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jk2185 BSN, RN

CCRN
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jk2185 has 6 years experience as a BSN, RN and specializes in CCRN.

6 years nursing in LTC, Urgent Care, PCU, CVICU, PACU.

jk2185's Latest Activity

  1. jk2185

    Treat the Patient, not the Monitor.....Really?

    I wish people on this site wouldn't ask damaging things such as,"are you a nurse?" or "how many years have you been a nurse?" just bc you disagree. I find this very childish and cutthroat. I wish we were all more supportive of each other. This is supposed to be a forum for discussion and learning, not bullying and chastising. As for the BLS survey. You most definitely perform the BLS survey first during a code, albeit you may do it in 3 seconds, you still do it. Even on the vented patient. Not all vented patients are sedated either...we may be trying to extubate or performing a sedation holiday. Also, not every patient in the ICU is vented; in my experience half are and half are not. ACLS is the heaviest protocol used in a code, but step one is always BLS.
  2. jk2185

    Tired of being angry

    PREACH!!!!!!! Tired of being tired....well put; I've said that myself. Hobbies help-lots of them A good therapist helps, really really helps A little bit of dissociation from others, which is WAAAAY hard, maybe impossible. Can you turn off empathy for the sake of doing your job better at a lower cost to your being. People are hard to take care of
  3. jk2185

    Treat the Patient, not the Monitor.....Really?

    Thanks everyone for weighing in....this post didn't go where I thought it would, I apologize for the confusion.
  4. jk2185

    Treat the Patient, not the Monitor.....Really?

    Well no duh!!! Of course if your patient looks horrid and the monitor doesn't reflect that you should most definitely perk up and do some investigating. Im regretting this post! Your assessment skills can fail you just as badly as a monitor can, we have to use ALL THE DATA at our disposal.
  5. jk2185

    Treat the Patient, not the Monitor.....Really?

    The fact, though, is that you do not know how to use physical assessment skills and what you will be able to do if you master them. Sorry. wow..thanks for the encouragement. I can't help but feel very misunderstood by these responses, as I prefaced, of course you should assess your patient with both your physical assessment and your data from monitors. I am simply stating that the saying "treat the patient, not the monitor" can get you into just as much trouble as fumbling into a room and starting cpr bc of some artifact. They should both be used equally to care for our patients. I think using suggestions/cliches like this is ultimately misleading.
  6. jk2185

    Treat the Patient, not the Monitor.....Really?

    "Look at the patient, not the monitor" doesn't work for me either. I've seen plenty of patients that look fine chatting away with a CI of 1.8 or an SBP around 200. So...as long as my equipment is calibrated correctly and not being assessed by someone who doesn't know how to properly use the devices, more often than not, I believe what my monitor tells me 100%. Your story is interesting and it sounds like it made for a terribly stressful day. Seems to me there may have been a failure in protocols. Did anyone check a pulse or responsiveness? Even if a monitor shows a shockable rhythm you still follow the BLS survey first. It also seems odd that the monitor in room A (which was presumably hooked directly up to the patient in room A) would show data from a different room. I'm no IT guy for sure, just seems very odd. I'd say my point of view only works if you know what you are doing. It doesn't work if you put the wrong size BP cuff on a patient, or if you have bubbles in your pressure lines, or if you don't check your patient's pulse and responsiveness when you have some strange artifact that often does look fib-ish. I just find this old expression to be only mildly useful. Of course you use your intuition and assessment skills, but the notion that you should treat based on what you see over data drawn from high-tech equipment seems a little over the top. I think treating the patient and the monitor should be on an equal plane....use all the data you can get.
  7. This is my least favorite "go-to" that I hear all to often. Why even have monitoring in the first place? I trust the monitors more than my own ability to intuitively know a patient's condition based on my limited assessment skills; and just to ward off evil comments spawning from this notion I want to remind everyone that we all have limited assessment skills, our senses can only do so much. And of course, if your monitor screams asystole or vfib and your patient is smiling at you politely asking for more apple juice, I do hope that we all know to check lead placement or something. We didn't have numbers 100 years ago and look what kind of healthcare we had...not the greatest. I just wish we could flush this saying out or maybe change it.
  8. jk2185

    Malpractice Insurance Question

    What does a 2mil/6mil aggregate coverage entail? Im not sure how all this works...what's the difference between the 2mil coverage and aggregate coverage?
  9. jk2185

    CSC help

    I'm taking the CSC pretty soon....what did all you fantastic people that passed use to study?
  10. jk2185

    Tattoos?

    Nah...I've had no problem getting jobs and both my arms are sleeved. I did have to wear long sleeves ALL THE TIME at my last job which was awful at times, overheating and sweating like crazy. It's pretty lame when you have to cover yourself up; my tats aren't offensive at all. Seems wrong to make people change their appearance. That's a rant for another day. I say get the tat...make sure your artist is using high quality ink, as in the kind that doesn't have loads of heavy metals in it (not good for you).
  11. jk2185

    Question about Cussing on the job.

    doubt it....Can't say I've ever cussed at a coworker, but I've cussed out a few patients, family members, and doctors.......in my head
  12. jk2185

    Pushing Code/Emergent Drugs

    Here's the question... Are there times in emergencies when you still push drugs over 2 minutes? Like during a code: Epi always seems to be pushed as fast as possible, but what about the Amiodarone 300mg dead dose? What about Calcium or BiCarb? or Mag? During RSI: I've heard two ways of giving RSI drugs. Get a running NS line flowing to gravity and push your Propofol/Rocc or Succs or whatever through the Y-site or just push them directly into the IV site. I've seen more of the latter. Can't say I've ever seen somebody push Propofol through a Y-site. Same question goes for these drugs too. I've given Roc a few times and pushed it over a minute which seemed to anger the impatient pulmonologist before a bronch.... It would be nice if you kind nurses out there can fill me in on which drugs are out there that you know can be pushed rather quickly....and please only speak out of experience. Thanks!
  13. Wow, lots of response. Thanks to all for participating and doing my biased poll, it's just nice to know there's introverts out there silently suffering too!!
  14. jk2185

    Diluting your IVPs??

    No no no...just one syringe at a time. Fentanyl is our first-line drug so I'll have a syringe with 100 mcg in it and give 25-50 mcg boluses every 10 minutes as needed. If I'm done with that drug for that patient or if I switch drugs I'll waste what I have before continuing.
  15. jk2185

    Diluting your IVPs??

    Good point....my example is from a PACU where nurses commonly draw up an entire vial and give boluses as needed instead of wasting for every administration due to the higher volume of IV narc pushes immediately post-op. The wasting occurs after the patient's pain is controlled.
  16. jk2185

    Burnout after 1 year?!?

    Sounds like an existential crisis. I can relate. Here's my question....if money were no object, what would you do with your life (for work especially)? and I don't mean buy a yacht and move to the Hamptons, i mean realistically.
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