TI2Grr

Thanks for the encouragement, my last day in the ICU was today. Kind of sad to be honest with you, it is a group of people whom I will cherish and miss deeply, but they are also a very understanding unit and are happy for me as well. I am at the nervous point now, my orientation begins on Monday the 4th, I am just planning on being a sponge and as I have always learned about nursing you can never know everything, but you will quite frequently find someone who can help you find the information or give you the answer or assistance. I just hope my bucket of knowledge is big enough to handle it all... Anyhow thanks again for the encouraging words, and I will try and post later on the process of the orientation and maybe look for new questions to ask as I progress...

I just got accepted in to our flight program and am very excited I have over 6 years of ER experience and 2 and a half years of ICU experience. I am trying my best not to get stressed out or nervous about the whole thing as I just put in my two weeks notice in the ICU. Was a wonderful unit to work in it is always hard to leave something that you are comfortable at for something that you have strived so hard to do or be. Just curious as to any suggestions or comments from any of the seasoned flight nurses out there; like what is the best way to approach the new challenges; what does it take to be an exceptional flight nurse; what are some of the things to avoid... Any subtle hints or defined processes would be of great help... Basically I would just enjoy hearing from some other flight nurses and hear about when they first started, their trials and tribulations... :)

The PASS CCRN! second edition Mosby book by Robin Donohoe Dennison is a great resource and even gives you a lot of the informative info on taking the test and how's, why's and what not's. I found mine at Barnes and Noble for I want to say $30.00 it also has a wonderful Cd-Rom with it that has a pre-test which breaks down all the areas of the actual CCRN test. This is as good a place as any to start looking. Good luck, I am in your same shoes as well, I am hoping to take the test in the next year, I have been working the ICU for 8 months now after working primarily rural nursing in Montana doing everything from OB to ER to PEDS.. heck I find the ICU sometimes more peaceful than what I have done in the past.. but anyhow, good luck with your CCRN, I do feel for you..

Janine Looks as if you did wonderfully.. The big thing here is making sure that you don't shift to quickly the patient is in acidosis and the most important thing is insuring his Ph changes occur slowly, thus you want to keep giving dextrose and maintain the blood glucose preferably above 200 or 250 so he/she doesn't crash on you, then presenting more problems. The important thing is watching Ph, and also Ketones in urine.. Hence you will be giving quite a lot of bolus, normally in a couple of different IV solutions, one probably being NS, and the other being a dextrose solution, and watching the shift occur from acidosis to a normal baseline. An important thing to realize here is that different strokes for different folks -- referring to Doc's here, and this shift can occur in a couple of different manners, initial phase of getting this person stabilized was done as normally seen by a lot of different facilities and also patients. Sounds like the intern didn't know what the heck was going on or didn't explain something else due to something seen in the patients lab values.. Don't get frustrated.. You did well..