NuBeeT

Had a dka/septic pt on heparin gtt, dopamine, dobutamine, levophed, prbc's, ever changing ivf (d/t trying to close the gap and maintain that blood sugar between 120-170), k-riders/mag/calcium gluconate), and insulin gtt.... Any advice on how how to juggle those interventions, words of wisdom, asking the a-hole rt to change settings to help out my pt's bp, and how to wean off what vasopressors first? Do ICU nurses understand that the vasopressors are on going during transport and the bipap is off so when they see that pressure they go----"the pressure is great" no bi-atch! Put him back on that bipap and it'll go to -ish!!!! Watch the ******* map (no swans in the ER so couldn't Check the wedge)!!! Can't do anything about who u work with, how much experience they have, a lazy doctor who refused to put in a central line (really!!!!!!who in the hell was I gonna get ur blood gases/ sugars/ chems/etcs fir the meds And Iva's I was giving!!!!! I love autonomy in the ER but this is ridiculous!! I'm going back to county.... No thank u private!!!! I am so open for advice, wisdom, and helpful hints :) XOXO

I had a similar situation. I landed a job at a small community hsp that had no new grad training program but had good benefits & stable hours. The second offer came 2 months after I started the first. This was my dream job in a trauma center in Los Angeles had a new grad training program and the pay was better but no benefits and had 8 hr night shifts 5 times a week. I decided to take the dream job because I felt the experience is priceless and I can find a job with the same stability the first job had after getting my 1 yr experience from this place. It's not about pleasing people..... It's about the patients and u not poising that license. I want the best experience and education so that patients under my care are safe and that I'm safe. I hope that you find happiness either way you go. Good luck and wish ya the best!

I was working at a small community hsp in LA. The ER there is small, nice and comfy but I wasn't learning anything. I recently got an offer to work at a trauma center in LA as a new grad and I accepted. I'm absolutely more frightened of the nurses than the pt's. So I know what u mean but it seems like a hazing process. I can't give u any advice but I can tell u that I make an effort to be as independent as possible, know my drugs, laws, and I got malpractice. I'm hoping that soon enough these people will come around. Remember to set yourself up for success.... Be the person you would want to work with in this environment. Be strong, assertive, and don't loose your integrity/momentum. I'm right there with you and we got this. XOXO