PeakRN

PeakRN

Adult and pediatric emergency and critical care

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All Content by PeakRN

  1. How would Medicare for all affect nursing?

    PeakRN replied to Emergent's topic in General Nursing

    I see healthcare being expensive in the US for three reasons. One is that we have a system where private companies develop drugs and recoup costs through profit rather than government research grants,...

  2. How would Medicare for all affect nursing?

    PeakRN replied to Emergent's topic in General Nursing

    This will certainly vary in different systems but we either get patients in clinic or seen inpatient the same or next day. If they are seen and diagnosed in the ED and are appropriate for clinic we...

  3. Frustrations with the dreaded OSH

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

    The live in that and confide in your

  4. Frustrations with the dreaded OSH

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

    The weird thing is that for some reason the ethics board keeps turning me down for my requests to harvest some neonatal pulmonary vasculature so I can test in the

  5. Frustrations with the dreaded OSH

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

    You are in EMS. You provide emergency medical services and transport the patient. EMS is more than just the EMTs and Paramedics in an ambulance. Regardless of if a team is non-transport, ambulance...

  6. Frustrations with the dreaded OSH

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

    I'm just making an example that not every indication can be found in the package insert. Some indications are... off label. Various paralytics have effects on smooth muscle through effects on...

  7. Frustrations with the dreaded OSH

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

    Wrong study link, although still a great read on cardiac anesthesia.

  8. Frustrations with the dreaded OSH

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

    Allow me to add some clarity to my posts. I don't think that you are a bad clinician. I've never met you and even if you didn't give the 100% best care (not that I'm saying that) we all make mistakes...

  9. Frustrations with the dreaded OSH

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

    I'm so glad we are using the package insert, I'll remember that the next time I'm giving sildenafil to one of our pulmonary hypertension kids who has been on it for more than two years. The literature...

  10. Frustrations with the dreaded OSH

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

    The fact that you automatically assume that you are the standard of care since you work at a level IV says enough about your interest in quality improvement and personal insight. Medicine evolves and...

  11. Frustrations with the dreaded OSH

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

    I'm not saying the to comment on your particular call, but a lot of staff have transport experience who have given it up for some reason or another. I guess I'm one of those dreaded email writers,...

  12. Are all for-profit hospitals soul-sucking despots that truly only care about the bottom line

    PeakRN replied to klone's topic in General Nursing

    I've worked in or been affiliated with dozens of hospitals. County, nonprofit, for profit, university, non-university academic, adult, pediatric, community, referral... they are all obsessed with...

  13. ICU Research Project

    PeakRN replied to kjacks759's topic in Critical Care

    This is so sweeping and broad it will be almost impossible to measure in a meaningful way. Length of stay is affected by so much more than just how we manage delirium, not to mention that those with...

  14. On call - what is it like for other ERs

    PeakRN replied to WiseAtHart's topic in Emergency

    We've had call shifts in the past but none currently. We used to require 1 call shift per schedule period, but if you picked up an overtime shift you didn't need to take a call shift. We used it as a...

  15. Checking consciousness by touching the patient?

    PeakRN replied to PMHNP2023's topic in Emergency

    Yeah... if you act unconscious your going to get assessed. Whether that means tapping, sternal rub, pinching nail beds, or a pop-up timer (when they pull the NPA they are sober to read test) you will...

  16. Why working as an ED nurse so competitive?

    PeakRN replied to ScaredRN's topic in Emergency

    I actually started in the ED of my current hospital specifically so that I could end up working on an inpatient critical care unit, and another nurse before me did the same thing. I don't intend on...

  17. Giving up PA school acceptance to pursue ASN?

    PeakRN replied to ang314's topic in General Nursing

    Just a couple of thoughts. If you do end up going down the nursing route get your BSN from the beginning. It is hard to get the more desirable nursing jobs without it, and an ADN with a BS is not...

  18. Looking for advice/reality check - 1 year on a stepdown/ICU floor

    PeakRN replied to TammyTho's topic in General Nursing

    The ED is just as physical as the floor. Lifting homie drop offs onto a bed, restraining patients, reductions and other procedures, et cetera. Have you considered the NICU? There can definitely be...

  19. anaphylaxis

    PeakRN replied to Dacatster's topic in Emergency

    No, those doses are largely inappropriate and treatment should be based on individual presentation. You should consult a reputable evidence based medical site, I personally like

  20. Decrease of Peds units

    PeakRN replied to Dacatster's topic in PICU, Pediatric

    With the ever increasing proportion of pediatrics having medicaid over private insurance most pediatric units hemorrhage money. Larger hospitals can typically make this up with large PICU, NICU, and...

  21. phenobarbital for ETOH withdrawal

    PeakRN replied to freckles23's topic in General Nursing

    Personally I prefer the phenobarb approach over benzos, I find it to be far more effective and the patient has a more stable level of therapy and taper compared to benzo based CIWA protocols. I do...

  22. PCU Nurse Feels "Second Rate"

    PeakRN replied to PacoUSA's topic in General Nursing

    While the ED will teach critical thinking there are many significant differences between ED and inpatient critical care. ED is all about the now. Triage, stabilization, and disposition. There is...

  23. Anxiety and night shift. Hospital to clinic? Thoughts and advice appreciated!

    PeakRN replied to Mishl029's topic in General Nursing

    Have you considered something like lactation or newborn home

  24. PCU Nurse Feels "Second Rate"

    PeakRN replied to PacoUSA's topic in General Nursing

    Have you actually applied? We want candidates to have experience in critical care, but that often isn't possible. I wouldn't test for CCRN without actual critical care experience, it can give a bad...

  25. Bad Interview - Should I withdraw?

    PeakRN replied to DowntheRiver's topic in General Nursing

    I'm guessing that you interviewed for some critical care area like the ED or ICU, so I'm going to base my response on that. We don't try to be rude in our interviews, but we do ask hard questions that...