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ptier_MNMurse

ptier_MNMurse BSN, RN

CVICU

CCRN-CSC, TNCC

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ptier_MNMurse has 4 years experience as a BSN, RN and specializes in CVICU.

ptier_MNMurse's Latest Activity

  1. ptier_MNMurse

    Chances for CRNA School

    I was in the same boat! I took two classes through Winona state university (pharm and patho, designed for DNP students) and I also took the Barry University nurse anesthesia prep course! They were good courses and really helpful in anticipating the next step in processes in the ICU’s! I would recommend them! You will have to put in time to study the material, but it’s doable and the professors were all very helpful!
  2. ptier_MNMurse

    Shadowing Experience

    talk to your coworkers, talk to your manager, your could even try contacting the HR department otherwise!
  3. ptier_MNMurse

    Chances for CRNA School

    Hey cosmo! It sounds like you are on the right track! many people spend a lot of time/effort to get in. I came back from having a low GPA (did not do well in previous engineering degree) and took multiple graduate level science classes to boost my GPA. I would recommend working on this instead of applying to so many schools. I hear you with wanting to cast a wide net, and I think that wise, but you might also allocate that money toward taking classes! Most accepted applicants have 3-5 years experience, leadership on their resume (AACN board, unit council, preceptor and/or charge, volunteering, etc.), multiple certs, multiple shadowing experiences, great references, advanced coursework in math/science after nursing degree. Not trying to be overwhelming/discouraging just trying to give an accurate picture of the applicant pool. I would recommend contacting the schools and finding what they are looking and gauging where you might have a better chance. I was once told that any applicant can have one hole in their resume. Yours currently has two, GPA and experience. Again, not trying to be discouraging, just trying to be real. I felt the same way in your shoes, a few years back, but know that it is still totally possible! Start working on classes, get some more certs, BLS, ACLS, PALS (for sure), then CCRN, TNCC next. Then do CSC, CMC and ENPC. Get a few grad level science classes under your belt to show you can succeed at the grad level (gotta get A's), then you will probably be up over that 3.0 mark (try to be smart about calculating your potential GPA with which classes offer the most credits that you think you can succeed in). Keep grinding to get the best ICU experience you can, do some leadership work on top of that and you will be going in the right direction. If you can drop some dough on classes and apply to all 40 schools, that is great, but you might not be able to devote as much time to classes and applications to do your best in each, if you are spreading yourself more thin. But you know yourself and your capabilities more than anyone else. I hope this is helpful, you can do it! Just trying to offer the advice I wish I had 4 years ago! Good luck!
  4. ptier_MNMurse

    Keep getting rejected

    I agree with loveanesthesia. Soak in as much as you can in the ICU, get some leadership experience (charge, preceptor, work on the local AACN board, join a committee, join unit council), and continue to take classes. Average accepted applicant has 3-5 years of ICU experience. On paper, everyone looks similar, so you have to keep working to stand out. The previous masters degree will help, but don't rest on your laurels. Showing continuous development will help you stand out! Keep working hard! Do not be discouraged by not getting in on your first round either, it shows commitment to apply again in subsequent years!
  5. ptier_MNMurse

    Advice for a new ICU nurse, vasopressors, fluid status

    Hey TitoG! Welcome to ICU! It's a blast and a lot of work, and totally rewarding! Answering your questions: 1. My facility has taught to ask for a second pressor once we reach a certain threshold. For example our norepi dosing is 0.03-0.4 mcg/kg/min. We are told to ask for another pressor once we reach 0.1 mcg/kg/min of norepi. See if there is a protocol, but it is wise to ask for a second pressor before you are maxed out, and I would imagine most ICU physicians would like to start a second pressor before maxing out on just one d/t mechanism/area of action (ie. vasopressin acts on mesenteric capillary beds and can cause bowel ischemia). They all have their different pharmacologic profile and potential complications, but as a rule of thumb, being maxed on one is not the best option. 2. You are listing legitimate assessments for fluid status. CVP, flotrac (a little more variable), a PCWP (if you have a swan), passive leg raise, trendelenberg position and assessing their response, looking at their hands/arms, legs/feet, face for edema, and listening to their lungs for pulmonary congestion are all good ways of assessing their fluid status and therefore responsiveness (Also check their I/O's in your chart to see how far up/down they are). You also have to look at the bigger picture as well. Getting to know your patient population is important! A young trauma patient may require and tolerate 2 liters of fluids wide open, while an elderly patient with cardiac disease may actually be tipped over the edge with a 500 ml bolus. Bottom line, read up and become an expert on your population! 3. Don't take it home with you, leave your worries at the door and build healthy coping habits! You will make mistakes, use them as learning experiences and move on. Always be open to learning, even when you think you know it all! Enjoy the ride! Best of luck!
  6. ptier_MNMurse

    New to ICU and having trouble adjusting

    Some days can be slow, as you progress and take more critical patients you will have to use all of those skills! We have a lot of additional monitoring which helps us to see changes in real time more quickly, but the most important monitoring comes from you. You seem to have an appreciation for this! Don't lose it! Sometimes ICU can get slow, but there is always something to do! Get your patient bathed (like a real bed bath, not just the CHG wipes), up to the chair, teeth brushed, hair washed/combed, walked, lotioned, massaged, etc. if you have the "downtime". That is the nursing touch you can bring to the bedside that gets overlooked at times in the ICU I would say. If you are looking for more critical stuff to do, practice starting IVs, learn about the various pressors/inotropes, study hemodynamics, study vents, get more in depth with heart rhythms, etc. Then you will be more prepared for when the fit hits the shan... at least a little. Also, you have only been there 3 months and are brand new to the ICU so you won't get the critical patients, and if you are bored that hopefully means you get everything that has been put in front of you. Show your coworkers you have it all together by doing all of the stuff above and it will show 1.) That you care about the patients, and 2.) That you know what's up and are maybe ready for some further advancement. If you really want to advance, take a permanent gig on a unit you like. If ICU really isn't for you and you want to use more kinesthetic clinical assessment, ED might work better for you! Though you will experience the same general monotony of most patients being less acute, and then some that are absolutely crumping. Overall, I would say give it some more time and try to learn some more.
  7. ptier_MNMurse

    Bouncing back after a bad shift

    It sounds like you definitely need to debrief. Talk with your other nurses and definitely talk to your manager about it. What you are experiencing is definitely understandable and you are not alone in how you feel about this! Many of us have had similar experiences, where you get that gut rot feeling like you did something wrong and someone suffered for it. This doesn't sound like your fault. Talk to your manager and see if there is anything else that could have been done differently, talk with your colleagues to see what their experiences have been, and maintain some HEALTHY coping mechanisms (workout, yoga, tea, meditate, pray, walks, music, etc.) to get your mind right. I have definitely been through some tough things where I felt like I had done something wrong, but things turned out to be out of anyone's control. Critical incident stress management is important! Keep your chin up!
  8. ptier_MNMurse

    5 Year Plan?

    I agree with Defibn’. Everyone’s five year plan is different. Try to look at what interests you in anesthesia, then you can formulate what you might want to do with your career. Then you can create a plan for how to get there and your five year plan would be integrated into that timeline. Make sure you have shadowed, researched and explored the field so you know what avenue you want to go, then you will have an answer to this question. I think you would more likely get the question “why do you want to be a CRNA?”. Make sure you can answer this, then extrapolating on your plan will additionally set you apart from other applicants in showing how in depth you have thought things through.
  9. ptier_MNMurse

    Best nurse brain sheet?

    Hahaha. Funny how that works. All my notes are now in my head. lol
  10. ptier_MNMurse

    Best nurse brain sheet?

    This is an awesome sheet! The only things I would add are: Current continuous gtts, vascular access (location, type, size) and Pain/Interventions.
  11. ptier_MNMurse

    ANE695

    Hey! I took ANE 695 last year. Great class and I enjoyed the history and being in a cohort with a lot of other people working toward the same goal. The final was similar to all the other tests. I don’t remember specifics of it, but if you did well on the other tests, you should do fine on the final! Good luck!
  12. ptier_MNMurse

    Best Online Chem Course for CRNA school resume

    University of New England has some online courses. Chem 1, chem 2, O chem and Bio Chem available. I took Chem 1 again through this and found it pretty straightforward. It was a lot of self learning though, definitely be prepared to read the book in depth and take thorough notes. UNE also has a wide variety of other science pre-requisite courses for health professionals. The schools I am applying to accept this as undergraduate coursework. Good luck!
  13. ptier_MNMurse

    Saint Mary's CRNA Program 2020

    Just came in the mail. Dated for 6/6 but I received it on 6/11. No email and no change to application profile.
  14. ptier_MNMurse

    Saint Mary's CRNA Program 2020

    Nope. I think that has been pretty variable whether it changes or not in previous years.
  15. ptier_MNMurse

    Saint Mary's CRNA Program 2020

    Well, I got my rejection letter in the mail. Generic stuff: average math/science gpa: 3.3, average years experience: 3, chem taken in the last 5 years. It sucks to get this letter, but I sincerely wish you all the best! Good luck!
  16. ptier_MNMurse

    CRNA Applications

    It depends on the school. Some schools require that in order to replace a grade you need to retake the same class at the same institution, while others substitute the grade with a similar course. Your GPA and certifications look good. Maybe work on the overall GPA but the math/science seem fine. The GRE would be helpful, and scoring a 300+ would look good. You have the minimum experience for ICU. Often, schools seem to like people with 3-5 years experience. Do you work SICU at the level 1? I would definitely apply as even if you don’t get in, reapplicants are appreciated per the schools I am applying to (shows commitment and dedication to becoming a CRNA). It often comes down to what the applicant pool looks like though. You could be very qualified and still not get in because other people are better qualified. apply, keep you chin up, be patient and good luck!
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