PeakRN

PeakRN

Adult and pediatric emergency and critical care

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All Content by PeakRN

  1. NICU (Pros and Cons)

    PeakRN replied to singlesunshine's topic in NICU, Neonatal

    Maybe you should consider volunteering in a NICU so that you can see what it is actually

  2. Distractions & interruptions: ICU vs. other units?

    PeakRN replied to Lemon Bars's topic in Critical Care

    Critical care units absolutely have distractions and unpredictability. We constantly rotate through new admits and transfers out, patients have rapid changes in their presentation that require...

  3. Join the ER or go to another specialty?

    PeakRN replied to Shimmer580's topic in Emergency

    I can't speak to the OR, that is a specialty with little crossover to other areas and really is it's own thing. ED is very fast paced and priorities are always changing. In many ways the nature of ED...

  4. I need my instructor

    PeakRN replied to SquatsNScrubs's topic in General Nursing

    Some of this will vary based on the school, hospital, and units the students are in. Our hospital has different rules for students in general med/surg areas, critical care areas, and other specialty...

  5. Thoughts on vegetarian/ vegan diet

    PeakRN replied to bs76247's topic in General Nursing

    There are ways for many adults and older kids to receive all of their nutrition through a vegan diet, but it something that is pretty difficult and requires a high degree of competence. Humans evolved...

  6. ICU or PCU?

    PeakRN replied to tp1159's topic in Critical Care

    If you want to be an ICU nurse, go to the ICU. While stepdown units will provide some insight into critical care, it isn't the same as having truly sick patients. Step down units can still provide a...

  7. Whiskey peg tube flush?

    PeakRN replied to SquatsNScrubs's topic in General Nursing

    1: Most patients can be be detoxed in 2-3 days. Gastric cancer is not a surgical emergency that cannot wait a few days, if it is that profound the outlook will be poor regardless. In fact the current...

  8. Destined to Be a Flight Nurse

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

    You were given the opportunity to work in an ICU, and your current development isn't at a level that can support that. Your managers are providing you a way to build that experience and come back to...

  9. Whiskey peg tube flush?

    PeakRN replied to SquatsNScrubs's topic in General Nursing

    Why did the surgeon take a patient who is currently alcohol dependent to theater? Do your surgeons routinely maintain the patients on their service and not under the intensivists, did an intensivist...

  10. Are O2 sats a vital sign?

    PeakRN replied to roxhannah's topic in General Nursing

    I hate to tell you this, but you don't. It truly confounds me that any hospital would not have a pulse ox check as part of their standards of care. I mean, pulse oximetry has been a standard of care...

  11. If you could give one piece of advice back when you were a new grad RN, what would it be?

    PeakRN replied to Mursthetics's topic in General Nursing

    Know you limits. Know when to ask for help. Know when to say

  12. Why do you love your specialty so much?

    PeakRN replied to AbbyLane's topic in General Nursing

    The hard thing is that what people find rewarding changes so much individually. My nightmare is probably adult med/surg, home health, or any kind of nursing home however there are nurses who are great...

  13. What would you do

    PeakRN replied to nagar's topic in Emergency

    Homework?

  14. Most Burned Out Nursing Specialties?

    PeakRN replied to Mursthetics's topic in General Nursing

    Burned out as in jaded? Emergency. Burned out as in uninvested in nursing? That's going to be a bit more difficult, although I think med/surg has a good chance of being the

  15. Nurse Charged With Homicide

    PeakRN replied to Nurse Beth's topic in General Nursing

    From my understanding this nurse made several deviations from the standard of care that placed the patient at risk and the patient resulting died. While I sympathize with her, it doesn't change the...

  16. hyponatremic seizure

    PeakRN replied to zzyzx's topic in Emergency

    It doesn't, but if a patient comes in seizing and we don't know why, we aren't going to get saline. We wouldn't know that they are hyponatremic until we have their lytes

  17. hyponatremic seizure

    PeakRN replied to zzyzx's topic in Emergency

    Yes, several times. It looks like a seizure. You treat with hypertonic saline, but if you give too much you can cause demyelination. Often these patients get a bandaid fix by a benzo or other classic...

  18. Any facilities actually using an AccuVein? Any thoughts?

    PeakRN replied to BiscuitStripes's topic in General Nursing

    There are several studies that show it to not increase success. Since it has been proven to not increase success over traditional placement I'm not sure why anyone buys them or why they even exist....

  19. PA catheter and parameters

    PeakRN replied to hyhero89's topic in Critical Care

    For the record there are many alternatives to PA catheters. I've use the flotrac on quite a few adults and have found it to be very easy to use and the risks with an A line are much lower than a PA...

  20. Air Force Reserves flight nursing Vs. Navy active duty

    PeakRN replied to Rizzo02481's topic in General Nursing

    To get a direct commission with a flight nurse billet is essentially unheard of, and there are very few for ED nurses. Without experience in that specialty you won't get a direct commission. Even then...

  21. Insulin drips patients on L&D

    PeakRN replied to Upgrading_Status's topic in Ob/Gyn

    We admit them to the unit because of their disease process: their metabolic acidosis, changing electrolytes that often require replacement, frequent gas interpretation, and so on. I think our labor...

  22. Insulin drips patients on L&D

    PeakRN replied to Upgrading_Status's topic in Ob/Gyn

    I disagree, when we have a laboring patient outside of OB all of our supplies fit into one cart, including our emergency surgical trays. There is no possible way for me to fit all of the ED's or ICU's...

  23. Insulin drips patients on L&D

    PeakRN replied to Upgrading_Status's topic in Ob/Gyn

    If the patient is in DKA or HHNS we don't want them laboring at all. Depending on the presentation this may mean a section but usually would just result in us giving tocolytics. But to your question,...

  24. Insulin drips patients on L&D

    PeakRN replied to Upgrading_Status's topic in Ob/Gyn

    At our medical center mom would be admitted to the ICU, but we would have an L&D nurse come and monitor the fetus if needed. Our policy dictates that insulin drips can only be given in the ED,...

  25. On call pay

    PeakRN replied to Cmb82's topic in General Nursing

    Our ICUs, PICU, NICUs, critical care and pediatric float pools, as well as services like the OR all have call lists. Most of our floors don't have call. Depending on the season the EDs sometimes have...