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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

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How YOU can get accepted into CRNA School (on the first try)

August 15, 2020September 11, 2020

We all know CRNA school is extremely competitive. The average percentage of those who get accepted to those who apply is about 10%. Yikes. So how can you possibly stand out amongst thousands of qualified applicants across the country? I mean what more can you do, you’ve got your critical care experience, your CCRN, taken your pre-reqs and tests. What else?

I want to share with you my journey, and how I believe you can stand out OUTSIDE of the above qualifications when applying to CRNA school. Cause guess what. All the other thousands got those too sweetie.

As a side note, I really am not qualified to give recommendations about CRNA interview panels and how they decide between candidates. I have never been on a CRNA school interview panel. This blog post is truly my opinion and nothing more, so take what you want out of it. Carry on.

I got accepted into CRNA school on the first try. I applied to one school, one time. And why would I do that? Wouldn’t you wanna apply to several schools to boost your chances? Nah I’m good. Cause guess what. I knew I would get in.

GAGGG at that cockiness right. I mean honestly. But there’s a difference between cockiness and confidence. I was confident that I would get in on the first try. Why? Well I had been working towards this since high school! I’ve had the knowledge since that age of the CRAZY IMPORTANCE of a resume. And work ethic. Did I say work ethic?

So you might be saying to yourself well of course I have a good work ethic. I’ve been on this unit for years! I precept… I bust my ass at work caring for my patients… well, that’s expected yes. I’m talking about what you are doing OUTSIDE OF WORK. Ok maybe you’re on a committee at work. That’s a nice bullet to add to your resume, yes. But AGAIN. I truly mean outside of work.

If I’m reviewing your resume, and I see a work-based committee, great! But in the back of my mind you know what else I’m thinking? That could possibly be an easy “resume boost.” Some facilities allow you to clock in for these meetings… how do I know you truly care about this committee, versus did you need the extra cash? And if it was volunteer, were you trying to use those hours to level up at work for a raise? Trying to get on better terms with management to get better patients? Who knows! I don’t mean to tear down those of you doing this, especially those of you doing it with good intentions (hell, I’ve done it too for the selfish reasons, who hasn’t?). But. I am showing you my thought process if I were to take a look at your resume and see that. Eh. Not suuuuper super impressed. A lot of people have this on there. I don’t think this is something that would make you TRULY stand out and make you unique.

On my last CRNA school post I focused more on the broad and general check offs in regards to getting into school. Remember everyone’s path is completely different, and I think it’s important to see more detailed stories as well. I’m going to expand on my above conversation as well as tell you what you can possibly add to your resume to stand out even more. Don’t get intimidated with what I had on my resume below and think that you need all of that to get into CRNA school. But I do want to give you guys examples of extraordinary and unique resume additions if you’re struggling with, “what else can I do?” Here’s a peek into what I had on my resume when I applied.

Let’s go back to Marissa in high school. I knew I wanted to go into anesthesia at that time in my life.

So here’s my resume extra credit bullet #1:

Junior year of high school I went on a medical mission trip to Honduras, shadowed an anesthesiologist for an entire week straight. And it was great cause hey, you can do a lot more out of the country shadowing than keeping it domestic. I had an awesome experience.

surgery

So much so that I returned to do it again my senior year. Another extra credit point. This shows consistency as well as demonstrated my passion for the trip, the mission, and the anesthesia experience. Again, a one time trip is amazing 100%. I just reallyyyy want to get nitty gritty with this post in regards to how I look at resumes, and maybe how schools can interpret them. I really want to help you guys become overachievers, because standing out truly is your acceptance letter.

So is going to another location in addition.

So my third extra credit resume point was my medical mission trip to Haiti while in nursing school. I’m not going to expand much more on this cause I’ve listed my 3 trips and want to move on. Now don’t go planning mission trips to boost your resume cause that’s not gonna benefit anyone. I am in love with travel and in love with mission trips. This was something I felt in my heart I was truly called to do and will continue to do. If you don’t like travel or the conditions are too much for you, there are many many other options to stand out OF COURSE, I’m just listing what I did.

Extra credit bullet point #4:

This one may be my biggest one. I was a board member for the local AACN chapter for 3 years. Length of time = commitment. Volunteer hours and no pay = passion. Board position = leadership.

You’re probably wondering how and what in the world I’m talking about. In short, AACN stands for the American Association of Critical Care Nurses and if you’re not familiar with that as an ICU nurse well then you need to be… and I’ll direct you to their website here. This is the national professional organization for critical care nurses. This is a big deal. This is the organization associated with the CCRN.

So how did I get involved? While the AACN is a national organization, there are scattered local chapters across the US in a ton of locations. (I’ll link them here so you can search if there is a local chapter by you). “But what if I’m a nursing student still?!” No matter. Most, if not all, of these chapters welcome students. There’s your ticket in.

Students are able to help board members with simple tasks, and help spread the word to their school about the chapter’s local events like fundraisers, conferences, etc. At least in my chapter, a LOT of these student volunteers got hired into the ICU… Who do you think is on the board of these local chapters? Um, people that have an “in” with hiring decisions at all of your surrounding hospitals. Ka-ching! #networking

So if you’re not a student but you’re a nurse. Great! Same above goes. I didn’t know about this as a student but was told about it when I was hired as a new grad into the ICU. I was curious and decided to show up to a board meeting to see what it was all about. Things like this are uncomfortable! I went in as a new grad nurse to a room full of ICU nurses with 30+ years of experience. They noticed this. And I think they had a lot of respect for me to show up by myself, knowing I was basically a nobody in there. I didn’t have much to offer other than passion for critical care, and this was seen very quickly.

So much so, that I was running for a chair position within two months. Like HELLO I’m barely learning what a ventilator was at the time and here I am joining a group of very sophisticated and experienced nurses. The board actually told me I should apply. I took on the role of marketing for the board. Which was absolutely perfect right because being young, I transformed their email marketing, Facebook page, made everything actually…marketable. And I loved doing it so I stayed on for 3 years before I moved out of the state.

I can’t recommend being involved like this enough. I think this was a major selling point for me to get into school.

I know this is a loooong post, congrats if you’ve made it this far! There’s just so much important detail I want to point out if you’re seriously considering applying to school, or are having a hard time getting in. You can do this!! Two more extra credit points and we’re done!

Extra credit point #5:

Publication. Ooof. I know I know. So I had 3 publications on my resume.

First one was from my senior year of nursing school. There was an option that if you wanted to graduate with honors, you would take an additional course and work the entire year on a project of your choosing that you would eventually publish. I did a systematic review of the literature regarding epidural analgesia knowing I would be applying for CRNA school years from then.

Second and third publications were through Bold Voices, one of the journals by the AACN. My first one was my biggest one, “Being New in the ICU” and the second was a Q&A about social media in nursing.

You may think well yeah you’re a blogger thats why. Not necessarily. They encourage anyone to submit their experience! It looks like this below in the journal. How cool would it be if you added a publication to your resume? Completely possible.

Extra credit point #6 (LAST ONE!):

AACN’s annual national critical care conference (NTI).

I’ll keep this one short cause you’ve stuck around for awhile and I’ll link the info here if you’re interested. NTI happens every year in a different state, and ICU nurses from across the country gather for a week-long conference filled with ICU education, networking, and a giant vendor expo. Those vendor expos also include reps from most CRNA schools, so how cool if you could meet someone from your dream school and hand em’ a resume you just happened to have in your bag. Going to these conferences truly shows your passion for critical care and will be noticed.

I’m gonna stop there, that was a lot of info, but I hope it was helpful! In addition to that, in case anyone is interested, I had a 3.5 GPA, CCRN, 6 years of ICU experience before applying, and that experience was in all ICUs (CV, surgical, medical, neuro, trauma). While this definitely isn’t necessary, I’m glad I have such broad experience going in. Additionally, I was a preceptor and educator at my first hospital in the ICU, and took care of all devices possible (totally not necessary, devices are irrelevant to CRNAs, so don’t focus so much on devices. I get this question a lot). Don’t tell yourself you’re not going to get in if you don’t have the above things on your resume, because that is completely not the case. In fact, I’m pretty sure most of the accepted students don’t have most of these at all on their resume. I simply am giving you ideas on possible badass additions to your resumes that make it stand out from the rest and get you admitted!

I wish you all the best!! Comment below with any questions and good luck!!

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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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