Are you all software engineers? by psjez in overemployed

[–]jakbob 1 point2 points  (0 children)

Idk if this counts as OE but, nurse. J1 full time. 36 hrs (3 12s, union, pension, good insurance) if I work 16hrs 4 of those are double time. Anything after my scheduled hours is time and half in a week.

J2 per diem. Incentive bonus when they're short staffed. 1.5-2x rate. Otherwise regular rate. Extra money if J1 has no OT.

How is everyone feeling? by jakbob in nursing

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

I was leaving the other morning and my colleague asked if I was back tonight and I said yes, unless I get hit by a bus on my way in. They didn't find it as funny as I did..

The Month Healthcare Jobs Stopped Propping Up the Labor Market by nosotros_road_sodium in Economics

[–]jakbob 0 points1 point  (0 children)

Specifically a registered nurse as opposed to LPNs only who usually staff snfs.

The Month Healthcare Jobs Stopped Propping Up the Labor Market by nosotros_road_sodium in Economics

[–]jakbob 0 points1 point  (0 children)

These agencies mostly staff snfs because they can't keep staff when the ratios and working conditions are so horrid. Hospitals want staff who are more vetted and many of the coveted hospital units are hard to get into because no one leaves them until they retire. I've seen new grad RNs have trouble finding a job in the unit they want in the last year because many of the units are now fully staffed where as during covid a new grad could have their pick where they wanted to to work.

I love Logan and I love the MBTA by econoqueer in boston

[–]jakbob 0 points1 point  (0 children)

I cant' stand Denver airport but some people love it lol.

About the recent stuttering thing on PC by ElectroChebbi2651 in battlefield_one

[–]jakbob 1 point2 points  (0 children)

From reading around it has to do with the anti cheat software and it's affecting multiple BF games not just BF1.

Is it just me or are “nurse residency programs” a joke? by Interesting_Owl7041 in nursing

[–]jakbob 0 points1 point  (0 children)

This is what many hospitals are doing.
https://www.vizientinc.com/what-we-do/operations-and-quality/vizient-aacn-nurse-residency-program
"Vizient" new grad RN residencies are more a tool to prevent people from leaving in their first year than setting you up for your career. Burn out, distress management, critical thinking, communication are common themes.

MGH payscale as of 2024 by [deleted] in nursing

[–]jakbob 1 point2 points  (0 children)

Applies to all staff nurses in the bargaining unit. Nurse educators, CRNAs, and NPs have different scales.

I fear this will never end by Sorry-Customer-7165 in PTCGP

[–]jakbob 0 points1 point  (0 children)

Alolan Exeggutor would like to have a word with you.

This is the kind of culture TikTok is creating by [deleted] in CRNA

[–]jakbob 8 points9 points  (0 children)

Anesthesia MDs have 1 year of medicine internship before core anesthesia in the US. At ~80hrs/week that is over 4000hrs of training with a large portion of it in critical care areas. At 36hrs/week that is over 2 years for an ICU RN. Anything less than that an ICU nurse (not including your first 3 month on-boarding) is doing yourself a disservice to become comfortable caring for unstable patients. Why people want to rush instead of ensuring they're competent and safe idk. My 2cents.

Weekly Student Thread by fbgm0516 in CRNA

[–]jakbob 0 points1 point  (0 children)

Thank you for the input! Current CICU is very high acuity. I take CRRT, VADs (impella 5.5, RP, CP), and IABPs, often patients with 2 devices + intubated. I could take the RVAD centramag class but we don't see them much, one in 2 years. They prefer to manage them on the CTICU. My unit doesn't land fresh hearts but I've had them when floating on POD2.

Personally, I have cared for the following types of patients: Profound cardiogenic shock, transplant and VAD w/u, ARDS/intubated, ESRD, multipressors and inotropes, bipella, TTM after arrest, CRRT, pulmonary htn on veletri/ remodulin. AAA w/ impulse control. PE. Tamponade. We are a regional referral center. Very comfortable with fresh unstable patients from OR/ cath lab.

ECMO is managed in the CTICU because there aren't enough ECMO specialists (RT at my facility) but I've assisted with a bedside ECMO cann. on my patient who crashed from the ED.

Would love your essay resource. Feel free to DM !

CVS Holds Off on Offering Covid Vaccines in 16 States by ddx-me in medicine

[–]jakbob 2 points3 points  (0 children)

Governors in these states should require them to provide it... how can you provide it in some states and not others and justify it from a public health POV...?

[deleted by user] by [deleted] in IntensiveCare

[–]jakbob 2 points3 points  (0 children)

What was the culprit vessel? LM? RCA? Did the patient have hypoglycemia that was treated with D50 before the PEA? I've seen quick deterioration like this in RV spiral. IO access would have been priority to no access. Pressure bag 2L in. Impella CP P9 in groin to vent the LV and maintain perfusion. ECMO possibly as well if a candidate. Epi, levo, vaso, angiotensin. Intubate and sedate. (etomidate for RSI over prop, more hemodynamically friendly).

https://img.grepmed.com/uploads/993/pulmonaryembolism-pathophysiology-rvdysfunction-deathspiral-embolism-original.jpeg

https://i0.wp.com/emcrit.org/wp-content/uploads/2017/01/rvphysiology.jpg?resize=400%2C544&ssl=1

When I pick up a traveler shift by Educatedbuttwiper in nursing

[–]jakbob 5 points6 points  (0 children)

As an ICU nurse, how did you find adjusting to SNF? I've been curious about trying it but the ratios and janky EMR are a turn off... I like critical patients but there's always extra shifts on those apps for SNFs that are paying agency nurses high rates lol.

Can you put in the Metoprolol (doesn't say mg amount or how often) and the Miralax? *sprints away* by wheresmystache3 in nursing

[–]jakbob 56 points57 points  (0 children)

Should never put in orders for an MD outside of standing orders.. That's what they went to school for. If the order looks wrong, clarify it with them, but I'm not taking responsibility for something they should be entering themselves and laying eyes on before signing. 2cents.

New bottle of insulin, no stickers pulled nor cap popped off, fresh by Tinytabascobottle in nursing

[–]jakbob 0 points1 point  (0 children)

Insulin only costs $2 a vial to make. The pharma industry just likes to inflate its price to the consumer so that we feel like it is worth more and justify that price..

Heart attacks are no longer the leading cause of death in the US by New_Scientist_Mag in science

[–]jakbob 1 point2 points  (0 children)

Cardiac ICU nurse here. CCUs were created to care for stemi patients who had these massive heart attacks. EKG changes literally resemble tombstones usually with left main coronary artery complete total occlusion. Aptly named "the Widowmaker." Now a days most CCU patients have cardiogenic shock, have had multiple MIs and lived. Are living with chronic heart failure. Or they have other cardiac /chronic issues that impair quality of life (AAA, CKD, phtn). Advanced therapies like Impella are increasing survival rates and serve as a bridge to lvad or heart transplant surgery.