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Surgical ICU
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I_See_You_RN has 4 years experience and specializes in Surgical ICU.

I'm amaziballs

I_See_You_RN's Latest Activity

  1. I_See_You_RN

    Question for SUNY Downstate students.

    NICU as in neonatal ICU right... no neuro... If you're in Neonatal ICU i don't think its about labels,.. its about logic. they want you to have experience with dealing with the patient population that you will mostly serve. There is a slew of chronic diseases and surgeries that you will most likely not see in a neonate. Yes neonates do have some difficult to manage congenital disorders but they still don't mirror the adult population. Everything from lab values, appropriate treatment, and pharmacology is different. I think the idea of preferring SICU and CTICU is that they know that you have experience with dealing with the general population and should be able to comprehend basic principles of treatment geared to them. They worry about training in sub-populations later.
  2. I_See_You_RN

    UPenn CRNA 2012 University of Pennyslvania

    anyone else out there :)
  3. I_See_You_RN

    Accepted to U Penn!! Now in need of syllabus

    congrats!! are you from the area or will you be moving? do you have any specific questions about the program,.. maybe i can answer.
  4. I_See_You_RN

    Accepted to U Penn!! Now in need of syllabus

    Yeah drexel is actually very close by. Not even a 5 minute drive. And you're right. Parking is ridiculous!! I've been so spoiled by having a car for so many years, unless you wanna spend all that extra cash, we might have to look into public transportation,.. at least some of the days. I haven't even started looking at apartments or neighborhoods yet.
  5. I_See_You_RN

    Accepted to U Penn!! Now in need of syllabus

    really sorry to hear that. Don't let that get you worried and nervous about your next interview. Like you said, just use it as an experience.
  6. I_See_You_RN

    Yes, another question about CRNA pay?

    I'm not a CRNA so i can't help with your actual question, but i know for a fact that most people who work along side each other in differenent professions rarely know how much each other make. just recently me and one of my surgical attendings (we have 24 hour attending coverage on floor, always less than a hallway away) were talking about future plans and salary. I told him i made Gross 88,000 last year (i live in NY) and he nearly fell out of his seat. He didn't believe that we made that much. And then he told me as a 4th year Resident he was only making 35-40 thousand. So if a resident ever gets an attitude with you, just remember that he's just miffed that he did the surgery and you're making more money , at least for now. And if you're worried about salary... just on a staff nursing salary I can afford a nice apartment and the payments on a brand new car, plus my other bills. I'm single. So as a CRNA, whatever the actual figure works out to be,.. I'm sure you'll be very comfortable. Good luck!
  7. I_See_You_RN

    Pennsylvanis CRNA's

    Is there anyone on this board that practices in Pennsylvania or went to a Pennsylvanis school like UPenn? If so, would you be willing to share your experience training and working in hospitals in that state. Are there many restrictions on your practice or on your training? any information would be appreciated :)
  8. I_See_You_RN

    Have you ever infused phenylephrine peripherally?

    Phenylepherine can be used peripherally but care has to be taken to ensure that your PIV does not extravasate. Also, know your pharm and have some Regitine on hand just in case it does.
  9. I_See_You_RN

    Nurse/patient ratio in ICU...what is yours?

    2:1, max 3:1 but that is rare and usually due to a nurse calling out sick last minute, or extreme bad weather. If you only have 2 nurses on then I think Code Team should be deferred to another unit. What if two codes occurred at the same time?
  10. I_See_You_RN

    mistake on heparin??

    Wow! some of the responses (the policy/practice of the hospital and not people) are ridiculous. Firstly I don't believe that it is your job to put in 24hours worth of labs slips. 1) Lab slips are suppose to closely correlate with what time the lab was drawn. What if heparin was held for an hour, or two hours, and then restarted. what if she drew the lab at n:30 instead of on the hour? What if the results come back delayed and therefore changes made were delayed? Even if you were able to enter a future time for the draw on your system the whole schedule would be thrown off. 2) Don't EVER, EVER, EVER put your name on something that you didn't do. This goes for heparin slips, Type and crosses, etc. Codes or emergencies are an exception, but even then you see what is being done and enough people are around to back you up. Also. The nurse who didn't check the patients previous labs and did not draw the PTT's should be the one in hot water. If shift check was done she would see what time the drip was started. And then it is her responsibility to review the lab results and see 2 consecutive therapeutic draws. If not there.. then her job to continue the coag lab draws q6... thats just policy. Did she even look at the Heparin flow sheet? And for any hospital who requires the first nurse to enter 24hour slips.. what exactly is the reasoning? It doesn't ensure that it gets done. Its repetitive if its in the orders. Its confusing and could be an issue when billing the patient. And Heparin is extremely patient specific and sometimes takes days for the patient to become therapeutic if at all, especially if you're dealing with septic/oncology patients. I wouldn't let anyone coerce me into signing any write ups. You did your job as you should. You asked for help when needed, you did your lab draw as ordered, you documented as per policy, and you followed through and reported off to the following nurse as appropriate.
  11. I_See_You_RN

    UPenn CRNA interview questions

    Upenn... I've heard (but not experienced) mixed reviews of their interview. Some call it a meet and greet without much technical/medical questions and others have been asked specific drug/clinical questions. I'm really interested in that school... do you mind sharing your stats or what landed you an interview? :)
  12. I_See_You_RN

    has anyone ever discharged a patient with their IV still in?

    personally, never, since I rarely discharge patients home in the ICU. But even when I just discharge patients to another floor its just a natural check for me and the other nurses to review all their lines because some lines are managed on the floor and some are not so we have to d/c them before they leave. Even if certain central lines are able to be managed on the floor we always request to d/c them if we don't think the patient needs it anymore. I don't think you're an idiot because crap happens, but isn't that a major major liability if the patient was to get hurt by say infection (Some patients are crazy or just cognitively not there enough to EVER call back) or recreational drug use? for that, although it was an extremely easy mistake, I wouldn't take it lightly. So even if the patient purposely tried to get out of the hospital with it due to drug use, if he died, it could come back to you. Addiction is an illness, and so is depression. So if you let them out the hospital with something that could lead to their injury (an IV line, medication carelessly left on a counter, etc.) it could come back to haunt you. For now,.. don't sweat it. In the future,.. be very careful. Make it a habit to check for lines before you hand them their discharge papers... if they leave before you hand them the discharge papers then its them leaving AMA and not your fault. :)
  13. No more pee?? you will live by pee. During big operations it will be your job to climb under the OR table making sure not to contaminate anything and MEASURE PEE! intake and output will be critical. You need to know their perfusion status, you need to know their total output,.. are you overloading them, do they have comoridities which would make this even more dangerous (chf), are they in acute renal failure? does it appear that their GFR is sufficient enough to handle the dose of medications that you are giving them? Not all cases will have central lines and CVP and arterial line measurements,.. even long ones. So appreciate pee and get ready to be infering a lot of information about the patient just from their pee. :)
  14. I hate when people accuse my pursuit to becoming a CRNA as solely dependent on the money. My general reasons. 1. I love the human body, I love controlling it, altering it, doing everything that I can to help make it better. Becoming a critical part of the surgical team would satisfy this desire. 2. I love learning. I hate sitting at work everyday knowing that there is a lot that I dont know. I know that my potential has not been reached, I know my understanding of my patients are not complete. 3. I love being hands on,.. I like seeing the benefit of my intervention. Whether this be titrating sedation and paralytics to get the best abg outcome or giving a real good enema (a really really good one, lol) and providing relief for a patient and preventing obstructions... I just love it! 4. When I walk into the OR or the SICU,.. it just feels right. I can't explain it. 5. The higher pay compensation is just a bonus... and it is nice to think that one day my family and I could be less financially stressed. But,.. If you look at my history,.. If you look at all the classes that I've taken and had to pay out of pocket for (thousands of dollars ppl), all the times I come into work unpaid to sit and listen to this educational program or etc,.. the time I spend reviewing research and then presenting it to my fellow employees .. I think you'll see that I do this because I love it not because of the money. I think you have to appreciate bedside nursing first, appreciate the person as a whole, be able to help them medically and truly comfort them when they are at their most annoying before you can be entrusted to "give it your all" when they can't complain and you won't be seeing them and their family the next day. good luck to everyone!!
  15. I_See_You_RN

    IV drip dose error

    I do agree that every medication error is a "big deal" in theory because the issue is the the action (or lack there of) and not the consequence. You were lucky since it was just a fentanyl drip and 15mcg/hr is not a problem.. call it a sedation vacation or an agressive titration off , but what if we were talking about levophed/dopamine/cardene.... then it could of been a HUGE problem. she should not of called you and scared the bejesus out of you... I would of waited till you came back,.. told you about it nicely and firmly reminded that its very important to do double checks ,.. and the one thing that can't be rushed is medication. If she wasn't so high and mighty she should of also apologized because it is her duty to double check with you. Don't let this bring you down, just use this as a learning experience. :)
  16. I_See_You_RN

    How much does your school cost? I'll go first.

    Hi. I had applied to Upenn and now those numbers seem so daunting, but I suppose worth it in the end. How do you like UPenn?? Do you believe it is giving you the experience and education that you need. And do you like the social/community aspect of the program/area? Any info would be greatly appreciated