MYSTICOOKIEBEAR

Congrats! What managers are usually looking for are examples of leadership, examples of sound nursing judgment, and split second decisions that you made whilst using solid critical thinking that is based off of evidenced base practice. They want to k...

The ICU nurse that is assigned to the CVVH patient (1:1) is the primary care nurse for that patient and does all of the patient's care i.e. running the machine, baths, meds, etc. The CVVH/Dialysis Nurse does rounds and if the filter clots, does re...

That path that I took was Cardiac/Vascular/Thoracic Stepdown first as it will get you moving fast, thinking on your feet, using your time management, prioritizing, and getting familiar with EKG readings. After that I went directly into my Cardiac/Tra...

I'm gonna be honest with you, you will be in the same world of very critically ill patients but on completely different ends of the spectrum. You are already familiar with end of life and comfort care which can be a very big part of Critical Care Nur...

Broncophony and making the patient say "99"

Hello ladies and gents, I thought I would chime in since there are a few new to ICU RNs in this thread. I have made a few videos that help as a review for seasoned ICU RNs but I really have it tailored to the new kids on the block. As new ICU Nurses...

The Doctor has either A) Never experienced a patient on long term Neuromuscular blockers (which shouldn't even be a thing but sometimes there are extenuating circumstances) B) Too proud to admit that they didn't know. Per our hospital policy and phar...

Unless the patient had a lung transplant, had an esophagectomy, has active varices, the RNs do it. If we are using it just to decompress, we just listen and hook it up to LIWS, if it is watery and biley then it is safe to assume it is in the stomach....

MICU, definitely MICU!!!!!! Brush up on your Anatomy and Physiology (heart and lungs) as well as pharmacology especially cardiac meds (CCB, B blockers, Adrenergic Agonists, ACE, ARBS, Digoxin, Adenosine), the rest will come with on the job training.

Whenever I pull an A-line, I go straight up cath lab rules on it. Minimum 20 minutes of solid pressure usually 30 minutes, CBR and completely flat for 4 hours post pull. I sometimes cheat with reverse Trendelenburg. Too many times have I seen inadeq...

Hey brother, we have all been in that situation, but admitting and knowing your limitations is a step in the right direction to working on becoming better. When it comes to charting, get your vitals, Is & Os, and drips in because that information...

I have seen it and have been part of the decision to move people to the CVT step down from my Cardiac/Transplant ICU. First and foremost our patients come first and if an RN shows an inability to competently practice safe ICU nursing even with guidan...

I respectfully disagree. If there is an issue with incompetence in one of my coworkers, it affects us all, and is something that needs to be addressed immediately. In times of high stress, which happens quite often, I need to know that my teammates w...

In a septic patient, the body's natural response to any foreign invader (bacteria, fungi, etc) is to massively vasodilate in order to dilute and spread out the invader in order to more easily destroy it (think how tough a roman phalanx is and how muc...

If it was an LTAC with patients who have been on the vents and have been stable on them for months, maybe. But in an ICU setting? Absolutely not. Unless it is some new progressive place that is trying to pilot a new program where there is one nurse ...

35? Absolutely not! If you are interested and want to increase your knowledge, skill set, and your nursing abilities, go for it. It is a very fun world to get into, it is scary, exhilarating, and exciting all mixed into one. If you were say 62 and we...

I recently had a patient on VV ECMO at 100%, on the vent at 100%, Nitric at 40. The spO2 was 92% but the PO2 was 52. So the spO2 is not the end all be all, it definitely helps to have both to guide and direct your team's plan of care. Not only that...

I am proud to have you as a colleague in arms in this small but very important world of Critical Care Nursing

500mL bags?! Woah. I guess that would be nice for the patients on rocket fuel with vaso @ 0.12 (Canadian Fellows brought that into our practice ) but I have actually seen it work so I can't really knock them on it. Our bags are only 100mL and running...

You had a perfusionist at the bedside 24/7?! Lucky!!! My First deviced patient was an ECMO/IMPELLA. Mind you, I had never had either and lo and behold I had both, in front of me, in the same patient! Oh and as a kicker the patient was on CVVH as w...

5 Years? Congratulations, that is more than most people last on the units . I completely understand where you are coming from, I know what you are going through, and know how stressful it can be. But for me, those are the nights that I live for and l...

Having worked on a CVT Stepdown and now a Cardiac/Transplant ICU, I would recommend you go into the Critical Care arena. The Units is where a lot of the action is at, you get to work on your time management, use your brain for critical thinking, and ...

First things first, CONGRATS! Getting a job offer before you are even finished with nursing school is a very big deal and at Cleveland Clinic no less! Directly out of nursing school I started on a Cardiac/Vascular/Thoracic step down in a top 10 hospi...

I mean this in the most respectful and encouraging manner possible, leave that hospital system. A hospital system that truly does not care about their ICU RNs, ratios, or patient safety is one that no ICU RN should ever work in. That is a dangerous s...

When you meet everyone stand up to shake their hands and introduce yourself and for the love of God try to remember their names. Be nice, be cordial, be honest, as much as possible try to come off as a team player, someone that is hungry to learn and...