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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

Life

The Story Behind My Injury

February 2, 2017June 22, 2019

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For those of you who don’t know the story behind my injury, I have started this blog in an effort to document it, heal from it, and hopefully get others to gain an appreciation of the simple things as a result. June 22, 2016 will be a day I never forget, as it marks the start of the worst thing that has happened to me so far in life. A coworker and I decided to go on a basic hike to see a nearby waterfall. We both had never been there before and when we arrived, we weren’t sure exactly how to get to there. We found a path and talked our way along it. Eventually we heard water and knew we were close. We walked towards the sound of the water and actually ended up above it, instead of at the bottom. We started to look for ways to climb down but all I saw when I looked over the edge was a dropoff with rocks at the bottom. “Well we’re not going that way,” I laughed. I took a couple more steps in a different direction and next thing I know, I’m sliding on my back headfirst down the slope of the cliff. It’s crazy how your life really does flash before your eyes when you think you’re about to die. Working in a trauma ICU, I remember envisioning for a split second all our TBI patients. I told myself that’s how I would end up if I survived this fall. And all in probably the 5 seconds I was thinking this, my body was the calmest it’s ever been. I had accepted it. And I gazed happily into the white light that blinded my eyes. 

The next thing I remember was that I was on the ground with my stomach facing down, and my right leg underneath my left. I couldn’t see. I wiped my eyes and blood covered my hands, and was splattered on the rock in front of me. I felt my head, “shoot, I must of hit my head.”  Nothing hurt yet – I was still in shock that I was actually alive. I went to lift my right leg to straighten it out in front of me and my leg caved. Right away I screamed up to my coworker, “my legs broken, call 911!” I had to hold it in place with my two hands, one of which ended up with a broken wrist as well. Then the pain kicked in. I just remember screaming probably the loudest I ever have. And it was just me and my friend wailing back and forth unable to help each other, as she was standing on the cliff above me and couldn’t get down. She yelled that a helicopter was on its way to get me. Reality still hadn’t kicked in. After what seemed like 15 minutes of pure agony, two firefighters came down from the sky to get me. They started to move me and I refused to move without any pain medicine. He started an IV and gave me morphine before I was zipped up and lifted into the air. 

As I stared at the ceiling of the helicopter, I knew we would be going to the hospital I work at, as I was in our area of trauma coverage. “Where are we going?” I asked. They replied with my hospital and I laughed. “Why are you laughing?” 

“That’s where I work.”

“Oh really where?”

“The trauma ICU”

“Oh…”

I remember thinking how funny the situation was even though I was in so much pain. I rolled out of the helicopter to be greeted by our chief of trauma. Cool. I said hi and remember giving him a report of what had happened and how much medicine I had received, even though I’m pretty sure he had already heard that from the firefighters HA. I told him how much pain I was having and last thing I remember in the trauma bay was “give her 4 of morphine, 2 of Ativan, and get her to CT.” The rest of that day was a blur until I woke up in external fixation. 

I guess I was pretty funny while I waited for surgery. As they went to cut off my clothes I screamed “save the lulus!” and forced these poor people to struggle taking off my shorts with my very broken leg. I also apparently attempted to convince the anesthesiologist that it was my opposite leg that was injured until my roommate ripped the blanket off of me and showed him herself. Drugs man.

I spent 5 days in external fixation and those things are no joke. You feel the nails so sharp and deep, tugging inside your bones, muscle, and skin. No amount of pain medicine worked. I feel so bad for the nurses who took care of me. I was in pain nonstop and being a nurse, I was probably their worst patient. Actually, I know I was. I was so high on pain meds I had no problem telling them that they were late on this pill, their lines were overdue to be changed, and by the way, no I’m not a self turn as you have labeled me. 

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On day 6 I went back to surgery for an ORIF with hardware placement. My arm was wrapped in a cast and the 13 stitches above my black eye were starting to look a little better. The overwhelming pain continued and I was discharged on day 8. 

Those 8 days were only the beginning for some of the worst days of my entire life that were spent at home. But what kept me going through that hospitalization was the overwhelming amount of love and support I received from my friends, family, and coworkers. You all know who you are. The friends who drove hours just to visit with me for one day. The friends who stayed the night with me in the hospital, getting up every hour to attempt to move my leg in a more comfortable position. The friends who made me feel like I was in a spa, washing my hair, massaging my legs and feet, and giving me a facial. The friends who stayed late giving me a bed bath because I didn’t trust anyone else. The coworkers that personally called pain pharmacy themselves and told them to get to my room because my pain wasn’t taken care of. And the coworkers that used their 15 minute break or lunch to come and spend time with me in my room, or sneak in supplies to make me more comfortable. You guys are amazing, you will never understand how much those little things meant to me. 

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I could go on about the course of events, but I’ll try and wrap this up. Let’s just say it was 6 months in a wheelchair, two hematomas that came out via my incision, a third surgery for an allergic reaction to the hardware, osteomyelitis and a PICC line for 6 weeks, a nonunion of the bone and possible bone graft, and 3 allergic reactions resulting in IM benadryl and prednisone in the ER. 

While my leg is “healed,” I still struggle with pain, alignment issues, and missing out on activities I used to love. This accident has changed my entire life forever.

Thank you to all of you for reading and for your help and support along the way.

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TAGGED WITH: disability, hiking, icu, injury, intensive care, medicine, nurse, Nursing, surgery, trauma
10 Comments on The Story Behind My Injury

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10 comments on “The Story Behind My Injury”

  1. David Lingner
    July 1, 2017 at 12:22 pm

    Marissa. My heart is full of love and my eyes full of tears after stumbling upon your blog this morning. You’ve always seen the positive side of life, even in chemistry class! You’ve always been kind and generous with your smile and quick to find a reason to laugh. I’m so sad to learn of your terrible pain over the past year, and so proud to see what a wonderful nurse you’ve become. It makes me happy and warms my heart to see that this ongoing experience has not harmed at all but has increased your positivity, your love of people around you, and sense of humor. I’m praying for your full and fast recovery and I’d love to hike Torrey Pines with you someday soon.

    Reply
    • lipstickandlifesaving
      July 3, 2017 at 2:08 pm

      Thank you so much! I appreciate you reading 🙂

      Reply
  2. A Year In Review - My Hiking Accident - Lipstick & Lifesaving
    June 27, 2017 at 7:51 pm

    […] For those of you who haven’t read my story, I wrote about it here. […]

    Reply
  3. Melissa Slagle
    May 2, 2017 at 9:48 pm

    Marissa Labate the nurse who eats peanut butter from a can. You are a trooper. You are an avid hiker and this is crazy how this happened. I am so happy this blog is your inspiration. Keep writing and doing your awesome self. This is motivation for me that anything is possible to overcome. Stay strong my friend and I hope work is a great time and you always feel a sense of purpose in life. You are truly valuable person. Hugs and LOVE!!!!

    Reply
  4. Amanda
    February 17, 2017 at 10:40 pm

    Your story is truly inspiring to stay positive and always push through no matter what life throws at you. I live in San Diego too 😉 can’t wait to watch your journey!

    Reply
  5. Through It All
    February 11, 2017 at 11:11 pm

    Keep pushing through this horrific journey! You’re doing amazingly!

    Reply
  6. janet cross goyette
    February 10, 2017 at 12:01 am

    Marissa, we are all so sorry to hear about your difficult journey, praying for your recovery and glad to see your awesome blog. Keep it up.
    Love,
    Janet Cross Goyette & family

    Reply
  7. Brittany
    February 8, 2017 at 4:42 am

    oh Marissa I had no idea what you had gone through. I’m really glad you made it. Thank you for sharing. Hugs!!! Love you lady!

    Reply
  8. Sibananda Bhanja
    February 6, 2017 at 12:05 pm

    Wonderful lines & so touchy one .

    Reply
  9. Apatientnurse
    February 5, 2017 at 6:37 pm

    Love your fall risk bracelet – there’s an understatement! Amazing story!

    Reply

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author

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