nurseinthemaking24

That rule is so helpful! I love it.

Hi guys so I’m doing a case studies project and I cannot for the life of me word either of the two questions correctly. It’s supposed to be on a PowerPoint but I don’t want to throw a bunch of info at my viewers when presenting. 1. pathophysiology of septic shock 2. progression of sepsis from sirs to severe sepsis to multi organ failure

I agree. It is a dumb question. it’s not a test question but it sounds like one. part of my ICU’s new nurse orientation is that we have to present case studies. it’s a case study question. I also think it’s a dumb question and poorly worded. truth be told, I know it’s different depending on the patient. Everyone’s body responses differently. Im not stupid, I know this. I know there is no set sequence they fail. Some people experience organ failure faster than others too. If they already have existing AKI, or a history of respiratory issues, that could be taken into account as well.

What organ is the first to fail from sepsis? im like certain it’s kidneys but now am unsure because of ARDS. help!

Hi guys I have been struggling to take on two patients. Even if one is stable and the other is critical, I really struggle to do this. Does it just take more time? What can I do to improve my time management skills? I'm working on clustering my care but don't know what else I can possibly do to implement changes or things to enhance and better my time management while still maintaining patient safety and doing my 3x checks. I'm assuming I will improve overtime but I am just not sure :/

Help needed! How can I prime a line without getting air bubbles in it or without wasting half of the bag when priming? I have tried pinching off the end after the chamber but fluid still gets through. I normally always clamp my line before spiking it, is this causing my issues? step by step on how you prime your new lines would be so helpful. xoxo

I’ve never seen a K+ order for a central line specify that an IV filter is needed. It’s standard policy at my facility that if it’s going through a central line, it needs a filter UNLESS it’s propofol.

She honestly had a lot of experience, but was not a great preceptor. Like not at all, so I’m glad I asked!

I am a new grad nurse and have heard a combo of different things and stigmas revolving around the idea of getting malpractice insurance. I was told by my preceptor to absolutely not get malpractice insurance because doctors attorneys, and or patient attorneys will see that you have it and come for you rather than the hospital and that the hospital is supposed to protect you. ideally yes the hospital is supposed to protect its nurses, but is that guaranteed? No help..

I really feel for you as I am in a similar position now but my management has now written me up twice. Granted my mistakes and errors were made under my preceptors supervision. No one was harmed and it did not negatively impact the patient. But I never got to go to management first, my preceptor went behind my back and even though I had voiced my want to talk to management on my own because it’s my responsibility, she went and did it without my knowledge. It’s so frustrating.

If your transducers cap has a hole in it, there is no purpose in removing the cap. Do the following. 1. turn stopcock off to the patient. 2. flush the line 3. press zero on monitor 4. turn stopcock back to neutral. if the cap does not have a hole in it then it needs to be removed. 1. turn stopcock off to the patient. 2. remove the cap. 3. flush the line. 4. press zero on monitor 5. replace cap with new cap 6. turn stopcock back to neutral this should be done every 4 hours at least with your Q4hr assessments!

Hey yall I am looking for a good report sheet and or a good tool that yall use when preparing/giving info during rounds on your patient. Please feel free to attach any recommendations, pdfs, etc to the comments. Thanks in advance :)

Does anyone have a common meds ICU drip cheat sheet? I am trying to make one for myself but my hospital doesn't have an updated one!

I thank you all for the feedback, I will keep this in mind for my clinical on Friday. I feel like it is hard for me to do things such as read my patient's chart and do things via their EHR because we do not have long in abilities like I have at previous clinical sites. Normally, that is my number #1 go to thing to do when my patient is taken care of and there are no other tasks for me to do. I have decided to make myself a little schedule chart based off how things have gone the past two weeks. She gives us times to do A,B,C so I feel like having that all written down will help me a lot. I understand the personal student time and how it could be seen that I was maybe playing mentor to another student, doing CNA level takes. I understand that in other perspectives it could be frustrating, but she has told us time and time again that we are supposed to help each other. But in the event that maybe I need to stop and not worry about my peers to prioritize my personal learning needs, how do I say no when someone comes to me and asks me for help? I know that sounds insanely bad, I do know how to say no. But when it comes to helping others I have always been told to help in clinicals. So I am not sure how to go about this. I appreciate all of your comments, thoughts and perspectives. I reallly appreciate each of you :)

I probably should’ve clarified that I said this as a joke to one of my friends/peers in the conference room and it wasn’t referring to nursing at all. I have accommodations as a student so she was aware of those explicitly. But she told me I needed to try harder than I am which really bothered me because I really do try so hard

Hi yall, I could use some advice. I am currently taking my final course before I graduate and am going into my second to last clinical rotation. Background: I am a student with ADHD that receives accommodations from my school's ADA officer. I have had ADHD since I was 13 years old and I have never once used it as an excuse because that simply isn't what it is. It is a unique difference in my brain, thought pattern, and learning/studying style in comparison to others. In fact, it is what many instructors have told me will make me a fantastic nurse, I have never had things easy for me. I have always had to study twice as hard and try six times as hard as the average student to obtain decent grades. This has given me so much resilience. I have been in clinical settings since 2019 which a wide variety of different clinical instructors. I have never had a problem with any of them until this current instructor. Keep in mind that this instructor has known me for 2 full days and only known me for a maximum of 4 hours in total. She does know about my ADHD because the school sends out my accommodations. The story- I'm insanely frustrated and feel beaten down at this time. My instructor told me on Friday that she is not satisfied with my abilities and need to stop using my ADHD as an excuse and do better. What provoked this you may ask? I got distracted and jokingly said, ADHD probs then returned to my task because I felt the need to address my distraction. Me saying I cannot focus because I have ADHD is not an excuse, it is a statement, a true statement. In the clinical setting, I tend to ask for clarification to ensure that I am doing what I am supposed to be doing. This helps me to fully understand what is expected of me because sometimes I miss part of an instruction or hear the wrong thing. So it is important to me to ask for clarification. She wrote down that I am progressing with reminders, which is ironic because she has never once reminded me to do anything. I go to her and ask her to confirm, she tells me yes if I understood correctly and no if I did not. That is not her actively looking for me on the unit and having to remind me to check on my patient or a task. On top of that, there was a girl in my clinical group that didn't know how to do anything patient care wise. So once I finished with my patient, I went with her to show her how to do everything under the sun. She didn't know how to use the BP machines, nor what a MAP was, how to put a patient on a bedpan, change the patients chucks, etc. I had no problem showing her how to do these things, but of course I receive no credit whatsoever from my instructor. My instructor refuses to acknowledge anything I have done correctly and instead tells me all of my weaknesses at one time and tells me I am not doing my best and need to do better, "you understand?" On top of all of that, she kept reinforcing the fact that I need to do better and I'm not doing good enough. Giving me now credit from this point forward for anything I have actually done well. This is extremely discouraging to me because I know I provide fantastic patient-centered care. I am constantly receiving compliments from patients and patient family members for how well I am taking care of their loved ones. The reminder thing- Sometimes, she doesn't give a clear instruction to the point I ask the girls in my clinical what we are supposed to be doing and none of us have a clue so I go to ask her to clarify my understanding so I don't do something I am not supposed to be doing. this is what she classifies as "reminders," I approach HER to clarify. That is not a reminder to me. It really frustrates me because I try so hard and it isn't recognized at all.

Thank you so much! Especially for clarifying for me. I was under the impression I wouldn’t be able to be a ICU nurse til I take the CCRNA exam. I’ll definitely keep an open mind. I really appreciate you! Thank you so much again :)

I’ve wanted to be a Critical Care Nurse for as long as I have wanted to be a nurse. I’m a senior in nursing school now, and currently in my critical care specialty. I am BEYOND devastated with my school’s clinical placement. I ended up being placed at a hospital where we are placed on a med surg floor with incredibly stable patients. Don’t get me wrong, I’m glad they’re okay! But I feel like I’m missing out on the experience that the other 75+ students get that have a different clinical assignment. I’ve already taken a huge interest to this course. Spending a lot of time developing a deep understanding of cardiac and ACLS. I applied for a nurse externship in the ICU and am hoping to get it so I can somewhat know what I am doing! If not, I'm thinking about doing a PCT in the ICU. Is that a good idea? With that being said, I’m looking for some advice. Becoming a CCRN: When do I take the CCRN exam? After NCLEX? I don't graduate until December but I really want to go ahead and maybe take my ACLS certification over the Summer? Good idea or bad idea? I'm honestly just a nursing student who wants some direction and advice from other critical care nurses! I just want to make sure I understand the steps to make this my specialty :) Thank you in advance!! Much love.

SOS yall! anyone have good advice on how to get a level 2 on the pharm CMS?! I have been studying under the learning systems tab. I have read the book. I study by drug class. but the predictor quiz was NOTHING like anything I had taken! any advice? any one have good study guides?!