twss2323

Long time follower/lurker of AN. Rarely a poster. Anywho. I’m presenting at a career fair at a high school on Friday. It’ll be small sessions where groups of students come to my table at once. Im going to talk about the general stuff like pre-reqs and the day to day job as an ICU nurse. However, this is a STEM career fair, so I was thinking of having a quick STEM related activity for them to do, maybe hand out some candy to participants. I was thinking maybe having an ABG and talking about vent changes that would be made to correct said ABG, but I think that might be too advanced for high schoolers. I’m looking for SIMPLE and quick activity ideas. Anyone got anything good? Your help is greatly appreciated, I’m drawing a blank, everything I think of I think may be too complicated. Thank you!

"Hey, let me out of these things (in reference to restraints) so I can bust out of here and get us some McDonalds" "You don't have any money, how are you gonna get McDonalds" "Well with your money, of course!"

"I feel like something isn't right"

Jesse on Code Black. So many nurses on these shows don't play a part more than "yes, Doctor", but he actually plays more of a nursing role AND he keeps the residents in line--and I love that.

I also believe (let me try and find an article) that it's recommended the tube be oral vs nasal. Nasal tubes can cause sinus infections which can then lead to VAP.

I just want to chime in that I also think the app deterred a lot of people. I used to get on to AN daily, I was more of a lurker, but would contribute to conversations. Once the app went away, I did too. It's too hard to navigate on a smartphone. I hate that it doesn't keep my spot in the thread, I can't just scroll through "What's New" and it's just not as user friendly. I would love to see the revival of the app! I do like the idea of people trying to revive the specialty forums. There's so much potential for learning, and fun topics... Just not enough traffic. Currently racking my brain for topics.

Temp/BP/HR/RR Ht Wt q1h How much ya think he's gonna grow or shrink every hour doc?

I was checking my patient's gastric residuals, my least favorite thing to do, eck. The pt had a 12 Fr PEG tube, it was tiny. Apparently I got way too ambitious when giving the contents back, I pushed too hard and gastric contents squirted all over my face, all over the RTs face, and the patient. The RT was freaking out, I was freaking out; our co-workers were getting a good 'ol laugh from outside the room. I washed my face like 27 times that night.

I graduated from the Tucson campus in December 2015 and I know there's been some small changes, so it might not be accurate information anymore, BUT when I applied/went there if you had applied and not gotten in, you had a higher probability of getting in when re-applying, so fingers crossed you get it this semester. The campus location has changed and I feel like some processes have changed so I'm not sure how up to date my info is, but if you have any questions, let me know and I may be able to answer. 🙂

As other have mentioned, look at the surviving sepsis guidelines. I actually went to an AACN presentation the other day about the sepsis guidelines and CHF/renal patients and fluid resuscitation was a topic of discussion. The current recommendation is to do small volume boluses of 250-500mL at a time and use passive leg raise to assess fluid volume status. If there is a greater than 10% increase in MAP with passive leg raise, they're fluid responsive and need more fluid. You resuscitate them as long as they are responsive.

There are certain requirements to cool, to include ROSC within an hour and a GCS score. I can remember the exact score but it's a GCS less than 8 or 12 I believe. If the patient is responsive and following commands, no need to cool them.

Thank you!

Please forgive me if there's already a topic on this, I did a search and didn't see anything, but I'm used to using the app not the site so I could have done it wrong. The app was crashed or something for a couple days, so I deleted with the intention of re-downloading it, thinking it'd be an updated version. But, the app isn't even in the App Store! What happened?! I loved it!

Please use the quote button when replying to posts so we can follow what you're saying [emoji4]

I was in a patient's room with 3 doctors in a tricky situation trying to find a solution the other night and the surgeon, who is very well respected and highly regarded piped in and said "have you tried googling it? I do it all the time when I'm stuck". The Internet is a plethora of information. Obviously you need to use legitimate sources (such as the AHA source mentioned above) and not just any random website... But don't judge someone for using their resources. The Internet can be your best friend if used appropriately. PS: Google led us to a solution.

I had really high hopes for that show, with it being based off a real person and stuff. But it was awful.

VALOR is a internship like program for BSN students.

We have a chart that stays up and running in the room. At the end of shift you "lock" it for the next person to sign in, but all the while all the patients vitals and data are slaving over to the chart. There's a button you can click to see the patients I&Os. Doctors (we're a teaching hospital, new docs all the time) really like that info and like that button. Except they don't always know what button it is and just starting clicking stuff in my chart. Drives me crazy.

The VA's new grad program is called RNTTP-- RN transition to practice. Look for facilities with that to maybe help your chances as a new grad.

You need to experience the things for yourself, people telling you what it's like isn't going to help. And you never know what you'll fall in love with. I wanted to be a NICU nurse, when I was younger my cousin was in the NICU-- with a happy ending. I saw kittens and rainbows and wanted to work NICU. Then I took a tour of a NICU through a pre-nursing club at my University, I took one look at a micropreemie and realized there was NO was NICU was for me. I then thought I wanted to be a mom/baby nurse. I mean, you get to hang out with babies all day? Awesome, right?! So when I signed up to volunteer at a local hospital and was offered mom/baby I was stoked. Being exposed to there made me realize it's not all that it's cracked up to be and I decided it wasn't for me. I love medical reality shows and thought that ER nursing was for me. I went all through nursing school thinking I wanted to be an ER nurse. I COULDN'T WAIT til I got to do my ER rotation in clinical. It was great and I liked it, but the TV shows show you like all the cool stuff and just a hint of the day-to-day not so cool stuff that is reality. I still liked ER, but my program doesn't prefer ER preceptorships because past students spent more time shadowing than actually practicing the role of the nurse. I once had a nurse tell me to get ICU experience before going to the ED, so I requested an ICU preceptorship and was lucky enough to land a spot. In those 8 weeks, I completely fell in love with the ICU. The complex physiology and drips and actually getting to know your patient inside and out and there's always an opportunity to learn (not that there isn't opportunities in other specialties) and ahhh, I left there real starry eyed. I was lucky enough to land a job as a new grad in that ICU and I absolutely love it and have absolutely no interest in the ER for the time being. So long story short, you have to experience it. You can't just hear what something is like and make a decision. If I made my decision before nursing school I'd be a NICU nurse scared out of my mind at the itty bitty babies lol.

Proactive rounding sounds like a good idea. It could take care of problems before they are bigger problems and actually warrant going to the ICU. I'd be really interested in hearing others' experiences with that.

I don't have any first hand experience, but patient/family initiated RRT sounds like a giant can of worms. What may seem like an "emergency" to a patient or family member could be a giant waste of time and resources. Imagine someone initiating an RRT because the nurse hasn't gotten them their pain meds fast enough or the aide got busy and forgot to refill their water pitcher?

I'm gonna give you the benefit of the doubt and think you're probably thinking a little irrationally because you're freaked out and you actually do understand the concept of a sterile needle. I stuck myself with an insulin needle right after I drew it up when I was a nursing student. I knew I was fine because it was a clean needle; my instructor wanted me to be extra vigilant of feeling lightheaded or anything in case I inadvertently got some insulin. But really, I was fine. But I still freaked out inside A LOT-- because it showed me how EASY it is to stick yourself and it's not always gonna be a clean needle. But as others have said, you're fine. Breathe.

Literally can't please everyone. I'd offer some unpleasant PRN suppository or something to make it feel more hospital like for 'em [emoji6]

I will say there were lots of goodies from the pharmacist on the unit and Sees Candy from the Union. The union even had designated boxes for days and nights so that was really nice.