PeakRN

PeakRN

Adult and pediatric emergency and critical care

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All Content by PeakRN

  1. MDF Sprague-X Stethoscope

    PeakRN replied to adventure_rn's topic in Scrubs, Uniforms, Gear

    I've used the DLX and the elite, the DLX definitely has a a better sound quality. The elite is a bit lighter, but not enough to make a real difference (they are both on the heavy end of stethoscopes)....

  2. Non-profit Nursing Facilities: A place to heal from burnout

    PeakRN replied to MarylandMomma's topic in General Nursing

    I have worked for or been affiliated with multiple not for profit and non profit healthcare systems, and they can pinch pennies just as well if not better than the for profit

  3. TNCC Course

    PeakRN replied to Shaynamarcella's topic in Emergency

    I would recommend contacting the facility that is offering the course directly, and preferably at a high volume trauma center that is either a level I or II. The large trauma center education...

  4. Cen, tcrn, cpen, atcn, atls, ccrn

    PeakRN replied to AubreyGurley's topic in Emergency

    I would make sure that you have the basic ED certifications before worrying about board certifications. For me that would include ACLS, PALS, TNCC, ENPC, and NIHSS. These are all 1-2 day courses, they...

  5. So you're an RN - you must be earning big!

    PeakRN replied to _littlemissBSN's topic in General Nursing

    I don't really care about people who think I make a lot of money. I chose to work in healthcare because I want to help people, but I went from EMS to nursing because I was tired of being paid almost...

  6. Labor as a spring board to acute care?

    PeakRN replied to jcol1460's topic in General Nursing

    Congratulations on your position. In our hospital we consider the ICUs, BMT (adult and peds), L&D, and ER (and to some extent PACU) to be critical care. While non-ICU units are not the same as...

  7. Treating Dehydration DT Physical Exertion

    PeakRN replied to NurseNurseNurseNurse's topic in General Nursing

    The causes of dehydration are multifaceted. Was this patient also drinking beers while mowing the lawn increasing his urine output? If he had an increase in respiratory rate then he is also breathing...

  8. Lowest bicarb on abg

    PeakRN replied to mpilkington's topic in MICU, SICU

    That lived? 8. Lowest ever? 2, during a code that was down for an unknown amount of time and was brought into the ED after they worked the patient for 45 minutes in the

  9. Ear irrigation policy

    PeakRN replied to meledrn's topic in Pediatric

    If we are looking for a source of a fever, especially in pre/non-verbal children, then you have to visualize the TM. We irrigate ears pretty frequently, rarely do we have any injury to the TM or ear...

  10. Nurse:Pt ratio

    PeakRN replied to first123's topic in NICU, Neonatal

    Level IV. 1:3 for stable patients 1:2 for those with more time needed for interventions 1:1 for critical patients 2:1 for ECMO Any breast milk or formula that comes from the nutrition room must have...

  11. RN to patient ratio in Pediatrics?

    PeakRN replied to Lemon Bars's topic in PICU, Pediatric

    None of the pediatric hospitals in the region consider family members to be patients, I have never heard of this being a thing before. Assignments vary based on acuity. General Peds is 1:3 to 1:4...

  12. An ER nurse who passed CCRN!

    PeakRN replied to JordieRNCCRN's topic in Emergency

    I agree. We tend to push for CEN, CPEN, and TCRN first but if someone wants to get their CCRN that is great. We start out ICU patients and start vents/NIPPV/other 'critical care' respiratory support,...

  13. Not your usual questions

    PeakRN replied to ScottMedicRN's topic in Flight, Surface Transport

    How does rotating bases work? Do they just tell you that you have to drive far to work and you have to just suck it up and do it? I only work on a specialty team so I don't know the their exact...

  14. Not your usual questions

    PeakRN replied to ScottMedicRN's topic in Flight, Surface Transport

    1) Is it possible to get a job in a rural area instead of a city? I really want to move to a more rural area one day. Our flight program rotates medics and nurses throughout all of the bases, most of...

  15. NICU

    PeakRN replied to dreamerachiever's topic in NICU, Neonatal

    My previous freestanding pediatric hospital did have a very small low risk L&D, but unless mom was healthy she couldn't labor there. The vast majority of patients came as transfers from other...

  16. Intubation turning into a code blue

    PeakRN replied to ICUisLife's topic in Critical Care

    My guess if he really couldn't advance the airway is that the patient could have had a good bit of laryngospasm. I'm always a bit dubious about the excuses made about failures to intubate or place...

  17. Day vs Night Personalities

    PeakRN replied to ScottMedicRN's topic in General Nursing

    We definitely have a different culture on days and nights. Days plays by all the rules and are generally more up tight. Nights are much more relaxed and has a more get it done approach. There isn't...

  18. RNs: How much vacation time do you get?

    PeakRN replied to SummitRN's topic in General Nursing

    How many weeks of vacation do you get per year? Paid time off is accrued at a set rate based on years with the organization and how many hours are worked. We accrue more PTO by working over time for...

  19. What experience would be better, higher acuity or a pediatric ER?

    PeakRN replied to ladybug95's topic in Emergency

    A high trauma rating doesn't necessarily mean you will see sicker patients nor a whole lot of trauma. I work more trauma cases in my current level IV trauma center than when I used to work in a level...

  20. Safety with dangerous pts

    PeakRN replied to Hazelgirl_06's topic in General Nursing

    The vast majority of psych admits are medically stable on arrival (or perhaps just need to detox from drugs or alcohol). We admit less than 5% of our psych patients to the hospital for medical...

  21. ER Travel with an ADN

    PeakRN replied to detrelibre's topic in General Nursing

    You may have problems finding travel assignments, we only allow nurses who have a BSN as well as ACLS, PALS, ENPC, and TNCC to travel to our ED. We actually don't require travel nurses to have NIHSS...

  22. Safety with dangerous pts

    PeakRN replied to Hazelgirl_06's topic in General Nursing

    I'm a bit confused at the situation. If patients are cleared and awaiting transfer then why are they being admitted rather than staying in the ED? Unless you are licensed as a psych facility you can't...

  23. Repackaging Medications

    PeakRN replied to Pinupnurse76's topic in General Nursing

    It sounds like there is quite a bit of risk involved here and should be investigated. Are you sure that the medication aide was the one who repackaged the meds? Do they know that this is outside of...

  24. As a PA, how can I be better for the nurses in the ER?

    PeakRN replied to Warningsign's topic in Emergency

    My best advice is to have conversations early, and be friendly about it. A breakdown in communication is often the source of a lot of problems. My provider pet peeves are those who are unapproachable...

  25. Oxygen therapy in ED

    PeakRN replied to nikki199's topic in Emergency

    This is something that in no way will fit into a single post or thread, but I'll try to start with some basics. First you need to assess what you are trying to support. I think that you might get more...