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beekindRN

beekindRN ASN, RN

ICU
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beekindRN is a ASN, RN and specializes in ICU.

beekindRN's Latest Activity

  1. beekindRN

    Seriously? I'm concussed!

    I'm breaking my no-sceeen rule to rant. I fell last week and gave myself a gnarly concussion the afternoon before my first night of three. I worked two days, but the third day I left at the beginning of the shift because I almost passed out three times while receiving report. It wasn't until then that I went to the ER. Because I postponed my rest, the ED staff said I'll get worse before I get better and my healing time is different (ie. I still can't drive and I have to avoid screens, even though it's been days ago). I'm currently off until I follow up with my PCP about restrictions. As of today, I have vision changes, dysathria, aphasia, short-term memory issues, dizziness, and a little bit of nausea. My boss knows this because she checked up on me last night... ...then asked if I wanted to work tonight because they were short-staffed. Would YOU want your ICU nurse to be concussed? Didn't think so.
  2. beekindRN

    Nursing Smells You Love?

    This is real, real morbid, but I love the smell of a body bag. It's such a fresh plastic scent. IV tubing is nice too, but not as strong.
  3. beekindRN

    Thready Pulse in Cardiac Arrest

    I agree. It all depends on rhythm. If the patient is v-fib or v-tach, that's not a perfusing rhythm. Ask the MD, if possible. "Doc, patient is in [insert rhythm here] with a thready pulse. Would you like to continue CPR?"
  4. I'm fairly certain we're on call the whole shift. The latest I was called in was 1 am on a 7p to 7a shift. We're unofficially cleared at 1 am. Usually if something awful comes in after that, they'll shuffle teams and the charge will take a patient. Irrelevant, but the worst that I've been called in for was for one med/surg patient post-cath....I work ICU. She had no PM meds and just slept off her Versed. I had been specifically placed on call because I had a migraine and it was the only way I could stay home without calling out...so I was just a bit irritated. /rant over/
  5. beekindRN

    What is your "thing" and how do you deal with it?

    Burns. I can deal with gangrene, I can deal with wounds, I can deal with pressure ulcers. But ugh, burns freak me the heck out. I even skipped class in nursing school that day. But mine is fairly easy in that I deal with it by not working a burn unit
  6. beekindRN

    Question regarding minimum staffing

    Nope nope nope. I only read the first paragraph and skimmed the rest. I'd check your laws for staffing ratios at the very least. 1) We had a dry spell this summer. We follow a strict staffing ratio, and one night our census was so low that it left one RN (a new grad, nonetheless) and one CRN (who is a bada** RN but had only been in the CRN role for two weeks at this point). They had a code and it was pretty devastating. There wasn't even resources to even begin the code appropriately. Thankfully, the patient was fine, but it really opened admin's eyes to the potential dangers. Apparently they were turning a patient and couldn't hear the vfib alarm on another patient at the nurse's station. When they left the patient's room and heard the alarm, they scrambled to start a code. 2) Our critical care unit consists of a 14-bed intensive care unit and an 8-bed progressive care unit. The PCU hss a minimum of 2 RNs and usually one tech. These patients are still VERY ill, in that they'll be downgraded to PCU a day or two after extubation and stay in PCU for a week or so. We are allowed to have feeding tubes and drips. Sometimes our patients are a "wait to intubate" ED admit, that they keep PCU level overnight until the pulmonologist can intubate in the morning. We RNs each have a 4-patient team (My team last week was two Afib with RVRs, one post-heart stent who kept having long runs of vtach with reperfussion, and one with respiratory failure satting a sustained 82% on continuous BiPap). It's TOUGH. Sometimes the other RN is JUST as busy, and often our aide will "float" to ICU to clean a stool or turn a patient. If my patient goes downhill, and the other RN is doing a med pass down the hall and our aide is in ICU, I'm pretty screwed. It's happened before and it will happen again. Sometimes I'll call my CRN on my cell and holler for them. This unit is L-shaped too, so there's many places you really can't yell for help. The two RNs and one aide make me nervous, I can't imagine one RN!!
  7. beekindRN

    I have made a huge mistake...

    Our staffing is odd right now. We have a lot of agency nurses finishing their contracts and a lot higher acuity patients than normal. We're WICKED short-staffed. My boss asked last week if I was willing to work a dayshift instead of a nightshift to help them out. Sure, I'd said, no worries. I'm nervous because this would be my first dayshift off of orientation, though I've been on my own for nightshift for a few months and I'm not sure if I like it or not. The following week, I'm scheduled to take a vacation. Long story short, she needs help on another dayshift and will give me an extra THREE vacation days. Heck yeah, I'd said, but please don't abuse my offer. She has asked twice more if I'm willing to work dayshifts, to which I apologized but said I'm not able to at this time. I don't mind helping out, but I'm out the $4/hr shift differential and I'm helping them out without any incentive (for reference, our bonus shifts are $20 bonus/hr). My husband works second shift and nights give us more time together, but I just found out I have hypothyroidism and I'm exhausted to the core...nightshift does not help this. Should I say no to swing shifts or see if I like days better, but ask for an incentive? If I prefer days, I may ask for a dayshift position should one come available. I'm still trying to figure this all out... Any tips?
  8. beekindRN

    Rant: Feeling like the worst nurse ever

    Full moon was the 15th
  9. beekindRN

    Words of Guidance to New Nurse

    1000x times yes! I'm not sure how your schedule is done, but I'm able to view online everyone who will be working with me. I like to pick a "preceptor," so I never go into a shift clueless. I know who loves to teach and who is receptive to helping me improve my skills. Usually it's our charge nurse, but sometimes a staff nurse is just that good! I'm also very honest. If I am experiencing something new or unfamiliar, I let our charge and a couple staff nurses know. This way, they check in frequently to see if I need help. That's a huge help, and I feel less dumb asking for advice and help. Good luck! This is such an exciting time!
  10. beekindRN

    new onset afib

    If you sat outside his room monitoring him all night, that's continuous monitoring. I would call the MD and say he is not currently Afib with RVR but with his extensive cardiac history, I'm afraid he will convert without us knowing on a non-telemetry floor. I work in ICU and have had two different patients convert into Afib with RVR in the 140s to 190s...completely asymptomatic. That's great that they don't feel it, but that's a HUGE risk for stroke. I called the MD, who is very laissez faire, incessantly. It took many hours, but I got my patient back on a Cardizem drip. Don't be afraid to vocalize your concern. If your charge is not reacting appropriately, and it seems as though she isn't, contact your house supervisor if you have one. Call the MD available at nights. I hate calling people at night, but they're on call for this reason. Best of luck to you!
  11. beekindRN

    Ineffective Compressions

    This is wicked -- thank you so much! This patient had JUST arrived to our ICU, so she didn't have an A-line and her pulse ox wasn't reading even on her forehead. I don't hope for another code soon, but should they have one, I'm definitely hoping for an A-line. Thanks!!
  12. beekindRN

    Ineffective Compressions

    We do not have access to feedback pads, but are the process of introducing them at our facility. I thought the aide's compressions were well timed, as I was recording and literally watching the clock. Her compressions to me did not seem slow, but a couple other nurses said she was going much slower than everyone else and seemed tired. I love your recommendations on recording the time. Thank you!
  13. beekindRN

    Ineffective Compressions

    I participated in a code yesterday that was textbook. Everything went as expected, but the overall prognosis for the patient was extremely poor. This was her fourth (and seemingly endless) code in just a couple hours. My question is we had two nurses who were absolutely jackhammering their compressions. I thought it quietly but didn't say anything, as I'm a new nurse and didn't want to argue during a code and potentially compromise quality care. I also accepted that our efforts were most likely futile anyways. However, an aide who is in nursing school later pulled me aside and noted that these compressions seemed incorrect. She provided slow, deep compressions and even started she was humming "Stayin' Alive" to maintain a proper beat. She was berated briefly during the code by a nurse for performing "tired" compressions due to her "slow" rate, but I thought she allowed for complete chest recoil and maintained an even, appropriate rhythm. Next time, how do I address incorrect compressions professionally and appropriately?
  14. beekindRN

    Panicking Over Vaccines 3 Weeks until School Starts!!!

    My school said that this would "exclude" you from starting this semester, and you'd have to reapply for the following semester. I, like you, missed my timeline for vaccinations. I was in the middle of planning for a wedding I wasn't sure I wanted and a very close family member was dying. I spoke with our dean and she accepted my "late" vaccines with a slap on the wrist, provided I had proof of appointments or attempts to get said vaccinations. Good luck, OP! It's probably nothing more than a wake-up call.
  15. beekindRN

    Nurse as a Patient?

    I provided a non biased report, but explained the issues and encouraged oncoming nurses to glance at some notes entered about her behavior. My shift brought aboard a team conference with management and even HR! I heard she's been a bit better since then.
  16. beekindRN

    Nurse as a Patient?

    I told her When she was being particularly manipulative, I told her I was going to document all care given and conversations had appropriately, and that my goal is to provide good care. She was not pleased.
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