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There was a day at clinical way back when I was in There was a day at clinical way back when I was in nursing school 10 years ago. It’s funny how some of the simplest of conversations you remember forever. 

My preceptor asked me how I liked my coffee, and scared and passive little me mumbled “oh, however…”

She looked at me and told me, “Always know what you want. So how do you like your coffee?”

Black I said. 

Always know what you want. ☕️

#nursingschoolproblems #crnaschool #srna #anesthesiaschool #anesthesia #nursingschoolprobs #futurenurse #futurenurses #registerednurse #registerednurses #bsnrn #icunurse #icunurses #nurseanesthesia #nurseanesthetist
Precedex Education! 💉⁣ We love precedex in th Precedex Education! 💉⁣
We love precedex in the OR, but I didn’t so much in the ICU 😂 ⁣
Who’s a fan and who’s not?⁣ & save this post for reference!
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#crnaschool #anesthesia #anesthesiaeducation #icunursing #icu #icunurse #icurn #crna #srna #srnalife #srnaprobs #futurecrna #nurseanesthetist #nurseanesthesiologist #anesthesiology #nursingschooleducation #nursingeducation⁣
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Another quarter down only ONE MORE to go 😀 3 mo Another quarter down only ONE MORE to go 😀
3 more months until graduation!! 🎓👩🏻‍🎓
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⏰ 2,200 hours of clinical experience down and some more to go BUT
⠀⠀⠀⠀⠀⠀⠀⠀⠀
The countdown begins 🎉
⠀⠀⠀⠀⠀⠀⠀⠀⠀
#crna #srna #srnalife #srnaproblems #nurseanesthesia #nurseanesthetist #nurseanesthesiologist #anesthesiology #nurseanesthesiology #futurecrna #srnatocrna #nurseblog #icurn #crnaweek #nurseanesthesia #crna #crnaschool #srnatocrna #nurseanesthetists
I highly do not recommend tag-teaming a case with I highly do not recommend tag-teaming a case with your friend cause you will end up dying from laughter at each other the entire time. 🫀💉 @ed.tee 
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#crnaschool #arewedoneyet #futurecrna #futurecrnas #srna #srnalife #srnaprobs #srnaproblems #nurseanesthesia #nursesweek2022 #nursesweek #anesthesia #aneathesiaschool #nurseanesthetist #nurseanesthesiologist #operatingroom #scrublife
PROPOFOL FACTS🤍😴💤 Did you know the last 2 PROPOFOL FACTS🤍😴💤
Did you know the last 2 slides? 🤓
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Don’t forget to save this for later!
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#propofol #milkofamnesia #anesthesia #anesthesialife #crnaschool #srna #srnalife #srnaprobs #srnatocrna #futurecrna #icunursing #icunurse #icunurses
Nurse Anesthetist loaaaaadingggggg… ⠀⠀⠀⠀ Nurse Anesthetist loaaaaadingggggg…
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4.5 months til’ the title!! 🎓
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#futurecrna #crna #nurseanesthetist #anesthesiaschool #nurseanesthesiologists #nurseanesthesiologist #srnalife #srnatocrna
I thought I’d be all coordinated and wear this c I thought I’d be all coordinated and wear this cap for dental cases, then the OR nurse asked me if there were butt cracks on my cap & now I’ll never unsee it 😂 🍑 looks like this is my new endo cap 💩

#crnaschool #srna #srnalife #scrubcap #scrubcaps #mallampati #futurecrna #anesthesia #anesthesiaschool #icunurse #gastrointestinal #dentalanesthesia
I’ve been seeing so many versions of what happen I’ve been seeing so many versions of what happened with #radondavaught that me & my roommate found the official court documents & photo evidence for those who are interested in what happened in the words of RaDonda herself. In general, don’t ever trust what comments you read on social media, & read the facts before forming your opinion, regardless of what stance you take. This is an unfortunate circumstance for everyone involved & I am so SO ready for the nursing profession to start to feel passionate and empowered again. 😕 Swipe to read, what do you guys think?
Let’s talk about blood transfusion! 🩸⁣ ⁣ Let’s talk about blood transfusion! 🩸⁣
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𝐩𝐑𝐁𝐂𝐬 ⁣
🔴 Transfusing 1 unit of pRBCs raises Hgb ~ 1g/dL & Hct by 2-3%. This provides a good estimate of where you should be at without drawing labs.⁣
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🔴 There are 𝘢𝘥𝘥𝘪𝘵𝘪𝘷𝘦𝘴 that increase the shelf-life of blood. ⁣
- 𝐂𝐢𝐭𝐫𝐚𝐭𝐞: anticoagulant. You don’t want your blood clotting in the bag! It inhibits calcium. Keep this in mind if giving multiple units, could lead to hypocalcemia. ⁣
- 𝐃𝐞𝐱𝐭𝐫𝐨𝐬𝐞: substrate for glycolysis for energy (ATP). This prevents the RBC from using the oxygen they’re transporting to the tissues. ⁣
- 𝐏𝐡𝐨𝐬𝐩𝐡𝐚𝐭𝐞: a buffer that prevents acidosis⁣
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🔴 Although these additives are great to prolong banked blood, they also come with consequences the longer the blood sits there. ⁣
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𝐑𝐢𝐬𝐤𝐬 include:⁣
- ↓ 𝐩𝐇 = ↑ lactic acid = bad⁣
- ↑ 𝐊 (keep in mind for renal fail pts). Hyperkalemia can result from an impaired RBC cell membrane that happens with stored blood, causing K to leak out. ⁣
- ↓ 𝟐,𝟑 𝐃𝐏𝐆 = ↓O2 release to the tissues. Which is the whole point of RBCs right. To deliver oxygen to the body. This is why with ECMO patients we used to ask blood bank for our blood to be <10 days old, to get the max benefit for these sick hypoxic patients. ⁣
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🔴What does 𝘭𝘦𝘶𝘬𝘰𝘳𝘦𝘥𝘶𝘤𝘵𝘪𝘰𝘯 mean? You’ll see this a lot on your blood bags. Leuko = WBC, reduced. This reduces/removes WBCs from pRBCs. This decreases the risk of febrile transfusion reactions & other adverse effects. ⁣
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💾 Save this post for reference! Want more posts like this? Let me know in the comments 👇🏼
It was a cool day. I remember the first time an an It was a cool day. I remember the first time an anesthesiologist went to intubate and he let me peek at the vocal cords when I was 15. I fell in love with anesthesia that day. 

Early on in clinical, I would think of that moment sometimes & wonder how he was able to do that so gracefully. I remember being so overwhelmed with intubating - how was he able to keep that perfect view for so long and so casually? I felt like I had seconds before I would lose my view and struggle to find it again. I felt like that would never be me and that I was a failure. 

I remember being asked by preceptors to explain each step of what I was doing during induction, and how my mind would literally black out cause I was trying so hard to focus on the tasks. How could they expect me to say everything out loud and the rationale plus answer their questions during such a critical moment? 

Today there were 2 nursing students shadowing in the OR, & my preceptor told me to explain everything I was doing & then I did. And when I went to intubate I got my view & asked them both if they wanted to see & then they did. And idk if I’m emotional because I’ve had 3 hours of sleep or cause that was just kinda cool because I finally felt competent enough to do what that MD did 15 years ago but yeah it was a good day.

Sassy Anesthesia

Nursing

Organizational Tips for the ICU

September 25, 2018May 4, 2019

Hey everyone! I’ve gotten a few requests for a post on how to plan out and organize your ICU shift for beginners. This post can definitely apply to experienced ICU nurses however, I wanted to tailor this post more towards the novice ICU nurse, still trying to figure out time management and the flow of the 12 hour shift. While every unit and nurse is different, I’m just going to go over my thought process to set myself up for success in the beginning of my shift.

So you sit down to get report. As I’m getting report I’m looking into the patient’s room and the environment. Are they vented, on drips, obvious line tracings on the monitor. Is there family in there? Make sure the offgoing nurse addresses everything you see. Don’t be afraid to ask questions to clarify any gaps in information.

If I have two patients, I always go into the sickest patient’s room first. Now I know some people are the type to glaze over orders first, over assessing first. I was always taught to assess first, so the second that person is your patient, you know every square inch of them right off the bat if anything were to happen at the beginning of your shift. People love to code at the change of shift sometimes I swear. However, I can see if you know doctors are about to round, especially dayshift, that you would want to look at your orders quickly to address any questions. Both options are appropriate depending on the type of patient. Always be thinking ahead regardless.

While I’m in the room doing my assessment, this is the time at the beginning of your shift to do your safety checks. Ambu bag in the room, side rails up, bed alarm on, call light within reach if applicable. If you didn’t do line reconciliation with the offgoing nurse, pull up your MAR and verify that the correct bag is programmed into the IV pump running at the correct ordered rate and dosing weight. Are the bags or lines expired. ALWAYS make sure you have one canister hooked up to suction – I don’t care how healthy some 25 year old Olympian patient looks, everyone in the ICU is there for a reason (unless they’re med-surg overflow lol but STILL) and that is that they’re critical. I always look for where the code pedal is since they vary on different beds. Where’s your IV access – if you need to emergently push a med? Check and flush those lines especially peripherals. People get lazy with maintaining those if you have a central line. Get in the habit of doing all of this at the beginning of your shift EVERY TIME. When you’re new, you’re still so moldable…you can set up your routine that will become second nature for years to come. So you want to make sure you start off with good safety habits at this time. Don’t get distracted by all of the tasks you have to do right away unless they’re emergent. Make sure you get to know your patient, your room environment, and that it’s safe.

 

New icu nurse report sheet

 

So when I’m feeling pretty good about how my room looks I go and sit down at the computer and make a schedule for my night. I write out the next twelve hours on the back of my report sheet and go through the orders and the MAR – plugging in medication times and scheduled flushes, feeds, oral care, bath, etc. I’m someone that loves crossing things off a list. Makes me feel great. Sometimes there’s too many tasks in a shift and it’s easy to lose track of time or forget something. That’s why I love to write everything down if I can. Do this ESPECIALLY if you are new. There is no way to remember all of these tasks if you don’t write out a shift schedule for yourself. It will then become a habit and eventually you may not need to write things down. Notice my emphasis on forming all these great habits while you’re still fresh.

If you’re open for an admission, I like to prep my room the second I’m caught up on my other patient. Don’t be one of those people that doesn’t look in their other room until that new admit is assigned to you. You should be using that time to look up your new patient, not stock your room. If you’re on nightshift, bathe your first patient early in the evening, so that won’t be something you have to do later if you’re busy with the new patient. Dayshift won’t buy the excuse of you having an admission as a reason not to bathe your other patient.

Hm what else. Before the end of my shift I always have a 12 or 24 hour intake/output total, and specifically shift totals of anything we were concerned about (low urine output, high NG or chest tube output etc). If anything pops up throughout my shift that I have a question about I either write it on the whiteboard in the room or on my report sheet to cross off after it’s been addressed. Now obviously if there’s a major issue or question you’ll call the doctor right away. But for smaller questions/comments I write them down to pass on to dayshift or when the team rounds next. There is so much that happens in a shift that it’s so easy to forget a minor concern/question you had for the doctor.

Moral of the story is think ahead. Think in your head the 3 major issues your patient has at the beginning of your shift, and try to imagine any complications/emergencies that could potentially happen on your watch. Then think about what you would do in each scenario. If you plan ahead, you won’t be surprised/panicked if an emergency happens. And you’ll be calm and collected when it does. Any other questions for me write them below! Thanks for reading guys!

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TAGGED WITH: critical care, icu, intensive care, new grad, new nurse, Nursing, nursing school, registered nurse
7 Comments on Organizational Tips for the ICU

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7 comments on “Organizational Tips for the ICU”

  1. Rachel
    August 1, 2020 at 10:19 am

    Thank you for this i know it’s okder but i’m staRting my first ICU job as an RN coming from Med- Surg as an Lpn and then rn. Thank you again for Sharing your life and advice.

    Reply
  2. Namae
    October 19, 2018 at 2:47 pm

    Thank you for going into details! Since I started my orientation, my head has been spinning. I dont even know where to begin! You’ve definitely helped me with my thought process in organizing tasks. Would it be possible for me to get a copy of your report sheet also?? Thank you!! 🙂

    Reply
    • lipstickandlifesaving
      October 19, 2018 at 2:56 pm

      Yes and thank you so much!! Email me!! hello@sassyanesthesia.com

      Reply
  3. Rob
    October 7, 2018 at 4:14 pm

    Any way I can get a copy of your report sheet also, please!

    Reply
    • lipstickandlifesaving
      October 8, 2018 at 10:16 pm

      Sure! Go ahead and email me and I’ll send it your way!! My email is hello@sassyanesthesia.com

      Reply
  4. Angela
    September 30, 2018 at 12:29 am

    Thank you for this post! Is there a possibility you can upload what your report sheet template looks like?

    Reply
    • lipstickandlifesaving
      September 30, 2018 at 12:31 am

      Hey Angela! Thanks so much for reading. Email me and I’ll send it to you! My email is hello@sassyanesthesia.com 🙂

      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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There was a day at clinical way back when I was in There was a day at clinical way back when I was in nursing school 10 years ago. It’s funny how some of the simplest of conversations you remember forever. 

My preceptor asked me how I liked my coffee, and scared and passive little me mumbled “oh, however…”

She looked at me and told me, “Always know what you want. So how do you like your coffee?”

Black I said. 

Always know what you want. ☕️

#nursingschoolproblems #crnaschool #srna #anesthesiaschool #anesthesia #nursingschoolprobs #futurenurse #futurenurses #registerednurse #registerednurses #bsnrn #icunurse #icunurses #nurseanesthesia #nurseanesthetist
Precedex Education! 💉⁣ We love precedex in th Precedex Education! 💉⁣
We love precedex in the OR, but I didn’t so much in the ICU 😂 ⁣
Who’s a fan and who’s not?⁣ & save this post for reference!
⁣
⁣
⁣
⁣
#crnaschool #anesthesia #anesthesiaeducation #icunursing #icu #icunurse #icurn #crna #srna #srnalife #srnaprobs #futurecrna #nurseanesthetist #nurseanesthesiologist #anesthesiology #nursingschooleducation #nursingeducation⁣
⁣
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⁣
Another quarter down only ONE MORE to go 😀 3 mo Another quarter down only ONE MORE to go 😀
3 more months until graduation!! 🎓👩🏻‍🎓
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⏰ 2,200 hours of clinical experience down and some more to go BUT
⠀⠀⠀⠀⠀⠀⠀⠀⠀
The countdown begins 🎉
⠀⠀⠀⠀⠀⠀⠀⠀⠀
#crna #srna #srnalife #srnaproblems #nurseanesthesia #nurseanesthetist #nurseanesthesiologist #anesthesiology #nurseanesthesiology #futurecrna #srnatocrna #nurseblog #icurn #crnaweek #nurseanesthesia #crna #crnaschool #srnatocrna #nurseanesthetists
I highly do not recommend tag-teaming a case with I highly do not recommend tag-teaming a case with your friend cause you will end up dying from laughter at each other the entire time. 🫀💉 @ed.tee 
.
.
.
.
.
#crnaschool #arewedoneyet #futurecrna #futurecrnas #srna #srnalife #srnaprobs #srnaproblems #nurseanesthesia #nursesweek2022 #nursesweek #anesthesia #aneathesiaschool #nurseanesthetist #nurseanesthesiologist #operatingroom #scrublife
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