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stacylethani BSN

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  1. stacylethani

    Pediatric Cardiovascular acute unit

    Hey! I used to work on an acute care peds cardiac floor, currently in peds cardiac ICU. On the floor it was almost exclusively post op cardiac surgeries or cardiac catheterizations, working up on feeds, weaning respiratory support (HFNC/o2 cannula), occasional VADs, heart failure on a cardiac drip called milrinone to help reduce the workload of the heart while waiting for heart transplant, and kiddos who just got transplanted or are transplanted and rejecting. You usually have anywhere between 2-4 kiddos, lots of oral medications, they’re usually NG/NJ tube fed, working on pain management, especially for the fresher post-ops. Can have super sick kids especially pre/post transplant who are on a lot of drips, need a lot of monitoring. Personally, I loved being on my floor. I learned SO much! Let me know if you have any other questions! 🙂
  2. stacylethani

    Depressed, unhappy, feeling lost

    I want to preface this by saying, this is a rough time in life for everyone. I have yet to meet someone who isn't struggling. I'm feeling so anxious, overwhelmed, and depressed. I never feel like doing anything anymore on my days off d/t quarantine. My state was one of the harder hit ones, and we've been on a very strict stay at home order for multiple months now. I've been baking a lot and that's basically been my newest hobby but late at night, when I'm lying in bed alone I just feel so unhappy/miserable. Many of my friends are also struggling with anxiety/feelings of frustration and sometimes it feels like we are walking on eggshells around each other. I feel like I can't talk to them about it sometimes because they're struggling so much with it too that its just too stressful for them to talk about it and they just end up getting more anxious and angry. Everything feels kind of meaningless right now. I'm so tired. All the time. I mean, I work night shift so I'm already always tired but this just feels worse. I just want to sleep all the time. Things that used to make me happy before, don't. I feel like I'm just going through the motions of everything in my boring, unexciting, lonely life right now. I've been reading here and there and the weather is finally warming up so I've been trying to get outside more. I live with my family and its constant covid talk - the news is always on and even when I've asked them to stop watching it so much because it just creates anxiety in everyone plus its only so reliable, they won't. I don't know what this post is about, really. I'm just feeling really lonely and really down. It's my birthday soon and I honestly couldn't care less.
  3. stacylethani

    What is an RVOT?

    Thank you for your help!! I really appreciate it!! 🙂
  4. stacylethani

    Bagging ETT

    Adventure_rn, thank you so much!! That is so helpful! I’ve been lost on which forums to post questions to because peds cardiac ICU doesn’t have its own category - I guess lumping it with PICU makes sense. Thanks for your help guys!
  5. stacylethani

    What is an RVOT?

    Can someone please explain what an RVOT (right ventricular outflow tract) is? Or LVOT? What does it do? What does that mean? Why would you need surgery on it? For reference I’m in the peds cardiac ICU. thank you! 🙂
  6. stacylethani

    Bagging ETT

    How do you know when you should start bagging your pt with an ETT? I read something saying disconnecting the pt from the vent should be a very last resort because then they lose the recruitment from the vent (someone please explain this to me, what does that even mean?) but if your kids sats are sitting in the 40s and they aren’t coming up with going up on their fio2, how long do you wait/how do you know to bag? Also with cardiac kiddos, you don’t want to automatically increase their oxygen first, right? Cause then their lungs steal blood flow? I’m confused 😕
  7. stacylethani

    U of Michigan interview, Advise Please!!

    What unit are you interviewing for? What I’ve noticed is everyone is super helpful and eager to help you learn. They want nurses dedicated to learning/improving their practice. Very focused on evidence based practice/research/teaching (it’s a teaching hospital) so anything related is helpful. Just show your passion for nursing and why you’ll be a great fit! do your research on magnet status, awards in the last few years, etc.
  8. stacylethani

    ICU - overwhelmed, exhausted

    I started in the peds cardiac ICU this past Summer. I have two years of experience previously on a Cardiac peds step down unit. My orientation went well, I learned a ton. I’ve been on my own for almost two months now and I’m feeling so anxious to go into work each day. I don’t love my job/nursing the way I did before because I’m so scared all the time. I feel like I’m getting easier assignments than my peers who started with me and it makes me feel like I’m not as smart as them, or that the charges trust them more. For example, I’ve only had one intubated kid since getting off (which honestly I’m still so scared of intubated patients so I’m not complaining, just think it’s odd). I just feel like there is so much I don’t know and I’m just feeling so overwhelmed and I don’t know how I’ll ever be good as a nurse again.
  9. I’d say at about one year I felt like I could possibly handle harder assignments (that’s also when they started giving my harder ones) and after a month or two of those I started to feel much more confident. I’d say around 1 year-1.5 years I started feeling pretty good about my assignments and like I could handle most situations. And the thing is, if there was anything I wasn’t sure about, I’d just ask my charge nurse for help! I also started precepting about 1.5 years in and that helped my confidence as well! You will get there, just give yourself some grace. this is a hard job!
  10. Random question, do you think we don’t get enough training on basic emergency medicine/situations? For example, when you’re in a focused speciality, you know so much about your particular specialty but when a patient comes along with another issue do feel like you know enough basics to provide proper care? For example, I’m a peds cardiac nurse and I know a lot about my specialty but if someone is my family is having neurological issues, I’m almost no help. It feels kind of pathetic to be honest. Because of it, some family members like to make rude comments saying nurses don’t know anything and I’m useless when someone is having a medical issue because I don’t know anything. It’s so frustrating to be so belittled all the time, especially because I’m the only one in the family who is in medicine.
  11. I just started a new job on a peds cardiac icu unit. I've had two weeks on the floor so far (which I know isn't much). I'm feeling overwhelmed and kind of anxious. I've been a nurse for two years, coming from a peds cardiac medsurg unit, which helps a lot, however, all the ICU stuff is just kind of going over my head. There's so many lines/tubes/gtts and it's so hard keeping them all straight and remembering what they all do! CVPs, art lines, vents, CVLs, NIRS, oh my! For example, when my preceptor tells me to draw a blood gas, it takes me a minute to figure out which line/lumen I'm supposed to draw off of because there's just so many. I know that you'd draw gases off your art line and use that for bp's as well. I'm still taking care of the stable kids right now, so I want to get my understanding of these down before I move onto the sicker kids in my orientation. Additionally, I think my preceptor is a really good nurse, but I'm second guessing whether it's the best fit. My first preceptor when I started as a nurse was very very by the book, policy driven, and pushed me like crazy, which helped me become a good nurse! This preceptor is a little more laid back, lets me do a lot more on my own, has never pulled up a policy for me, and I feel like I have to ask her to explain what she's doing in more detail sometimes. She's a great nurse and has been a nurse in the cvicu for over eight years, however, sometimes I wish she just talked me through more things and communicated more/watched me a little more. It's interesting because I was a preceptor at my previous job and there's just a lot of things I wish she would do for me as a preceptor that she isn't. I don't know how to approach that conversation though without making it awkward. I just really want to be a good nurse on this unit and get myself in a good place before I end orientation in a few months! Any advice?
  12. Hi, just wanted to jump on here and talk. I recently left my old job (a job I completely loved) on an acute care med surg floor to start on a peds CVICU at a large hospital. I had to relocate due to family reasons/cost/etc. I really didn't want to make this move but it's just a better plan for me long term and it was something that was going to happen eventually. I was so in love with my previous unit and I started there as a new grad. It's been so hard, I know this transition is good but I'm so heartbroken at the fact that I left at all. I am so excited to go to ICU and it was always a goal of mine eventually but I'm so nervous (but also thrilled), since there's such a huge learning curve, I can't possibly know it all, and these are super super sick kids! I finally felt really good/comfortable (not terrified of work every morning) on my previous floor and then I left just a few months later, and now I'm starting all over again and it's so overwhelming. I'm just having a hard time adjusting to the new environment, new place, new hospital and I just miss my old hospital so much. I know it's going to be good, and CVICU was eventually my end goal but I just am so sad 😢.
  13. stacylethani

    Night shift mentality: keep them alive until day team comes on

    Thanks for all your responses! So the situation was a kiddo in severe heart failure who couldn’t hold their temperatures. They kept dropping to 35C and at one point went as low as 33C. Most of the shift they were 34-35. I had utilized all warming measures I had available - increasing temp in the room, warming blankets, heat packs, etc. At one point the docs just stopped responding to my pages about the kids temps being low. I understand that they have a lot of patients and they don’t want to make changes but in my opinion, temps this low need to be addressed/fixed, especially in a heart failure patient. What do you think?
  14. I’ve been a nurse for two years on a cardiac step down peds unit. As I’ve grown as a nurse, it’s hit me how much pushback I get from doctors, team members, and charge nurses to make changes in the middle of the night when my pt isn’t looking good. Unless my patient is actively crumping, I get a lot of “we’ll pass it along to day team.” Or “it’s not an immediate issue right now, we can wait a few hours to address that.” It’s so frustrating as a newer nurse though because a lot of the time it feels like my concerns are not being validated. Then day shift comes on and states they feel uncomfortable with the patient and the team does 20 interventions. Sometimes it makes me feel incompetent even though I know what I’m doing at this point and feel comfortable on my floor, because of how much pushback I get. Yes, you can call an rrt if it’s bad, but i deal with a lot of chronically sick kids who always look bad. When “looks like crap” is your baseline, it’s hard to get you moved to icu. Ive just been so frustrated lately with the lack of action on night shift/the lack of concern. I don’t know what to do anymore. Almost every shift I come home frustrated that we didn’t do something else for the patient.
  15. Lately I've been getting put in this tough assignment pretty often where I have a well known severely delayed CP/DD kiddo on our floor. This kid is notoriously very difficult to take care of. Parents are super particular about care, the kid needs q2 turns and changes and is honestly as big as me. He gets agitated and cries very easily and is very difficult to calm down. I find myself getting super frustrated very easily when taking care of him. He wears me out so badly emotionally, physically and mentally. I feel so exhausted after a night with him because it's nonstop crying and whining and it feels like nothing I do to help him calm down is good enough. I feel like an awful nurse for feeling this way but I honestly just dread work when I get him in my assignment. Moreover, I've been moved from my original assignment multiple times in the middle of my stretch to take care of him on my second day. I dont know if I should talk to charge about it because I don't want to sound difficult or create problems or make them think I'm a bad nurse cause I'm asking for a different assignment. I am just so so tired. 😩
  16. stacylethani

    Seizure code blue

    I'm one year into nursing and the other night I had my second ever code blue, my patient seized and O2 sats fell to the teens, HR skyrocketed, she was apenic and blue. I called a code, and all I could think about was respiratory support. I immediately grabbed the bag mask to start bagging but her sats started coming back up and the seizure stopped. The code team finally got there and she was fine again. I didn't even think to make someone grab Ativan because all I was thinking about was that she stopped breathing, so I was so focused on respiratory support, I completely ignored the cause: the seizure. I feel so stupid and like I totally screwed up... the scariest part was that I was alone in the room the whole time because by the time the code team/docs/staff got there, he was recovering ������