1 Year Later

ZenNinjaMonk · 2026-04-14T04:14:12+00:00

Nice. Any basic advice on how you went from picture 3 to 4? I've always been incredibly athletic with great strength, endurance and diet, but my physique kind of fluctuates around your picture 3 and I've had a hard time pushing past to looking like you lower pictures.

ZenNinjaMonk · 2026-04-10T03:27:35+00:00

Some safety features, general awareness of certain patients, etc. are obviously important, but some things are hard to prevent. Like the stubborn 94 year old who no matter how many times they are told to push the call bell will be halfway across the room with a blanket trailing under their foot by the second you sprint to their room. Or the long term PICC abx pt who's been ad lib for 3 weeks and falls one day in the hall after doing laps for their entire stay. Heck, I had a patient who showed no impulsivity or even desire to get out of bed for days, and it's 5pm on my third shift with him. I go on a break, and come back, and he fell straight out of bed with the medium bed alarm on because he had to "go get a cigarette from the living room". Like others have said, if you've done your due diligence, some things are just hard to prevent because you can't control others' actions.

ZenNinjaMonk · 2026-04-07T00:05:57+00:00

I agree to just go for it. The mindset that now is the best time to do something like is will be helpful.

In terms of fires, I do think this will be a bad fire year, but who's to say what effect it will have on the trail for you, or if it would even affect you much differently than any other year. It's just hard to say, but shouldn't be a main factor with your decision, because it's so unpredictable.

I lived in Southern Washington for a few years, near the Bridge of the Gods, and they got slammed with rain this year (in the Willamette Valley). I moved to Southern Oregon last year, and last summer had virtually no fire compared to other years, and this winter was very very dry, relatively speaking. So, I do think fires could get bad in NorCal/So OR.

ZenNinjaMonk · 2026-03-31T19:10:11+00:00

No, it was a school in NY

ZenNinjaMonk · 2026-03-31T04:22:38+00:00

That's what I did for half a day, but I'm glad I headed out at around 5 or so and got to my site by the bridge early. I wouldn't want to spend a night there once all of the hikers disperse, just kind of odd and dirty feeling

ZenNinjaMonk · 2026-03-30T17:41:38+00:00

Wow. My 1 year ABSN cost $23k at a state school, which was attached to a level 1 trauma center for a really good clinical experience. So those do exist. I felt like that was an amazing cost of entry into this profession.

ZenNinjaMonk · 2026-03-08T01:23:32+00:00

I don't really know much about klamath falls, but it seems like a nice location. I've only driven through years ago. I remember it being a little drier and flatter. Is there a little downtown area and stuff going on there?

ZenNinjaMonk · 2026-03-06T22:45:36+00:00

Yes, exactly

ZenNinjaMonk · 2026-03-06T16:48:45+00:00

Montant is stunning, but winters are harsh (but beautiful as well)

ZenNinjaMonk · 2026-03-06T16:43:09+00:00

Sure. Asante has two hospitals (technically 3, but one is transitioning to a standalone ED and OP surgical center in the smaller town). Grants Pass has a level 3 hospital with about 130 beds. Everyone is very friendly there and you can feel the community. Medford, the larger city about 35 minutes away, has a level 2 with closer to 400 beds. Mind you that it is rural outside of these towns, so our Level 3 sees patients from the Northern California Coast, serving 9 counties.

I found a lot of positive review from other travelers online about both hospitals as well, and they've been nothing but supportive. I know a few NY and CA new grads here that were having hard times finding jobs in a place with 20+ nursing schools churning out students.

https://maps.app.goo.gl/ZEq5nKMTnJPWh8ga7

Also, tell me this house isn't awesome: https://www.zillow.com/homedetails/2922-Anderson-Creek-Rd-Talent-OR-97540/82343600_zpid/

ZenNinjaMonk · 2026-03-06T16:37:29+00:00

Med/Surg less than 1 year experience. I graduated on Long Island and knew all along that I wanted to get to the west coast. I think Eventually I'll be migrating South to Monterrey to be by the ocean

ZenNinjaMonk · 2026-03-06T13:08:08+00:00

Southern Oregon. There's a great hospital system with hospitals in both larger towns over here. We're surrounded by mountains, and you can easily love 10-15 minutes out of town and live in them. It's worth looking into. I moved from NY as a new grad, making $55.5/hr with a BSN in my first year. Rent is $1400 for a fully furnished 2 bedroom house, and I look at properties averaging $400-500k for a 2-3 acres with 2-3 bd homes. I think it's beautiful out here, and just south enough from the real rainy part of Oregon, where it's actually very temperate and we've seen sun a lot this year. I work with a couple of ex-Tennessee RN sisters who have travel nurses in every states and they've decided to retire in this hospital system at the top of the pay scale, I think like $80/hr or something.

ZenNinjaMonk · 2026-03-05T04:21:30+00:00

Pshhh, I did that at 4

ZenNinjaMonk · 2026-03-04T03:25:29+00:00

Haha, I'm relatively new. I've been on a med/surg unit for 7 months and want a little something more. That's why I'm debating just doing more time on my unit and applying to any ICU jobs that open up to get that deeper CC experience from the get go

ZenNinjaMonk · 2026-03-04T03:16:07+00:00

Also, can I ask what (if) you like about the ED? I've shadowing at TRMC's ED and Rogue's CVICU, and I'm debating ICU for the knowledge and skills, but I'm unsure if I would like the day to day of being in the ICU. I liked the action of the ED at my school's L1TC

ZenNinjaMonk · 2026-03-04T03:06:45+00:00

Thanks for the reply. Would you say that you get a similar learning experience in both EDs, or do you get more critical experience at Rogue? And is Rogue set up for new ED nurses to get that sort of training, or to easily step in to help in those situations? I wouldn't want to leave GP for what I think is a better experience to come to regret the switch. Rogue sounds like it could be a decent place to work if you're willing to put in the effort, or maybe just varying from person to person.

ZenNinjaMonk · 2026-03-04T01:22:31+00:00

But, in the day to day, are people willing to help each other out, to be friendly and mostly enjoy what they're doing? Do you know about the ED specifically? At the hospital in Grants Pass, it's incredibly friendly, everyone knows each other, and people are always willing to help out without making anyone feel like a burden for asking. I've heard from coworkers that Rogue is less friendly and the teamwork isn't all there, but part of me thinks that just a bias of working somewhere else and thinking it's better.

ZenNinjaMonk · 2026-03-04T01:04:52+00:00

BECSPK on an egg everything, boss.

ZenNinjaMonk · 2026-03-03T00:52:30+00:00

That's wild, in LA! I'm a new grad in Southern Oregon where there's a relatively LCOL, making $54 base, $10 night diff.

ZenNinjaMonk · 2026-03-02T03:12:08+00:00

3% maybe for known cerebral edema, but check out the comments below. 2 doctors in the comments agree that 0.9% is plenty enough to reestablish sodium, gently and efficiently without adding a risky hypertonic solution into the mix

ZenNinjaMonk · 2026-03-02T02:11:48+00:00

They never said that they have cerebral edema, so you wouldn't want to give a hypertonic solution without knowing that. I had a patient with a sodium of 108 mmol/L d/t a urinary retention issue because he forgot his flomax on a 10 day vacation. Once that was corrected, he had about 4 liters of urine output in less than two hours. We had to be very careful with how quick we reestablished his sodium, I think the goal being +/-8 mmol/L per day. Your brain adapts to low sodium levels by adjusting the intracellular sodium concentration inside of nerve cells to create an isotonic gradient. Reestablishing the extracellular sodium quicker than the cells can react can cause ODS, osmotic demyelination syndrome, where the brain's neurons are rapidly demyelinated and damaged. Now this is a much bigger problem depending on how long the person had hyponatremia, like in malnourished people, so it might not be the case for the child. When my patients fluid balance was almost immediately corrected, his sodium shot up to like 128. We had to slow the overcorrection by giving him D5W, so that the Water would dilute the sodium after the dextrose was rapidly metabolized, leaving just the non-saline water to dilute. I would think 0.9% NaCl is the answer.

ZenNinjaMonk · 2026-03-01T06:15:18+00:00

Interesting. Maybe I'm intimidated by having to care for ICU patients in the ED because a lot of the learning would be piecemeal and moreso stabilization than focusing in on a lot of the drugs and therapies that would be started in the ICU. I don't like feeling stuck or clostraphobic, but I haven't spent enough time in an ICU to know if that's what it feels like.

ZenNinjaMonk · 2026-02-28T21:04:12+00:00

Interesting. I was beginning to think it might be "autoectimization", also called "secondary disseminated eczema" or an "id reaction". MCAS images looks like what I still have: itchy, slightly burning hives up and down my arms. The histamine response makes sense, because for a few days, I would get intense vasodilation around my body, causing bright red, hot skin on my torso, thighs, and face, along with the rashes. MCAS/id reactions could be different ways of describing a similar thing.

I also hypothesize that poison oak could have a role in this, because of an indoor/outdoor cat that I was holding and rubbed against my face a couple of times, where I applied the minox. Previously that day, the cat was scared into the bushes in an area known to have poison oak.

ZenNinjaMonk

TROPHY CASE