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Cath lab, EP lab, CTICU
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estherojin has 8 years experience and specializes in Cath lab, EP lab, CTICU.

estherojin's Latest Activity

  1. estherojin

    Need help choosing 1st job....

    reading what you wrote about your personality and what you enjoyed in your clinicals, it seems like you are already leaning on an ICU.
  2. estherojin

    On my way...

    honestly, i think you should wait until you have a full year's worth of critical care experience. you are not going to do yourself any favors by not meeting the admissions criteria. they might be willing to overlook one, but falling short on two might not reflect well on you as a candidate. your first year as a nurse in the ICU will be tough, there will be a lot to learn. on top of that you will be working on your BSN and studying for your GRE (not to mention NCLEX). what you don't want to do is waste money and effort in the application process if you aren't a strong candidate (yet). I think you have a good start already, your experience in the ED and surgicenter will help you on your first year as a nurse. a few of my colleagues who are excellent nurses and had top grades hurried their application and unfortunately did not get accepted. Anesthesia programs are competitive, you want to make sure that you can meet (and exceed if possible) all their admissions requirements. good luck to you. it took awhile for me to figure out this was the path i wanted to take, i admire you young folks who've figured out what they want early on.
  3. estherojin

    Current SRNAs, I need your wisdom.

    This seems obvious to me- to work and save. However, I've worked my butt off for the last 6 years. I've been juggling a full time with a part time/per diem position, supporting my husband's graduate education. Cutting down my hours this spring to take the two classes was the first "break" I had from work in a long time. I will be working part time through my first two quarters, so I will be getting tuition reimbursement and I don't have kids, so the money thing isn't too bad of an issue. The syllabus suggestion seems sound, but I don't see how professors or students would want pass their syllabus on- it might be considered an unfair advantage? Thanks for the suggestion to brush up on the autonomic nerv. system. I will definitely do that. Thanks all for responding. One more question, what classes did you find most difficult in your program?
  4. estherojin

    Code blue: family at bedside????

    We would allow the patient's family to witness the tail end of the code, after we had exhausted most of our resuscitation efforts, so that they would know that we had done as much as possible to care for their loved one and be able to spend the last few minutes with the patient. it's worked well the few times we did it, only because there was an APN to explain what was happening. i don't think it's appropriate to have family witness everything such as putting in invasive lines, drains, etc, but that usually happens in the beginning/middle of the resusitation process.
  5. estherojin

    Please help me answer my case study!

    agree with queen216. sounds like she might be going into CHF. she's obviously volume overloaded. i'd put her on oxygen, get a set of VS, and listen to her lungs. also, i noticed there was nothing mentioned about her breathing pattern. if she' in CRF, is she responding to the lasix dose she's getting? if her pain wasnt well controlled early on post op, she probably had atelectasis that didn't improve. She might also need some aggressive pulmonary toilet.
  6. estherojin

    Atrial Overdrive Pacing or Cardioversion?

    In the EP lab, we've paced pts out of A flutter, but generally I believe you can't overdrive pace A fib since it's a disorganized rhythm- for the same reason you can't pace VF, but can overdrive pace VT. During EP studies, if you pace the atrium too fast, you can cause A Fib.
  7. estherojin

    You Know the patient is going bad when...

    when they order a rotoprone bed for your patient.
  8. estherojin

    What's YOUR nursing obsession?

    oral care on intubated patients. there's nothing better than freshening up a smelly crusty mouth. love brushing those teeth and deep glottic suctioning. another obsession- i have to have the IV bags hanging directly over it's corresponding pumps.
  9. hmmm, if i had to do it for a job, nursing tops it all specifically being a nurse in a large teaching hospital in an urban setting in a fast paced ICU. i guess i'm lucky cause that's what i do.
  10. estherojin

    Rapid Response Teams

    love love RRT. i work in a critical care area, so many times i get report from the RRT nurses for the patients that get admitted from the floors. they're the rock stars of nursing!
  11. estherojin

    Why do you LOVE your job?

    What is it at your job that makes you happy -Comraderie- I don't see it as much on my current job in the ICU, but when I worked in the Cath and EP labs, I relished the teamwork approach to patient care- MDs, RNs, and techs all focused on one patient at a time. There is comraderie in the ICU, but to a lesser degree- it's mostly just among the nurses. is there a particular program in place that has a great success rate with the overall attitude? -no, i wish there was. there was a large group of new grads (10-12) as well as some seasoned nurses that were hired when our unit expanded from 13-23. the education department on our floor was unable to meet the demands all of the new grads and i think after the one year mark, we were able to retain only 2 of the new grads that were hired. after this "failure" the leadership team on our unit decided to orient at most 2-3 new grads at a time to allow for more comprehensive orientation program. i feel for the new grads that left because i think most of them had great potential if only they had been oriented properly and it saddens me that most of them left feeling defeated. the newly adapted appoach of hiring and orienting smaller groups (2 new grads and 2 seasoned nurses) at a time has been successsful so far, we'll see after a year how it goes.
  12. estherojin

    Bovie settings????

    In the Electrophysiology lab, the MDs used 40/40. From what I heard, the general recommendation is to use the lowest power setting as possible. I do remember that on our older units, we had to crank up the power to get it to where our MDs wanted. check this website out, you might find something helpful. it helped me understand how cautery worked. http://www.valleylabeducation.org/index.html
  13. estherojin

    Family calls to the unit.

    I work in the ICU and I concur with the previous posts. I really don't mind updating immediate family members, but there is a limit to the number of callers and the calls. ICU patients are in the ICU for a reason, they need close monitoring and a lot of nursing care. It seems like everytime I'm in the middle of something critical, i get a call. Most family members understand, but there are the few that can get irate for having to be put on hold. I am a strong advocate for designated family rep, it saves the time of explaining the same thing over and over and also if there is a status change, the communication process is less complicated. One thing I've noticed is there have been incidences where extended family members and friends of the patient called for updates and when denied information called back saying they were immediate family members. It's a huge privacy risk. Though it might seem curt, I strictly restrict giving out information to anyone but the primary contact listed on our kardex and refer the caller to the primary contact for updates. Lately, i've also been telling family members not to call during change of shift plus the first hour after the shift change to allow for enough time for pt assessment without interruption. There's nothing I hate more than being asked questions about a patient that i haven't even seen.
  14. My suggestion won't work if you want to stay in acute care, but how about cardiac rehab? They have great hours and be able to build relationships with your clients. If you want to stay on the floors, did you ever give thought to critical care nursing? It's still very busy, but since you're working with one or two patients at most, it's not the mind blowing chaos of juggling a team of 4 to 7 patients who have call lights. Cath lab is also a great place to work and there might be some call required that might provide extra income. I worked in the lab setting for 6 years and loved it. In the lab you work as a part of a team consisting of mds, nurses, and rad techs. You'll get a chance to work cases that are wicked challenging and fast paced- pts with acute MIs to pts in cardiogenic shock, and the routine diagnostic cases. Many cath labs might require you to have some critical care experience, but some don't. Another cardiology related area is noninvasive cardiology testing- stress labs, nuclear medicine, and echo labs. I've had to cover these areas while working in the cath lab and found it to be an enjoyable place with a easy pace of work. Good luck finding your next step!
  15. estherojin

    RN doing conscious sedation non-intubated patient

    Most hospitals require nurses to have documented competency in moderate/conscious sedation as well as have ACLS if administering sedation will be a part of their job description. Even if the surgeon is present, if he's occupied with the procedure, as the person who administered the medication, it'll be your job to monitor the patient and intervene if necessary. In the cath and EP labs I've worked at, sedating and monitoring patients were a big part of the nruses' responsibility.
  16. estherojin

    Do you like being a nurse?

    I love, LOVE being a nurse. Every job has its drawbacks, but how in many jobs can can you make a real tangible difference in another person's life? What other jobs can you really witness the human drama of life and death?