Latest Comments by francoml

francoml 12,775 Views

Joined: Nov 7, '12; Posts: 148 (41% Liked) ; Likes: 239
ICU Nurse; from US
Specialty: Critical Care at Level 1 trauma center

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  • 1
    MursingMedic likes this.

    Hey everyone. Haven't posted here since I was I baby graduate nurse. Fast forward 4.5 years into my career, I have been a MICU nurse at a level 1 trauma center (4 years), dedicated rapid response nurse with ability to independently order emergent medications and diagnostics (1.5 years), PICC nurse (3 years), and most recently 4 months as a CVICU nurse recovering openhearts, impellas, and balloon pumps. I will graduate as an AG-ACNP in three more semesters. Long story short I love critical care and my goal is to specialize in pulmonology/critical care as an ACNP. I love doing procedures (only PICC lines at this point) and I want to intubate, do chest tubes, bronc, paracentesis, etc. I'm currently in New Mexico (independent practice) but would relocate to find an optimal job.

    So my question.... How many of you are doing invasive procedures? For those that do, what procedures are you doing? How often? Independently or supervised? Can you bill yourself? Big trauma center or rural hospitals? Basically anything you tell me to give me the best chance at landing an intensivist position!


  • 0

    holy crap I started this thread years ago and people are still debating it... Kinda proud lol.

    After years of experience I now believe that all acute care nurses (MS, ICU, ER, ect.) should start off getting paid the same. The caveat to that is we should be substantially compensated for the training and certifications we get. If I pass my CCRN that should be a few dollars extra, if I completed hours upon hours of specialty training in critical care competency I should be paid more. Learn to place PICC lines more pay, CRRT, therapeutic hypothermia, LVADS, ECMO more pay. ACLS, PALS, NRP, TNCC more pay.

    Currently I have all of these certifications/training and with exception of my CCRN (+$1/hr) I am not compensated for any of these skills. Funny thing is the MS nurse with the same years at the hospital still gets +$3/hr more than me in differential pay for simply being a MS nurse.

    I am all about MS being a difficult area, I have picked up there multiple times. They should be compensated if they get their specialty certs as well. THE THING IS... in no way should a MS nurse (or any nurse for that matter) get paid more than me with the same years at the facility with FAR LESS training, certifications, and liability.

    Although its kinda of a moot point now because I am in ACNP school and will get a substantial pay raise when I finish

  • 2
    theRPN2b and amzyRN like this.

    Ultrasound.... Should be the gold standard. I don't know how it is in other hospitals but in my unit (large level one ICU) the majority of our nurses know how to use ultrasound to place difficult IVs. I am a pretty darn good at IVs and if I think a PIV is going to be hard I just grab the ultrasound.

    That being said, I work in a very well funded and nurse friendly environment that fosters clinical expertise and training on advanced techniques. I have never worked in a rural hospital or a facility with poor funding or many restrictions on nurse scope of practice.

    If your facility allows it learn how to use ultrasound. I truly believe that it will be the gold standard in the next 5-10 years.

    Also remember that practice makes perfect and don't be afraid to try just because they are difficult.

  • 11

    Hey guys I have read many of your posts about bias, not fitting it, the mean girls don't like me, blah, blah, blah.

    Let me give all you new male nurses some advice. Stop with this whole male vs female nursing BS. We are all professionals and should conduct our selves as such. I have been a nurse (male ha) for about 4 years now and I still don't understand why new male nurses are so sensitive about things...."Oh my patient doesn't want me to put a foley in because I'm male"...get over it. Just have one of your female colleagues put it in and return the favor some other time.

    Maybe its because I work in a busy 33 bed ICU and at least 30%+ of us are male, but I just don't see the problem. We don't have problems in our unit because we are not males and females....just nurses. If your not comfortable working in close proximity with the opposite sex that is very telling about your personality.

    Now Im not saying don't protect yourself. If you are putting in a foley, rectal tube, ect in a female just have one of the women hang out in the room for a bit till your done but dont pawn off your duties just because "you don't feel comfortable"

    And for god sake stop assuming all women only talk about gossip, makeup, and bon bons (what ever those are lol). I for one know many women on my unit who hunt, work out, play video games, nerd out on medical stuff, and are adrenaline junkies.



  • 0

    I would join relatively soon an an RN.

  • 0


    I am currently contemplating joining one of the Reserve branches and had a few questions. I know civilian training/experience plays a role so here is my background.

    4 years Medical ICU experience in a level one trauma center.
    cross trained in Trauma/Surgical ICU, Cardiac ICU, and Burn ICU
    CCRN certified, PICC line certification, CRRT certification, ACLS, PALS
    Rapid Response Team member
    Student Preceptor

    Currently in my first year of Acute Care Nurse Practitioner School.

    1) What is the time commitment?
    2) Pay and benefits?
    3) With my background what rank would I have?
    4) When I finished ACNP school would my rank go up and would I automatically serve in the NP function when I was done?
    5) What are the basic duties I would perform and how would a typical drill weekend/2week training play out?

    Thank you all so much for your help!

  • 0

    Hello all,

    It has been quite some time since I have been on this site. Anyways, I am currently in ACNP school at Texas Tech University. I am writing this to ask for y'alls help. I need to attend a professional meeting or conference before Oct. 21 and write a summary over the content covered.

    The problem is, I am having a hard time finding something that would be acceptable. The meeting has to talk about nursing/APRN policy and how it can be incorporated into daily practice.

    I live in West Texas and would be willing to travel up to a couple hundred miles in order to attend a quality conference.

    So.....Do y'all know of anything in the West/Central Texas or Eastern/Central New Mexico area???

    Thank you!

  • 4

    Its okay not to like cleaning *** and ****. God knows I don't. You just have to look at what makes you happy. I am an ICU/RRT nurse, sure I have to clean poop but I also get to run codes, manage CRRT, and titrate pressors and sedation.

    It was mentioned before that men usually want ICU or ER. I think there is some truth to this. I was one of the people who got into nursing to save lives and manage critical patients. Sure I wipe butt and even though I dont like to, I do it in a way that gives my patients dignity and respect.

    I understand that you are having a hard time at your current job, its hard when you feel like you are a glorified maid. Put in your dues and learn as much as you can so that you can land a job outside of patient care.

    Personally I love high acuity patient care, I love the patho and pharmacology that goes with being an ICU nurse. I hate cleaning poop but I look at is just one more chance to further assess my patient.

    I would give you a few words of advice. 1st, its okay to hate cleaning poop and vomit, just make sure your patients never know how awful it is for you. 2nd, if you decide to stay in nursing go back to school AND KEEP YOUR GRADES UP! 3rd, if you are strong in school and dont mind hard work and taking on a lot of debt become a CRNA/NP. It is the most autonomous field and you are not really practicing nursing anymore. CRNA/NP are medical providers ​not nurses and you will no longer clean up body fluids. Just know that if you chose this route you will have to be at the top of you field, study a lot, deal with ungodly amounts of stress/liability, and work 10xs harder in school then you did in nursing school.

  • 6
    Susie2310, akomismo, KJoRN81, and 3 others like this.

    I would like to say something on behalf of all the medsurg nurses out there. Being an ICU nurse and rapid response I too used to be on the side of we (ICU/RRT) should get paid more. I used to think that I was in one of the elite nursing fields and better than medsurg nurses.

    Now that I have more experience, I see how wrong I was. Sure I can teach about advanced hemodynamics off a PA cath, I can manage critically ill patients on CRRT, I understand how to use different pressors/inotropes to maximize cardiac output, and I can use ultrasound to place difficult lines just to name a few. The thing is, all these things are done by using invasive monitoring. I see now that it is easy (with a lot of study) to see how your patient is doing when you have an art line, PA cath, and biz monitor. It is a true art to be able to treat a patient and recognize a de-compensating patient using only your eyes and non invasive monitoring while still being responsible for 5 other patients. This is a skill that many ICU nurses do not have as we are so dependent on our monitors. It wasn't until I worked rapid response that I was forced to learn how to use my eyes and ears more than my coveted invasive monitoring.

    To be an excellent ICU nurse it takes experience, lots of study, and confidence in yourself. Thing is, medsurg takes these same skills. Many times the difference between a patient coding on the floor and getting better is nothing more than the nursing intuition that develops from treating patients without knowing every single aspect of their physical status.

    So simply put, I now view medsurg as a specialty and have much more respect for them. It takes a very intuitive and vigilant person to recognize signs of distress before it become a full blown emergency. While I am not one of the people who thinks you need to work MS before going to the ICU, there are certain skill sets that MS nurses have that ICU nurses should learn to utilize. Much love to all the MS nurses out there! Don't let anyone talk down to you and have pride in your skills!

  • 0

    I thought the PassCCRN practice test where harder than the actual test. If you can consistantly pass those, even by the smallest margin, then just schedule your exam already! You will do fine! Look at it this way, if you pass HELL YA! if you fail then you gained a lot of insight and probably learned a lot of useful things along the way, pay for it again and test again soon. I don't know anyone who has failed more than once if they actually took it seriously and put in some good study time. You will do great just do it! ......and like the local vendors walking around on the beach in Mexico say, its only money Americano

  • 0
    In CMC

    So regretfully to say, I failed my CMC certification last week. I studied for 3 full days plus I have been an MICU nurse in a level one facility for 2 years and I float to CVICU regularly for extra shifts.

    I got a 51 when the pass cutoff was 52 FML!!!!! Do y'all have any recommendations or study guides to get me over that hump? I am already scheduled to take it again in a few weeks. CANNOT FAIL AGAIN!

  • 0

    to be clear when I said bolusing propofol I was talking about when anesthesia orders induction meds for intubation. After intubation we can titrate the drips such as propofol ect. I do not bolus propofol at my own discretion.

  • 2
    ICUKeesh and jamisaurus like this.

    I am a rapid response nurse as well as an MICU nurse in a level one hospital I am CCRN certified and have my BSN. I run CRRT, and can place ultrasound guided PICC lines and PIVs. I can run codes and order diagnostics and interventions without consulting a doctor. I do not get any more pay. In fact medsurg nurses get a $2 differential. Financially fair? maybe not. Will I get into a top CRNA school because of these skills coupled with high grades? Absolutely. If you plan on being a bedside nurse long term than it is a big deal. If you are going into advanced practice then your ICU time is really just an extension of the class room and one long clinical rotation where you learn critical reasoning, advanced pathophysiology, and improve your dexterity with procedures. I look at it like I am getting paid to go to school everytime I go to work. Just my 2 cents

  • 0

    Are you all allowed to bolus propofol and titrate drips? What about ketamine? I was under the impression that all ICU nurses could do this but apparently there are some facilities or states that it is not in our scope. Also do you all do conscious sedation as a staff nurse? Do you push induction meds for intubation or does the doctor? Just curious.

  • 0

    Okay I am sure y'all get this a lot but could a current CRNA tell me how strong my resume is please?

    I have really worked hard over the last year to boost my resume.

    2 years level one regional medical center MICU
    1 year Rapid Response Team
    PICC certified

    Sci GPA - 3.3
    Last 95 hours - 3.783
    Las 45 hours - 3.96
    Last 11 hours of science (Chem II, O Chem, and Genetics) - 4.0
    Have not taken GRE yet

    Contributed to research in synthetic marijuana. That research was cited by Texas Senator as a major driving force in him proposing a senate bill to outlaw all analogous of synthetic marijuana.

    Community service with free clinics and Ronald McDonald house

    Taking CMC certification this week.