Pheebz777

Pheebz777 BSN, RN

ICU, CVICU, E.R.

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All Content by Pheebz777

  1. Treat the patient, not the monitor

    What about "Treat the patient, THEN the monitor?" (if this catches on, then you know where it started!) LOL! I don't know how many times I've seen a patient with O2 sats in the 90's while the pulse Ox was on the floor. Or a monitor saying the patien...
  2. RN's in my ED are having a problem with a tech, need advice

    Someone like that is a liability to your unit. She does not see the legalities of her actions. If any legal issues were to happen in your E.D. every staff involved will be examined and cross examined and every staff's scope of practice will be brough...
  3. How long did you study for CCRN?

    I have been studying on and off for almost six months, but I realized it wasn't enough, so I requested two weeks off and studied from 8 am-3 pm at the local library for two weeks straight! Which was awesome! Quiet and provided an environment conduciv...
  4. Agency Nursing - Who loves this work?

    When I worked agency I was lured not only by the larger salary/hr, but also the opportunity to try different facilities without having to apply for a full time position.
  5. Obese Nurses

    In our hospital, our mandatory "BMI" card takes priority over ACLS and BLS certification.
  6. How to know when you should move from floor to ICU?

    I moved to the ICU after 3 years of Tele/Med-surg because I felt so "plateaued", stagnant, same routine over and over, nothing new to learn, and felt like a plain 'ol pill pusher. What really pushed me to go ICU was when I noticed during Code Blues,...
  7. E.D. Protocols

    Both instances my patients were passed out from being too drunk. There were brought in by EMS after being involved in bar fights with other patrons. It just concerned me when people started calling saying they were "friends" of both patients (separat...
  8. CEN Study Recommendations

    Interested too in taking the CEN.
  9. I had a night

    2 weeks ago shooting at a strip club, 2 dead, several wounded, we were the closest E.R... fun night.
  10. EMTs Ever Look at You Like You're Dumb?

    Did you initially introduce yourself as the school nurse? Maybe they just wanted verification that you were the school nurse. "hi my name is "so & so", I'm the school nurse who called you guys, we called you because..."
  11. Nurse and MD relationships in the ED

    If you are a solid, reliable, knowledgable, assertive nurse that the MD trusts, he/she will treat you accordingly with better respect. If you cannot keep up with the unit demands, uncertain about yourself, need constant reminding, late at giving much...
  12. ICU RN considering moving to ER

    I've just transistioned to the E.R. after been working ICU/CV-ICU for 15 years, but I still do ICU as agency to a 2 other hospitals. You should have no problem adjusting to the organized chaos you are about to embark on LOL! Your routine will be tota...
  13. Ambulating a pt while on vasoactive drugs?

    wow, 50-100ml? When a patient is that volume depleted to cause dizziness, 50ml is like a drop in the ocean. I usualy give at least 250mls right off the batt. Especially when O.R. sends a patient up right after a push of Neo. You kinda wonder sometime...
  14. What stethoscope do YOU use?

    My dad who practices internal medicine since the 70's still uses his $8 Littmann Steth he bought in 1972 (that was fairly pricey back then). For his 69th Bday I bought him a $200 Littman Cardiology steth. When I visited him one day I could not help b...
  15. Nitroglycerin in MI

    On top of what was already explained, the RV is preload dependent. NTG causes vasodilation of the peripheral vascular bed causing pooling of blood volume, thus decreasing your blood pressure and RV preload. As long as the patient is not volume deplet...
  16. Handling Emergencies Outside the Unit

    Basically all we can do in an emergent outpatient setting is call for help, secure airway, stop the bleeding and immobilize before considering any form of transport. At least when the EMTs or flight crew arrive, there's no time wasted.
  17. What type of pacer from a 12-lead?

    You can't go wrong with wanting to know the Ins and Outs of how things work. I'm sure if you get a hold of a cardiologist and ask your question, you might get a perplexed look from him. It's just as significant as wanting to know what coronary artery...
  18. Night Shifters - Am I being too sensitive?

    I got floated to the med-surg unit one time and I had a patient complain to me that the "family" in the next room has been outrageously noisy the past 2 nights. Upon leaving the patient's room, I checked the "other room" next to my patient only to fi...
  19. 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!
  20. New grad advice for Arrhythmia Stepdown

    Look on YouTube. Everything you need to know about rythms, EKGs, waveforms, etc is all on youtube.
  21. 21 g needle vs 23 g butterfly

    You're not supposed to shake the vacutainers. Just gently invert them back and forth.
  22. Resigning after 3 months

    I can't remember how many countless times I resigned back then because I didn't feel nursing was for me as I dreaded coming into work and feared the unknown. Worked 2 years on a Med-Surg floor, resigned, then worked 5 years managing a music store and...
  23. Atrial pacing above 100 to increase CO/MAP

    It's not uncommon for the CT surgeons to set the pacer at 100/min for fresh CABG patients until the hearts intrinsic conduction system recovers. They usually wean off any pressors first before going down on the paced rate. Depending on the underlying...
  24. Future CVICU Nurse Just got hired today

    Get your CCRN certification. The studying alone will open your mind to key concepts related to hemodynamics, pulmonology, the renal system and everything else related cardiac wise. Then while fresh in mind, get your CMC and CSC as soon as you can.
  25. Adensonie

    Wait til you do some synchronized cardioversion after failed adenosine attempts! You'll be loving this cardiology!