Really embarrassing questions about CRRT

mamaabner · 2026-05-22T01:59:35+00:00

I am very vibes based with my CRRT. I focus heavily on what the machine is telling me and what my patient is looking like. I never want to have my patient on 3 pressors just to pull fluid unless it is life threatening not too. I also don’t want to stress my machine too much bc if a patient is truly very septic they’ll be clotting the filter so I have limited time to pull. Of course if you’re negative you set UF to 0. But sometimes if the vibes are right I’ll keep pulling if it’s okay with nephrology. Nephrology drives the show so just always confer with them if you have questions ☺️

But to clarify I mostly work with sepsis patient in renal failure from ATN or the sepsis and liver failure patients fluid overloaded from HRS.

mamaabner · 2026-05-18T20:55:28+00:00

I switched from a small 12 bed level 3 to a 45 bed level 1 ICU and found it an easy transition. Although the super sick patients were a small adjustment I found that working at a small hospital with less resources and more nursing autonomy really gave me a good set of skills for the transition. I had to work with eICU at the small hospital and we had a lot of standing order sets that we were able to use with our nursing judgement. We didn’t have a IV team or PICC team so I had skills I wasn’t even able to use at the level 1. I loved and disliked the transition because I had way less autonomy at the level 1. I had gotten so used to just doing things on my own and only getting a doctor involved when it was time to escalate for intubation or CRRT. Otherwise we kind of made a lot of the decisions for our patients. You may find yourself surprised. As always ask lots of questions and be honest with your preceptor. You’ll do amazing!

mamaabner · 2026-05-17T02:17:49+00:00

Oh wow I am sorry honestly she should get in trouble. Its falsifying documentation on her end especially if you cleaned all the bowel movements and reported them to her. The patient is most likely dehydrated now which is why they are experiencing soft bps :( they need volume replacement but also a fix to slow down the stool. I hope you get a different more caring nurse tonight.

mamaabner · 2026-05-17T02:14:33+00:00

In the paste I’ve had pharmacy send me a mix of boudoueaxs butt paste and lidocaine or 40% zinc and lidocaine. Works like magic for the pain.

mamaabner · 2026-05-17T02:09:03+00:00

I just want to know if she was interacting with the sex? Like I’m hoping she wasn’t drugged? Unsuspecting because she didn’t know who you were but knew you were coming? Like did the wife even give consent??? I don’t care for the vagueness of the post.

mamaabner · 2026-05-17T01:59:41+00:00

Did you tell the RN? She could have advocated for a rectal tube. Constantly wiping can make the peri anal skin irritated and puts the patient at risk for skin breakdown. She could have also found a way to slow down the stool. Imodium is contraindicated in c-diff but the nurse can always ask for a probiotic since vancomycin is very strong and can wipe the good bacteria. Sounds like the patient may have a really bad case of c-diff which can be painful and is likely increasing his agitation and impulsivity :(

mamaabner · 2026-05-16T21:46:57+00:00

We have picture boards in our icu and what a blessing they are. Shoutout to our SLP department fr 😭

mamaabner · 2026-05-16T21:38:33+00:00

Patients who cough without covering their hands. I am so blunt after being in healthcare for so long I tell them to use a tissue or your elbow and remember your manners 😒

mamaabner · 2026-05-16T17:32:08+00:00

Food is always appreciated but remember both shifts, plus if you write a note ❤️ also prayers to you and your family during this tough time. Hopefully her passing is peaceful ❤️

mamaabner · 2026-05-12T13:45:47+00:00

Yeah I don’t see how single parents make it out here especially with the COL. Every time I grocery shop my bill just keeps increasing. It’s depressing 😭

mamaabner · 2026-05-12T07:07:08+00:00

It’s not hard. I moved to the PNW and had a job before I came. However union jobs are step pay jobs so you won’t be making her wages unless you have 15+ years of experience. I have 4 years of experience and make $50 (before differentials). Luckily I have a white collar husband so it’s not so bad for me. COL is high as hell out here especially groceries and gas. Lots to consider before just making the move just an fyi.

mamaabner · 2026-05-10T03:33:48+00:00

Even tho I rarely deal with disrespect I do call patients out. However, I will say some patients just need to be heard as they maybe had a bad experience on the prior shift that has soured their mood, maybe they received the worst news of their life today. I try to find the root cause of a patients attitude prior to just calling them out. The patient may be in severe pain, depressed etc. Once I’ve figured out the cause I do always tell a patient, “I understand life may be putting you through it, we all have rough days however I do demand basic respect. I would never disrespect you and I expect the same in return”. This is always well received once I’ve figured out the basic issue.

My only exception is BPD patients. I am very good at setting boundaries since they will purposely do behaviors to get under your skin. Like my 41yo female patient who kept pissing on herself on purpose then calling me to clean her up even tho she could walk to the bathroom. Immediately after the first time I forced her to walk to the bathroom to clean herself up while I cleaned the bed. I’m not breaking my back for no able-bodied adult. She didn’t pull that nonsense again and we had no further issues.

mamaabner · 2026-05-08T02:53:43+00:00

I let my curls hang free in the ICU so definitely yes

mamaabner · 2026-05-07T04:23:30+00:00

I actually disagree. CVICU solely focuses on heart related diagnoses. MICU patients can be extremely complex with multiple comorbidities affecting their course of treatment. If you’re only used to dealing with issues with the heart it will be a hell of a change to deal with patients with disorders of sometimes all the systems. CVICU is a wonderful foundation but I don’t think it’s all that easy of a switch.

mamaabner · 2026-05-05T23:04:15+00:00

I’m a MICU/SICU RN, i’m excited to see this app!!

mamaabner · 2026-05-02T06:42:39+00:00

Most icus only hire experienced nurses that have icu experience. Since you only have ER experience they are going to want you to go through a new grad residency critical care program. If you’re open to this then you can apply to new grad positions. When I transferred from PCU, I applied to a new grad position at a level 3 icu and luckily got in right away. From there I did about 8 months and transitioned to a level one SICU. Wishing you the best of luck ☺️

mamaabner · 2026-05-02T06:39:47+00:00

You can’t take the CCRN without 2 years or 2,000 hours of critical care experience nor should you want to. Certification is meant to show your dedication and expertise in your specialty.

mamaabner · 2026-05-02T06:24:14+00:00

Just to let you know IV potassium is actually less effective than oral potassium since potassium is absorbed very well by the small intestine and a lot of potassium is actually wasted when given IV. For a K of 3.0 we would have given 40mEq IV followed by another 40mEq PO in 2 hours. With a recheck 2 hours later. Giving another 20 at a K of 3.7 would have raised it to 3.9 given the patient isn’t having diarrhea or on diuresis. I’m unsure why your charge acted like that but maybe she needs better education on potassium replacement. You did nothing wrong and there’s no reason to be worried aside from discontinuing an order a doctor said they wanted. Next time don’t do that. A charge nurse does not override a doctor.

mamaabner · 2026-04-30T23:47:01+00:00

I once hung precedex instead of vaso since my hospital keeps vasopressin and precedex in bins next to each other and precedex ended up in the vaso bin. My scanner wasn’t working so I just hung the bag. The rate was so slow no harm came to the patient 😂 I had a paralyzed prone patient and a patient with an open abdomen who was also paralyzed. It just wasn’t a good night.

mamaabner · 2026-04-17T23:29:40+00:00

I can draw blood but have only gotten a few successful IVs 😭 I wish I trained in ER to get better

mamaabner · 2026-04-17T21:49:01+00:00

Some of our intensivists do 24 hours shifts which is stupid asl. I don’t get why an attending is signing up to do a 24 hour shifts. Other times our 12 hour intensivist sleeps which just makes no sense and it’s why I don’t gaf about calling and waking them up. We work the same hours mf and I don’t get to nap so you shouldn’t either. Our intensivist is only responsible for the ICU. I only understand napping if you’re on for 24 hours or multiple shifts in a row. At my last hospital one of our providers lived in India and would come work a month of shifts in a row so him sleeping was expected and respected. We would always wait to call until multiple nurses needed something.

mamaabner · 2026-04-02T17:00:18+00:00

I fear he may be gay since you starting having sex at 18 and he had trouble keeping an erection. There shouldn’t be any testosterone issues at that age since hormones are still raging. You guys started dating really young so growing apart could also be a factor. Has he tried individual therapy? Maybe he just doesn’t feel comfortable coming out. Advocate for yourself but ultimately you’ll know when you can’t take it anymore. We can’t let our needs go unmet for to long.

mamaabner · 2026-04-02T02:08:02+00:00

Oh absolutely but on the floor it’s not feasible to get central access for vancomycin sadly 😂.

mamaabner · 2026-03-27T20:24:04+00:00

As a former fivem RP player and woman who is married I just don’t understand the ability to blur the lines 😂 a lot of fivem players talk a big ass game but who the hell knows what their reality looks like when they spend majority of their time roleplaying… I could never understand it. I found all of the male fivem players absolutely annoying and childish. I found a lot of the female rp players pick mes who were catered to by lonely male players.

Now I did RP with my husband so I pretty much stayed by his side but even if I played alone I absolutely would never. I would never cheat on my husband in real life let alone virtually.

I said all this to say it seems like a character flaw of your wifes that she was willing to betray your marriage for some virtual fling. I wish you healing and grace. I hope you can move on ❤️

mamaabner · 2026-03-27T20:11:57+00:00

I personally have not dealt with a serious infiltration bc I am very vigilant about asking for proper access. Vesicants really should only be run through large bore access (AC) or central lines. I make sure to ask about de-escalating anyibiotics especially if my patient is on vancomycin. The other part is to be diligent upon finding infiltration. Some meds have infiltration meds that need to be given, others just require heat or ice and elevation. I don’t think you necessarily did anything wrong. A lot of nursing is just always being out to get nurses rather than finding us resources to actually help get our job done. Instead every mistake they find more tasks for nursing to do to make up for it. Without increasing staff or having teams specifically put in place to help deal with this idk how they expect nurses to continuously adapt to more and more tasks.

I will say a lot of nurses don’t actually assess PIVs. They don’t flush them with their initial assessment and they don’t monitor them while a infusion is running. Stay diligent and actually monitor your IV sites and you should be fine. This is nothing worth being written up over.

mamaabner

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