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Pheebz777

Pheebz777 BSN, RN

ICU, CVICU, E.R.
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Pheebz777 has 18 years experience as a BSN, RN and specializes in ICU, CVICU, E.R..

Ready to rock and roll!!

Pheebz777's Latest Activity

  1. Pheebz777

    Low Ball Offers

    55-65/hour is just your base pay for the first 8 hours, beyond 8 hours it's x1.5 for each 12 hour shift you do. Beyond 40hrs per week you will be paid x2 of your base pay for each extra hour beyond 40hrs/week. You also have to factor in your housing stipend, travel allowance, etc, which are non-tax deductible. I am also looking into travel nursing in California and the 2 most lucrative offers I got was for $2800/week in Kaiser L.A. and Adventist in Tehachapi CA. But I wanted to work near my relatives in Fresno and San Jose since they have huge houses, swimming pools, vacant rooms, so I'm still waiting for an offer from a couple travel agents I'm working with to see if they can fetch me anything else above $2 grand/week.
  2. Pheebz777

    PA catheter and parameters

    Even though PA measurements are not routinely utilized, it is a great concept to grasp and understand. Many symptoms from various disease conditions reflect what is happening to your patient and understanding the pathophysiology behind these conditions make for better nurse anticipation and better patient outcomes. For example: patient with existing COPD, stable BP (101/62), placed on BiPAP, has a drop on blood pressure after 30 mins, 88/45. If you understand what the BiPAP does to the pulmonary vasculature, you can understand why there's a drop in BP. Or, what sepsis does to your SVR with subsequent drop in BP and compensatory response of your HR. Just think of the cardiovascular system as a system of pipes and valves, just like the plumbing system in your house. Key things you need to keep in mind: 1. Direction of flow (IVC/SVC --->RA--->TV--->RV--->PV... etc) 2. What systems and/or chamber lies before and after each valve 3. The normal pressure values before and after each valve. (before=closed, after=open) I would put a lot of effort into understanding these normal values, what they mean, and the effect of disease processes have on these parameters. To me, this is a very exciting concept to grasp. But it doesn't end there. Once you've collectively put together your understanding of the RAAS, sympathetic/parasympathetic response, catecholamines, as well as your understanding of mechanism of actions of antiarrythmics, pressors, vasodilators, ventilator management, etc, everything just falls into place.
  3. Pheebz777

    Esmolol and Norepi

    Plus the B2 stimulation promotes better perfusion through the pulmonary vasculature. Esmolol is primarily a B1 antagonist which has very minimal effect on B2 receptors.
  4. Pheebz777

    Tips for CEN 2018

    Print out the CEN blueprint and study all the material there. You can get by just by watching and understanding YouTube content on each topic. Also watch Mark Boswell videos over and over and take notes. Sheehy's Emergency Nursing book is also a helpful resource.
  5. Pheebz777

    Weaning/extubating vented patients

    We start weaning off sedation around 6am. Usually have orders for mittens to be applied just in case they awake enough to pull at lines, IVs, etc.
  6. Pheebz777

    CCRN

    The actual exam didn't seem as difficult as I thought it would. I had was getting high 60's in PASS CCRN. So I studied Laura Gasparis review book and studied all the material on the CCRN blueprint. Watching YouTube videos on most of the blueprint content really helped me understand majority of the topics. Scored 111 correct answers on the CCRN exam.
  7. Pheebz777

    Cen, tcrn, cpen, atcn, atls, ccrn

    Wouldn't hurt to take the CCRN. But the topics in Cardio and Pulmonary topics will be more in depth. You would have to memorize many hemodynamic values and understand each values' significance. Pulmonary will be the harder of the 2 topics to understand. CCRN would be over kill for any ED only nurse. You'll never handle Balloon pumps, impellas, fresh hearts (AVR,MVR,CABG,etc), and post-cardiac management. It would be more reasonable to take ED related certifications.
  8. Pheebz777

    Mobitz II vs. Third Degree Heart block?

    Don't start by looking for a dropped QRS. Pay attention to the PR/QRS pairing which is key. On Mobitz II, technically you'll find a consistent PR/QRS interval pairing on every QRS that isn't blocked. On 3rd Degree you will not, PR interval will vary from QRS to QRS (technically there is no PR interval because there is atrioventricular disassociation). But don't think of that, just concentrate on the PR interval. Just start with that. YouTube has a lot of videos and examples to practice on.
  9. Pheebz777

    Sterile Water for Enteral Feeding Tubes?

    Do you guys use sterile gloves when bathing patients too? No harm using sterile gloves. No harm in using sterile water as well. But the water we use is from the water dispenser. Not faucet water.
  10. Pheebz777

    School dosage math help

    There are several dosage calculation practice tests online with answers. The only way to get familiar with what equation to use is practice, practice and practice.
  11. Pheebz777

    But Why? Fingersticks and Common Sense

    This other facility where I do agency does not even do fingersticks in the ICU. All blood glucose level are obtained thru serum. Even patients on insulin drip get the hourly stick from lab.
  12. Pheebz777

    What's In A Name Badge?

    I put all the credential allowed onto my badge. I worked hard for it. However we're allowed only BSN-RN, CCRN. Can't slap on the CMC-CSC part.
  13. Pheebz777

    How long did you study for CCRN?

    I have been studying on and off for almost 6 months, but I realized it wasn't enough so I requested 2 weeks off and studied from 8am-3pm at the local library for 2 weeks straight! which was awesome! Quiet and provided an environment conducive to studying. Coffee shop nearby within the Library helped a lot. I used Laura G's CCRN question/answer study guide, also practiced the questions on the CD PASS CCRN, and I also watched a lot of Youtube videos explaining key concepts, pathophysio, anatomy etc.
  14. Pheebz777

    Looking to grow my brain

    youtube has a lot of valuable informative videos. Much easier to understand and retain than reading books.
  15. Pheebz777

    Does it bother CRNA's that MDA's get so much more...?

    Everyone should have just answered the question as follows: Nobody in their right mind would be bothered that MD's get paid more. I would be bothered if a CRNA was paid more than an MD Anesthesiologist! LOL!
  16. Pheebz777

    New grad advice for Arrhythmia Stepdown

    Look on YouTube. Everything you need to know about rythms, EKGs, waveforms, etc is all on youtube.