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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

icu nurses hanging blood on belmont rapid infuser
Nursing

My Tips for Surviving Night Shift

September 6, 2017January 17, 2018

Currently writing to you from the nurse’s station at 0300. Welcome to the night shift. Although there is a constant struggle of merely living your daily life, I do love night shift for a variety of reasons, and don’t plan on leaving the dark side anytime soon. However I understand that majority of people do not enjoy workin’ the graveyard, and that it basically depletes you of a social life and leaves you malnourished with sleep deprivation.

Regardless of your preference of shift, you’re probably here because you work night shift, are about to start, orrrr you’re on dayshift and just want to laugh at all the modifications we have to employ every day. So here’s what has worked for me after 3 years on nights.

Bring healthy snacks and eat throughout your shift. I could lie to you and pretend that I do this, but anyone who knows me knows that I eat like absolute crap. One day I’ll progress on my personal goals to eat healthier but in the meantime I’ll tell you to do the opposite of what I do. Carbs and sweets will give you a short burst of energy but quickly disappoint and make the night drag on longer. And instead of eating one big meal on your lunch break which can make you sluggish and tired afterwards, eat smaller meals throughout the shift to help keep your energy in a good place. I always try to go on lunch as late as possible cause once I eat my full meal… goodbye brain.

Know how you respond to caffeine. I can down a dangerous amount of espresso and still feel tired while others get palpitations with a latte. Think about how caffeine affects you, and when you should stop drinking it on your night shift. Definitely have something at the beginning of your shift to give you a jump start, but be cautious with having coffee near the end of your shift as it can keep you up when your shift is over. I try not to have any caffeine past 0400 so I can fall asleep as soon as I get home.

As an add-on to that, I try to fall asleep as quick as I can when I get home. I have a quick breakfast and I am in bed within 20 minutes of being home. When I get distracted by the chores I need to do or stay up a little later after my shift, I find it’s harder to fall asleep. Maybe it’s because I’ve been exposed to the daytime longer and it’s difficult to adjust back to it actually being your “night.”

Know what kind of schedule works for you. Some nurses like to do three shifts in a row, others prefer spacing them out a little more. Try both and see what works best. I prefer not doing three in a row because I feel like I have more off time when I split up my shifts. Others prefer three in a row because it improves their sleep schedule. You’ll read a lot of people’s opinions on how to sleep for nightshift. Again, do what works for you. Some people force themselves to wake up early mid-day if they don’t work again that night. This way, they’re able to fall asleep at a decent time that night and have a productive next day off. In contrast, I prefer sleeping until like, 1500 because it’s not worth waking up that early to me. I feel like death anyways and my day is wasted struggling hard. But as a result, I am up late every night of the week.

I pretty much stick to a nightshift schedule on my days off, staying up until 1-4am. I am fortunate to work nightshift with my roommate, so we both have each other for entertainment when we’re up in the middle of the night. Our neighbors probably think we’re crack addicts when we vacuum or rearrange our living room at 3am, but that’s their issue.

My biggest piece of advice would be to sleep when you are tired. That’s it. Don’t force yourself to get up early if you don’t need to, and don’t force yourself to stay up late if you’re tired. Nightshift is a weird, abnormal, (awesome, in my opinion) schedule. Just embrace it and prioritize your health first. Which leads me to my next suggestion…

Learn to say no. Nightshift is difficult in the fact that you potentially could be somewhere during the day if you just don’t sleep. Whether it’s a friend’s birthday, appointment, whatever… people may expect you to be able to show up with no neurological deficits after not getting any sleep for the past 24 hours. One thing I’ve learned is that a lot (not all) people on a normal dayshift schedule really can’t empathize with people on a nightshift schedule. I explain to them that their 2pm is my 2am, so no… I don’t want to be awake right now and yes, it was you that woke me up by closing your door too loud. Which again leads me to proceed to my next point.

Make your sleep space sleepable. Say that 10 times fast? Don’t expect to sleep well if your room is bright or hot or loud. I’m sure you’ve heard you need blackout curtains. Most of these aren’t true “blackout” curtains, so buy two and layer them on top of eachother to truly darken your room. You’ll need at least one black set to really block out light. If black curtains don’t jam with your bedroom ambiance, put it behind the curtains you want showing. Even if some light is showing through the curtains or your eyes are closed, light in your room will trigger your brain that it’s daytime. Your circadian rhythm is influenced by light. Try and stay in bright light at work and make your bedroom at home as dark as you can. Like the true soul of the nightshift nurse.

If your house is hot, then invest in a way to cool it down. I know so many nurses that don’t have air and don’t sleep well because they’re too hot. Nurses need their sleep for the safety of themselves and their patients. Run your AC, or buy a portable AC unit for your room if you don’t have central air. The extra cost of air is SO worth the good sleep. If you sleep around a lot of noise get a white noise machine, app, or air filter. Turn your phone on silent so you don’t get woken up nonstop.

Talk to your roommates/spouse/neighbors/neighbors dog if they do something that continuously wakes you up. Most people that have never done nightshift do not understand how your clock is the exact opposite of theirs. Explain this to them, so they can truly understand how much it sucks if you wake up mid-day in between shifts.

Find ways to stay alert during your shift. Drink ice cold water to wake your body up. Find productive tasks to help out dayshift, or get up and walk every hour. The more your mind and body are stagnant, the more tired you’ll be and the slower the night. If another nurse appears busy, help them out as a way to keep moving (and to be a nice human). Try not to hide out in a dark station, and talk with other nurses to keep awake. I guess you could talk to your patients too, for those of you on the floors. For whatever reason my patients never talk to me much..

DRUGS. Ahh sleeping pills..I know of a lot of nurses that need to take something to force themselves to sleep during the day. I’ve left this until the end because personally, I don’t use any sleep aids as I’m able to sleep pretty well. So, I don’t really have any specific recommendations for you in this regard. All I can say is that I would try everything I mentioned above to try and improve your sleep first, before needing to take a pill every day to get some rest. You don’t want to have to rely on sleeping pills the rest of your life. And the hangover when you wake up and have to go to work is dreadful.

Then there’s the more natural option, melatonin. I hear great things from a lot of people regarding melatonin. I don’t notice any difference when I have taken it day or night. And from what I’ve read, melatonin supplements may actually not work if taken during the day. This is due to the fact that melatonin is only naturally released in the body at night. So even if you take some during the day, your body realizes that it’s not nighttime, and it may not work as effectively. If it does work for you, awesome. Maybe it’s a placebo effect that I just ruined for you. Let’s pretend I didn’t say anything.

Stay safe on your drive home. Lastly, blast the air/roll down your windows to stay awake or play some loud music. Whenever I can barely keep my eyes open driving home I just think of becoming a trauma patient again and that usually keeps me wide awake. Trust me, STAY AWAKE.

Get home in one piece so you can do it all over again the next night.

Anything else that works for you nightshifters? I’d love to hear it! Thanks for reading.

www.sassyanesthesia.com

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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. 
⠀⠀⠀⠀⠀⠀⠀⠀⠀
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.
⠀⠀⠀⠀⠀⠀⠀⠀⠀
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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