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NeostigMe BSN, RN

Cardio-thoracic Surgery Recovery and Resuscitation

Critical Care RN based out of North Central Florida. Areas of specialty include post cardiothoracic surgery, VA/VV ECMO, and pre/intra-hospital resuscitation.

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NeostigMe is a BSN, RN and specializes in Cardio-thoracic Surgery Recovery and Resuscitation.

NeostigMe's Latest Activity

  1. NeostigMe

    Duke CRNA Class 2023, Applications Oct 2019

    Just got an acceptance call this AM! Just requested to the group
  2. NeostigMe

    Duke CRNA Class 2023, Applications Oct 2019

    Grats
  3. NeostigMe

    Raleigh UNCG CRNA SNA

    Called the graduate school and they said the program still hasn’t released the decisions, so it does seem like the program not the school. Not sure if to email the director for an update or just keep waiting. Got to hear something eventually!
  4. NeostigMe

    Raleigh UNCG CRNA SNA

    Sounds like a group, general overview of the program to start with and then individuals are pulled into their personal interviews after. In the past it was a panel interview with some of the faculty and director.
  5. NeostigMe

    Raleigh UNCG CRNA SNA

    Same! Got an interview scheduled for Nov 13th.
  6. NeostigMe

    Raleigh UNCG CRNA SNA

    Same here.
  7. NeostigMe

    How to read atrial ECG?

    This is a good article talking about AEG techniques, indications, and atrial fibrillation. 1c229e075ffd6f076658cdc91c564061ba03.pdf
  8. NeostigMe

    How to read atrial ECG?

    Hey there. My experience with intracardiac atrial ECGs are purely with using epicardial wires, so if you are using them in another sense this response may not be helpful. We use 'atriagrams' (I don't think this is the technical term but what we use ubiquitously on our unit) usually to differentiate atrial flutter/fib , junctional, or NSR. Using the now amplified atrial signal, you can more clearly see atrial activity, if any, and how that correlated with the patients intrinsic ventricular response. I have attached an image which shows how it amplifies the atrial activity in atrial fibrillation and you can see the larger disorganized fib waves and differentiate it from a irregular flutter. Although this was easily seen as flutter in the top rhythm, this technique is useful when the f waves are not as present in the standard ECG. As for the technique, these atriagrams use the principle of Einthoven's triangle to replace the right arm lead with an atrial epicardial wire. Lead one makes up the electrical activity going from the right arm to the left arm so by replacing the right arm lead (White) with the atrial wire you are kinda 'zooming in' on the atrial activity. You can 'zoom in' further by also replacing the left arm (black) lead with the second atrial wire however I find that this is usually excessive. So the down and dirty, put your monitor in lead I, touch the metal of one of the epicardial wires to the metal of the white ECG lead, review the monitor and assess for the presence of now amplified atrial activity. If still unsure, you may additionally attach the second atrial lead to the black ECG lead. I will try to find more examples from my own clinical practice and update the post. *EDIT* I have found more examples and can send them to you if you would like.
  9. NeostigMe

    Raleigh UNCG CRNA SNA

    I haven't yet. Finally got out of admission specialist review and now its sent to the faculty. Hoping next week as I think interviews are about a month away.
  10. NeostigMe

    Raleigh UNCG CRNA SNA

    Yeah, mine was submitted about two months ago and was just waiting on GRE scores that came in about 1 month ago. Still just an x for being reviewed by admission specialist. Talked to them today and said that's normal and they are still reviewing applications and sending them over to faculty. I guess just gonna keep my fingers crossed.
  11. NeostigMe

    Raleigh UNCG CRNA SNA

    Congrats! Does your applications still have an X next to "Application Materials currently being reviewed by your assigned Admissions Specialist"? I reached out to them before the deadline to make sure they are not missing any of my documents but starting to get anxious it might not have been sent to the faculty yet.
  12. NeostigMe

    New Grads in the ICU

    I wholeheartedly support new grads in the ICU. This being said, facilities need to take advantage of the probationary period when someone is clearly not making it in that environment. Our ICU is relativity high acuity in a level one trauma center and primarily hire new grads. We feel that they are very plastic out of nursing school and have the drive necessary to put their nose to the grind and learn the ropes. I have found this to be a huge factor in creating great nurses on our unit and new grads tend to have more of this drive. We have had to find a home for some of the nurses in a med-surg unit if they haven't made it on our unit after an extensive, prolonged orientation. I will say it is more of a gamble though. A students academic success does not have any clear correlation to professional success at the bedside. A nurse with prior experience is more established in their practice which is great for providing an outside perspective and a grounded practice. All in all, an idealized unit would have a mix between new blood and the old guard but as stated in other posts, the necessity of a nursing shortage leads many units to take whatever thy can get.
  13. NeostigMe

    Duke CRNA Class 2023, Applications Oct 2019

    Mine currently says 'Under Faculty Review'. We shall see soon I hope.
  14. NeostigMe

    Ultrasound Guided IV cert

    I agree with what the others have already stated. I think attending an extra course outside of your facility is probably overkill. Our facility didn't start with a standardized course until this year. When starting off I self taught myself with youtube videos and using the ultrasound on myself to understand the difference between normal venous and arterial anatomy. I don't think there is a current standard national certification for USGPIVs.
  15. NeostigMe

    Raleigh UNCG CRNA SNA

    Have also not heard anything yet. Hope its soon, looks like interviews are usually early/mid November.
  16. NeostigMe

    Duke CRNA Class 2023, Applications Oct 2019

    Use this link and click on the part that says 'check your status': https://nursing.duke.edu/apply-now
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