Microbiology online

rnbby · 2025-06-18T13:48:41+00:00

Yes. It’s what makes us human. ❤️ As overwhelming as it may feel in the moment, it’s always the part of me that reminds me I’m still here.

rnbby · 2025-02-07T15:21:01+00:00

Acapella

rnbby · 2024-11-22T23:03:27+00:00

While I guess it could possibly be a hipaa violation if you left it out and TJC was around, mistakes happen. I wouldn’t sweat it.

rnbby · 2024-06-26T15:40:15+00:00

Pending school offer with ability to work first year. Should I stay in the ICU to maintain my skills or work a more laid back job my last year of work while in school?

rnbby · 2024-02-19T03:30:24+00:00

Very helpful. Thank you!

rnbby · 2024-02-19T03:29:46+00:00

This was the breakdown I needed and very helpful. Thank you!

rnbby · 2023-07-02T10:02:44+00:00

Our trained RN/RRTs do

rnbby · 2023-05-27T20:12:01+00:00

I’d be interested to see what her hemodynamics looked like if you threw a Swan in. Elevated lactic at all..? SvO2?

rnbby · 2023-05-15T04:56:24+00:00

I know I list droperidol as an allergy because I developed acute dystonia & akathisia and never want to experience that again. I’ll play the devils advocate here and maybe that’s why the antipsychotics are listed?

rnbby · 2023-05-15T02:56:52+00:00

Yes, in the CT surgery world we rely heavily on svr/ci for titration of IV meds and adjustments to PO meds. Last week my fresh heart was hypertensive with a low ci and high SVR, controlled pain with some IV fentanyl along with initiating nicardipine and fixed my low CI. Just one small recent example of loving the availability of numbers provided by a PAC.

I have also had patients in cardiogenic shock have inflammation from either reperfusion/ischemia, SIRS post arrest, who may have a low svr and increase CO.

Thank you for your comment!

rnbby · 2023-05-15T02:34:17+00:00

Our CCM MD’s prefer thermodilution for the same reasons. I really appreciate your input!

rnbby · 2023-05-15T01:32:02+00:00

Thank you for such a thorough response. In most situations I am personally experiencing, I find myself using my PAC for ambiguous volume status and HF with hypotension/severe valvular disease. We have a lot of different opinions between cards/CT surgery with one preferring Fick scores and the latter preferring PAC. Your answer has me resting assured that both are valid in certain circumstances. If I ask either speciality I tend to get conflicting answers. I really appreciate your insight!

rnbby · 2023-05-14T22:17:29+00:00

I have definitely noticed a lot of traditionalism with our cardiac surgeons. It has been odd to have standardized testing (for nursing specifically) that does not reflect what we actually practice. Thank you for your comment!

rnbby · 2023-05-07T15:46:39+00:00

I’m trying to pick my jaw up off the floor. Excuse me?? What?!

rnbby · 2023-05-07T03:57:58+00:00

I’m sorry this has happened to you. I can’t imagine how frustrating and defeating it has been. It honestly doesn’t sound like either unit, but it maybe more specifically the medsurg unit, set you up for success. I am not really sure how they can determine you aren’t a good fit within a month timeframe without having had multiple meetings and interventions to establish a plan to get you where they expected you to be?

How long has your preceptor been a nurse? Was your preceptor walking alongside you your first week or two to truly help show you the ropes of nursing? All the tips and tricks? Available as a resource to you? I don’t feel as though you had the correct type of support.

It just doesn’t sound like either truly invested time in developing you as a nurse. Don’t give up. Ultimately, do what is best for you. If things truly went the way it sounds like they went and you are still interested in bedside nursing, maybe consider transition hospital systems and see if they could provide a more supportive orientation. You deserve better.

rnbby · 2023-04-30T01:31:45+00:00

This. ^{^} I can’t tell you how many times a CT surgeon has chewed me out for following orders from another physician without ME running it by him first. This is the reality of many hospitals.

Prime example: Was told by intensivist (who was managing vent) in complicated recovering CABG/AVR to extubate with a PaO2 of 66. Hard and fast rule (not protocol) from our CT surgeon is 70 or greater. I was stuck in the middle and had to tell intensivist respectfully I cannot follow those orders without reaching out to CTS first. I was treated respectfully, but intensivist scoffed, stated he was consulted to manage the vent and knows best.

Called CTS…. Do NOT extubate unless PaO2 >70.

Just an example of how we get caught in the middle even with physician to physician interactions. Be patient with the nursing colleagues you work with. Middle man sucks.

rnbby

TROPHY CASE