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AmyCardsNP RN, NP

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AmyCardsNP is a RN, NP and specializes in Cardiology.

I was a cardiology RN for 8 years (CVICU, Cath Lab) before going back to school to get my FNP. I am now a NP in a cardiology office.

AmyCardsNP's Latest Activity

  1. AmyCardsNP

    how many calories do you think we burn during a 12 hour shift?

    I wear a pedometer (http://fitbit.com) every day to work and depending on how busy I am in the ICU, I walk anywhere from 2-6 miles in a 12 hour shift. It's great to see how far I've walked during the day, especially after an exhaustingly busy shift.
  2. AmyCardsNP

    Annual Arrhythmia competency testing

    ACLS recertification does not require you to know rhythm interpretation to pass. It only requires that you recognize fatal rhythms (Vtach, Vfib, Asystole). They do cover heart blocks, afib, aflutter, etc during lecture, but they do not adequately test on it. I think arrhythmia interpretation should definitely be required for all RNs (and monitor techs) in an environment where it is a part of your job duties.
  3. AmyCardsNP

    Patients' Perceptions of Nurses' Skill

    Every once in awhile an article comes along that I love. Heck, I've even been known to rip out an article and put it in the nurses' lounge at the hospital a time or two. In September 2009, they published an article titled "Patients' Perceptions of Nurses' Skill" which I read and loved. The article discusses the factors that our patients use to assess our skill level. How do the factors that they use differ from the factors you use to look at your own nursing skill, or the skill of your coworkers? Nursing practice has three domains that make up skill: interpersonal, critical thinking, and technical. Which of these can our patients most easily pick up on? Interpersonal, of course. Our patients have very little insight into our critical thinking skills. As they lay in bed trying to breathe post-extubation with stridor, they don't know that you're the one calling the doctor for racemic epi, IV steroids, and heliox because you know the cause of the stridor. The same is true with our technical skills. Sure, they see us removing their central line, but they don't know correct steps to tell if you're performing the procedure in conjunction with best practice standards. All that our patients can see is our attitude about these things. When you call the physician on your patient with respiratory stridor, they see that you are doing this quickly and with confidence. You are in the room reassuring them that things will be okay and educating them on what is happening. When you are pulling the central line, you are explaining each step to the patient to reduce their stress level about the procedure and possibly chatting about another topic to get their mind off of it and show interest in them as a person. I highly suggest reading the article (I've attached the PDF below), but the big take-aways for me were: Patients describe the attributes of skilled nurses as: friendly, caring, compassionate, kind, good listener, confident, enjoyed his/her job, well-organized, and followed through with tasks he/she said they would do Patients describe the attributes of a non-skilled nurse as: Lack of confidence, timidity, rudeness, abrupt answers to questions, indecisiveness, frustration, and a negative attitude So, I look at these terms that our patients use to decipher our nursing skill and I can see the affect on our unit. There are a certain group of nurses who often get thank you cards or small tokens of appreciation from patients and family members and they display off of the attributes of skilled nurses - seems that this article is telling the truth 🙂 This article helps me remind myself when my day is going horribly, to take a breath. You're getting paid to be at work and these patients/families are going through a hard time right now. Relax and do your job, they don't need to know that you just got chewed out by a jerk physician or that the patient next door is confused, crawling out of bed, and on your last nerve. When you go in the room to do something, do it with a smile and take the extra time to try and make a connection with each one of your patients. You will stand out as they remember their hospital stay and you will personally feel better for having a relaxed attitude.
  4. AmyCardsNP

    NCLEX in different state than graduation state??

    I graduated in Illinois and took the NCLEX (and am practicing) in Arizona. I didnt have any issues with the process.
  5. AmyCardsNP

    Uniforms and dress codes

    We rolled out the same thing about 2 years ago... all of the nurses wear red tops, techs wear navy blue, unit clerks wear teal, etc, etc. When we all learned we were going to have to start wearing uniforms, no one was very pleased- we were happy with what we had picked out on our own. But, after just a few months, it became "the norm" and now no one thinks twice about it. I actually enjoy it when I'm floated to other units, I can tell who the nurses and/or techs are so I'm asking appropriate questions to the right people. So, I can imagine that the doctors/patients feel the same way. I know you mentioned that they are more than welcome to ask you if you are an RN, but I think that's just as big of an inconvenience for them as it is for us when we can't see a doctor's name tag... it'd be nice just to KNOW rather than have to ask. Try and go into it with an open mind... you'll find that it's not that big of a deal afterall (as we did at my facility).
  6. AmyCardsNP

    Heat/cool w/ CVC?

    We induce hypothermia on patients post witnessed cardiac arrest using external blankets. The way I've often seen patients "go to crap" during the rewarming phase is resultant from electrolyte shifts. We don't replace potassium during the 8 hours prior to rewarming for this exact reason. You can expect to see many arrhythmias.
  7. AmyCardsNP

    PCRN or CCRN

    The CCRN has a lot of questions on swans, ABG interpretations, titrating mutliple vasoactive drips at one time, and ventilator weaning. I think the PCCN would be a great test for you to take with your current experience (and getting that certification shows your dedication and will show the ICU managers your commitment to your patient care when you are ready to apply to that area). Good luck! :)
  8. AmyCardsNP

    Do you keep your license(s) in your wallet?

    I have copies of all the cards in my wallet, but not the original
  9. AmyCardsNP

    I am allergic to...

    I had a patient that reported to be allergic to potassium... and another patient who reported to be allergic to insulin. How do their bodies work?!?!? :)
  10. AmyCardsNP

    Question about Pay

    Agreed. Our managers only make a few dollars an hour more than the staff RNs
  11. AmyCardsNP

    what?...q 15 NIBPs with an art line???

    Could you explain your rationale for taking a cuff pressure every hour? I'm curious to the benefit for the patient if your Aline is correlating.
  12. AmyCardsNP

    Lasix gtts

    Sounds dangerous to be giving potassium supplements Q4 or Q6 hours.... unless you're checking potassium levels prior to each supplement dose. Sure, the lasix drip (assuming it is increasing urine output) will lower your potassium level, but too much supplementation will cause hyperkalemia... much more difficult to treat than hypokalemia.
  13. AmyCardsNP

    Any good review test for csc?

    Oooooh.... I'd love this information as well! Any good tips about the CSC?? and kmihaek- Congrats on your CCRN; doesn't it feel great? :)
  14. AmyCardsNP

    Soo has any one heard of StO2??

    I haven't seen StO2 used at bedside, but I have read about it. Are you using it at your facility? I'm very interested to hear how it works as the articles I've read didn't explain the actual set-up on the patient. From what I hear, it sounds like it's going to be of great value as a non-invasive correlation to SvO2.
  15. AmyCardsNP

    Chest tubes/Open Heart Surgery

    I had a patient ask me this question the other day, and I dont think the answer I gave was very complete (read: technical) so I was hoping someone could fill in the gaps for me: After open heart surgery, what exactly is the chest tube draining? And why does it need to be there? I understand the use of chest tubes in hemo/pneumothorax, pleural effusion, empyema situations on non-operative or post-operative patients as well as the purpose of the chest tubes directly post-op when the patient is actively bleeding. But I'm wondering more about a day or two down the road... when the chest tubes are in for a few days and continue to drain (besides for the initial dump when the patient gets out of bed for the first few times). Is that still blood that was caught in the chest cavity during surgery? If the chest tube was not in place would the fluid be reabsorbed into the tissue like it is in abdominal surgeries? (aside from frank bleeding immediately post-op, of course) Thanks in advance
  16. AmyCardsNP


    I recently took a balloon pump refresher course that was instructed by a Datascope rep and they recommend that you do NOT draw blood from the pump. But, on the other hand, on my unit (where we get a very high volume of balloon pump patients) we will always draw blood from the balloon as long as the patient is stable enough to allow the balloon to be put on standby for the few minutes it takes to draw the blood and flush the tubing out. Hope that helps