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adventure_rn BSN

NICU, PICU
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adventure_rn is a BSN and specializes in NICU, PICU.

adventure_rn's Latest Activity

  1. adventure_rn

    Pediatric CCRN

    How did it go? I'm debating applying to take it in the next month or so. Also, did you have any delays signing up for a testing slot? I've been worried that it would be hard to get a testing appointment since so many people's tests were put on hold due to covid.
  2. adventure_rn

    new grad residencies or start working

    TBH, he probably just played cards all shift. πŸ˜‰
  3. adventure_rn

    floating medications in water to administer

    LOL, I know this post is several years old, but now I can't stop imagining all of the inmates getting their meds in brightly-colored, flavored liquid form like we do for the kiddos, slurping them up from oral syringes one-by-one. It would address all of Orcas considerations, though.
  4. adventure_rn

    Fact or Fiction?Β  Masking and CO2 Dangers

    It's a really interesting topic. I wish there was more actual peer-reviewed evidence instead of a bunch of supposition (not a criticism of the article, but a criticism of the situation as a whole). I don't dispute the surgical mask concept one bit--surgeons have been doing literal brain and heart surgery for decades while wearing surgical masks for several hours at a time, and it hasn't impaired their psychomotor abilities. However, I have far more concerns about the consequences of N95s. Even though CO2 can diffuse through the N95 mask, I'd imagine that it 'escapes' at a far slower rate than with a surgical mask. That would allow the CO2 to accumulate to much more quickly at higher levels, and would slow CO2 diffusion in the lungs. An ICU friend of mine told me that she and her friends tested their O2 sats both before and wearing masks, and they were the equal. However, even if their oxygenation is fine, I still worry about ventilation being impaired due to CO2 rebreathing. It's entirely possible for people to be well oxygenated and poorly ventilated, and it would be really interesting to check capillary gases on nurses before and after long stretches in N95s. The article states that once people become symptomatic, they can just take off their masks, and the symptoms will self-resolve. Unfortunately, unlike laypeople, most nurses don't have the luxury of just 'taking off the mask' whenever they don't feel well. Even if nurses get headaches because their N95s make them hypercapnic, they can't always ignore patient needs because they want a mask break. I really want to see concrete data about the functionality of reusing masks that were designed (and tested/approved) for single-use. It's hard to know how many uses you can get out of mask (surgical or N95) before they become less effective, since that's never been an issue in the past. In circumstances were masks are reused for weeks on end, I wonder if they actually provide much protection at all. I also wonder if after a certain amount of time, they become carriers of other nasty parasites; even if COVID dies on cardboard within 24 hours, the hardier bacteria/fungus from your mouth and face might still thrive on used, damp masks.
  5. LOL, yeah it's a huge pain. I've never found a better way, though. Just keep a really close eye on them, stick them back in when they tongue them out, and retape/reinforce q 3-ish... Sometimes it helps to tape in the corner of the mouth instead of the center since it gets a tad bit less slobbery.
  6. adventure_rn

    Stethoscopes?

    I know I'm late to the game, but you could probably just buy replacement tubing...
  7. adventure_rn

    Guns at the Bedside

    Absolutely not. Earning a driver's license gives me permission to drive a car--it doesn't give me permission to drive 100 mph in the wrong direction down the highway. Having a permit to carry a gun doesn't mean that you get to ignore the rules and carry it with you wherever you darn well please. SMH. People have rights, but to exercise those rights you have to act in accordance with the law. I understand the rationale behind personal gun ownership for hunting or self-defense, but there's no possible reason that it would be appropriate for patients/families to carry a gun in the hospital. Yes, I'm sure there's some liability to storing patients' weapons, but it's obviously a smaller liability than letting them loose in the hospital. If the weapons (or contraband) are illegal, they can be turned over by security to the police instead of giving them back to the patient (most commonly done with drugs). I applaud your determination (it sounds like something I would do), but respectfully, I think you need a better boyfriend. If he would truly argue in favor throwing a fit and getting trespassed/arrested for illegally bringing a gun into a hospital just to prove a point (instead of just leaving it in the car so he can be with his sick loved one), he sounds like a kind of a tool.
  8. adventure_rn

    Best States for RN's and NP's both in terms of pay and practice?

    Dude, last fall I specifically remember telling you that Seattle wasn't the financial panacea you were expecting because the cost of living is quite high (even compared to the higher-than-average salaries), and that it wouldn't be practical for you to live out of your van, shower at the gym, and eat exclusively at buffets due to the high cost of housing/parking/fuel/gyms/food, and the painfully long/slow commutes. You replied that I didn't know what I was talking about. This. This is what I was talking about. Living 'comfortably' in Seattle means paying $800,000 for a dated 3 bed, 1 bath, 1000 sq ft house, or about $2,200 a month for a 1 bed, 500 sq foot apartment. I know it it's fully maximizing your return, but it sounds like you've found a place where you're making 'enough' money and aren't entirely miserable.
  9. adventure_rn

    Disappointed New Graduate in Pediatric ICU

    It stinks when timing/acuity doesn't work out during your orientation. Unfortunately, all you can do is go out of your way to learn whatever you can, and keep moving forward. Not sure if you're at a facility that does peds surgeries, but once those resume, you'll probably see an increase in volume and acuity. At my hospital, PICU was down to < 1/4 census for over a month, but now there's a huge backlog of surgeries and procedures so they're slammed. In a sense, it may be better that the major covid shutdowns occurred at the beginning of your orientation rather than at the end. For now, you really should be focusing on the basics, and soaking up whatever knowledge you can. Even if things don't pick up, try to be kind to yourself. Your situation does stink, but I'm sure that your coworkers will be understanding. People recognize the current circumstances; if there are certain therapies you don't get trained to (ECMO, CVVHD, etc.), they'll make time to teach you whenever they come up. If the unit has a super-sick kid once you're off orientation, maybe you could ask to have a "buddy" shift to take that patient along with a more experienced nurse. I'm sure you're not the only one in this boat. For now, try to learn as much as absolutely possible given the current conditions. If anything exciting does happen on the unit (like a code or a procedure), be proactive about watching/participating. Ask your preceptor if they can teach you about the pathophys of the most common conditions/diseases on the unit, even if they're not currently present. Depending on how your unit does code carts (I.e. if they restock/lock their own), perhaps they could let you go on a code cart scavenger hunt. Also, If you have any downtime, read through the policies for the therapies that you haven't been exposed to yet (I.e. ECMO). Once you read through them, you can ask your preceptor questions, and maybe they can show you where to find supplies, how to set things up, etc. When I worked peds cardiac ICU, the nurses would occasionally have to cover for the unit secretary if we were short. Over a couple of 'secretary shifts,' I read through our entire policy book (30+ policies, 200+ pages). I ended up learning things that some of the most experienced people on the unit didn't even know, and it helped me figure out which questions to ask. Chin up!
  10. adventure_rn

    Temperature checks for Employees

    Same (except we get stickers for our badges--wristbands seem like an infection control risk...) Our 'touchless' infared temp screening is kind of a joke--my temp usually reads about 93-95 degrees (so, dead?) I'm sure if somebody actually had a fever of 102, the thermometer would only register as 98-99. Still, this allows the hospital to be 'compliant' and say that they checked. πŸ™ƒ
  11. adventure_rn

    I put the blinders on and am regretting it

    They try, they're just not very good at it. 4-year-olds, on the other hand, will kick the absolute crap out of you if you have to hold them down for shots or IV sticks. In all seriousness, when people say that they're assaulted on a daily basis, I wonder if they're referring in part to verbal assault and patients being rude or demanding. Honestly, some patients and families can be jerks, but that doesn't necessarily amount to verbal assault. It burns some people out over time, but others just start to ignore it. I think that a lot of it has to do with how good your unit and facility are about setting boundaries and enforcing behavioral contracts. If facilities allow patients to act out without backing up their nurses, patients will act out more often.
  12. adventure_rn

    Knicked et tube balloon tube while shaving

    We had something really similar happen in my unit. A pretty sick baby had just rolled back from an interventional cath, and while the entire team in the room, our very experienced RT straight up cut the balloon in half (I'm not quite sure what he was aiming for). He was a bit embarrassed and we teased him for about two seconds, but we just reintubated, the patient was totally fine, and nobody thought any less of the RT. The thing is, stuff like that happens. Sometimes the most experienced people do dumb things, and sometimes freak accidents (like the one you described) make us look like we've done something dumb. It happens to everybody. Even if people are talking about it, I don't think it's something that will follow you. Assuming this was just an isolated incident (not part of a sequence of similar issues), I doubt that anybody will think less of you overall. At the time, it might have been beneficial for you to pull the specific nurses aside and calmly explain what had happened as well as your thought process. It's way easier to nip it in the bud at the moment than to do it after the fact. Just make sure that you present it in a way that isn't purely defensive, because that will only make things worse. It's important to write an incident report for stuff like that, because that's how we track system-wide errors and make changes. It could be that your experience isn't uncommon, and that there should be a policy change related to shaving intubated patients. For the record, I think it's really admirable that you went out of your way to attend to the patient's hygiene. That stuff can easily be overlooked, or left for the next shift. It stinks that the actual process went pear-shaped, but it's still very thoughtful that you made the effort to do a good job for your patient.
  13. adventure_rn

    Married/Engaged Travel Nurses! I need your advice

    I'm sorry, I know that sounds really hard. There are couples who make it work, but only if they're both 110% on board, and it sounds like you have a lot of reservations. It's much easier to do as a couple if both people can travel together, but your concerns about quitting your job make a ton of sense (especially given the state of the economy and covid considerations). Have you talked to her about your concerns? I don't think what you're describing is being clingy, and not talking about it sounds like a recipe for disaster down the road. It's also quite possible that she will begin to feel lonely the longer she travels, and decide for herself that it's not worth the strain on your relationship. To be fair, up to one year isn't indefinitely--it's one year. One year of long-distance is tough, but having a definite conclusion might make it easier. I have a friend who is in a long-distance marriage; he's in vet school on one coast, and she's in NP school on the other. It's rough, but they make a lot of time to visit with one another, and they have a definitive date to look forward to when the separation will be over. There are some things that you could do to try to compromise. Maybe between contracts, she can take a full month off to spend some time together. Maybe every other contract, she can choose a city that's close enough so you can drive to see each other every week. Maybe when she makes her contracts, she can require that they block her shifts together so she can have some stretches off work where she can come see you. Unfortunately, it's also possible that she'll decide that having the freedom to travel right now is a higher priority to her than staying in the relationship. It would really suck, but coming to that realization might be better than making you wait indefinitely or stringing you along. Regardless, it would probably be very beneficial for you to sit down and talk about it. The fact that you're not on the same page about something that so deeply affects your lives/relationship seems like a bit of a red flag to me (just my humble opinion). It definitely seems like something to figure out before you get married.
  14. I'm considering applying to NP programs this fall, and I'm hoping to get some feedback. As experienced NPs, did you find that your school's name/reputation was helpful in getting hired as a new grad? I'm sure that this topic has come up many times on AllNurses, but I've searched through a few forums and couldn't find it. I know that as an RN, school "name brands" are pretty useless. However, over the last several years, I do recall a few NPs on AN saying that attending a reputable NP school was beneficial in the hiring process; perhaps it's because those specific NPs were hired by MDs (vs. RNs, who are hired by other RNs), and "name branding" is a much bigger deal in medicine than it is in nursing. I'm specifically interested in U-Penn's PNP program for a number of reasons: it's the only PNP I've found with a 'major'/concentration in my specialty of interest, it has rotations at one of the best children's hospitals in the world, it conducts classes in-person (though this may change post-COVID), and it can be completed in one year full-time. It also happens to be an expensive private school that is very well-ranked in both nursing and medicine (Top 3 in nursing, pediatric advanced practice nursing, and medicine). According to the website, the entire MSN can be completed for $55,000, although I'm not totally convinced. Upon graduation, there's a very competitive new grad PNP fellowship (entirely unaffiliated with Penn) that I'd love to take part in. Unfortunately, given my nursing background (primarily in NICU, not PICU), I wouldn't be the strongest applicant. I'm hoping that attending a well-ranked, reputable NP program with a unique, pertinent concentration would make me a stronger applicant for the fellowship. Any and all feedback is greatly appreciated!
  15. adventure_rn

    Coronavirus Second Wave?

    In the upper right hand corner, click on account, choose account settings (drop down menu), choose account options (button at top of screen), then choose ignore users (drop down menu). It is so tremendously satisfying. You’re welcome. πŸ˜‰ That is, by definition, an internet troll.
  16. adventure_rn

    The Dark Side of Breast Augmentation

    I'm kind of conflicted. On the one hand, I don't think it's anyone's place to judge what a person does to make themselves feel beautiful. For instance, women wear make-up and dye their hair all of the time, and nobody thinks twice. I wonder if people would feel differently in cases of breast-augmentation post-mastectomy; you're still putting a foreign object purely for cosmetic reasons, but people might be more empathetic in that case than a run-of-the-mill 'boob job.' On the other hand, I think it's kind of gross that plastic surgeons (and the 'beauty industrial complex' as a whole) literally turn a profit by encouraging women to buy into the idea that they aren't attractive enough when compared to completely unrealistic standards (photoshopped images portrayed by the media)...... I also agree with @Emergent that it seems problematic for people to undergo a procedure as invasive as surgery over something that's purely cosmetic. There are plenty of people who have died from plastic surgery, and their deaths were entirely preventable. Back when I worked in outpatient radiology, we had a plastic surgeon who was doing implants on an 18-year-old; he thought she blew a pneumo during the procedure, so he drove her to our outpatient, walk-in radiology clinic IN HIS CAR, and she ended up in the hospital. Plus, that doesn't even start to cover the number of people who are severely disfigured or permanently disabled by getting discounted, under-the-table procedures from unlicensed or fraudulent providers.
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