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IMC, ICU, Telemetry
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maolin has 2 years experience and specializes in IMC, ICU, Telemetry.

maolin's Latest Activity

  1. maolin

    Telemetry vs. Cardiac Stepdown at Brack in Austin

    You're going to see a LOT of indigent & homeless @ Seton's ER as well - fresh off the street many times (not always cleaned, buffed & puffed, as they will become once admitted). All Seton campuses are not for profit, charity hospitals. While Brack will see many, Seton gets a fair amount as well.
  2. maolin

    Telemetry vs. Cardiac Stepdown at Brack in Austin

    I still say do stepdown. Again, the ratios are better and there is more "controlled chaos" on a unit vs. the ER (this said from a recovering EMS adrenaline junkie). There are great reasons to work ER - huge variety of diagnosis & lots of procedures/interventions vs a unit, pt population from the very young to very old. Huge patient attrition - leaving you little time to get to know the patient and their "whole picture". Lucky you - so many great jobs to choose from! That gives you a little bit of an edge negotiating compensation packages, too, so don't leave anything on the table!
  3. maolin

    Telemetry vs. Cardiac Stepdown at Brack in Austin

    I vote for Stepdown/PCU. While it's a cardiac specialty unit, you're going to have a lot of comorbids with those patients. It will be easier for you to do a tele/IM from there then the other way around. You could always pick up extra shifts on the tele unit if you can't decide. But I think the stepdown is your best bet. A girl I went to school with is on that unit and she LOVES it. Great ratios, great staff, lots of continuing ed opportunities in Seton's network. They are big on evidence based practice - very proactive with all the latest & greatest. (I haven't worked Brack, but have worked in that network) Good luck!
  4. maolin

    I work in one of the worst region in the US

    Taco palenque! Just about the only great thing about The Valley. My pseudospouse is from Brownsville. We drive down there from Austin 3-4 times a year. And I dread it every time. Though I haven't worked down there (as much as my MIL has tried to talk me into it), I feel your pain & frustration. Have you considered travelling? Hubby can stay down there and you can take little 3 mo assignments elsewhere to revitalize your passion for nursing and come home in between. It might be a win/win for you. Hope you weathered Dolly ok...best wishes!
  5. maolin

    Tax home ?

    Greetings, I have been doing a ton of research & reading lately about travel nursing and am about the take the plunge. So I'll likely be a regular poster in the travel forum now. Travel nursing seems to be the perfect means to our end (end = early retirement, hopefully not the celestial kind ) - try out several West Coast locations to determine where to put the solar-powered-ecofriendly-off-the-grid-earth-sheltered-hobbit-hole-dream-house-and-Border-Collie-farm. I cohabitate with my pseudospouse. We've been happily UNmarried for 10 yrs. We intend to keep our house in Austin as home base and return in between assignments until we are ready to sell & permanently relocate (love Austin, but can't handle one more summer here & have always been drawn to the West coast). My partner bought the house a few months before we met and so it's only in his name. I have never paid him rent or split the house payments because it's paid in full. He is our breadwinner & also takes care of all the household expenses. (yes, I realize how very lucky I am to have found The Perfect Man! :redbeathe) We've been cohabitating for about 8 years now. I know that I'll need to keep my TXDL, insurance & vote here in Austin in order to keep Austin as home. Since I don't pay for housing, I'm not on the deed and have no utilities in my name, can I still claim it as my tax home? Will my housing stipends still be tax free or taxable because the Austin house wouldn't be considered my tax home? TIA and thanks for all the good info in the stickies & the forum - I feel very well prepared for this exciting new angle.
  6. maolin

    How can I explain to a LOL

    Perhaps a bipap might help in this case - the pt will feel like she's getting the amt of air she's been begging for and it will help her blow off all that extra co2. Some ativan and or morphine might be of benefit as well.
  7. maolin

    anybody else have this problem

    excellent point. many of our forgein born docs with hard to pronouce names allow us address them by abreviated nick names - it's easier for the patients and staff - who likes their name butchered? the docs rather like it too - gives us all a sense of a less formal relationship. these are also the type of docs that don't have that "high and mighty" ego.
  8. I'd caution you about spreading yourself too thin and taking on another job, even though it sounds like HH will be more to your liking. Given the stress and anxiety of your MS job, you need to take full advantage of your time off to recuperate. If it's absolutely not possible to exit the MS position because of the contract, be sure to take extra care of yourself. I think the time spent in a 2nd job might add to your anxiety, especially the first few weeks when you're learning the new job. It's not usual for a new grad to go into HH, they typically want 1-2yrs experience - that they would hire a new grad 3 mos out and only 3 wks flying solo - big red flag.
  9. maolin

    Failed clinical because...

    It seems as if the OP classmate is getting a 2nd chance, being allowed to retake the course the next year. This major compromise of patient safety would have been an automatic dismissal from the program I went to, with no appeal or readmission. This was a serious incident and cause for a serious consequence.
  10. maolin

    letter to manager appropriate, regarding transfer?

    I agree face to face, and align your reason to the effect of you have learned a lot there, but feel it's time to expand your skillset...etc. I find this is most receptive and garners support from your current team, rather than leaving with the sense you are bailing on them. Perhaps offer to stay to help train the new hire to fill your shifts. Best of luck to you!
  11. OMG!! ME TOO!! I have never had a drippy nose - ever. Then I started nursing. Mine starts as soon as I hit the floor, though, not just in pt rooms. I never gave it much thought until I read your post, but maybe it *is* nerves. I thought maybe it was just the hospital smell or something. For me, it usually resolves a few hours into my shift. And I'm never really all that congested - just that annoying nasal drip. It seems taking a claritin before I go to work seems to help a little, but I still keep tissues handy in my pocket. How STRANGE!!!!
  12. maolin

    canker sores

    I personally suffer from chronic, terribly painful mouth ulcers. Still don't quite understand the etiology - vitamin deficiency, stress, viral, trauma (often erupt where I've bitten my cheek). I've had them for as long as I can remember. They are often so bad, I can't eat for several days - often lasting 7-10 days from onset to complete healing (w/o tx). I tried all the OTC preparations - found most to make it even worse - alcohol based, sting & slow healing. My doc rx'd a Kenalog/Orabase .1% paste (triamcinolone acetonide). This has been a MIRACLE solution for me. It doesn't sting (gelatin/pectin base). Apply at HS. coats the sore & speeds healing - usually completely recovered in 3-4 days. From insert: Triamcinolone Acetonide is a synthetic corticosteriod which possesses antiinflammatory, antipruritic and antiallergic action. Emollient dental paste acts as an adhesive vehicle for apply the active medication to the oral tissues. Vehicle provides protective covering which may serve to temporarily deduce pain associated w/ oral irritation.
  13. maolin

    Dumb Question?

    I suppose some, maybe even all the med, could end up in systemic circulation after circulating from the radial artery>hand's cap bed>venous circulation, but it would be taking the long way around and could be VERY dangerous... necrosis, thrombus.. Point is, IV meds go into veins, not arteries. A lines should only be used for monitoring BP & for blood draws (ABG's). A tough lesson for this new grad. I hope there was no harm to the pt.
  14. maolin

    Dumb Question?

    Think of where the blood is traveling... what's "downstream" from the A-line insertion site? If you gave an IVP in the A-line, the med would be traveling distally into the hand's capillary bed. Intravenous meds are pushed in veins so they travel into systemic circulation, further diluted in large volume of blood and then distributed throughout the body. You don't want that phenergan dose concentrated in the hand - you want it going the other way to get where it needs to be so your pt won't puke. HTH.
  15. maolin

    IV Haldol?

    Use caution with giving IV - it's a cranky drug and doesn't play well with other meds. Will form a pretty white precipitate with just about anything - big, good flush before & after.
  16. maolin

    what's the appropriate name for this procedure?

    Without being there it's hard to know for sure - but what you are describing sounds like an I&D to me (incision & drainage) - often done to remove pus & fluid from an abcess. Have not heard of this to treat an infiltration - but perhaps this wasn't a typical infiltration to begin with.