FiremedicMike

FiremedicMike BSN, RN, EMT-P

CEN, Firefighter/Paramedic

Member

  • Content

    612

  • Visitors

    6,990

  • Followers

    2

  • Likes

    1,100

All Content by FiremedicMike

  1. I need your advice/opinion desperately

    FiremedicMike replied to throwaway1's topic in General Nursing

    Pt was offered a purewick, did you not even read the post? To the OP, sounds like this patient sucked. I've never personally been fired from a patient but I'm sure I had patients who didn't care...

  2. Made a huge mistake as a new grad

    FiremedicMike replied to Peaceofnurse's topic in General Nursing

    Unless you have completely toxic management, this shouldn't be any more than a counseling/education discussion. I've never done this by I've seen it happen. I don't really know how it happens,...

  3. How long should orientation be?

    FiremedicMike replied to Pug RN's topic in Emergency

    4-6 months new grad, 6-12 weeks for experienced nurses. That said, ED is a totally different ball game. We've had med-surg nurses and psych nurses try to make the switch, none could keep up....

  4. Tiny vein tips for IVs

    FiremedicMike replied to mariaconcetta's topic in General Nursing

    Learn ultrasound, LOL honestly im to the point now where I don't go digging or praying small veins will hold up. If they look like a hard stick or spider veins, I just grab the ultrasound...

  5. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    FiremedicMike replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    2 out of 3 programs in my area specifically exclude ED, the third does not. I have another year before I can apply due to other obligations, I'll start investigating at that

  6. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    FiremedicMike replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    With the caveat that I have never worked ICU, I'd argue that we do those very same things in the ED every day, amplified by the fact that we are generally 4-5:1 and must learn to rapidly prioritize...

  7. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    FiremedicMike replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    Asking for genuine input and out of curiosity, and based on anecdotes from nurses I've worked with who have prior ICU experience. Why is ICU experience the benchmark? I've titrated drugs, I...

  8. CRNAs Should Not be Allowed to Practice Independently - One Anesthesiologist’s Opinion

    FiremedicMike replied to tnbutterfly - Mary's topic in Certified Registered Nurse Anesthetist, CRNA

    I believe there's an IM subspecialty for critical care docs, pretty much specifically trained for the

  9. Documentation that is true but looks bad

    FiremedicMike replied to LandofMaybe's topic in General Nursing

    "I'm not sure, I would need to have access to my charting at the time to attempt to recall the entirety of circumstances at that moment". It's extremely rare that we're any worse than 4 to 1, I'm...

  10. Documentation that is true but looks bad

    FiremedicMike replied to LandofMaybe's topic in General Nursing

    This just isn't realistic on a busy unit, unless it's a critical med, but then that goes back to proper prioritization.. Quick survey - anyone been before the board of nursing because a med...

  11. I want a future where all nurses have science degrees and are not mean girls

    FiremedicMike replied to RitzyCinnamonRoll's topic in Crusty Old Bats's Chatter

    I took both philosophy and algebra as a part of a prior degree. I think philosophy taught me more about understanding human behavior and considering alternative perspectives than reasoning, which I...

  12. Optometry or NP?

    FiremedicMike replied to PaedRN's topic in Student Nurse Practitioner

    Honestly - you know what you know. You sound like you genuinely miss optometry and at the end of the day, you really don't know what being an NP is like. It would suck to get into that debt and time...

  13. Documentation that is true but looks bad

    FiremedicMike replied to LandofMaybe's topic in General Nursing

    When I miss med timing in the ER, I write "priority of care" in the comments, which is a valid response. We spent a lot of time during nursing school running scenario of "you have orders for the...

  14. I want a future where all nurses have science degrees and are not mean girls

    FiremedicMike replied to RitzyCinnamonRoll's topic in Crusty Old Bats's Chatter

    Thread title doesn't match content.. Since we're giving our wishlist, I want a future where we stop pretending that college is mandatory for everyone. I believe in education, but I believe that...

  15. CFRN vs CEN

    FiremedicMike posted a topic in Flight, Surface Transport

    Just wondering.. I have prior flight experience as a medic, passed my FP-C on the first try. Im currently an ED nurse and also passed my CEN on the first try. I'm going to start stacking my...

  16. Hard to get a job as new graduate nurse (Houston)

    FiremedicMike replied to mmy3's topic in General Nursing

    New grad residency programs are asking for experience? That doesn't

  17. Can chart audits be a HIPAA violation?

    FiremedicMike replied to George001's topic in General Nursing

    Quality improvement is a clearly stated exemption from

  18. PICC certification?

    FiremedicMike posted a topic in General Specialties

    So I'm interested in home PICC nursing. I'm extremely good with ultrasound PIV, but the only way my facility will send me to PICC training is if I agree to go full time and be on call, both a hard...

  19. I HATE cleaning poop

    FiremedicMike replied to Lilrn's topic in General Nursing

    Come to the ED, high paced, tight knit group, far less poop. Not zero, but

  20. Choosing LPN or RN

    FiremedicMike replied to Amber Shepherd's topic in Pre-Nursing Students

    My wife is an LPN and I am an RN. I have the highest respect for good LPNs, they are an extremely valuable asset to patient flow. Observationally, my wife has managed to find good jobs, but her...

  21. Psych NPs that Quit Psych

    FiremedicMike replied to CuriousConundrum's topic in Nurse Practitioners, NP

    There is an interesting dichotomy in medical education in our country at the moment. On one end, you have the undertaking of medical school, full of inefficiency and risk. Starting with 4 years of...

  22. Public safety personnel focused psych practice?

    FiremedicMike posted a topic in Advanced Practice

    I am coming to the end of my career in public safety. I've worked as a firefighter/paramedic for the longest bit, an ED RN for a few years, and have even spent some time driving a cop car around....

  23. Public safety personnel focused psych practice?

    FiremedicMike replied to FiremedicMike's topic in Advanced Practice

    I am in a metro area, but not one of those. I'm also in an area which has openly embraced mental health resources for public safety including city and state funded operations with dedicated mental...

  24. Public safety personnel focused psych practice?

    FiremedicMike replied to FiremedicMike's topic in Advanced Practice

    I completely respect your opinion, but a few points 1. I do live in an area with a pretty significant amount of public safety personnel. 2. I think the mental health in this population is...

  25. Stable Vtach

    FiremedicMike replied to Matthew89's topic in General Nursing

    There's really no such thing as stable v-tach.. I get it, your patient was "asymptomatic" but v-tach by its very nature is unstable and arrest should be considered imminent if it's not