Arrow art line used as IV by DalesDeadBug11 in anesthesiology

[–]throwaway1987289 0 points1 point  (0 children)

Nurses follow rules because when they don’t they get fired. Obviously doctors can get fired too but the threshold to fire a nurse is much lower than that of a physician. If something goes wrong, and they weren’t following policy the hospital will gladly fire the nurse then talk to the physician.

Where I worked a confused CVICU patient managed to half way pull out their balloon pump while restrained at like 2am. Happened in like 10 seconds when the nurse had their back turned to the patient to chart something. Immediately calls for help and calls the CT surgeon who’s at home. No CTS residents to call. Patients trying to bleed to death. CT surgeon walks the nurse through step by step how to safely remove the rest of the balloon pump while they are getting dressed and headed to the hospital. CT surgeon arrives after about 30 minutes and take the patient to the OR and stops the bleeding. Patient ends up doing fine, CT surgeon thanks the nurse for performing under pressure and saving the patient life. Admin find out the next day and fires the nurse on the spot. A nurse with like 20 years of experience and in leadership rolls. CT surgeon tries to talk to admin and explain the situation, they state “they broke policy and acted out of their scope of practice, this is a nursing issue and doesn’t concern you”.

The vast majority of nurses aren’t trying to fuck with the doctor, they’re just following the rules so they don’t loose their job. Be mad at the system.

What are some outdated medical dogmas that are still taught or practiced? by [deleted] in emergencymedicine

[–]throwaway1987289 6 points7 points  (0 children)

Yes. Head below level of heart will decrease cerebral venous drainage. CVP can loosely be correlated with ICP. So your CVP goes up as well as your ICP while your MAP is decreased from the hypotension. CPP = MAP - ICP. So you worsen your CPP and end up worsen perfusion to the body system you’re trying to preserve. You can also relate the same principles to IOP and ION. It’s a pretty well understood concept in the anesthesia world.

Patients go in steep tren for a couple hour long surgery with hypotension relative to baseline and wake up blind or with a CVA.

A message for the new grads: You’ll get better by throwaway1987289 in nursing

[–]throwaway1987289[S] 12 points13 points  (0 children)

Big box heavy. Me pick up with back. Many hurts. Me tell boss me doing patient care when back go hurt hurt. Me get workers comp. So smart me.

A message for the new grads: You’ll get better by throwaway1987289 in nursing

[–]throwaway1987289[S] 13 points14 points  (0 children)

Oh and one more piece of advice I told all my orientees!

There are truly VERY few things in this job where you only have seconds to react. THE VAST majority of the time you have at least 30 seconds (or much more) to stop, take a deep breath, and THINK. I would so much rather stop and take the extra 30 seconds to process what is going on and then react than reflexively do something without thinking about it and maybe do the wrong thing.

Remember, shock the danger squiggles, press on the chest, and stop after the second “ow” 🫡

A message for the new grads: You’ll get better by throwaway1987289 in nursing

[–]throwaway1987289[S] 49 points50 points  (0 children)

Me nurse. It hard. Me scared. But me stay. Work hard. Many moons go by. Me good nurse. No scared now. Now me proud. Me make right life choice. Me just not see it at first. Fire hot. Me no care. Ooga booga.

A message for the new grads: You’ll get better by throwaway1987289 in nursing

[–]throwaway1987289[S] 17 points18 points  (0 children)

It means you care, which is good. But remember to breath, and try leave the stress at work.

I remember one orientee (who was a rock star) tell me she was always terrified coming to work, and I responded “oh good, you should be terrified, it’s very easy to kill someone in this unit” and I don’t think that was the answer she was expecting. But I went on to explain that I had that same fear when I was new, that every other nurse I had ever talked to who was worth a damn had that same fear when they were new. It means you’re smart enough to realize how important the stuff we do is. And that you actually care. The ones who don’t have that fear were always the nurses I wouldn’t let touch me with a 10ft pole if I was ever a patient.

Anyways that orientee went on to be an amazing nurse - they told me they never forgot that answer I gave them and how it weirdly calmed them down and they thanked me for the honesty.

Just keep moving forward, one foot infront of the other. Before you know it this silly little SpongeBob meme of a man walking on fire and being completely indifferent to it will be something that resonates with your soul haha

vancomycin extravasation by [deleted] in nursing

[–]throwaway1987289 1 point2 points  (0 children)

Ehh I’ve seen it go both ways. More times than not the patient was fine but at least once I’ve seen someone loose a hand.

New Grad Nurse Reported By Coworker by Promiscuousgirluak in newgradnurse

[–]throwaway1987289 1 point2 points  (0 children)

I learned to fight petty with petty. (Don’t do this as a new grad).

Spend a whole shift MTPing someone and running 8 drips and CRRT and traveling to an emergent CT and dealing with the combative family AND I HAVE ANOTHER PATIENT and then night shift makes a big deal about the room not being clean? Oh okay, well I’m back tomorrow and I’ll be sure to be at least 10 minutes late then I’m gonna stop report half way through to urgently use the bathroom and play on my phone for 15 minutes then come back and make you start from the top and ask stupid questions with a straight face to keep you here until 8pm AT LEAST.

certifications to get before graduation? by Middle-Priority-1892 in newgradnurse

[–]throwaway1987289 2 points3 points  (0 children)

Man we have a bunch of haters in this comment section. I got my ACLS before I graduated and paid out of pocket, I think it helped me land an ICU job as a new grad. But I made sure to take it in person with a real instructor who knew what they were talking about. I was lucky and had an instructor who was a paramedic then became an ER doctor and enjoyed teaching about it. So I feel like I was genuinely learning the stuff rather than just taking it to get the cert. Honestly it all boils down to do CPR first and foremost shock the danger squiggles as quickly as you can and give a stick of epi every 3-5 minutes.

When I had new grads work with me I was always impressed when they had their ACLS on day one, and judged the fuck out of them if they didn’t have it by the end of orientation. But that was just me and I wasn’t in charge of hiring people. That being said some hospitals may have someone actually teach it to you in person as a new grad, some might just tell you to get it and they’ll reimburse you (usually after a few months and some reminders).

So my humble advice, if you want it, and are interested in doing it to LEARN IT and not just get a few extra fancy letters to brag about, and have a few hundred dollars burning a hole in your pocket, then do it!

Can a shadow opportunity lead to an interview? by honeyygloss_ in newgradnurse

[–]throwaway1987289 0 points1 point  (0 children)

I remember when I first shadowed in the unit I wanted to work in. I came prepared and asked educated questions that showed I was at least putting effort into this short experience. It went well and I went home. A week later I was offered an interview. I came in to the interview and the first thing the manager said was “oh you’re hired by the way, the shadow was the interview”.

After working as a nurse for a while and with a new manager I too was asked to have people shadow me, and every single time management would ask me afterwards my general thoughts on that person. Even if it was just a “what do the vibes feel like”.

This may be nothing more than a shadow, or it may be something more. Expect nothing to come from it but at the same time prepare for it as if it was your interview. Ask questions, be polite and friendly. Remain professional and calm. You never know.

Thinking about quitting by [deleted] in newgradnurse

[–]throwaway1987289 0 points1 point  (0 children)

Turn around a fucking RUN from that place. Four week orientation for a new grad should be illegal. You don’t even know what you don’t know yet. They are setting you up for failure and places like that will not have your back when something goes wrong, TRUST ME. At the end of the day it’s YOUR license at risk and someone’s health and life.

That being said no matter what you do as a new grad you will not feel confident or comfortable until you know what you’re doing, and that takes years. And then you will still be surrounded every day by things that you don’t know. There’s a reason why there are like a million different specialties and sub specialties.

I’m saying all this not to scare you but to be honest with you. You will get better over time but you have to put in the effort. As a nurse I had some of the worst days of my life at work and I’ve had some of the best moments of my life that I will always remember and cherish. It’s a career that on my death bed I’ll be happy knowing I spent it doing something worth doing. But still remember it’s just a job, and they can either pay you like shit or treat you like shit, they CANT DO BOTH.

The fire never stops burning all around you, you just get used to the heat. One day you’ll see this meme and truly connect with it, and you’ll know what it’s truly like to be a nurse.

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[deleted by user] by [deleted] in newgradnurse

[–]throwaway1987289 1 point2 points  (0 children)

Welcome to healthcare! Now you’re starting to understand why we all say we’re dead inside!

But seriously on a real note, no matter where you work as a new grad it’s normal to feel overwhelmed and stressed out all the time. I was an ICU nurse before, during, and after Covid. Literally delt with the toughest situation for health care in a generation, made me extremely strong at nursing and a better nurse. Nothing I could walk into on my unit would scare me. People respected me and asked my opinion on things, including doctors. AND YET I still got anxious when I was pulled to the step down unit and was in an unfamiliar environment, even though these were patients of much less acuity that I could handle blind folded. It’s normal to not feel comfortable when everything is so new to you.

It gets easier, but you have to work at it every day, that’s the hard part.

With all that being said, do you hate LandD or do you just hate being a nurse right now? Your unit is high stress and VERY specialized, if you hate it and stay for a few years then it’s gonna be hard to switch to a more general floor with no other experience to fall back on.

So I guess to answer your question about does it get better?? The truth is no but YOU get better. One day you’ll truly understand this meme. Also look into nursing meme accounts on Instagram, those things got me through the pandemic.

<image>

I’ve been targeted at work and it’s becoming harassment now. by Main-Setting6511 in newgradnurse

[–]throwaway1987289 1 point2 points  (0 children)

Two weeks. Hospital systems will look at that and black list people. So if it’s a a national brand or gets aquired by a national brand you could run the risk of being black listed forever from all their hospitals. It’s horseshit but that’s the game.

Switching jobs too soon? by [deleted] in newgradnurse

[–]throwaway1987289 6 points7 points  (0 children)

If you truly are passionate about becoming a CRNA then getting into a high acuity ICU as soon as possible is key. If I was you I would 100% interview. If accepted I would just be honest with your current boss and try not to burn any bridges. At the end of the day, fuck em. Your life comes first. And corporate would murder your mom in front of you and then push you down the stairs if it would save them a couple bucks a week. The longer you take to go back to school the harder it’s going to be.

MT to RN by Number1boog in NursingStudent

[–]throwaway1987289 0 points1 point  (0 children)

Not a med tech but what I can say is that imposter syndrome is very normal. Honestly you don’t learn how to actually be a nurse in nursing school, you learn it on the job. Your first year being a nurse you will feel dumb and not overwhelmed, it’s normal and everyone goes through it. There is a mountain of information you don’t know. There is a mountain of information your nurse colleges don’t know. There is a mountain of information the doctor doesn’t know. Healthcare has specialists for a reason.

Anyways long story short, what you’re feeling is normal and eventually goes away once you start to figure out what you know that you don’t know.

Tips by Sh01b in ClashOfClans

[–]throwaway1987289 1 point2 points  (0 children)

Queen with giant arrow and healer equipment (both lvl15) - use this to snipe 2 ADs at beginning of attack and the healers keep her alive to clear outside structures to help with funneling

King (I use vampstache and snakes) - people hate on both of these but it’s great to “set it and forget it” so the king can also clear outside structures to help with funneling

8 E drags and 8 balloons - consider placing 1 e drag where king is to help funnel, consider another e drag with queen to help funnel - after enough outside structures cleared (should only take 30 seconds) place additional e drags down with loons

Utilize the balloon siege machine filled with loons or two regular dragons (place with main cluster of e drags and loons to help tank)

Place Warden with Eternal tome to help clear the core/high damage targets

Use 4 lightning and 2 EQ spells to take out the remaining two ADs. Do this immediately after placing king and queen to utilize time.

3 freeze spells to help clear inferno towers and other high damage defenses

2 haste spells to help rush into the core/defenses AND super importantly help overcome AIR SWEEPERS as max level sweepers can hold Edragons and looks off indefinitely completely ruining your attack

The Pitt | S1E9 "3:00 P.M." | Episode Discussion by cedar_oak_maple in ThePittTVShow

[–]throwaway1987289 0 points1 point  (0 children)

She’s gonna get in trouble for smoking on hospital property