murseman24

Why?

I think the general recommendation is to take tylenol over ibuprofen as ibuprofen has been shown to reduce the immune response somehow. This is probably more of an issue with older patients who typically don't mount as adequate of an immune response to the vaccines in general

agreed. If already coding RT can intubate, as they don't need meds at that point and all you need is the physical act of intubating. Someone circling the drain requires much more consideration with someone that has the legal authority to make independent decisions (ED doc, ICU providers, anesthesia).

I performed over 500 intubations before graduating CRNA school, and after that there were still plenty of airways that would give me pause or require extra help and consideration. Special situations like limited mouth opening or deranged anatomy/physiology aside, even a normal airway on a 300lb + patient you have about 10 seconds before they start desaturating. You miss an IV and you get to start again. You miss an airway and that could be someone's life. Why take on that responsibility as an RN?

Why wait so long to take your boards? Didn't you just spend the last 4 years learning what you need to take them? I think it better to cram really hard over a two week period if you're worried about boards then to wait so long to take them. I mean how hard are you really going to study for 2 months straight? I would end up forgetting more than I learned in those two months.

How can one have the capacity for this when they are focused on how to prime the IV tubing they never got to touch in school? No, you have to be able to go through the basic motions before you can "ascend" to the level of critical thinking.

This is ridiculous and SHOULD NOT BE A THING. You should not be able to graduate without a minimum of clinical hours. When I graduated I worked as a CNA in the ICU full time during the nights while I did nursing ADN program full time. I did CPR more times than I could count and did every nursing skill one could do multiple times, I was very well prepared, and I was still stressed as can be during my GN program in the ICU. The CRNA schools around me took their students out of clinical for a few months and have since put them back in. They now stay longer during the day and their graduation has been postponed. Many stay past their scheduled hours to make good impressions and gain valuable experience with complex cases. There is no substitution for clinical experience. It is expected that you go above and beyond. This lowers the bar quite dramatically. I don't know what the legal minimum standard to graduate nursing school is, but this makes it appear like one could do the job after watching some Youtube videos. Embarrassing.

yes

Noice! *tips hat in your direction

Toradol is supposed to have the same strength as 10mg of morphine. There is good evidence for magnesium. Tylenol and ibuprofen work best when given together. Gabapentin.

"When medication such as a vitamin is administered via intravenous infusion the vitamin bypasses the liver; this is known as the first-pass effect." That's not really how that works... Why waste your time exaggerating the purported dangers of hanging IV fluid? I'm not surprised this is the only place that let you publish this drivel.

Looks like ya'll pretty much got the physiology covered, quality post guys! Only thing I can add towards bagging "technique" is when squeezing hold the bag for a quick half second at end inspiration to allow the alveoli to remain open and turn up the PEEP. If the desat is due to junky lungs from pna or something that could cause some atelectasis it is really helpful to do some "recruitment breaths" at first. This means giving a couple big breaths while holding your squeeze on the bag at end inspiration for a few seconds to pop open the alveoli, it really helps to increase their oxygenation if they have collapsed alveoli. I don't do cardiac peds in my job but I've got some experience ventilating kiddos and adults. Take care!

I just want to say I think it's great that you're critically thinking and questioning these practices.

the IBR schedule is 20 years, not 10, that is PSLF. Mathematically you just pay less this way, plain and simple.

This statement was made in response to a comment on the general utility of Dave Ramsey's advice from someone other than the OP. My advice as previously mentioned to the OP is to get on an income-based repayment program and go for forgiveness. In this manner the OP should still have enough extra income to invest for retirement and live their life. Even so, it looks like those on here who are fans of Dave Ramsey advise to "go all in" and pay down the debt with every remaining cent (characteristic of his advice). This again, would be a poor choice.