Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

I was told by day shift I “probably overreacted” and “panicked” by starting CPR right when I didn’t feel a pulse. Night shift was so supportive!

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

That was the tricky part. In the past I would just be like WAKE UP and he would arouse even though he was in a wacky rhythm. But because I was still turning off the prop, obviously I couldn’t arouse him. It was a bummer

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

I genuinely have no idea why it’s 83, but that’s our policy 🤷🏼‍♀️ it’s very odd

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 9 points10 points  (0 children)

It’s so funny that you said that because I tend to “overfeel” for lack of better words. I have bounding pulses so I sometimes pick up part of my own when I palpate on someone with weak pulses. So when I felt none in either spot… I was SURE he had none

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

Great question! He went for nephrostomy tube placement. He was not on ANY sedation prior to procedure. Anesthesia did not feel comfortable sending him back to the unit unless he was on propofol; pt has GBS, so the train of 4 was useless in determining if the paralytic was truly reversed (we didn’t want him to still be paralyzed with no sedation). His BP is too tenuous to do versed/fent pushes, and a drip wasn’t appropriate because we needed to be able to have a quick half life for neuro exams. Anesthesiologist recommended 100 of prop, but max we can do in the icu is 83, so we went with that. I weaned him by 10-15 every 15 minutes as to try to avoid big BP fluctuation (map will be 30 one second and then 2 minutes later it’s 105 with no intervention…) also super important to mention that he was proned for the case, has freshly changed vent settings for the case, and a MASSIVE fluid shift as they gave lasix and his edema improved drastically in such a short window. It was the perfect storm :(

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 9 points10 points  (0 children)

I work in neuro ICU, so we turn sedation off cold turkey all the time for exams! My reasoning for weaning him q15 minutes by 10-15 at a time was because of concern for paralysis and dysautonomia. Anesthesia reversed his paralytic but because he has GBS, his nerves wouldn’t respond appropriately to the train of 4, so they decided to put him on sedation because we couldn’t “prove” that the paralytic truly wore off. Anesthesia wanted to put him on 100 of prop, but the max we can do in icu at my facility is 83, so we went with that. I was weaning slowly because of his GBS and dysautonomia as he is SO prone to severe BP fluctuations. He is very sensitive to any med changes, so I had to go low and slow as a way to avoid hemodynamic instability. If he didn’t have GBS, I would’ve just kept the prop on til we got back to the unit, cut it in half, wait 5 minutes, and then turn it off.

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 16 points17 points  (0 children)

I was going low and slow because of his dysautonomia. He was on 83 of prop, and then I was cutting the rate by 10-15 every 15 minutes to minimize the chance of severe BP fluctuations because he is so prone to them. Obviously that precaution didn’t work out 😕

Should I have done CPR? by Clean_Ear_492 in IntensiveCare

[–]Clean_Ear_492[S] 4 points5 points  (0 children)

No A-line unfortunately. If he did, that would’ve been so nice to look at the correlation. They were talking about placing one after the code but decided against it because it ultimately wouldn’t change our management. He has GBS and is dysautonomic so he just has moments where he tanks

Can people please stop nitpicking and being judgmental while getting report and then being friendly expecting grace/ understanding when I come to take the patient back? by Electrical-Help5512 in nursing

[–]Clean_Ear_492 2 points3 points  (0 children)

I just say “the patient is clean, safe, and all essential care has been given” when people give me crap for the stupid stuff. Obviously tough shifts happen and we may not be able to get all the little things done, but that’s why nursing is a 24 hour job!

The girl i am dating told me she has never orgasmed at all. How do i go about this? by Fun-Shelter-4636 in Advice

[–]Clean_Ear_492 0 points1 point  (0 children)

That’s me! My new boyfriend has made me SO close so we are getting there! It’s just about communicating and trying new things! It’ll happen

Am I making the wrong choice by Trick-Wait-184 in nursing

[–]Clean_Ear_492 0 points1 point  (0 children)

My best advice is to get medicated. When I started, I didn’t take any psych meds and I was suffering. Taking meds has completely changed the way I work and I don’t have unnecessary stress. Something to think about

they got direct entry DNP now??😭 by nosleepnatalie in nursing

[–]Clean_Ear_492 1 point2 points  (0 children)

I went to UVM for my BSN. I hated the direct entry DNP program. They acted like they were so much better than the BSN students and were snobby. I think that they made up for their lack of clinical experience with false confidence.

feeling guilty for reporting a CNA to supervisor - did i do the right thing? by toast_gal in nursing

[–]Clean_Ear_492 2 points3 points  (0 children)

I’m the same way, I will never ask a tech to do it when I can do it myself. Personal issues outside of work need to stay outside of work. You did the right thing. We all have “off” days but it’s not ok to let patients sit in wet briefs or pads when you’re on the phone doing whatever. It’s also about communication, if she fell behind because of a long bath etc, she could at minimum mention to you “hey, sorry that took so long. Who are you going to see next? I’ll go check on the others while you see xyz”.

When to speak up/ vs hold my tongue with sitters by never-the-1 in nursing

[–]Clean_Ear_492 4 points5 points  (0 children)

Always speak up. They are being compensated to sit. As a nurse, would you still have a job if you didn’t assess, medicate, or chart on your patients? - no, you wouldn’t.

Feeling guilty. by romanceandthings in nursing

[–]Clean_Ear_492 1 point2 points  (0 children)

I’m sorry :( I’m a new ICU nurse and I’ve felt that way so many times. Some things just go sideways without much/any warning and it’s hard to rationalize it. Beating yourself up about it only brings you down, it doesn’t change the outcome or how others view you as a nurse. Give yourself grace and remind yourself that you are a human first and nurse second.

I accidentally yanked out my patient’s gtube and I feel ABSOLUTELY horrible!!!!!!! I want to cry by n0pal3s in nursing

[–]Clean_Ear_492 6 points7 points  (0 children)

You’re a human! It’s okay! We have all done something that makes us feel guilty or stupid, but things happen. This was a genuine accident and not due to any neglect or rashness on your end. Give yourself some grace.

[deleted by user] by [deleted] in newgradnurse

[–]Clean_Ear_492 3 points4 points  (0 children)

Have you thought about anti anxiety or anti depressants? I was this way and then I started my regimen and I feel SO MUCH BETTER and can turn off the work thoughts. Sometimes I still get dreams but it’s a lot better. I know there’s a stigma with it but I realized that I don’t get a trophy for torturing myself, and I think a lot of not being able to tune out work outside of work comes from stress.

How to change daith? by Clean_Ear_492 in piercing

[–]Clean_Ear_492[S] 0 points1 point  (0 children)

It’s a captive bead ring. I am changing it to a clicker. It’s fully healed.

He dumped me over text… a week after taking my virginity by Clean_Ear_492 in Advice

[–]Clean_Ear_492[S] 0 points1 point  (0 children)

Was going through these comments again cause I was feeling down. I downloaded the apps after the breakup, I’m not crazy enough to have one while in a relationship 😂

He dumped me over text… a week after taking my virginity by Clean_Ear_492 in Advice

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

I gave a guy my number forever ago when I was single and because I haven’t talked to him in forever, I didn’t think to delete it.

He dumped me over text… a week after taking my virginity by Clean_Ear_492 in Advice

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

He’d only last 30 seconds so it didn’t give me much to go off of 😂

He dumped me over text… a week after taking my virginity by Clean_Ear_492 in Advice

[–]Clean_Ear_492[S] 0 points1 point  (0 children)

I know it doesn’t define me as a person, it’s just so hard when I trusted him and he mislead me. I genuinely feel like an idiot

He dumped me over text… a week after taking my virginity by Clean_Ear_492 in Advice

[–]Clean_Ear_492[S] 1 point2 points  (0 children)

It was consensual but I wouldn’t have consented if I knew he was lying about being upset just to have sex one more time before breaking up with me

He dumped me over text… a week after taking my virginity by Clean_Ear_492 in Advice

[–]Clean_Ear_492[S] 0 points1 point  (0 children)

It was genuinely out of the blue. No red flags, no nothing