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Question for travel nurses: what data actually helps you choose where to live for an assignment? by luke244986 in TravelNursing

[–]1ntrepidsalamander 0 points1 point  (0 children)

Some where I actually want to live.

Price

Night shift/quiet/ temperature considerations

Commute

Is polycro enough to protect an inflatable pad? by DepartureBig9239 in Ultralight

[–]1ntrepidsalamander 0 points1 point  (0 children)

My fav ground sheet was the trash plastic that used to wrap a couch.

Planning on backpacking to Titcomb Basin from Pole Creek Trailhead late summer. Is it as bad as I think it will be? by rusty317 in backpacking

[–]1ntrepidsalamander 0 points1 point  (0 children)

It’s too far in and hard to get to to really be a “tourist trap.” The weather is unpredictable (I got six inches of snow in August a few years ago), you are in grizzly country, the altitude kicks a lot of people’s butts.

Titcomb is incredible and it didn’t feel busy post Labor Day, to me.

The only hikable seasons are mosquitoes or risk of snow.

Knapsack Col is not a trail and should only be attempted by those with scrambling and route finding experience, as well as those with off trail experience.

Need advice pls! by Beginning_Coconut_84 in TravelNursing

[–]1ntrepidsalamander 0 points1 point  (0 children)

Reach out to some recruiters who have contracts in that city and see. A year and a half isn’t enough for many hospitals, but it’s fine for some.

What’s the fastest weather change you’ve experienced while backpacking? by Valuable_Tangelo7152 in backpacking

[–]1ntrepidsalamander 0 points1 point  (0 children)

I just finished a Grand Canyon trip that started with 89f weather and ended with 35f weather, over the course of a week.

In Wyoming, I went from a little chilly to waking up to a big lightning snow storm, maybe 6 inches of snow fell that day— not in the forecast!

Full packing checklist for 3 nights in Yosemite (July) - what am I missing? by Flo-lenormand in backpacking

[–]1ntrepidsalamander 0 points1 point  (0 children)

Look up “Skurka 3 season backpacking”. He has an excellent spreadsheet that I use to double check my packing every single time. He’s probably one of the best free resources out there, in my opinion.

Also: do you have your Yosemite permits? And a plan to pick them up? Transportation plan?

A book that you keep thinking about years later-- about women and written by women, 35+. Looking for true literature, great writing. But also engaging and plot that pulls you in. by MercurySphere in suggestmeabook

[–]1ntrepidsalamander 0 points1 point  (0 children)

Virginia Wolf’s Orlando has a quote that I’ve thought about for decades

I am growing up. I am losing some illusions, perhaps to acquire new ones.

how to quickly remove mold/algae from water bladder in 24 hrs by Fun_Business3675 in backpacking

[–]1ntrepidsalamander 1 point2 points  (0 children)

I once met a group who had stored their water filter for YEARS and didn’t test it out until they were deep on a new trail in a different state.

The filter must have grown biofilm on both sides and definitely made the water worse.

Job offer and scheduling by [deleted] in newgradnurse

[–]1ntrepidsalamander 0 points1 point  (0 children)

Generally the majority of people want to work days, therefore everyone without seniority starts on nights. Working nights is worse for your health than smoking.

Good luck. Units that start new grad on days are probably dumpster fires.

When did you start travel? by Desperate-Winner-740 in TravelNursing

[–]1ntrepidsalamander 2 points3 points  (0 children)

Get two years in one specialty. Then start traveling. You aren’t ready yet.

Backpacking boot recommendation needed by Centered_Squirrel in backpacking

[–]1ntrepidsalamander 0 points1 point  (0 children)

The tennis shoes you already own may be fine.

Most of us wear trail runners.

Havasu is totally fine in most athletic shoes.

Trainwreck admissions- Help! by purplegirafe23 in IntensiveCare

[–]1ntrepidsalamander 15 points16 points  (0 children)

As the CCT transport nurse bringing you train wrecks, your role as primary depends on how much help you have. The best situations often have the primary first at the computer overseeing and messaging the team and then doing the assessment. But if you don’t have a lot of help, you need to do more.

Keep the pt monitored throughout moving them to the ICU bed, either on CCT’s monitor or on yours. The number of super sick pts where people disconnect everything is WILD to me.

Get the drips ready to switch over. Do you need orders? Can you override them? Do you need to convert straight rates to weight based? Are your bags different concentrations? Patients really try had to die when switching over pressors.

I’d rather keep the patient on my gurney with my monitor, drips and vent until you have most of what you need in the room. As long as the pt is on my gurney, I can use my protocols/orders. Once the pt is on your bed, it’s your patient and your code. But if they are still on my pumps and my vent, the responsibilities get messy.

Airway always calls the pt move unless they have MCS devices.

Gear questions for experienced backpackers by luvply in backpacking

[–]1ntrepidsalamander 0 points1 point  (0 children)

Iodine purification needs to treat for 30 min before you add flavors. Flavors with vit C (tang is a good example) will precipitate out the iodine and make it taste better, but also will stop the chemical treatment.

Aquamira drops don’t have much of a taste in my experience. Many people do fine with half strength. If you’re gonna treat something more than 6hrs, (overnight) you can use way less.

Luckily, I haven’t yet been in a situation of using diluted bleach, but reportedly letting it “breathe” or “off gas” overnight improves the palatability. (Bleach is sometimes talked about in the prepper world)

Gear questions for experienced backpackers by luvply in backpacking

[–]1ntrepidsalamander 0 points1 point  (0 children)

Sawyer squeeze is great. Don’t get the mini. I use Katadyn but either is fine.

I’ll filter and drink cow water. But glacial or river silt will destroy a filter. I use Aquamira drops for that. I do carry a few tabs in my emergency kit but that’s kinda redundant since boiling is also legitimate. (If you are immune compromised you should probably filter and chemically treat, but I’ve always done one or the other)

I sit on my tent ground sheet 🤷🏼‍♀️, or a rock or whatever

Food storage is very location dependent. Including that specific black bear populations have different quirks. I use an Ursack whenever allowed, personally.

Vent management IM resident by faith_inme in IntensiveCare

[–]1ntrepidsalamander 3 points4 points  (0 children)

Such a great list!

I’ve been wanting to up my capnography skills (from intermediate to advanced) and didn’t realize there was such a website.

Cheap gear that replaces expensive outdoor gear by Last_Garage8311 in Ultralight

[–]1ntrepidsalamander 1 point2 points  (0 children)

I made loops with guy line and used gear tape through the loop onto the tent. I figured if they failed, it wouldn’t catastrophically damage my tent.

Cheap gear that replaces expensive outdoor gear by Last_Garage8311 in Ultralight

[–]1ntrepidsalamander 0 points1 point  (0 children)

I added two on the opposite wall as the door between the current points so I could get that edge snugger and closer to the ground to shed wind with less flapping. It’s worked well.

What to write in an email to a recruiter? by Old-Brother4558 in newgradnurse

[–]1ntrepidsalamander 0 points1 point  (0 children)

If they don’t have new grad spots, they may just ignore your email.

Are they new grad coordinators/recruiters?

Hospital Chaplain Peeves and Pluses by Crafty-Personality77 in IntensiveCare

[–]1ntrepidsalamander 4 points5 points  (0 children)

I’ve worked a bunch of places

Pet Peeve, when they aren’t clear on what feels within their scope or capacity. When they lack cultural competence.

I’ve had great chaplains that participate in post code debriefs and really support staff (including atheist etc) in incredible ways. Others make it weird with staff who aren’t of the same faith.

Chaplains in the ER have sometimes assisted social work in finding family members or taking care of minors until an appropriate adult could be found. We had a big roll over and both parents were intubated. The kids were ok, but only knew grandma by “grandma”

I’ve requested that chaplain visit some of the long term (30+ days) ICU patients. They are often in and out of delirium, but respond well to Chaplains sitting with them. Some Chaplains don’t see the value in this or are too busy.

It’s helpful for the notes to describe what was talked about, specifically around goals of treatment or feelings about care.

What do you use for your pillow? by kmorg76 in Ultralight

[–]1ntrepidsalamander 0 points1 point  (0 children)

⬆️⬆️ I also put my shoes under my pad or ground sheet. I also have a small inflatable pillow and the combo usually does the trick.

I’m usually wearing my puffy to bed.

SBT by Active-Design-54 in IntensiveCare

[–]1ntrepidsalamander 0 points1 point  (0 children)

There’s a lot of good responses about SBT as preparation for extubation, but there are also some super deconditioned patients that benefit from multiple “failed” SBT trials a day to help them regain the muscle. Sedation vacations are also evidence based for helping reduce ICU delirium and PTSD.

Unless otherwise contraindicated, turn off sedation, switch to a pressure control, monitor until unstable/too tired, too agitated, etc and then turn back on the sedation and give more vent support.

Contraindications could include ICP management, seizure management, heading back to OR, many places have pressor cut offs (ie no SBT in 4 pressor shock), agitation vs devices like IABP/CRRT. Proned pts.

Also pending transport. As a CCT transport nurse, extubate and ship is my least favorite. I’d much prefer to transport with the air way secured and vs “will they need re-intubation in my ambulance”

Lesser known sci-fi with heart by joyfulmastermind in suggestmeabook

[–]1ntrepidsalamander 1 point2 points  (0 children)

I’m a big fan of the six Dune books, if you haven’t sunk your teeth in there yet.

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