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ambersky004 BSN, RN

Registered Nurse in Cardiac/Telemetry Unit
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  1. My Easter Sunday at work was unfortunately quite challeging. I came in to work that morning, had a patient that became lethargic and in respiratory distress even with bipap support. She was given a low dose of Ativan to help her relax and a 1 unit of PRBC 3 hrs ago per night shift. I assessed her lungs and heard rales and crackles, HR-125s. BP normal. O2sats were falling below 90s even with bipap support. I called the RT to help assess her respiratory status and check the bipap. Had the chance to talk talk to the hemodialysis nurse and made her aware on the patient case and patient may need an urgent hemodialysis. I called the Hospitalist and Nephrologist, and finally transferred the patient for hemodialysis room. O2 sats went up but she is still on Bipap support all shift. Patient and family has been informed that she will need to be in hospice or comfort measures, however patient does not want to give up her dialysis and she does not want surgery of her AVS. Is there anything else we could have done differently on this patient with known severe AVS, recent AKI w/ placement of tunneled hemodialysis catheter and now with worsening respiratory distress and might be Bipap dependent??
  2. Don't be too hard on yourself. I know it takes a toll on you or might even feel like a nightmare. It is hard when your patient dies on your shift. You have questions. Instead of ruminating those thoughts and feelings, learn from it and let go of those thoughts and feelings. Forgive yourself. Stay strong. You cannot always save everyone. We are all going to die here on earth. What matters is your values, your compassion and service to human kind.
  3. ambersky004

    5 yr Nurse Burnout

    Nightnerd, what you wrote just summarizes about what I am feeling and thinking. Sometimes, I come to work happy and confident, sometimes I come to work questioning my worth and feeling like I am not supported or feel like not part of the team. I tried to delegate and follow-up the tasks with my co workers but when I do I feel that they get upset so I think to myself if I'm bossy. I work in bedside nursing now for 5 yrs. There are just like these days and this year had me reflect really hard if I should be staying in bedside for next 5 yrs.
  4. ambersky004

    5 yr Nurse Burnout

    I feel the no tolerance sometimes on their unrealistic expectations. I am trying to use some of my PTO hours for some break away from work.
  5. ambersky004

    If the QT Is prolonged wouldn't the QRS Always be widened?

    The QT interval is the time from the start of the Q wave to the end of the T wave. From the time taken for ventricular contraction and relaxation. How fast the ventricles recharged for the next cycle. While the QRS duration is how fast the ventricles contracts. It's not always that way. But both prolongation of these two will cause a lethal arrhythmias.
  6. ambersky004

    PH-RN doing LVN-bridge Program?

    Have you tried to go to CGFNS website? You can apply for Credentials Evaluation Professional Report for Foreign Educated Nurses.
  7. ambersky004

    5 yr Nurse Burnout

    I have been a nurse for almost 5 yrs now in a cardiac step-down unit/progressive care unit. This year, i feel like I am in a rut. I love being a nurse but lately at work, I am more grumpy and just feeling lost in my purpose. I don't know where to go or begin if I need to move on to a different nursing field? I don't want to come to work grumpy at my co-workers. That is the main thing. I still do my job with hard work and compassion to my patients and their family members. Maybe this is just a phase where I feel in a rut? Has anybody experience the same feeling?
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