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Trauma/Surgical & Neuro Critical Care
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MaxAttack has 5 years experience and specializes in Trauma/Surgical & Neuro Critical Care.

MaxAttack's Latest Activity

  1. MaxAttack

    New grad, got the ICU! TIPS?!!

    Congrats!! Ask questions and look up everything. If you have access to UpToDate, use it. The AACN has a book Essentials of Critical Care Nursing that I bought and found useful. You're going to be nervous and feel like a fish out of water. Stay thirsty and soon enough you'll feel right at home.
  2. MaxAttack

    Best route to ICU for new grad with no healthcare experience

    I was the same way coming out of school - anything but med/surg. I found that many hospitals in my area have new grad programs. Get your resume on point and apply to every job you can find that sounds like they might accept new grads. I started just walking in HR departments with applications after a while and that's how I got my first job - new grad program then straight into ICU. It was a smaller community hospital but once I had a couple years I was able to go anywhere.
  3. MaxAttack

    Is there a Stigma with a Male working in Nursing?

    I think of my co-workers almost like family. You spend a large portion of your time with these people and I've found it's not unusual for people to want to get to know you personally or even say things like calling you handsome (especially from older women - think of it like it's coming from your grandma LOL). It sounds like maybe their culture is a little more relaxed than other places you've been in. If you truly find the behavior inappropriate, the only person that can address that is you.
  4. MaxAttack

    Blacklisted from HCA

    I broke my contract and got re-hired at a different facility a few years later. I don't remember the terms of the contract but maybe it was just this specific recruiter being difficult?
  5. MaxAttack

    Ridiculous medical mistakes on TV

    Smokin Aces! I just realized one of them isn't even vented, which makes this scene even more ridiculous lmao
  6. MaxAttack

    Ridiculous medical mistakes on TV

    Man I wish I remembered what show it was, but I saw a beautiful code - checked pulse, good compressions and breaths. The doctor even yelled for 1 mg of epi IV! Right dose and everything! Then the classic - shocked asystole. I died a little.
  7. MaxAttack

    How to be on an ICU Nurse's good side?

    Welcome! Just the fact your asking this makes me think you'll be ok. I was a night nurse and I loved getting the chance to talk with doctors/residents before I left. My only complaint was someone looking for a full-on conversation about a patient during report. Asking for a quick update or overnight events makes sense to me. It gets excessive when I'm interrupted for a history, vitals, or what brand of cigarettes they smoked. That being said, don't let cranky nurses get under your skin.
  8. MaxAttack

    Vent management and sedation/pain management

    Mixed med/surg population. I'm not referring to a specific patient or condition, but to the idea that intubated patients should have any pain managed as a possible cause of agitation before sedation is started.
  9. Another thread sparked me to write this: Where I'm at our vent management essentially is putting propofol on every person through our door on a vent. Getting pain management can be like pulling teeth (I recently had a pulmonologist give me 1 mg morphine q6hr prn.. I laughed). Does anyone remember how their unit went about changing practice to reflect the "analgesia first" guidelines? I think our problem is vent management is scattered throughout the various pulmonology groups and we don't have a medical director or an intensive care committee to look at and disseminate best practices. Basically I need help modernizing my unit before I go crazy.
  10. MaxAttack

    Being Pulled into the Office for calling CAT

    I'm sure I'm repeating what was said before me, but find a new job. Any place that says you overreacted when you called a rapid/MET/CAT on a lethargic patient with a pulse in the 30-40's is a place that's jeopardizing your license and career.
  11. MaxAttack

    Central line compatibility

    You're right. They're wrong. Why was the director waiting for you in the first place? She sounds lovely.
  12. MaxAttack

    Blood pressure drastic variation

    Anxiety can definitely make someone's BP skyrocket. Not only does anxiety raise BP (fight-or-flight sympathetic activation), but usually they're tense or moving which will skew the reading even higher. That could be the reason for the difference between the arms. If I remember right, they should be within 15 mm Hg of each other - a difference greater than that could indicate peripheral artery disease. But again, anxiety and accuracy don't go together. Quick onset could be the meds, could be the patient calming down, or could be a placebo-like effect where just the act of taking the pills starts relaxing her (especially for benzos and if this is something she takes frequently). You handled it perfectly.
  13. MaxAttack

    Dismissed battery charge

    It sounds like they're just requesting clarification. It was dismissed, which means you were not found guilty. I wouldn't include "we both became physical" as it implies wrongdoing. If that doesn't work, I'd suggest you consult an attorney. If you can find one that does free consultations, it wouldn't hurt for you to talk to one now.
  14. I told the recruiter flat out I need ER or ICU. I was signing a contract within a week. The only foolish thing here is the people living in their own reality that think this is uncommon.
  15. MaxAttack

    High dose insulin for Beta blocker OD

    First result on Google was an article posted in Clinical Toxicology found on PubMed "CONCLUSIONS. While more clinical data are needed, animal studies and human case reports demonstrate that high-dose insulin (1-10 U/kg/hour) is a superior treatment in terms of safety and survival in both beta-blocker and calcium-channel blocker poisoning. High-dose insulin should be considered initial therapy in these poisonings." I've seen it used twice where I work. I never worked directly with the patients, so I'm not of much help. I can tell you the nurses had two patients. I believe they were hourly blood sugar checks. You can't realistically have two patients with q15min checks. However I have no idea how long it would take to stabilize the insulin dosing and I would expect to take the first admission once they do so.
  16. MaxAttack

    I&D...sterile procedure?

    Sterile gloves protect the patient, not the provider. It would be a costly and strange utilization of resources to don sterile gloves every time you worked with a patient on contact precautions. Basically, if it's good enough for cleaning C. diff, it'll be ok for an I&D.