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eCCU

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  1. No you shouldn’t quit. You have now learned something about massive PE. It sounds like the ER dropped the ball on that one and should definitely review this case for future improvement. On an experienced standpoint, anytime you feel that care has been delayed significantly in this case CT scan in a patient with high risk PE. I would advise to escalate it before they decide to wheel the patient in ICU. Call your pulmonary doc or cardiologist consulted to follow the patient and notify them your concerns. The reason why I say this is because they can ask the ED doc to do a quick FAST exam to determine the RV stress in PE which would determine a need for STAT systemic TPA or EKOS. This is a case you can use to drive change in your hospital to improve care. My ED any imaging ordered especially CT is usually completed prior to transferring patient in ICU. Do not quit☺️
  2. I will not lie it's a steep learning curve and it doesn't matter how long a critical care nurse you were. That being said every decision must have an evidenced based rationale remember every action must be defensible in a court of law. No longer documenting you told so and so. Dealing with staff nurses is easy, appreciate their input by doing clinical rounds instead of intervening when something comes up. It also gives you an opportunity to meet the family and talk to them. You will have some nurses that will try to bully you, I see it happening mostly to NPs who haven't had a lot of experience previously as ICU nurses or work in the same ICU from staff RN to NP. Handle it gracefully and professionally, most workplaces now have bullying statements on their policies. Recognize your staff, be a role model, don't get into workplace gossip and politics. Know your go to people example...I love my ICU PCA! I rarely place a Central line without them. They literally know where my ultrasound sits, what size sterile gloves I wear, they drop all my required sterile stuff in my field before I even ask for anything. They are truly a blessing! Develop a relationship with the clinical pharmacist they are walking pharmacology books with current research. Several specialties to develop strong relationship and have their numbers... nephrologist I have been known to call them in the middle of the night to get the okay to start CRRT or emergency dialysis. Cardiologist...cause they do crazy stuff that works that's not in any textbook í ½í¸¹and I have yet to meet one that freaks out. Pulmonologist or intensivist when you have tried all the vent settings on your vent on that ARDS patient and you and the experienced RT are out of ideas in the middle of the night! Infectious disease if your facility doesn't have a sepsis team. Find out their pet peeves..Sanford guide is awesome Chaplain...if you are spiritual there are those cases that will have you wanting some spiritual guidance or continue to believe in humanity. Earn your FCCS by SCCM they have several classes around the country. Attend CE offered by the local medical school if your place of work is affiliated with one. Familiarize yourself with vent settings off the top of your head...I have heard the RTs complain there is nothing more annoying than intubating a patient emergently and the provider has no clue on basic settings. Imaging position of ETTubes, Central lines, chest tube can be the determinants of life or death. Ask to rotate with radiologist and anesthesia. I learned how bag appropriately with the anesthesiologist years later! And intubate gracefully with anesthesia, intubate with head of bed up with ED doc. Keep learning ask your intensivist for feedback consistently and ask for areas of improvement. The rest enjoy it it's actually funí ½í±Œ Hope that helps
  3. Nurses and their titles kill me! í ½í¸‚í ½í¸‚í ½í¸‚. How about we focus on making our NPs ready when they graduate? I once knew a really smart friend who had 4 PhDs never once heard him introduce himself as a doctor. I introduce myself as a "Nurse Practitioner." No need to confuse the little old ladies in the ICUí ½í¸‹í ½í¸‹í ½í¸‹ use that time on important patient clinical issues.
  4. AGACNP is the way to go working with 14yrs and up in TX. Plus you can stay in specialty clinics like cardiology clinic, nephrology, Ortho or even just internal medicine clinic. Best wishes the sky is the limit í ½í¸€
  5. Go with Baylor Dallas or parkland
  6. Did they not have a choice to walk away to the nearest attorneys office? This is insane and very abusive 😡
  7. All are great schools including UT.I am not familiar with WCU. keep in mind Texas Nursing schools are very competitive so try to bring up the GPA. Good luck!
  8. Sounds like this was their way of coping with the pain. I'd be more concerned with managing it than what coming out of their mouth. Besides every one has different tolerance levels.
  9. Undergraduate alumni, great reputation for Acute care, in-state and awesome professors great mentors, one can tell they are happy to be part of the program 😀
  10. 72hrs but most will allow extra shift esp in critical care
  11. Galleria is a nice location but known for heavy traffic and the prices are similar to Rice Village area or upper kirby with significant reduced drive time and same amenities.... FYI...Former galleria area resident
  12. Just turn on your cellphone on record go close to him and say " oh doctor would you please repeat the whole conversation about nurses being monkeys? I just want to make sure I get an accurate description for human resources " That should fix him 😂😂
  13. The problem with us Nurses we accept and start positions without getting a job description, hours, pay and out of norm expectations in writing. Always ask for this before you start otherwise your job description becomes a he said she said discussion!

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