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erwindt

erwindt MSN, RN

Critical Care
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erwindt has 13 years experience as a MSN, RN and specializes in Critical Care.

erwindt's Latest Activity

  1. erwindt

    COVID patient venous access

    Hey ALL. Hope everyone are safe and in good health. Seems like we are nearing the end of COVID19. However, I hear a lot of rumors of the possibility of a second wave of COVID19. I just would like to hear other people's feedback regarding venous access of patients with COVID19 in their facility. Many of the facilities in NYC, placed femoral access, then transitioned to something more suitable after. I am a vascular nurse and I was placing mainly PICCs and Midlines for all COVID19 patients. Many doctors didn't want to place IJs because they were too close to the patient's airway and so they fear of getting the virus. For this reason, our vascular access team (consisted only 2 people) were being utilized for majority of central line access for all of these patients. Since the pandemic began, we placed more than 150 PICCs. Many patients were on the vent for weeks, but eventually passed away, and put in our temporary morgue in our parking lot. Anyone reading my post and is also a vascular nurse, can you share your observation on COVID19 positive patients. I found that 90% in positive COVID19 patients have large basilic veins. Another, the medication, Hydroxychloroquine, made patients highly susceptible to blood clots. The pandemic was a nightmare and a nursing experience that will continue to be a conversation topic in the healthcare community. During the peak of the virus, many non-ICU nurses were forced to function as ICU nurses in a couple of hours. For this reason, I observed a lot of medical/medication errors. Many healthcare workers fear of catching the virus that as soon as someone was suspected or confirmed of having COVID19, everyone ran away. And yes, I give A LOT of respect to TRUE frontline heroes, but I discredit many who were so fearful of the virus, abandoned patients and let them die in agony. May ALL the souls taken by COVID19 have eternal rest-in-peace.
  2. I am not sure if this topic already exist, but I just would like to read other people's response regarding hospital employees presenting their hospital/work I.D. when they become a patient in any healthcare setting, visiting a family/friend, or as the healthcare proxy of the patient. When I become a patient myself, I disclose my profession, only discuss when ask to. My two opinions about this is that (1) you don't get proper service if staff knows you're a healthcare provider because they get intimidated, (2) it is often great for them to know, so that they are aware you understand their "language". VERY vocal family members or friends of a patient can often be harmful for the sick individual and they don't receive proper care (in my opinion and my observation). Health care staffs, especially nurses become highly aware, fear of something will happen, so they avoid pretty much engaging or even going into the patient's room. I have witnessed this a couple of times in small and large, well renowned medical centers. I think it is OK to reveal to healthcare providers that you are also a healthcare worker, if the interaction is not aggressive or very demanding. Many people often forget about this and I feel sad for the "individual" in the bed. I treat all my patients like my own family members. That is the only and best way I can provide upmost care for them. Before entering a patient's room, I often receive warning signs from staffs about the patient. It is wonderful, but sometimes, patient's anger is NOT about the nurses, doctors, or other healthcare workers. We forget they are sick and they are in unfamiliar environments. I had a patient 10 years ago, with pancreatic stage IV cancer. He was nasty to everyone, but I took care of him to the end. We all know that this type of cancer is very aggressive and sometimes, doctors give patient and their family a hope to hold on. They told the guy, he will have 6-months to live, but his prognosis was so rapid, that within 2nd week, he was at the end of his life. He became so nice, apologetic about his behavior and thank me how nice I was to him. He had no family at the bedside, so I held his hands, prayed for him, when he took his last breath. This is the main reason why I love nursing.
  3. Numbers does matter. Many people, not just nursing, choose a profession that (1) have high salaries (2) and something they like. Many would disagree, but I am just laying out the facts. First and foremost, I am blessed to be a registered nurse, especially during these unprecedented times. So many people are unemployed right now and I feel terrible in, still, search for a career that will pay me more $$$, so that I can retire early. When I was a young nurse, I had a goal of going to CRNA school, just like the majority. Obtained all the requirements and even re-took my sciences, but after shadowing CRNAs in action in the O.R., I realize the profession was not for me. I attended ACNP school, but left the program, knowing it wasn't for me also. I needed a challenge, but at the same time, I didn't like the whole nursing thing anymore. Just fed up with how nurses treated each other. My hospital pays 100% of nursing tuition (e.g., BSN, MSN, DNP, PhD, even Pharmacy) with the exception of no more than 18 credits/year. It's a great deal, you just have to be a full-time staff and give them a year after finishing your degree before leaving, otherwise, you will have to pay all that tuition back, which is fair. I did my MSN in Administration and did not pay a single dime. Now, do I want to be a manager or a director... hmmm, not yet. I was offered to be nurse educator for critical care, but turned it down. So, my post is about nursing salaries. I remain a bedside nurse, because of union benefits (e.g., retirement, school, health, etc...). I practice as a vascular nurse specialist, aka PICC nurse to the majority. It's a good gig, very low key, work independently without an NP responsibility. I am practically a ghost. I only come out when I get called for PICC or Midline insertions. Been an RN for more than 10 years now and my salary as a bedside nurse is $120,000 with 10 OT every year, which is not bad. A lot of NPs start with this salary and they do a lot of work. I admire these nurses, and alike. At one time, due to short staffing, I did a lot of OT my salary reached $170,000. Any thoughts on other specialties with high salaries that doesn't do much. Don't know about you guys, but as a nurse, we work like horses, often forgetting our own health. I left ICU 6 years ago because I had shoulder issues, which I needed surgery on it eventually. What's your own story or input?
  4. erwindt

    PICC NURSE

    iluvivt, totally agree with you. When we've done PICCs a million times, it looks easy on the eyes of those that haven't place one. I welcome others to join our specialty, but I don't like it when whey say, I like your job, it "LOOKS" easy. I often get called for difficult sticks and I help the nurses. When I arrive in the unit, they hand me the vein finder. First, I thought it was a Glucometer, but it's a vein finder. I kindly informed them, I don't like vein finders. They make me see birds flying afterwards, LOL...
  5. erwindt

    PICC NURSE

    LibraNurse27, yes I have heard of other nurses placing PICCs without an ultrasound, but am told, those were the days. I know, just the think of it makes me cringe. It's like being blindfolded while driving. I guess because I've never done it before, but I must say that those nurse are pretty darn good at it. I've met nurses that places PICCs via fluoroscopy, but when they place PICCs at the bedside, their measurements are off or not perfect, meaning their catheters are either too long or too short.
  6. erwindt

    So nervous! CCRN time!

    Thank you for your words of encouragement. I believe what I am going to say is not something new... I want to go to CRNA school but it's so difficult to approach it being that my neck is tied with a mortgage. Luckily, I'm not married or have any children yet. I'm so interested in anesthesia even before I started nursing school. I shadowed an obstetric anesthesiologist, who is also an anesthesia professor at Stony Brook University at that time. That was like 8 yrs. ago. I have mixed feelings about it because I LOVE the bedside (sounds crazy, but there isn't a lot of young/new nurses that loves the bedside). I love advocating those sick sick ones in the ICU. I think the only discouragement I get from the bedside are my co-workers. Not offense, but they're old and SOOO CRANKY!!! Anyway, I just want to pass this exam and then maybe do the CMC. Will let you know if I have any good news. Thanks again...
  7. erwindt

    So nervous! CCRN time!

    SOMEBODY GIVE ME A SHOT OF ATIVAN HERE!!! First of all, a co-worker last year who took the exam and passed told me that the test was easy and not that bad at all. Taking her opinion, I studied ONLY 3 weeks and went to take the exam. I flunked the damn test with score 87 and passing of 89. So disappointed that I pack up all my books and put it on the back of my garage. Going for a second try again but am more anxious than before. Being doing 150 questions in one sitting from the PASS CCRN CD and been getting 110/150. I'm using mainly Laura Gasparis material now until when I'm due. I've an ICU nurse for 4 yrs. now. The bulk of the exam is HEMODYNAMICS, from what I remembered. I hope to pass and go on with my applic. for grad school.
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