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critical care transport
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buddiage has 10 years experience and specializes in critical care transport.

buddiage's Latest Activity

  1. buddiage

    I'm so lost :(

    You will be doing so many things in med-surg. The COOLEST part of this is, you are gonna get PAID while you figure out what calls to you! How cool is that? You will be exposed to different disease processes and wound care, and certain aspects of patient care are gonna get your attention and pique your interest. You're gonna talk to nurses that came from other floors and hospitals, and you are gonna find your way. What is even better is, if something isn't a good fit for you, you can always switch! There's a no lose situation for you! :)
  2. I've been in the hospital in a CCU, CVICU, and have been a transport nurse (on an ambulance) for 10 years. I've really enjoyed the 'nerdy' aspect of critical care, but I feel especially connected on a more spiritual/human level with hospice patients and families, which I think speaks to me more. Ultimately to me, the reality of dying is the moment of all truth- an opportunity for a death bed and reflection of your relationships. One of the things I don't like about my job (I think nursing can say this generally), is I'm annoyed with trying to make people live that should be allowed to say good-bye. I see the view of death as something feared and scary. I feel like I want to do my part in changing it. For whatever reason, I feel comfortable (and privileged) to be a part of someone's world when they are in a crisis. Critical care has definitely given me a sometimes salty and gritty view of things and the state of the human race sometimes but I don't get this way with the dying. I want the opinion and view of people that left critical care to do hospice. What made you like it more/less? Did you have friends that challenged the choice of hospice, as if you were "downgrading" the value of your nursing care you provide? (My husband, an ICU nurse, says, "Ew, why would you want to do that?") I've only dealt with hospice through transporting them home or to hospice facilities (as well as caring for them in the hospital). Any words of advice? Did you get bored? Feel more fulfilled in your job (perhaps you felt your purpose in life was this, and feel content)? I work a ton of hours in transport and haven't picked up in the hospital in almost six months (per diem). The thought of going there turns my stomach. I'm thinking of just axing that altogether. Sorry for the wordiness, but I don't know hospice nurses and I want your input please. I've been thinking about this for about 2 years and now I'm burning with it practically.
  3. buddiage

    Nurse union contracts

    I read a story that the hospital I was considering went union. Thanks for your input!
  4. buddiage

    Nurse union contracts

    I'm considering a move to Covina area from Washington. I want to review the contract that the nurses have with the hospital I am considering. I looked up CNA. There is nothing to review. Where are these contracts at to look at? WSNA has them all online.
  5. buddiage

    Have you ever been insulted for what you do?

    I am quite shocked at the STUPIDITY of what people say. We ALL have our specialties. THANK GOD. There's enough work for everyone, so let's not step on eachother.
  6. buddiage

    anyone leave high paying 1st career?

    Honestly, you aren't going to know if it was truly worth it until you become a nurse, and some people can't imagine NOT being a nurse despite the fact that their job frustrates them. IMO, if I were you, the idea of more money sounds good. I'm in a situation where I am almost done with a divorce and I'm on my own. I hate living in an apartment, miss my house with a big ol yard. What I've learned in 3 years of nursing is: I aboslutely am smitten with some aspects of being a nurse. My attitude at my job I think has enabled my survival there, and I can actually enjoy aspects of it. I think this applies to any job though. My favorite part of nursing is patient education. My least favorite parts of nursing is jumping through all the 'bs' hoops that supposedly make pt care better. These thoughs race through my mind as I become a slave to the computer and not in with my patient. I also don't like the nature of health care which is 'do more with less.' I hate that I feel like ultimately EVERYTHING rests on my shoulders and therefore if anything goes wrong, it's my fault. The floor you work, the work culture on the floor you work will have an impact on how you feel about your job too. This is just my
  7. i heard good things as well
  8. I agree with other posters. Volunteering to go down should be thoughtful. This isn't the yearly county fair looking for volunteers for the 4-H booth. This is tragedy to the fullest extent. If I WERE in that situation, I think it's entirely possible that I would do anything it took, EVEN BEING SAVAGE, to do what I could for my daughter's survival. This is beyond etiquette and social inhibitions, and I think it's important to acknowledge it.
  9. buddiage

    Sexually abusive doctor

    Concerned about his mental health? Hand the guy a rope in his cell and walk away...
  10. buddiage

    Assaulted and written up. (vent)

    I'm wondering if you sprain your wrist and have a 'demigod' for a medical director in the situation described, I wonder if the physician examining you would be inclined to treat you the way the medical director would want you to be treated. Would he or she stand up for you? Hmmmm...
  11. buddiage

    New national nurses union forms

    Another nurse union? I tell you, we are so fragmented with different organizations and associations that I feel we don't have a chance at changing anything. Frankly, I scared how healthcare is moving. I love the idea that healthcare could be available to everyone, but I am VERY leery that working conditions would be triply worse than they already are.
  12. buddiage

    A-fib + metropolol + diltiazem gtt + soft bp

    Pt had scant crackles in bases, but sats fine (97 to 99 percent), and no SOB. Lung assessment hadn't really changed since being there, and she had been on her back for a few days. EBL- can't remember the number, but it was hardly worth mentioning. As far as CHF, no echo had been done currently in our facility while I had her. I believe she had a previous EF of 60 percent. Pt was warm and dry. I am guessing that she was volume depleted, her urine output was OKAY, but for someone on NS 100/hr, I wasn't impressed with the output. Which reminds me, one of the reasons why I was concerned about killing her blood pressure is because I wasn't wanting to kill her kidney perfussion. I don't recall her labs exciting me much either. I believe her Cr was up a wee bit. It's hard to convey everything without the chart in front of me ;0), but I did solicit for some food for thought. I did not call the physician (I'm not afraid to, but I'm a night shifter and like to call only when I really need to). FST6 and others, thanks for your thoughts.
  13. buddiage

    A-fib + metropolol + diltiazem gtt + soft bp

    NO, no lisinopril, just metropolol. random things i remember: ef of 40%. I dont recall digoxin on her sheet. My supervisor said she would've given the metropolol. I had heard (but was corrected by her today) that diltiazem affects bp, just not as profoundly as betablockers. For rate control, the Ca+ Channel blocker was, in my understanding, the way to go. I was frustrated b/c I felt a little like I got my nose slapped by my supervisor, and I was mad at myself for making the mistake. I told two other nurses what I did, and nobody flinched, which made me wonder, is it me or is it our floor that could use some education on beta blocker vs calcium channel blocker. I was hoping for anybody's point of view to give me a "I didn't look at it that way before" inspiration. The better worded question is when is it appropriate to hold metropolol vs cardizem. I don't want to inspire an argument, just want people to share.
  14. buddiage

    A-fib + metropolol + diltiazem gtt + soft bp

    she has a history of afib. had gone in and out of it. the plan was to wait until her INR came down so that she could get the surgical proceedure. after proceedure she was restarted on coumadin. i might add her b/p had been on the soft side since admission, despite cardiazem and fluids going at 100/hr. i'll add- you cannot cardiovert someone unless you know they do not have a clot in there heart somewhere, which means they get a TEE to see...and, our pts are always on heparin. plus...this lady is in and out of it from what I got in report, but she's been in it for 3 days now :-) btw, i did a preceptorship in the icu, and learned so much. you will too.
  15. buddiage

    A-fib + metropolol + diltiazem gtt + soft bp

    Totally see your point, but b/p actually IMPROVED as heart rate went slightly up. I'm glad you shared your view, because I also want to see just how many people would've done what. i'd love to take a vote on my unit, but that won't happen.
  16. situation: rhythm a-fib, with rate 100-130's systolic lood pressure: 82 and 91 in different arms ns going at 100/hr (for 2 days!) diltiazem drip 5mg/hr metropolol 50mg bid i held metropolol d/t blood pressure, but i'm keeping an eyeball on the rate. up diltiazem to 10mg/hr about 5 hrs into shift after heart rate reaches occaional (not sustained) 140's. pt had screw put in femer, and was out of pacu for 2 hours when i got on shift. systolic bp 2 more times during shift is 90's, 1 time making it to 102. my question: which medication would you have held and why? i asked my supervisor/ manager of the unit just how much diltiazem affects b/p and asked her what she would've done in my position. i've been a cardiac nurse for 1.5 years and have always held the metropolol if they are on a dilt drip, because i thought that dilt was the way of controlling rate in afib. anybody want to share their brain with a greenhorn?