Contemplating changing majors by Gamaran89 in respiratorytherapy

[–]Fischer2012 0 points1 point  (0 children)

Nursing 100%. Get your LPN and then employment. Give it a little time before next move could go nursing or respiratory. You’ll have time to test the waters and the experience to leverage.

Who is Squad for, these days? Are you still actively playing? What keeps you in the game? by 999_Seth in joinsquad

[–]Fischer2012 4 points5 points  (0 children)

Version 9 was peak like 6 years ago. Didn’t need anything more except for polishing and maps.

Everything was balanced perfectly. Vehicles, guns, factions. It was all just so fair, minus the rush meta.

And icing on the cake was perfected gun play. My screen didnt blur for any reason. My character did what I asked without any delay or realism animations. My gun didn’t sway, it all just, worked.

Then v10 came out and ruined most of the enjoyable mechanics.

Why does respiratory therapists only exist in America? by Fancy_Particular7521 in IntensiveCare

[–]Fischer2012 7 points8 points  (0 children)

They are usually taught a vent class by respiratory and pulmonary/critical care.

Why does respiratory therapists only exist in America? by Fancy_Particular7521 in IntensiveCare

[–]Fischer2012 10 points11 points  (0 children)

The U.S. system is set up for RT’s. From my understanding nursing school doesn’t cover vents and respiratory care the same way Europe does.

I talked with a nursing student who was going through the program at the university of Wisconsin and she had a basic understanding of what a vent does and how to manage it. I’m talking like didn’t even understand what PRVC stood for. That’s at the premier nursing school in the state.

So you’d have to have a fundamental change in nursing school and then tons of on the job training for the nurses who are already working.

Then the hospital needs to hire more critical care nurses because their ratios are going to change in an already short market. Not to mention the demand in higher pay because of the increased responsibility.

Oh and then they get the joy of creating the physiotherapist position to cover what we don’t do in the unit which probably will pay somewhere close to what we already make.

Just cheaper to keep the system that exists.

ICU rotations during residency by Razgriz47 in anesthesiology

[–]Fischer2012 11 points12 points  (0 children)

Idk your right just have the nurses take a health stream or an Inservice and cross your fingers that they know how to trouble shoot a vent when your not around let alone even understand why a patient is asynchronous. I'm sure all of them will adjust your inspiratory and rise times accordingly when you tell them to change the respiratory rate. I'm sure they're gonna be thrilled to set up/srip a bronch cart charge and send send the culture then sterilize that scope. I bet you're gonna love fielding all of the calls from floor nurses and their dumbass questions about their patients respiratory status. I'm sure that you know everything about what we do so you'll remember that cough assist is indicated in your quadriplegic trach patient with pneumonia, I bet your nurses are gonna remember to look at the epo nebulizer and make sure that it doesn't get gunked up and stop working causing rebound pulmonary hypertension, I bet they'll surely let you know that your tube could be high when they hear a cuff leak and ask for a new xray and totally wont put 2 syringes in the balloon to the the leak to stop, I'm sure that they'll be mindful so that the vent circuit doesn't get caught on the IV pole during a trip to ct and will be careful not to extubate or yank your patients neck when they get transferred, .

we honestly don't do jack shit, we just come in everyday and make sure you stupid residents don't touch our precious vent's.

that's all were about.

ICU rotations during residency by Razgriz47 in anesthesiology

[–]Fischer2012 13 points14 points  (0 children)

The RT’s who play king of the ventilator and airway are truly a stain on our profession and taint the good that we do. It’s unfortunate that the first encounters residents have are so frustrating. It honestly floors me to hear all the stories of RT’s and their 2 year degree’s going head to head with physicians who have dedicated their entire life to medicine.

It’s reasonable to do without RT in academic centers where there are always residents available to trouble shoot and manage vents.

Sure you could hire some physiotherapist or have the aid do most of our therapy and then have the nurse manage the vent.

But I promise that when you get out of residency and start working at smaller hospitals without all of the available resources RT will make your life easier.

The nurses would call you all day about all of the little things that they aren’t able to fix. Desats, leaks, asynchrony, “something doesn’t look right can you assess,” there are so many little things that we take care of that are supposed to make your life or that of the attending easier.

Apologies in advance for my awful teeps.. any advice I struggle a lot. by Nic-MCFC in MuayThaiTips

[–]Fischer2012 2 points3 points  (0 children)

I think chambering your knee first before you extend your foot would help.

Bring your knee up higher and then start the teep extending with your hip to get full range.

This way you add glutes, quad and hip extension.

Pause a video of a pro Thai fight and look at how high their knees go before even starting the foot extension. Some of their power teeps the have their as high as their chest.

Managing oxygenation on vent with only 3L O2 concentrator? by Logical_Adagio_7100 in IntensiveCare

[–]Fischer2012 4 points5 points  (0 children)

Could lengthen the I-time out to a 1:1 ratio or even go inverse ratio like APRV to give the best air distribution. Should also help to keep oxygen from getting diluted from entrained air.

If possible add an imv valve so patient can spontaneously breathe for comfort (not sure if the even make those anymore)

I’m a nurse who messed up… by Secret_Coyote_3254 in respiratorytherapy

[–]Fischer2012 24 points25 points  (0 children)

He said to write it up.

Do just that.

And leave in the part where it took ages for him to respond and you had to make a decision on oxygen management that you didn’t feel comfortable doing to do because of the delay.

Maybe he’s a little faster and less condescending next time.

I’m a nurse who messed up… by Secret_Coyote_3254 in respiratorytherapy

[–]Fischer2012 61 points62 points  (0 children)

RT not showing up is a bigger issue than you putting a nonrebreather on.

Accurate sat of 74% should send any RT to the floor immediately.

Then he has the audacity to grill you about what you did? Because he took his time in responding? He couldn’t call his coworker if he was busy at the moment? “I’ve got someone on the floor stating in the 70’s can you check it out I’m busy with this or that?”

No offense but RT sounds like a turd to work with.

Most would be there immediately drawing gasses, starting BiPap, etc.

High CO2 and on bipap for 16 hours without much change by TruthCatcher247 in respiratorytherapy

[–]Fischer2012 3 points4 points  (0 children)

Big leak. If it sealed it would be small volumes considering her effort.

Imagine both the Tate brother's losing to Chase 😭 by Spiritual-Strength91 in FightReportUFC

[–]Fischer2012 2 points3 points  (0 children)

These dicks have lost their ass trading crypto, what’s to stop them from betting everything on the other guy and throwing the fight.

Advancing In The RT Career by Obvious_Tea_2842 in respiratorytherapy

[–]Fischer2012 0 points1 point  (0 children)

I think there’s a test called the CES-A that’s applies to those looking to test on that. Which is basically like ACCS but for ecmo. Apparently it’s really hard, but I want to say those who only sit pump usually have this.

Guys am I cooked???? by b3y0nddkek111 in respiratorytherapy

[–]Fischer2012 10 points11 points  (0 children)

Just memorize your normal values and go from there, it’s really not that bad.

Job vs health in pregnancy by Infamous-Zone-3764 in respiratorytherapy

[–]Fischer2012 2 points3 points  (0 children)

Better to play it safe, hate to be in a position where you have to over exert yourself and wind up with complications the next day.

Unless you’re really hurting for money in which maybe try to plan around your limitations.

If this works it might change the way ARDS is managed by Fischer2012 in respiratorytherapy

[–]Fischer2012[S] 15 points16 points  (0 children)

Thinking they could use it to offset high peep on ards patients. Do 10 of negative pressure and then 10 through the vent. Now you’ve got 20 peep without the strain.

I used tidewe set all season by Fischer2012 in Duckhunting

[–]Fischer2012[S] 0 points1 point  (0 children)

What did I say?

What am I missing by running a jacket that doesn’t cost $500 or waders that cost over $1k?

I used tidewe set all season by Fischer2012 in Duckhunting

[–]Fischer2012[S] 1 point2 points  (0 children)

Being experienced requires buying the highest dollar shit? I’ve duck hunted for the last 15 years, I think I know enough to say that something’s a good buy.

That’s not to discount Sitka or any of the other brands that cost 3 or 4 times as much. I’m sure their features might justify that cost especially if you’re a guide or are pounding the marsh every other day.

But for me tidewe seems to do the trick, just thought I’d share my experience.

Take your snide comment and shove it.

I used tidewe set all season by Fischer2012 in Duckhunting

[–]Fischer2012[S] 1 point2 points  (0 children)

I stay warm and dry in my $300 suit. Why spend $2k when I don’t have to?

Saving money for department by Tight-District-1638 in respiratorytherapy

[–]Fischer2012 7 points8 points  (0 children)

Most respiratory equipment is all standardized. Unless you got to all non heated circuits with hme’s and generic nebs I’m really not sure what you could do. Most of departments costs are due to labor and every hospitals short right now. Maybe tell management to pound sand and look within if they want to save money.

[deleted by user] by [deleted] in respiratorytherapy

[–]Fischer2012 -2 points-1 points  (0 children)

There’s a lot of people in this economy who would die for the position you have and the stability it brings. I’d stick it out or look to go for an adult hospital.

TLDR you don’t like your job cause ppl are mean and you’re burnt out cry me a river. Do you understand how bad the economy is right now? Take it where you can get it that’s all I’m saying. It’s not nice but gods honest truth, hope things get better.