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Hi Scribblz, Yes, it was a lot. I wasn't trying to make a world record. My instinct was just to help the docs and nurses to save as many COVID patient as we can. It was the worst experience. The worst part was placing these lines on your own co-workers and seeing them die before your eyes. Very very sad. May all of them have eternal Rest-In-Peace. I was actually suffering from shoulder and piriformis syndrome. Just pop some Advil, placed some ICY-Hot patches and go back to the battle field.

CN21IVT, thank you for making it clear. That’s what I was trying to say on my previous post. You are 100% correct there. Question, at my full-time, I use BARD PICCs and at my other job, I use ArroW for PICC and PowerWand XL for Midlines. Any intake? I find BARD is more easy to use whereas, ArroW is not and PowerWand is not patient friendly... lots of complications.

Hi Gmilitar, My initial base pay when I first started in NYC 2007 was $36/hr with a BSN for a major teaching hospital in Manhattan. I did not like my position there, so I left after 4 months and took a position in a community teaching hospital in Brooklyn. There, I started $34/hr. Many of the incoming young nurses are complaining about their base pay. They start $46-48/hr with a BSN. At this point of my career, I am content with my salary and I love what I do. I think that is the most important part of nursing and any other job. You must love what you do. Like this girl, she had an MPH and was a social worker, but was so tired of it, that she became a housekeeper. The more you make $$$, the more you spend and the more bills you have, and the more problems you will have. AND because you work a lot to make more $$$, you forget family, friends, and humanity... (this is speaking from my own experience). I am just blessed and humble to be a nurse, especially when many people are unemployed at the moment.

You are completely correct LibraNurse27. I feel like I am missing out that's why, everyone are going back for their NPs, DNPs, etc..., then I ask myself, for what purpose I need it when I have it all good. I know a lot of NPs still working at the bedside because they are afraid or not ready to work independently. School is great, but is also very time consuming. You can't replace time lost. I know, as nurses, we're always looking for ways to improve ourselves by finding that dream job and lots of $$$... agree/disagree???

My condolences to you and to your friend's family. Rest-In-Peace to your sister and to your best friend. I have not experience it, only partially, but YES, life is VERY short. It can disappear in an instant. Enjoy what you have, especially time with your family and friends. Stop arguing and crying for the little things in life. Accept and appreciate what you have.

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.

Hi DavidFR, Yes, definitely agree with you... "all depends". I brought this topic up because at my hospital, the mother of the fiancé of our hospital CEO was admitted to one of the medical floors. The CEO's fiancé is a Medical Doctor at another facility, and she displayed her work ID proudly at my facility. OK, I get it, you're a doctor. I think it is good in a way, because I was able to speak to her directly in medical terms, without the run arounds, explaining the many "whys". And, she was also calm her mother and explained the procedures being done to her. The daughter was very nice to me, but I have heard a lot of complaints from other staffs (e.g., doctors, nurses, etc...). Apparently, the daughter was commanding the other doctors and was asking a lot of questions. I meant, yes, I would, too, ask a lot of questions if the patient is family or a close relative, but commanding employees how things should be done makes them uncomfortable or fear of going inside the patient's room. As healthcare providers, we shouldn't fear or get intimidated of other healthcare providers, especially when they themselves become patients. I always wonder why. Is it because we don't want to make a mistake/error. I feel like, being a patient with VIP status can have both negs and pos. I still remember when I went for my shoulder surgery. I wrote a letter to my family, place it in a envelope, and instructed them to open it if I don't come out of anesthesia. The letter was all my bank account information and other personal properties. As healthcare workers, we SEE so many things, that's why we, more like me, have fears.

Hi Wuzzie. Same for me as well. One time, I went for a procedure. The anesthesiologist was having a hard time with my veins. I told him, "Doc, go to my right A/C". His eyes became big and ask me, "are you a nurse?" I just told him yes, and that was it. Did not want to entertain it. Plus, he was going to "knock me out", so I got to be nice.

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.

Hey WestCoastSunRN. My experience with the pandemic of COVID-19 was an eye opening or game changer for me. I saw how fragile life was and how it can just disappear in a matter of seconds. $$$ is great, but the big question is, "are you happy and maintaining your life healthy?" Time is something that is more valuable than $$$ and is something you can never get it back. As nurses, we work our butts off. Nursing is no easy job. But as nurses, we need to prioritize our life by putting our family, friends, and most of all, ourselves. Bless to all the nurses and doctors, and frontline workers. I pray that this virus or another virus alike will never appear again.

Hi WestCoastSunRN. I believe in faith and majority of my nursing career was preparing myself to get into CRNA school 6 years ago. I got my CCRN and I work in ICU for 7 years, primarily CCU and SICU. I used to work for a very busy city hospital, 28-bed CCU and 14-bed SICU. Did all the works... Swanzs, IABPs, CRRTs, lots of Hypothermia cases (sometimes 6 in one shift) because we were a level 1 trauma hospital. I hardly get report from the ED, majority of my reports are cases from other hospitals that were very sick. The door was so wide for me, applied to CRNA once, injured my shoulder in ICU, then vascular access nursing came to the rescue and I've been doing it since. I strongly believe that vascular access was a calling to me. I love and miss my ICU patients. I love to work because (1) yes, the money was there and help me obtain my other dreams in life, such as home ownership and having my own car, and paying off school loans... something that my parents or anyone can't provide to me; and (2) nursing is an evolving experience and I thirst for knowledge. I learned early in nursing that many nurses fear, especially floating to other units because (1) they are not familiar with the unit/system, and (2) lack of knowledge of the patient population in those units. I didn't like that idea, so I wanted to be comfortable or have a wide knowledge, so that I am ready to face whatever situation I was in when I go to those units. I got my MSN in administration, but I utilize it in educating future nurses, so that when I reach that time of my life, I want these nurses to be able to save me, if I still have 150 years to live (LOL). Venous access is one thing that every patient receive when they enter any healthcare system. My skills and knowledge in vascular nursing help me improve patient care and their satisfaction, and that is why I love my job. During this COVID19 pandemic, I placed majority of the lines in our ICUs, peds, and other floors. I would be inside these confirmed COVID patient rooms for hours placing their PICCs, Midlines, and PIVs. It was a traumatizing experience and I hope it will NEVER happen again. "Let your career guide you. Don't guide your career. Everything will just come into place."

Very interesting thread. While others make very good points, other just seem to have a lot of anger. Some physicians are troubled and don’t like the idea about nurses becoming APRNs and having independence as clinicians. They simply see them as “wanna be” doctors. I admire and respect every health care providers. For one, I don’t have respect for any physicians or nurses that are nasty. I have seen physicians that aren’t as bright, as well as nurses, and just makes me wonder how they manage to through the system. The patient is always our priority.

Hi MforMs. I used to work for ACCESSRN. It’s a big company and covers a lot of states. I left the company due to family obligations. See if you live in a state that they cover. They are always looking, specially for NYC.

He works in real-estate. He makes well over $600,000/year. It is sick, but he is very happy.

I oriented a new RN in our ICU many years ago, but only stayed in nursing for 5 years. He is only 28 y/o and informed me last week, he is already planning his big retirement party at the age of 30. This kid found the secret of wealth. His monthly take home salary is more than $60,000, which is the starting salary for many nurses in other states. I know for sure, money doesn't buy happiness. CRNA are the highest paid nursing salaries that we all know, but reading a lot of them, leaving their jobs because of the stress.

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?

LibraNurse27, don’t be afraid. Come join the club. I felt intimidated and scared when I first started 6 years ago, but is not bad. Vascular nursing is by far the best secret job. You are independent, but don’t have an NP responsibility. Most of all, very well respected because they will need you when surgical and medical residents are unable to place a other route of central venous access. You are already accessing veins with an ultrasound. The ultrasound is the most intimidating part and you have already mastered it. I think you will be great.

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...

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.

Let me just say, as a PICC nurse, if you are not familiar or proficient with PICC dressing changes, get help. PICCs are rarely or even hardly sutured due to risk of infection, unlike IJs, Subs, and Femoral. The stabilization device, StatLock, can be very sticky to your gloves, and is also tricky to remove it from the PICC, if you are not familiar with it. PICC dressing changes should only be done every 7 days or per facility policy, but as they say, the less manipulation, the less risk of infection. One time, I was doing my PICC dressing changes, and one nurse told me, "it's OK, I change the dressing for you". I kindly ask her if it was OK for me to check on it. Of course, the BioPatch was placed upside down. When I remove the sterile dressing she applied and changed the BioPatch, the PICC just started to come out like a worm from the patient's arm. I fast flush it and the patient felt weird on her neck. I ask the nurse if she accidentally pulled it out and push it back in, but she claimed to have no idea. As a PICC nurse, I know what happened, but because I didn't observe how she change the PICC dressing, I can't point fingers. I had the resident ordered portable x-ray and confirmed PICC to be on patient's IJ. I removed it, and placed a new one on the opposite arm. I avoid over-the-guidewire because of the risk of infection, especially since the patient had the PICC for over 2 months now. Like anything in nursing, ASK IF YOU DON'T KNOW, RATHER THAN GUESSING AND CAUSING HARM TO THE PATIENT.

"nursy", RN, I love this comment... "I used to have a lot of nurses watch me do it, then say, hey I want to do that. When you're good at it, it looks very easy. Then they would take the course, find someone or other to watch them the first time, fail miserably, realize it's not as easy as it looks, and never really get around to becoming proficient." That is very true and I agree with you 100% on it. I've always been a critical care nurse, wanted to pursue CRNA, just like the rest, but I was recruited to be one of two PICC nurses at my facility. I know, in nursing, either we want more $$$, more titles after our name, etc... I learn to just let your career guide you, not the other way around. I love being a PICC nurse. I get a lot of respect from doctors and my colleagues. I work very independently. When you have mastered a skill, others think it is a piece of cake. I love sharing my skills and even my techniques, but if someone is overly confident of themselves, they will never succeed or get it 100%. Like anything else in life, nursing is a learning process for life. I encourage all nurses to always challenge themselves, acquire new skills, and keep yourself up-to-date to evidence-based practices, especially these unpredictable times we're in. Don't chase the $$$, let it chase you.

Some ultrasounds can give you an estimate or help you determine if a 4-Fr or 5-Fr. catheter would cause DVT or some sort by calculating catheter size to vein diameter. Majority of ultrasounds show you different catheter size by French on your screen when scanning for vein. If you want to, let's say, fit a 4-Fr. in any of the great vessels, use those catheter size provided on your ultrasound screen and try fitting 3 of them in that vein you want to access. That's a good way to determine vein size for your catheter size. Hope that helps.

Hey ALL. My name is Erwin and I am a PICC nurse here in NYC. At my full-time job, there is only two PICC nurses and we insert a total of 400 PICCs a year and 200 Midlines a year. During the pandemic, I placed about 25 PICCs in 3 days. I am a single inserter. Very lucky if there's two of us, but it is rare. A lot of the COVID patients had blood clotting issues, so medical/surgical teams would request PICCs. The MDs would place femoral, but we try to avoid them because they can only stay in-place for 24-hrs. Other than that, my colleague and I wore a lot of protective gears, especially N95 when we did these cases. So far, we are both doing well. At my other job, one of my colleague got the virus, but she is alright now.

Hey everyone. Hope all is well. I remember those early years in the ICU, I was so active in trying to get into CRNA school. I've been a nurse for 9 yrs. now and I don't see myself doing CRNA anymore. I wish lots of good luck to those who wants it. I think I am just tired of nursing alone because of the politics... TOO MANY. Senior nurses are eating their youngs right and left... just sickening. CRNA job is no joke and I give credit to those who are practicing CRNA. I describe their job as being in a conveyor belt... once your enter the circle, you can't really get out for mini breaks all the time. I love my job right now. I work as a vascular nurse inserting PICC-Lines and I work in interventional radiology doing conscious sedation for heavy cases (I am practically an underpaid CRNA there, LOL). The MOST important thing in life is if you have a job that you really love. If you love money, there are many ways to make more money other than the CRNA route.

Thank you replying to my post. I've been wanting to do CRNA for a while, but you're right on your last comment... "you sound quite unsure about what you really want to do." That's why I started NP school because everyone were starting their masters and I felt left behind. I would not own anything from my hospital for going back to school. I've been with them 7 yrs. now. I know a lot of people that went back and then left after they finish their MSNs. I make 6 figures because I do 2-4 day/month per-diem at another hospital, which isn't that bad. I re-shadowed a CRNA 2 months ago to get a new perspective of the CRNA career. I understand money isn't always the case for CRNA. Their always on the go in the O.R.