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For those who have been struggling with staying se For those who have been struggling with staying serious about COVID, wearing a mask, limiting gatherings, then this is for you. I’ve seen this trending, and it’s to show awareness of how COVID has affected so many people. 
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I’ve talked to lots of my coworkers, and we can all agree that it’s hard for people to believe in something unless they have been affected by it. The goal of this post is to visually represent everyone that has been affected by this virus.
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Post the hearts that relate to you:
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❤️ Lost a loved one or friend to COVID.
🧡 Know someone who has lost a loved one or friend to COVID. 
💛 Have taken care of a patient with COVID.
💚 Have personally suffered from COVID. 
💙 Have a loved one or friend who has suffered from COVID.
💜 Have been an essential worker on the frontlines of this pandemic.
🤍 Have had a loved one, friend, or personally lost a job due to COVID. 
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Here’s mine: 🧡💛💙💜🤍
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What’s yours? Comment below and share, or repost to see how your followers have been impacted too. 💕
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#frontliners #frontliners #nurseonduty #crnaschool #srna #srnalife #anesthesiaschool #nurseanesthesia #nursingschoolprobs #wearfigs #awesomehumans #frontlineheroes #frontlines #frontlineworker #essentialworker #covidicu #nursesofig #nursesareheroes
Santa Klogs are comin’ to town 🎅🏼 Comment Santa Klogs are comin’ to town 🎅🏼

Comment if you’re working > 8 hours/day?

> 3 shifts a week?

> You’ve developed back problems from working bedside?

Haven’t worn Klogs in a few years and definitely forgot how comfortable they are. Perfect for these COVID days - wipeable, anti-microbial, non-slip. These shoes are great for all of you awesome healthcare providers working long hours and need the extra arch support for better posture. @zappos offers 365-day returns on these shoes and tons of other styles too 👟👠👢

Check out my latest blog post for the full review!

#sponsored #zappos #zapposxklogs #klogsfootwear #walkwithus @zappos @klogsfootwear
💙🚨CODE BLUE 🚨💙
Do you remember your H’s & T’s?

🚨A PEA Arrest stands for Pulseless Electrical Activity. If the patient is on a monitor, you can see electrical activity on their EKG. But, if you feel for a pulse they’re pulseless. This can sometimes last a couple of minutes before they flatline. 

🚨This is really important to catch early. If I know my patient is circling the drain and I’m expecting a code... my fingers are feeling for a pulse nonstop, even if I see a normal EKG on the monitor. You want to catch them in cardiac arrest ASAP for the best outcome, and start compressions the second you lose a pulse, not wait for the monitor to show you. 

🚨Even if you’re not in the ICU with a monitor, if your patient codes it is still so important to run through possible causes of the code. These are your H’s & T’s!

🚨Codes are chaos, we all know this. It’s so easy to let the adrenaline kick in and be the first to grab the meds or start compressions. OBVI this is important but don’t get too caught up in the process that you forget to assess what caused the code in the first place. You can do compressions on an acidotic patient all night long, and they’re not gonna come back unless you treat the cause of that acidosis (push an amp of bicarb, treat the K etc). 

🚨It’s extremely important for the code team to communicate. Be the one to shout out possible causes and run through them with others. All of the interventions listed in this diagram can be life saving ✨

#acls #codeblue #icunursing #futurecrna #nursingeducation #criticalcarenurse #nursingschoolprobs #srnalife #srnaproblems #srnatocrna
HOW TO REMEMBER DRUG CLASSES BY SUFFIX 💊 ⠀⠀ HOW TO REMEMBER DRUG CLASSES BY SUFFIX 💊
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🩸Anticoagulant: -arin
ex. heparin, warfarin
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🤧Antihistamine: -ine
ex. diphenhydramine (Benadryl), loratadine (Claritin)
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🤢Antiemetic: -azine
ex. promethazine (Phenergan)
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💥Antiulcer: -tidine
ex. famotidine (Pepcid), ranitidine (Zantac)
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✖️Proton Pump Inhibitors (✖️gastric acid): -prazole
ex. lansoprozole (Prevacid), omeprazole (Prilosec)
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🦠Antiviral: -vir
ex. acyclovir
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🧫 Antibiotics:
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Aminoglycoside: -mycin
ex. vancomycin
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Fluoroquinolones: -floxaxin
ex. ciprofloxacin
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Tetracyclines: -cycline
ex. doxycycline, tetracycline
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😞Antidepressants/Anti-anxiety
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Tricyclic: -triptyline
ex. amitiptyline (Elavil)
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SSRIs: -pram/-ine
ex. citalopram (Celexa), ecitalopram (Lexapro)
 fluoxetine (Prozac), sertraline (Zoloft)
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🗃 SAVE for reference & SHARE with your friends!
Feeling very thankful this year. 🦃 ⁣ I am tha Feeling very thankful this year. 🦃
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I am thankful for all of you here. Not only for following along my crazy journey, but for all you have done this year on the frontlines. We couldn’t have gotten through this year without eachother. Through the literal sweat, blood, and so many tears that were shed from COVID-19. 
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We needed eachother this year, and I am so grateful:
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For the people who physically worked together to manually prone so many
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For the respiratory therapists working tirelessly, changing vent settings and pulling ABGs nonstop.
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For the doctors who kept up on the evolution of an ever-changing virus, to make sure care was the most up to date.
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For the students who had to keep so mentally strong to adapt to a different way of learning, and still so eager so they too, can be on the frontlines 
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For those of you who had to hold the phone bedside, as family members said goodbye to their loved one for the last time over FaceTime. 
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And then having to go home and still be a support to your families. 
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Like everyone has said, this Thanksgiving is in fact different. While lots of us get to be incredibly thankful to be alive and celebrate our blessings, there are a lot of you wondering why a loved one has been taken from you this year, and this thanksgiving is really hard. 
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If you have lost someone special this year, drop their name below, so everyone who sees this post can pause and send you lots of positive energy for your difficult holiday 💘
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I wish you all a very happy Thanksgiving. Be safe, and keep on smiling the best you can 😌🍁
HOW TO BE THAT NURSE THAT EVERYONE WANTS REPORT FR HOW TO BE THAT NURSE THAT EVERYONE WANTS REPORT FROM 📋🩺👩🏻‍⚕️
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• Be PREPARED. Don’t be that nurse that’s scrambling in a panic when you see the next shift walking in - because YOU didn’t have time management. Obvi this is putting those crazy shifts aside, but if it’s a typical patient assignment, get your shift together (see what I did there 😜).
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•Your rooms better be spotless & ready for the next nurse. This includes:
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•Grabbing supplies for the day/nightshift nurse and put them in the room. 
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•If there’s a foley empty it, chart it right at end of your shift. While you’re giving report it will start on the hour, & you can tell them whatever’s in there now is theirs to chart for this hour. 
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•Making sure their medications are available. If needing to come from pharmacy, that can take time to request & receive.
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•If they’re on a critical drip (pressors, etc) have a backup bag in the room ready to hang. You’re about to get a major eye roll if the nurse you’re giving report to walks in to start their shift, the pressor bag runs dry, patient gets hypotensive, & there’s no backup bag in the room. Just, no. 
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•If they’re on sedation and you see it running low before report, grab the extra bottle of propofol etc. Again, eye roll comin’ for ya if you’re giving report and your patient starts waking up. You interrupt report to go in the room and up your sedation. Then your sedation runs dry, so you have to go get a new bottle/syringe, double-nurse verify it like no.
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• Wiping down the counters, clean up clutter. If there’s patient-specific hygiene products in there, go grab a wash basin & organize it all in one spot. If there’s wound dressing supplies stocked in there, again, put it in a separate basin. I can’t stand lined up clutter. 
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What do you guys do to prepare your room? I ran out of space 😅
WHAT SHOULD BE HELD FOR SURGERY? 😷 ⠀⠀⠀⠀ WHAT SHOULD BE HELD FOR SURGERY? 😷
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🩸Anticoagulants
-Plavix & Coumadin d/c 5-7 days before
-Low molecular weight heparin 💉 d/c 12 hrs before
-IV heparin d/c 6 hours before
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🧄 3 G’s
-Garlic, Ginkgo, & Ginseng ⬆️ bleeding risk. D/c a week before
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🍬 Oral hypoglycemics
-All you need is a long-acting hypoglycemic to cause life-threatening hypoglycemia in the OR, which can go unrecognized under anesthesia. These patients will be managed via insulin drip to be more carefully titrated & blood sugars checked every hour. 
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💧Diuretics 
-The patient will have already been NPO for some time, we don’t want to make them even more dehydrated for possible hemodynamic instability.
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DO NOT HOLD:
🫀 Beta Blockers
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-You’re probably thinking well, I wouldn’t want to give a BB before surgery, & drop their HR/BP. But for patients on a daily BB, it is especially important for them to take their medication to prevent possible MI or even acute heart failure in the OR. Why? 
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Their body’s beta receptors are “up-regulated.” 
AKA: their body is “used to” the drug being in their system regularly. When this happens longer term, their receptors are not as... receptive? 😉 This is the reason why people have to “up their dose” when they’ve been on the same med for awhile. So if you were to abruptly stop a beta blocker.. you wouldn’t be blocking those sympathetic beta receptors. You could have a HUGE “fight or flight” response. 👎🏼 That, combined with painful surgery and a tube in your throat, puts the pt at extreme risk for heart attack. These patients were already susceptible to MI at baseline...that’s why they were on a beta blocker 😬
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💊 Patients on opioids should continue to take them. By holding them for chronic users, think about how much harder pain mgmt will be post-op. ☹️
A simple explanation of the mechanics of breathing A simple explanation of the mechanics of breathing 🌬
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In a healthy person, our drive to breathe is based off of the amount of carbon dioxide in our blood. We have these lil things called chemoreceptors that sit in the carotid artery. 
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These chemoreceptors are basically takin’ ABGs nonstop, and constantly taking those samples of blood to titrate breathing to effect. 🩸
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An increase in carbon dioxide is sensed by the chemoreceptors, and they tell the body to take a breath. Remember that taking a breath in means exhaling a breath out. That breath out is exhaling the Co2 that came from gas exchange at the alveoli (swappin’ oxygen from the air for the “waste” in our body) that was building up. 🗑
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But why is Co2 “waste” and where does that even come from? Obvi we need oxygen to live but why is that? The body uses the oxygen we breathe in to actually break down the sugar(carbs) we eat. 🍞 Say whaaaat? Ya. Breaking down that sugar = energy that we need to basically exist. So. When that sugar is broken down by oxygen, Co2 is produced. 
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High levels of this waste product leads to a million different problems as you know. Some side effects include respiratory acidosis, tachycardia, dizziness, seizures, and loss of consciousness ☠️
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Phew! Now take a deep breath and let me know if this was helpful! 😃
I was told by my clinical instructor that I wouldn I was told by my clinical instructor that I wouldn’t make it in the ICU as a new grad. 

I ended up getting hired before I graduated. I was one of 3, out of over 800 applicants. 

When I was applying to take the NCLEX, my ATT (approval to test) date was delayed due to my school submitting it late. I had landed my dream job, and I couldn’t start if I didn’t get my license in time. I emailed the assistant dean asking if there was anything I could do. She replied with, “maybe this job wasn’t meant for you.” 

Her and I had been bumping heads since I began the program. She didn’t like me. I challenged her, and I stood up to her when everyone else was too afraid to. My nursing program was one of a punitive environment - my teachers had their years of experience. Now it was our turn to be mentally broken down like they were as a new nurse. It was a breeding ground for future nurse bullies - I opposed it, and I opposed her. 

So I ended up being able to test in time (no help from her btw), I passed, and began my new grad ICU job. 

Years later, on the same unit, I saw her visiting her mom who had just had surgery. She saw me standing in the hallway. And I smiled at her, said nothing, and I walked away. 

Don’t EVER let anyone tell you that you can’t.
Never realized how Italian I was until someone rec Never realized how Italian I was until someone recorded my hand gestures 😂 teach with enthusiasm right? 🤓🇮🇹
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Sassy Anesthesia

Nursing

How I Studied for the CCRN

March 19, 2017September 13, 2018

Happy Certified Nurses Day! I’m excited to say that it’s the first one I get to celebrate! I hope one day you will too if you don’t already. It is something to be proud of! The CCRN is not an easy test and is completely voluntary. So you going out of your way to take it shows pride in the nursing profession and yourself. I’m going to go through the requirements of this test, how I studied, and my thoughts on the exam.

CCRN Exam Eligibility

The CCRN (Adult) Exam is for nurses who care for acute/critical patients in a variety of settings (ICUs, trauma bays, critical care transport, etc).

  • You need to be a RN/APRN with at least 1750 hours in the past two years directly caring for acute/critically ill patients. You need 875 of those hours within the most recent year of applying.
  • OR, you need to be a RN/APRN with at least 2000 hours in the past five years directly caring for acute/critically ill patients. You need 144 of those hours within the most recent year of applying.
  • The cost of the test is $230 if you are an AACN member, or $335 if you are not (which, why are you not?!). I’ve heard most hospitals will help cover the cost of the exam if you pass, if not you can pay for it out of pocket which is what I did being on LOA.

How I Studied

Step one: Buy the exam. Yes before you study. Life is busy, we’re all exhausted working 12 hour shifts, the last thing you want to do in your spare time is study for an exam. I have lots of coworkers that want to test but haven’t started studying because there’s no pressure to take it! This exam can be put off for years and years and maybe forever if you don’t commit to it. If certification is what you want, you need to COMMIT. Commit to expanding your knowledge of critical care, commit to your patients, and commit to yourself. The pride you feel after passing this exam is incredible! So if you want those 4 letters behind your name, buy the exam. You have 90 days to schedule and take the exam once its purchased. That’s more than enough time to study if you commit to doing so.

The CCRN is made up of 150 questions you need to complete in 3 hours. Of those questions, 125 are scored, and the remaining 25 are used as performance stats for possible use in future exams. You need to get 87 correct to pass the exam (70%). This exam is unlike the NCLEX in that it doesn’t give you easier or harder questions based off your performance. So that’s a nice aspect of the CCRN.

The exam is made up of 80% clinical judgement and 20% Professional Caring and Ethical Practice. Of that 80%, the systems are broken down as follows:

18% Cardiovascular, 17% Pulmonary, 20% Endocrine/Hematology/GI/Renal/Integumentary, 13% Musculoskeletal/Neuro/Psychosocial, and 14% Multisystem.

A more detailed blueprint of the exam is in AACN’s CCRN Handbook here.

So. That’s a lot of information! But you will learn it just like I did if you put your mind to it. And I was able to study when I was half sedated on Percocet and Flexeril and who knows what else following my injury, so I know you can do it too.

Processed with VSCO with hb1 preset

The first resource I used to study was AACN’s CCRN Review Course Online. This is a course that had powerpoint lectures based off of each of the categories I listed above, with an instructor talking you through them. It was nice to have this on my computer and you can pause and restart as you please. This course is $159 for members/$199 nonmembers, but they have a special if you add the course along with your exam sign up, you will get this course for 50% off. So you might as well buy it when you register for the CCRN. Or, you can do what I did, and get this course for FREE the following month after attending NTI! NTI is AACN’s national critical care conference held once a year that gathers thousands of ICU nurses across America for education and networking. It’s so much fun if you’re an ICU nerd like me!! This year will be my third year in a row and I will post on that experience in May following the conference. ANYWAYS, there are some options for you to get this course. I felt like I learned a lot from it. Available here.

After completing the online course, I purchased Barron’s CCRN Exam book on Amazon for about $20 (link below). This book has a pretest in the beginning to show your areas of weakness right away. Each section corresponds with the CCRN test blueprint, with practice questions after each topic telling you how many you need to get correct in order to pass. There’s also 2 full length practice exams at the end with 150 questions each and explanations for each question. I highly recommend doing these practice tests as this mentally prepares yourself for that long of a test, and you can time yourself to make sure you can complete it within 3 hours. This book also includes an online practice test as well, to get the feel of a computer-based test like the CCRN. I LOVED this book and found it to be able to explain the things I didn’t understand well.

There are some CCRN study apps out there that I tried out, but most of the free versions only contain like, 25 questions to practice with.

For the topics that just couldn’t stick, I made flashcards with the condition and the related symptoms. There was a lot of MICU stuff on there that I had never had experience with on the SICU.

And that’s pretty much how I studied! I didn’t start studying until after I bought the test, and after doing the above I passed on the first try. Yay!

My thoughts on the test? Whew! It was not easy. I felt like I got a lot of random conditions I had never studied and I told myself I was failing halfway through. Also, I reaaally had to go to the bathroom an hour in, and I was on crutches. I didn’t want to lose any time for the test since I was so slow-moving and you can’t pause the timer! So somehow I just powered through. I was the last one in the testing room and took the entire 3 hours. Which I knew I would, I always reaaaally take my time on tests. Why not? Then you get the survey at the end that you can’t even focus on because you’re so nervous to get your results. And then you get handed your print out of exam results and you have your CCRN!! What an awesome accomplishment!

You renew your certification every 3 years with the appropriate CERPs. Which is really easy to do if you go to NTI…

Any questions about the test feel free to ask me below! Thanks for reading guys! I wish you luck if you choose to take on the CCRN!

Need motivation to take this exam? Check out my blog post on Why You Need to Get Your CCRN.


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9 comments on “How I Studied for the CCRN”

  1. Cecille Reloj
    March 18, 2020 at 2:31 pm

    What was your study schedule like? did you study even in between shifts or just on your days off? how many hours a day, and for how many weeks?

    Reply
    • lipstickandlifesaving
      March 22, 2020 at 4:05 pm

      Honestly I was very lucky in the fact that I was on medical LOA while I studied and tested. I studied a few hours most days of the week before testing at the 2 month mark. So I would recommend more time if you’re working full time cause I had nothing better to do than study lol.

      Reply
  2. Paul Correia
    March 23, 2018 at 12:03 pm

    I plan on attending The NTI being held in Boston this year… will I be able to receive the online course for free by doing so? how should I go about this? Thanks for all your help!

    Reply
    • lipstickandlifesaving
      March 24, 2018 at 2:46 am

      Awesome! I’m going too! They have the course in their online bookstore on the website. You’re able to access it one month post NTI.

      Reply
  3. Emily Wakefield
    October 18, 2017 at 12:11 am

    Can I ask what you were getting on various pretests percentage-wise? If you prefer not to answer, that’s completely ok.
    I am getting 65-70% on most of my pretests. Several co-workers have recently taken the CCRN and told me that they were scoring around there, and they have all passed. I have my test scheduled and am taking it regardless of what I am scoring pre-test wise, but I wanted to know your experience.

    Reply
    • lipstickandlifesaving
      October 18, 2017 at 4:22 am

      Hi Emily! Thanks for reading! From what I remember, before I took the test I was scoring around 70-80%. However, I feel like a lot of the topics I was confident on wasn’t even on my exam. I think that score range is pretty normal. The biggest thing to remember is to not talk down on yourself during the test. I remember telling myself I don’t know any of this, I didn’t study that! I think regardless of the question, all the exam prep you do helps you to answer the question regardless, even if you’re not positive on the answer. Good luck!!

      Reply
  4. Kathy Osteria
    April 28, 2017 at 5:11 pm

    Thank you for posting this blog! Just ordered my book! Thanks for the quick link ☺️ So you get the results right after you finish the exam? Congrats on passing first time!

    Reply
    • lipstickandlifesaving
      April 29, 2017 at 1:32 am

      Hey Kathy! You’ll love the book! And yes you find out your results right after you finish which is great. Good luck studying!! xx

      Reply
  5. neveradullmoment189
    March 20, 2017 at 9:12 pm

    Thanks for tips as I’m about to sign up to take my CCRN

    Reply

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Hi, I'm Marissa.

I'm a first year SRNA. Here you can find some education & motivation, along with a touch of sass to keep you sane in a difficult but rewarding career path. Thank you for stopping by!
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For those who have been struggling with staying se For those who have been struggling with staying serious about COVID, wearing a mask, limiting gatherings, then this is for you. I’ve seen this trending, and it’s to show awareness of how COVID has affected so many people. 
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I’ve talked to lots of my coworkers, and we can all agree that it’s hard for people to believe in something unless they have been affected by it. The goal of this post is to visually represent everyone that has been affected by this virus.
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Post the hearts that relate to you:
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❤️ Lost a loved one or friend to COVID.
🧡 Know someone who has lost a loved one or friend to COVID. 
💛 Have taken care of a patient with COVID.
💚 Have personally suffered from COVID. 
💙 Have a loved one or friend who has suffered from COVID.
💜 Have been an essential worker on the frontlines of this pandemic.
🤍 Have had a loved one, friend, or personally lost a job due to COVID. 
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Here’s mine: 🧡💛💙💜🤍
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What’s yours? Comment below and share, or repost to see how your followers have been impacted too. 💕
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#frontliners #frontliners #nurseonduty #crnaschool #srna #srnalife #anesthesiaschool #nurseanesthesia #nursingschoolprobs #wearfigs #awesomehumans #frontlineheroes #frontlines #frontlineworker #essentialworker #covidicu #nursesofig #nursesareheroes
Santa Klogs are comin’ to town 🎅🏼 Comment Santa Klogs are comin’ to town 🎅🏼

Comment if you’re working > 8 hours/day?

> 3 shifts a week?

> You’ve developed back problems from working bedside?

Haven’t worn Klogs in a few years and definitely forgot how comfortable they are. Perfect for these COVID days - wipeable, anti-microbial, non-slip. These shoes are great for all of you awesome healthcare providers working long hours and need the extra arch support for better posture. @zappos offers 365-day returns on these shoes and tons of other styles too 👟👠👢

Check out my latest blog post for the full review!

#sponsored #zappos #zapposxklogs #klogsfootwear #walkwithus @zappos @klogsfootwear
💙🚨CODE BLUE 🚨💙
Do you remember your H’s & T’s?

🚨A PEA Arrest stands for Pulseless Electrical Activity. If the patient is on a monitor, you can see electrical activity on their EKG. But, if you feel for a pulse they’re pulseless. This can sometimes last a couple of minutes before they flatline. 

🚨This is really important to catch early. If I know my patient is circling the drain and I’m expecting a code... my fingers are feeling for a pulse nonstop, even if I see a normal EKG on the monitor. You want to catch them in cardiac arrest ASAP for the best outcome, and start compressions the second you lose a pulse, not wait for the monitor to show you. 

🚨Even if you’re not in the ICU with a monitor, if your patient codes it is still so important to run through possible causes of the code. These are your H’s & T’s!

🚨Codes are chaos, we all know this. It’s so easy to let the adrenaline kick in and be the first to grab the meds or start compressions. OBVI this is important but don’t get too caught up in the process that you forget to assess what caused the code in the first place. You can do compressions on an acidotic patient all night long, and they’re not gonna come back unless you treat the cause of that acidosis (push an amp of bicarb, treat the K etc). 

🚨It’s extremely important for the code team to communicate. Be the one to shout out possible causes and run through them with others. All of the interventions listed in this diagram can be life saving ✨

#acls #codeblue #icunursing #futurecrna #nursingeducation #criticalcarenurse #nursingschoolprobs #srnalife #srnaproblems #srnatocrna
HOW TO REMEMBER DRUG CLASSES BY SUFFIX 💊 ⠀⠀ HOW TO REMEMBER DRUG CLASSES BY SUFFIX 💊
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🩸Anticoagulant: -arin
ex. heparin, warfarin
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🤧Antihistamine: -ine
ex. diphenhydramine (Benadryl), loratadine (Claritin)
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🤢Antiemetic: -azine
ex. promethazine (Phenergan)
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💥Antiulcer: -tidine
ex. famotidine (Pepcid), ranitidine (Zantac)
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✖️Proton Pump Inhibitors (✖️gastric acid): -prazole
ex. lansoprozole (Prevacid), omeprazole (Prilosec)
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🦠Antiviral: -vir
ex. acyclovir
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🧫 Antibiotics:
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Aminoglycoside: -mycin
ex. vancomycin
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Fluoroquinolones: -floxaxin
ex. ciprofloxacin
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Tetracyclines: -cycline
ex. doxycycline, tetracycline
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😞Antidepressants/Anti-anxiety
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Tricyclic: -triptyline
ex. amitiptyline (Elavil)
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SSRIs: -pram/-ine
ex. citalopram (Celexa), ecitalopram (Lexapro)
 fluoxetine (Prozac), sertraline (Zoloft)
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