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KeepinitrealCCRN

KeepinitrealCCRN

SICU,CTICU
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KeepinitrealCCRN has 7 years experience and specializes in SICU,CTICU.

KeepinitrealCCRN's Latest Activity

  1. KeepinitrealCCRN

    ER to CV surgical ICU or MICU?

    Agree with everything above. MICU is hell on earth. ECMO is also boring and depending on where you work a perfusionist might run the machine so you really don't do anything with that. You need to learn hemodynamics and managing emergency situations and intubations. CTICU or Surgical/Trauma ICU are your best bet for experience. Go for CSICU if your goals are CRNA or NP as they favor that type of experience over MICU.
  2. KeepinitrealCCRN

    Future Nurses are Brighter Than Ever

    I don't want a 4.0 GPA nursing student working alongside me. I'd like someone with some common sense, critical thinking skills, hardworking and knows how to communicate with people. You can teach most people the skills to being a nurse but you cannot teach common sense. They need to develop different testing measures for nursing school other than GPAs.
  3. KeepinitrealCCRN

    PACU nurses being floated to ICU?

    Everyone should come together and help out. Even if they are just transporting pts, putting IVs in or giving meds. The MICU nurses should not have to be the only ones working with the Covid pts in this very stressful time.
  4. KeepinitrealCCRN

    Thoughts on a new grad RN going straight to ICU?

    Nope, it is a bad idea. There are very few situations where I think it would be ok. 1. You already work on that unit as a PCA. 2. You have a 6 month orientation. Outside of these 2 options I think you are doing yourself a disservice.
  5. KeepinitrealCCRN

    Why is BSN required for CRNA?

    is this really even a question?
  6. KeepinitrealCCRN

    Need Advice on Accused Medication Error

    I wonder if there were cameras? I would tell them to roll the footage! and then we can see who took it off in the first place. Also, in this case it is the instructor's problem as they are supposed to do everything with the student and you guys finalized the medication and put the mask on the pt and left together. The mask coming off happens in real life all the time - could be by RT or another nurse or the pt and sometimes we have to put it back on or stop the treatment just as you mentioned in your original post. I also think you did the CORRECT thing by telling your instructor first before taking it upon yourself to put the mask back on. Im glad you got to move on as this is so ridiculous. Good luck!
  7. KeepinitrealCCRN

    new onset afib

    new onset fib + CHF history = Telemetry admit
  8. KeepinitrealCCRN

    Next Day Off

    zombie
  9. KeepinitrealCCRN

    PERRLA in the ICU

    So a few things to note here prop/fent for vent purposes should not affect a patients pupils. Unless there is a neuro aspect or some kind of anatomy/defect all pupils will be reactive. The most important thing though is you should be pausing all sedation (unless contraindicated) and do a thorough neuro exam at the beginning of your shift to get a true assessment. A lot of pts wake up easily and follow commands even without pausing their sedation.
  10. KeepinitrealCCRN

    First 8 months in ICU-2 jobs over- Question

    Just a few things that stuck out to me. psych per diem? Thats a whole different game and with no experience not a very good idea. Also, it will not help you at all in terms of ICU/CRNA in the future. Travel nursing I doubt they will take you and even if they do it is a bad idea. In my opinion you need at least 2 years in a specialty before you travel. You will have minimal orientation and be expected to get up and running right away. You also don't even have 8 months experience since a lot of it is on orientation. You need to set a plan and stick with it, whatever the plan may be.
  11. KeepinitrealCCRN

    Why is it "legal" for patient to decline male nurses?

    In the past 5 years I've had it happen to me maybe 3 times where they want a female nurse all together and then maybe another 3 times when they want a female to provide personal hygiene but everything else I provided for the pt. It rarely happens and should be accommodated if possible. Why not make a pt more comfortable if we can easily accommodate these requests.
  12. KeepinitrealCCRN

    How to be on an ICU Nurse's good side?

    Just being nice and not a know-it-all goes a long way. Also, clean up your *** when you're done, put my blankets back on the patient the way you found it and don't touch/unplug anything without asking first.
  13. KeepinitrealCCRN

    Platelet Administration

    I've always only hung platelets with special tubing (a filter) and it is hung by gravity usually goes in within 30 min.
  14. KeepinitrealCCRN

    Best sedation med

    I like prop/fent because you can bolus them and titrate them easily. I also love versed but it is not our go-to drug. Personally, I hate precedex because you can't bolus it, it doesn't really work and almost always causes bradycardia. Precedex is good to take the edge off or ETOH withdrawl but not great for intubated pts who need something stronger.
  15. KeepinitrealCCRN

    What separates great nurses from decent nurses?

    Number one would be critical thinking skills and a close second would be just caring about the patients. So many RNs lack these 2 even the senior RNs.
  16. I love my job on a good day. A good day being we have excellent staffing, a pct, all the supplies i need, pharmacy bringing meds on time or even close etc. As time goes on Im finding less good days and more bad days and I struggle with going back to get my masters degree. I hate management lecturing everyone on VAP when I don't even have anything to clean my patients mouth with or how to take care of a central line when I don't even have a flush to use. Often there is no PCT and the nursing staffing is bare bones I can barely find someone to help me turn my patient (i really need 3 people to turn them) but then we have to sit through in-services about pressure ulcers. Then a high risk patient falls (shocking) but the nursing supervisor wouldn't staff a sitter even though they know the patient is high risk for falls and then we have to sit through a fall reduction plan. An important medication is ordered and I have to harass and stalk the pharmacy and still wait hours to receive the medication. The overarching theme is you have to do everyones job on top of yours and that is frustrating and a burden. I love the high acuity of where I work; constantly being challenged. I love the relationship we have with our doctors and how we manage our patients. I love my coworkers and management. If I knew my job would be mostly good days for the rest of my career I would not go back to school and I would continue to work in ICU until retirement because I really love it, Im constantly challenged and learn new things every day.