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tachyallday BSN

ED/ Adult ICU/ PICU/ Acute Peds

You can lead a horse to water, but you can't make it drink...

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tachyallday has 10 years experience as a BSN and specializes in ED/ Adult ICU/ PICU/ Acute Peds.

tachyallday's Latest Activity

  1. tachyallday

    Am I too old to become a nurse?

    No. Not at all.
  2. tachyallday

    Aspiring RN, degree in Emergency Management?

    I am a nurse of over 10 years with ICU, PICU & ER background & department supervisory background. I just started in the ER early this year & started filling in as house supervisor here and there. After a disaster drill when I found myself part of the incident command, I became really interesed in the topc. I am looking at Masters Programs in Emergency Managment, but feel like it would be good to get more experience before applying (and also to find out if I like this field as much as I think I do). A lot of these programs include homeland security, and law enforcement & criminal justice peeps are generally applying. These are some of the things I am planning to help bolster my resume and empower me personally: Taking some free FEMA courses: Looking for a job on a DMAT: Volunteering with Red Cross in either a responder or community educator type role: Increasing my personal defense, and tactical skills & personal home preparedness: Looking into teaching some courses: ACLS/BLS/PALS/first aid: Just found out our hospital has a disaster committee, so will be joining that: If you went into DM, and had a job for a few years, it would looking great on your resume when you graduate from nursing school. It might help you land a job of your choice as a new grad. It won't however, help with your knowledge and skills as new nurse. No way to get that without putting in the time at the bedside. It will help you down the road, though if you decide to go that direction. I say, pick one field & stick with that. Work it for several years, and then add on. It would honestly be really hard for me to think about EM without the extensive background that I have gained (without going to school for it, and working in the field first). Feel free to PM me.
  3. tachyallday

    I've Been Employed at 7 Facilities as a New Grad RN

    seriously, and $&*^ all over them. ICU? Couldn't do days? wth? A little gratitude goes a LONG way. OP has cost organizations a lot of money with his/her whims & I have zero respect for that.
  4. tachyallday

    I've Been Employed at 7 Facilities as a New Grad RN

    Harsh words coming up here. The problem is you. Stop what you are doing. Take 100% accountability. Stop making excuses. Get used to being out of your comfort zone. It sucks balls to be a new nurse. Your resume is covered in red flags, so pick a job and stick with it for two years, and learn to manage your stress. Stop grad school - you have no business being there right now as a new grad, and especially one who seems prone to chaos. And listen to the people who have been around & have experience.
  5. tachyallday

    Quitting during probation/orientation

    Whenever I take a new job, I tell myself I will give it a full year - that is enough time to decide if I really like it or not, and enough time to count is as experience on my resume. I have been off of ED orientation for 2 months. It's really hard to keep up sometimes, but I keep reminding myself I am NEW and I am getting better as I go along. I went into it with a strong skill & critical thinking background - 10 years of ICU, peds & peds ICU. While I was on orientation (for 5 weeks), I kept wondering if I made the right choice. I still wonder that sometimes now, but I'll be sticking it out until at least Feb of next year. Hopefully I will love it by then. You CAN do this. Don't give up and make judgements about your ability before you've even actually done it.
  6. tachyallday

    Women's Right to Choose

    I'm not here to argue this^^^ I just presented both sides as I understand them. I'm tired of each side demonizing the other. Pro-lifers aren't out to subjugate women, and turn the US into that Hulu show that is so well-done that I can't even remember the name. Pro-choicers aren't on a mission to kill babies - they feel they are protecting mothers, babies that are already here, and potential babies that will lead a terrible existence. Each truly believes it is doing a moral, ethical action. No matter where you fall on this issue, demonizing isn't the way to change hearts or minds.
  7. tachyallday

    Women's Right to Choose

    here is the issue: pro-lifer's honestly believe the embroyo/fetus/baby is SEPARATE from the mother, and feel they are protecting an innocent life, not rolling back women's rights. pro-choicer's honestly feel the embroyo/fetus/baby is PART of the mother's body, and feel they are protecting the autonomy of the woman, not infringing on a separate human's life. There is no way to agree on this, unless science an determine for us when life (or personhood begins), and when when we begin to feel pain.
  8. tachyallday

    High (sort of) potassium

    Thank you!
  9. tachyallday

    High (sort of) potassium

    Lol @ "would you care to speak with ER Doc?" - I'm going to utilize this question - thank you! Ok, so I'm not off-base in my assessment that these docs are getting really excited when there is no need... In your ER experience, when do you start to get excited about K levels (asymptomatic), and in what instances are you pushing calcium gluc, insulin, dextrose & giving albuterol? (other than a code, or unstable situation?) If asymptomatic, just kaexylate, or facilitating dialyis asap for renal pts? Thank you for your input!
  10. tachyallday

    High (sort of) potassium

    New ED nurse here, but not a new nurse & just looking for some insight..I have extensive ICU experience, and I have seen high potassium many, many, many times, upwards of 6 without symptoms, even upwards of 7 without symptoms...I never recall anyone getting too terribly excited for a potassium level between 5 - 6. I don't actually recall remembering anyone symptomatic with a K between 5 & 6 Twice now I have had patients with heart rates in the 40s, one was sinus brady on a fit 60 year-old, one was junctional-ish looking on a not-fit 80 year-old. Both were A & O, stable on RA, BP WNL, no S/s of decreased perfusion. One came in for back pain, the other with throat "tightness". Not overt cardiac symptoms, but definitely could be considered atypical if it were cardiac-related... Both Ks were 5.5-5.7 (iStats & serum) - mild hyperkalemia On both cases, the docs were really worked up and like, "we need to do Calcium gluc, insulin and dextrose NOW for the hyperkalemia + albuterol." I was thinking, "ok you're really excited, and I've only ever done this during codes, and never saw anyone get this excited, but ok sure why not let's do this." I realize that people different thresholds for symptoms r/t potassium Both times, gave all those meds, heart rate/rhythm didn't change, not one bit. K verified to be down to 5.1 for one patient, and below 5 for the other. All other labs normal, except for Cr of 1.7 on the 80 year old (there was that person's cause of high K). Anyway, is this normal to do this protocol all the time? Is this just part of how you rule out causes of bradycardias? The fit 60 year old could have been living in the 40s & the 80 year old was on a beta-blocker...Anyway, a nurse told me she saw someone arrest with a K of 5.5 - does that really happen, or was there possibly another cause for the code vs. a K of 5.5 that was not known, and perhaps a cause there would never be an answer for? Also can CKD patients tolerate higher potassium levels because they are chronically elevated? Thank you!
  11. tachyallday

    Capstone Project Ideas - experienced nurse, but new to ED

    Pixie.RN - that is an excellent & one of the recommended strategies for not forgetting - good job. It can happen when our lizard brains are on autopilot & our routine is broken. I used to judge parents HARD until I read this article a number of years back: Can happen to the best of parents! https://www.washingtonpost.com/lifestyle/magazine/fatal-distraction-forgetting-a-child-in-thebackseat-of-a-car-is-a-horrifying-mistake-is-it-a-crime/2014/06/16/8ae0fe3a-f580-11e3-a3a5-42be35962a52_story.html?utm_term=.3a7bfa7f1417
  12. tachyallday

    Capstone Project Ideas - experienced nurse, but new to ED

    That's hilarious (and kind of a great idea)! I decided that don't want to annoy my new coworkers, so I have picked a community health project about a topic which I feel passionate: prevention of pediatric vehicular heattstroke
  13. not.done.yet Amazing & hilarious (and at least partially accurate) metaphor for an answer! Love it!
  14. tachyallday

    Anyone else go from adult med-surg to PICU?

    This was a HUGE jump for you. Adult m/s to peds m/s to eventually PICU, or Adult ICU to PICU *would* have been easier, however, you sound like an excellent conscientious nurse. So give yourself some credit, because you deserve it. Pretend you are brand-new again nurse again (because you basically, are), and don't set too high of expectations for yourself to learn or learn to critically think faster than you are humanly able. In your off-time read up on what you have experienced on your orientations days. If your preceptor is rude, ask that he/she treat you with respect. Explain that you are struggling, and his/her workplace incivility (WPI) is making it more difficult. Feel free to throw out there that WPI negatively affects morale, and negatively affects patient safety - because it does. This person has probably never been called on their BS before. You are an adult, so act like one, and speak up for yourself. If this fails, and your preceptor is still a jerk, ask your director for a new preceptor, and outline why. And to repeat, give yourself some credit!
  15. Agree, you will have endless opportunities after you get a few years of experience in the ICU! And you were lucky to get hired there! I started in ICU, went to PICU & Pediatrics 5 years later, and 5 years after that am heading to the ED next month, and also will be filling in as house sup. After you work in ICU in a few years, people give you this treatment of, "oh you're an ICU nurse? Then you can do anything." And it will be true to a great extent. Just know you will work HARD for that respect you will receive down the line. Harder than you can imagine. And it will be downright frightening at times. Of course, with babies and kids, it can be scary too. Five years later (and 10 years of being a nurse), they still scare me sometimes. Also, with regard to how people will eventually respect you, stay humble.
  16. Hey Everyone! I have been a nurse for almost 10 years. Over 5 spent in various adult ICUs, over 4 spent in pediatrics/PICU. I have always wanted to try working in the ED. It's been part of my nursing bucket list. So I'm checking that off next month when I transfer and will be rotating between adult & peds ED. I realize I will need to 'stop being an ICU nurse,' and I'm focused on looking forward to learning new things, and working in a new environment. I'm also a little terrified. I am finishing up my BSN as I write this and will be graduating in April. I need a topic for a Capstone project ASAP. I see my being the newbie (without prior ED experience), as a barrier to gaining buy-in or my new coworkers taking any potential ideas for a project seriously. With that being said, anyone have any great ideas for a project? Thanks for reading!