PeakRN

PeakRN

Adult and pediatric emergency and critical care

Member
  • Content

    547
  • Visitors

    7,491
  • Followers

    1
  • Likes

    400

All Content by PeakRN

  1. Blood pressure in peds patients

    Just for perspective I have found essential hypertension in otherwise healthy 2 and 3 year olds several times in the ED. While the ED is not the kid's primary care, that may be the only medical...
  2. When we hire in my center we typically favor critical care over floor pediatric experience. Unfortunately adult med/surg is unlikely to give you either experience, but you also have to start with the...
  3. The ICU book. The Ventilator
  4. Paramedics in the ED

    Query:
  5. What is your "favorite" procedure?

    One of our PICU intensivists loves giving haircuts to the long term
  6. What is your "favorite" procedure?

    Reducing dislocations. Instantaneous
  7. Paramedics in the ED

    While I agee with some of this I would like to clarify a bit. I was a messy medic. The floor and bench of my bus were a disaster by the end of my call. That was because we thoroughly cleaned the back...
  8. Paramedics in the ED

    You seem to have a bit of a chip on your shoulder. Why did EDs start hiring paramedics? Simply put they are cheaper labor than registered nurses. Paramedic and nursing education is not the same,...
  9. In my opinion your ED has not provided adequate training. All of our new grads must have ACLS, PALS, TNCC, ENPC, NIHSS as well as complete their online ED modules and all of their staged orientation...
  10. Peds Nurse Furloughed During Pandemic

    We never furloughed anyone, but we did cancel every traveler and PRNs have been removed from the schedule. We did rotate a lot of nurses with adult experience back to the adult world. PICU nurses back...
  11. Famous person as patient?

    I’ve taken care of more famous people and their families than I can count. Professional athletes, national media reporters, politicians, several heirs to european monarchies, CEOs who’s names are...
  12. Feeling Bored

    No offense but if you have nothing to do as a nurse on a peds unit for several hour you aren't really a peds nurse. There is always a kid that needs help with homework, another disease to be studied,...
  13. Finger Stick in Arm Alert AV Fistula

    For something like a glucose check I don't understand why you would really need to use the limb alert arm. In the unit we stick patients every hour when on IV insulin, often (repeatedly) on the finger...
  14. Coping with death and bad outcomes

    I'm fortunate to have the perspective of having worked with adults and peds in EDs and the units. Life is unpredictable, it isn't fair, and not everyone gets dealt a good hand. I've had plenty of kids...
  15. Scab nursing?

    I think that it's just part of the business for hospitals that have unions. There is probably variation based on union contracts and state laws, but if your union has the right to strike then is it...
  16. Do you have TNCC and
  17. ICU or IMU telemetry?

    I did the hour commute (a decent bit more than an hour actually) for almost two years. It wasn't fun but it can be done. Some HCA hospitals have a very poor reputation, some have a good reputation....
  18. Surge Pay

    It depends on the matrix but if we are down one nurse (as long as it is a float/resource) position and not a patient assignment we get your normal pay (1.5 for overtime, regular pay if under 40 hours,...
  19. TCRN Certification Study Materials

    The society of trauma nurses has a study
  20. Any 22 weekers out there?

    Because the expectation of parents and family are just that. They aren't going above or beyond, but rather to not be present is to do less. When you become a parent the bar is set at the top. This...
  21. Any 22 weekers out there?

    I don't say this as an anti religious statement, but those aren't just miracles. Those kids are the result of the hard work, perseverance, and love from their nurses, docs, therapists, pharmacists,...
  22. Any 22 weekers out there?

    The hard thing about premies is that their NICU course may have little to do with their eventual outcomes. I have taken care of 23 weekers that code 5+ times and make it out without any serious...
  23. Know your limits, know your emergency drugs and procedures, learn when to say no. Take advantage of every learning opportunity. Don't be afraid to ask questions. Don't be afraid to talk to the Docs....
  24. Pediatric CVICU experience, can I travel to NICU?

    Another thing to consider is the massive difference in independence in between the NICU and PICUs, even if the latter cares for preemies. We will take premies as long as they present with serious...
  25. If an ED has ESI 2 patients waiting in the waiting room for any amount of time, but especially over 10 minutes, the leadership needs to restructure how the department