The Perfect Job

Because I will complete the Acute Care NP program this summer- August 8th to be exact, I have been thinking a lot about where I would like to work.  Also, someone asks me almost daily when I am at clinical if I already have a job lined up.  The answer is no and this question has me second guessing whether or not I should already be scheduling job interviews.

I'll be honest- I am not passionate about any one particular area of medicine.  I either like or dislike them all equally.  I've spent most of my RN career as a bedside nurse in the ICU and I thought that perhaps I would end up in the ICU as a NP, but that specialty area is looking less likely.  I can see myself getting burned out after a few years. 

This week I spent my clinical time working with 2 NP's on the cardiac surgery service.  These NP's manage the patients pre-operatively in the clinic and post-operatively once they've been transferred from ICU.  They alternate their weeks- one week outpatient and one week inpatient.  We saw a few patients in the clinic and I really enjoyed the variety.  I also enjoyed getting to the know the patient in a normal setting, in street clothes rather than intubated and sedated in a hospital bed.  It might have helped that the patients we saw in clinic were kind and pleasant people.

This group of cardiac surgeons also employ 2 PA's and 1 RN first assist who work in the OR full time.  I talked at length with one of the PA's and she loves her job in the OR.  She worked in a community health clinic for several years but burned out quickly.  I've been in the OR several times to observe and while it is usually interesting, I could not see myself working in that setting exclusively.

So, after learning a bit more about my preferences and what I find interesting, here is my 'perfect job'

1.  Outpatient, inpatient and assisting in the OR- the specialty is secondary (don't have a preference)
2.  A competitive salary, of course.
3.  I don't mind working some weekends- but prefer only working 4 days/week.
4.  Off on holidays
5.  At least 3 weeks of vacation time/yr- more would be better.
6.  A short commute.

There you have it- the 'perfect job.'  I know I may not get everything on my wish list but a girl can dream, right? 

There are a lot of NP job postings in my area- so I might just have a chance.

Any words of advice when trying to land my first job out of NP school?

A Professional Poster

I recently completed a major project in my class- a professional poster.  I am surprised that with all of the technology available today that an old fashioned poster is still a popular way to share information.  I thought I would dread this project but I actually enjoyed the process.

I chose the topic of Mannitol vs. hypertonic saline and its effectiveness at decreasing intracranial pressure in the patient with traumatic brain injury.  There are several randomized controlled trials but all of the sample sizes are small (around 20-50 patients).

The results of the studies I analyzed concluded that both drugs effectively reduced intracranial pressure.  As expected, mannitol increased urine output more than hypertonic saline and hypertonic saline increased serum sodium.  Currently, the 2007 Traumatic Brain Injury Guidelines do not recommend hypertonic saline in this patient population but perhaps the updated guidelines will include this drug.

A few things I learned from this poster presentation:

1.  Use bright colors and interesting photos.  Presentation and styling are just as important as content- if not more so.  I kept my poster very simple but should have jazzed it up to attract more attention.

2.  Less is more.  When it comes to text on a poster, the rule of less is more definitely applies.  There were posters that read like research papers and included every detail.  I chose to present my information in succinct sentences or phrases, rather than pages and pages of text. 

Overall, I enjoyed the process of putting together a poster and if I have to do it again someday, I would do a few things differently.  

Balancing School, Work and Family

Today, I'm privileged to be a guest blogger at Midlevel U.  I'm blogging about balancing it all- school, work and family. 

If you have not checked out Erin's site, you must do so today.  She shares interesting insights about her experience as a family nurse practitioner.  If you are interested in a career as a NP or are currently a practicing NP, you must check it out. 

Thanks, Erin!

'Outside Hospital'

The attending in the ICU right now at my clinical site is absolutely hysterical.  He's cynical, sarcastic and witty-- a great combo in my opinion.  He's old enough to be my dad and reminds me of Ben Stein.

Today he was sharing this video with a few of the physicians and nurses.  As soon as I watched it, I knew I had to pass it along- too good not to.


A little R&R

I've been MIA on the blog lately but I have a couple of good excuses.

Jason and I took a trip to California over the weekend for a dear friend's wedding.  It was a beautiful ceremony and we just danced the night away- something I haven't done in a very long time.
I used this wedding as an excuse to buy a sari and I loved wearing it.  

The trip was too short and now I'm back in full swing with kids, grad school, clinical and work-- the weekend escape from real life was much needed. 

Before our trip, I spent most of my 'free time' working on an academic poster for class.  I'll unveil my poster in a later post but rest assured that the wedding was a lot more fun and exciting. 

US Healthcare in a graphic

We were discussing the topic of the state of the US healthcare system in class today.  

I was browsing the web and found this graphic that puts into perspective the state of our healthcare system based upon the article by Steven Brill.

All I have to say is wow-- let's get moving and try to make some progress on this monster problem of a healthcare system we have created. 

Cardiothoracic ICU

I started a new clinical rotation this week.  It's at a nearby trauma center working with a NP in the cardiothoracic ICU.  The unit is a 30 bed shared ICU- medical ICU and cardiothoracic ICU.
There are 3 cardiothoracic surgeons who average about 4-5 cases/day.  So far, the patients I have seen have been post-op aortic valve replacement (AVR), aortic root repair, coronary artery bypass graft (CABG) and total arch repair of a type A aortic dissection.

This clinical has taken me back to my days as a nurse working in a busy cardiothoracic ICU.  Some days I enjoyed being a 'heart' nurse and some days it was just too stressful and physically exhausting.  It also didn't help that the ICU intensivist was a former cardiothoracic surgeon and one of the grumpiest and most miserable people you'll ever meet.  Nope- don't miss it.

Working in the unit as a NP student is much different and I'm enjoying it.  The NP on this service was a former RN on the unit and when she graduated, the surgeons offered her this position.  She is very good at her job.  The ICU intensivist and a ICU fellow are always around for extra help or back-up when needed, which is also wonderful.

Although, I must say that I do miss the warmth and friendliness of the people I worked with at Christiana hospital in the neuro ICU.  It's funny how traveling only an hour south can make such a difference.  Ah-- gotta love the east coast. 

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