12 lead EKGs. I take vital signs and assess for changes much more frequently than on the floor (floor is every 4 hours. ICU is every 1 hour…sometimes more frequently. Step down is every 2-4 hours), as ICU patients can change very quickly. If a patient codes, we run our own. Admitting patients, discharging patients, educating. The procedures that take place in the ICU are much more invasive than on the floor, but more long-term than in ED. In that way, it’s kind of a combination of both areas. 

    Very very very basically, the differences between the areas in acuity:

    Med-Surg: Patients are sick enough to be hospitalized and need quite a bit of care, but they’re not the sickest. They are stable, but always have the potential to become un-stable.

    Emergency: Patients may or may not be stable. It’s up to the ED staff to determine how sick they are (discharge, follow up outpatient, admit to floor, admit to ICU). You see a lot of patients and initiate a lot of treatments, but don’t maintain them (for example: you may intubate them, but you’re not going to be worried about vent care).

    ICU: For the most part, patients are not stable. They need very frequent monitoring and invasive interventions to keep them alive.

    Wow. Ok. That was really long and all over the place, but it was quite a big question to answer! I hope my responses vaguely made sense, and keep in mind that my personal experiences are different from other nurses’. The opportunities for nurses are limitless, so it’s impossible to sum up everything we do in one post (I could write a whole book and it wouldn’t be enough). Even my jobs I didn’t talk about everything I did/do! I hope this was a little helpful, though (if you read it all haha), and please ask if you need clarification on anything or have more questions!

Source: cardiacattack
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My NEU/Boston tat as promised!

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  • Cashier: That'll be $4.03
  • Me: I only have $4...
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Source: autosomes
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4 Medical School Interview Topics Pre-Meds Must Know About

premedme:

It’s obvious that prior to your medical school interview, you should be comfortable talking about yourself. Often overlooked, however, is the importance of being articulate on other topics. Increasingly, medical schools are assessing applicants’ true interest in medicine by asking…

Source: premed.me
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brains-and-bodies:

From Daily Anatomy

"Incredibly beautiful micrograph of blood clotting"
"This awesome picture is a coloured scanning electron micrograph of human red blood cells (erythrocytes, red) and platelets (thrombocyte, white) forming a blood clot. Clots are formed in response to cardiovascular disease or injuries to blood vessels. Platelets secrete chemicals that promote the accumulation of fibrin (not seen) and other blood components required for clot formation."

Magnification x7000, by Steve Gschmeissner

Pure awesomeness

(via postgrad-premed)

Source: brains-and-bodies
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northeastern-samcarkin:

Northeastern University photography club (NuPic) had its first outing last night to the Esplanade. If anyone is interested in getting into photography, I definitely recommend checking NuPic out! We meet every Wednesday at 6PM in 106 West Village G.

Source: northeastern-samcarkin
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So happy I got to celebrate my 21st birthday with @itsknoxbro and my fellow #Virgo @yentruoc___ ! Even though I fell asleep on the bed at 11:30, I had fun haha. Love you guys!!!! (at Benihana)

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Today is the best day of the year!!! My birthday; the big 2-1! 💁