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emmjayy ASN, RN

ICU, CCRN
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emmjayy is a ASN, RN and specializes in ICU, CCRN.

emmjayy's Latest Activity

  1. emmjayy

    MICU Report/Brain sheets

    I don't know how to upload my sheet, but I like to know drips, lines, drains, vent settings, diet (usually a tube feed), skin issues, Tmax, blood sugar frequency, rhythm, lung sounds for previous nurse, last neuro assessment findings of previous nurse, and a space for ALL the labs (ABG's, CBC, CMP, ICA, coags, and other randoms like lactic acid, troponins, pro-BNP, etc.) - and multiple columns so I can trend the labs on my sheet instead of having to log in to the computer and look back to trend them. I keep the back blank to write down the patient's PMH/HPI/24 hr events, and imaging (date, type of imaging, results). I usually just write all this stuff down at the start of the shift and then never refer to it again but it does help cement it in my brain and gives me a starting point for when I report to the next shift (e.g., at the start of my shift the patient was on 50 of propofol and 15 of levophed, I got the prop down to 10 and the levo is now off). It's really a matter of what works for you though. If you are coming from med-surg, you probably already have a system that works that will just need a bit of tweaking. At the beginning you will be very dependent on your report sheet though and may even want to have one with boxes for each hour so you can annotate meds that are due, labs that need to be drawn, things that need to be assessed, etc. I also used an hourly box method to write down hourly I&O's/temps/blood sugars/etc. when I didn't have time to log in and chart them in the moment.
  2. emmjayy

    What does the floor really think of nursing students?

    I've had mixed experiences with the students I've gotten. Very rarely do I get a student that I enjoy and get to teach things to. Most of the time they are just lazy and on their phones constantly. I hate that and I will give any student who does that a really hard time (recently told one that she had the option of putting her phone away and learning, or exiting to the locker room until she could tear herself away from her phone while I wrote her clinical instructor an email about her behavior). I'm an ICU nurse so it's like... hello, come learn about this incredibly unstable patient that I am attempting to fix because I KNOW you've never seen anything like this before. I find that a lot of students in the ICU are "code-chasers" and don't really care to learn about what it takes to prevent someone from coding... they just want to do CPR. I love to teach about drips, EKG's, lines, pathophysiology, how to correlate lab values to patient's symptoms/meds, etc., but I hate it when I am all geared up and ready to teach and the student just sits there texting or scrolling through Instagram because the patient isn't actively coding.
  3. emmjayy

    Saying No to extra shifts, is it bad if you're new?

    Heck no, you should not work extra if you don't want to. I have been a nurse for 1 1/2 years and can count the number of times I've picked up extra shifts/overtime on one hand. I speak up about schedule abnormalities too, and absolutely refuse to be screwed over when it comes to holidays, being scheduled for shifts that I wasn't hired to work on, etc.. As a result, I am just as happy with my schedule as very senior staff are, while my peers are miserable and angry all the time. However, they let themselves be screwed over by management and never speak up for themselves, so they will continue to be taken advantage of until they realize their worth and go to bat for themselves. There is NO REASON for you to work when you don't want to and NO REASON for you to be constantly shafted when it comes to scheduling, either. Speak up for yourself and don't feel bad at all. This is just a job, friend. If you died tomorrow they'd have someone else to replace you within a week, so don't burn yourself out for a job where you are entirely replaceable!
  4. emmjayy

    Interested in IR nursing

    Awesome, thank you for this. I think it will help me to realize that I'm just giving them meds to take the edge off and make the procedure comfortable, rather than doing it to knock them out and keep them from self-extubating or hurting themselves/staff :)
  5. emmjayy

    Interested in IR nursing

    Anyone have anything to add to this? I have gotten burnt out, absolutely fried to a crisp on ICU and am applying to IR (among other procedural areas). I don't think I mind the sound of taking call, am familiar with sedatives, and am detail-oriented to a T. In the ICU, I watched over my patients through many types of bedside procedures, so I feel familiar with timeouts and documenting new lines/drains/etc. I've also managed plenty of reactions as well. The only thing that I am really worried about is administering the moderate sedation without the safety net of a breathing tube in case things go too far. I'm worried that my time in ICU has maybe desensitized me to what a good dose of midazolam/fentanyl is for someone who ISN'T intubated.
  6. emmjayy

    GCU RN-BSN 2019 Capstone

    Hey, all. I don't know if we have any other folks struggling through the GCU capstone course right now, but what the heck! It seems like the most pointless busy work. I was under the impression from other posts on this forum that we would be writing a substantial (20+ page research paper) but the final submission for the class is a 1,000 - 1,250 word paper plus all sorts of B.S. documentation of the 100 hours that we supposedly completed along with a journal and some stuff that our mentors are supposed to rubber stamp. I'm on week 4 of 10, praying that I can get through this with my sanity intact. I've definitely had some poorly designed and frustrating classes, but always seem to come out the other side with A's, so I'm hoping to keep this going for the next 6 weeks so I can graduate and say GOODBYE to continued formal education.
  7. emmjayy

    Social Media and Doxxing - Your Thoughts???

    I went through a crazy long process getting rid of Facebook... first I downloaded a complete copy of my Facebook data for my own records. Then, I went through and used a script to delete every comment/like/interaction I'd ever made (this took two weeks, even using a script!!), contacted every person who'd tagged a photo of me and asked them to take the photo down, untagged myself if they refused to remove the photo, used the script to delete every status update, downloaded all my photos and then deleted all of them, changed the contact information I couldn't delete to fictitious email addresses/phone numbers, and basically turned the account into a completely empty "shell" account. I then changed the name on my account and let it sit for awhile before I used the permanent delete option (e.g., don't log back in for two weeks and your access to the account is gone forever). The purpose of letting it sit empty with a fictitious name was to hopefully give FB the opportunity to perform a routine back-up of my account and hopefully over-write their saved copy of my full account with the empty shell account. I truly mistrust Facebook's use of my data and wanted to give myself as much of a chance to cut free of it as possible. This may seem sort of crazy (I can acknowledge that ) but during that process I learned just how much Facebook intrudes on your life. It is devilishly difficult to extricate yourself from the site, they purposefully make it tough for you to mass-delete things or truly control the privacy of your information. They save information on you that you really have no idea they were saving until you go looking to find out about it. I'm sure it's only gotten worse over the past couple of years, as well!
  8. emmjayy

    First-time ICU preceptor: any tips?

    Here for the comments. I have just been tapped to precept a student during their capstone placement just before graduation. This is not quite the same as training a new hire but is still kind of intimidating and overwhelming to think about, since I have been in the ICU for just over a year at this point! I do vividly recall what being a student in the ICU felt like, so I want to try to make sure I make the student feel welcome, explain everything that is happening, etc. I am a little nervous about explaining all my thought processes because I feel like much of what I do is instinct at this point and it may be difficult for me to slow it down and talk through what is happening. I am also feeling a little insecure now about my knowledge, because I will have to explain the why's of everything and I want to make sure I do a good job! It is going to feel a little weird, watching over my patients and watching over my student to make sure she has a good experience and learns a lot. I think I am going to learn a lot as well, since I will be brushing up on a lot of things to ensure I can teach them successfully. I think my strategy will be to encourage my student to ask questions and to have her first follow me and watch/ask/perform assessments with me, then start having her perform some of the tasks with my supervision while discussing why we're doing them. I'm really big on tracking and trending labs/vitals/I&O's as well, so we will definitely do a lot of that while correlating to the disease process we are dealing with and talking through what our next move will be. I never really realized how much thinking and knowledge goes into critical care until I had to start thinking about how I'm going to teach these things to a newbie!
  9. emmjayy

    Social Media and Doxxing - Your Thoughts???

    I hate social media as it exists on Facebook, Twitter, and Instagram. I think people over-share, are addicted to the attention they receive on it, don't think through the consequences of their (virtual) actions, and rely on it as a crutch to make themselves feel validated or worthy. As a nurse, I never post a single word about my job on a forum where I can be easily identified. Even here, I shy away from posting particulars about patients/situations. I used to be sort of prolific in discussing patients (no identifiers) on here, but reeled it back in when I sat back and thought about how I really have no idea who is reading my comments. I pretty much stick to commentary such as this, and commiserating about nurse burnout in the ICU section. I deleted my Facebook permanently about two years ago, don't miss it in the slightest or regret this action. I still have an Instagram account, but I don't even mention that I'm a nurse on it and mainly use it to post cute pictures of my dog and family when I feel up to it. I don't think that social media (esp. media that can be linked explicitly to the user) should be used as a therapy substitute, a platform from which to complain about your job at great length, certainly should not be used to discuss patients, etc. These are my values and I try to stick to 'em. Can't make anyone else follow suit, but I do highly recommend it for your own piece of mind! It's a crazy world out there, anything you can do to decrease the crazy you invite into your corner of it can only be a good thing!
  10. emmjayy

    Regret after starting ICU?

    I went in as a new grad, am almost a year and a half in, realized about six months ago that this is not for me. I am sticking it out a few months longer because I want to get my CCRN (scheduled in less than a month!!) and I want the pay raise my facility offers that comes with a certification. I am not the type of person who makes quick moves, though. I've always been more comfortable staying in the misery that I'm familiar with rather than moving into a situation that holds unknowns until I'm 100% ready. I have been looking around at other jobs for awhile, but am definitely going to stay put until I have my next step figured out. The one thing that has helped me feel less miserable is that I'm formulating a plan for getting out rather than just trying to push on.
  11. emmjayy

    Transition out of critical care?

    Thanks for sharing this! I did not really consider PACU because at my hospital, the general consensus is that you should have at least 3-5 years of ICU experience before trying to go to PACU. I will look into it, though, as I believe they have some open positions right now and I have heard that it is a different pace and flow compared to the ICU. I am considering NICU (already have an application that I am working on for it right now), but am just hesitating because I don't want to jump out of the frying pan and into the fire emotionally, so I will review that thread per your suggestion :) In the outpatient centers, the job description says that the nurse is responsible for administering and monitoring the patient under moderate sedation. Obviously, my job in the ICU involves much more than that (initiating, monitoring the effects of, and titrating many different kinds of drips), but I doubt there will be much mixing of norepinephrine drips in the general outpatient world, whereas I know moderate sedation is very common. I just don't want to lose the skills I worked so hard to get!
  12. emmjayy

    Transition out of critical care?

    Hi, all - I posted about feeling really burned out on critical care back in February or so in the MICU/SICU subforum. Things improved for a bit with switching to straight nights rather than going back and forth between nights and days, but I'm back to feeling horrible all the time again. I think part of it is the night shift, but I can't handle the thought of going back to days because of the stress level on days as well as the pay cut. I realized that watching people die practically every day is just wearing me out. Additionally, the personality games that have to be played to get along with management and midlevel providers are exhausting and as I've gotten to know the unit more, I've come to realize that there is a lot of unhealthy back-biting and gossip as well. I do feel that I've come to learn a lot and have a good amount of confidence in handling emergency situations/stabilizing sick patients, which is the upside of this experience, but the downsides are huge for me. My husband sat me down the other week and told me he thinks I need to leave this unit for my own sanity and I realized I have been crying every day I work, stressed to the max, and pouring everything into my job with nothing left when I come home to my family. I feel depressed. The other day, I had to get up and go back to work and I just laid in bed wishing I could sleep forever and that I would never have to go back to that job. If I've learned one thing in the past year and some change, it's that life is too short to take for granted and it's too short to spend at a job where I'm miserable. That said.... I went to ICU as a new grad. There is zero part of me that wants to work on a med-surg floor. I am considering NICU because the physical demands of that job are less and the positive outcomes are more frequent. I'm also considering endoscopy, interventional radiology, and outpatient surgery centers. I'm also sort of thinking about home care as well. Thoughts? Experiences on transitioning? I do still want to use my specialized skills if possible, such as administering moderate sedation. I would also like to maintain my independence, continue having 1:1 or 2:1 ratio, and having close teamwork and camaraderie with nurses and providers alike. It would really help my soul to experience good outcomes for my patients on a more regular basis, as well. Are there any other specialties that provide any or all of these things that I haven't thought of yet?
  13. emmjayy

    Women's Right to Choose

    As someone who had a baby as a teenager, after being raped by the "father", my position on the issue is that a baby's God-given right to be alive does not trump my (or anyone else's) government-created "right" to kill it. You can argue all you want, but you're never going to have enough snappy one-liners or paragraph-long posts about WOMEN'S RIGHTS to convince me that murder is cool, so I'm out
  14. emmjayy

    Women's Right to Choose

    I consider myself to be pro-choice. I support a woman's right to choose abstinence, birth control, motherhood, or adoption. This new law does nothing to curtail these choices, therefore I don't really have a problem with it.
  15. emmjayy

    Home Genetic Testing - Should You?

    Absolutely not. I remember that Facebook started out as good old fun and now it's just a data mining operation that sells your personal information to the highest bidder. I don't fancy having my genetic information stored and sold to whoever, which is what is definitely going to happen with these DNA testing companies.
  16. emmjayy

    Open visitation in the ICU

    My ICU has open hours and I hate it. I have had several situations where I've had to put my foot down and tell the family to leave because the patient was suffering due to the constant stimulation. For example.... we have an attending who doesn't believe in adequately sedating patients who are intubated and this particular patient was on just a touch of fentanyl - enough to keep him comfortable as long as he was not stimulated in any way. Of course, the family hovered over the bedside, calling his name, touching him, etc. and then came rushing to the station and yelling at me to help him because he was freaking out, tachypneic, coughing and gagging on the tube, etc. It was so frustrating. I politely explained MULTIPLE times that he needed to be left alone, that it was okay for them to sit quietly by the bed but that it was not okay for them to be agitating the patient, and that if he continued to be this way I was going to have to ask them to leave for his safety. They ignored me, I had them leave, and then they complained to my manager about my actions. Sorry for trying to achieve a restful night for your loved one rather than a night full of hypertension, tachycardia, tachypnea, and horrible discomfort. Soooo sorry. Ugh, I hate open visiting hours.
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