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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…
⠀⠀⠀⠀⠀⠀⠀⠀⠀
4.5 months til’ the title!! 🎓
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⠀⠀⠀⠀⠀⠀⠀⠀⠀
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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! 🩸⁣
⁣
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.⁣
⁣
🔴 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.
Let’s talk about heparin! A commonly used antico Let’s talk about heparin! A commonly used anticoagulant 🩸
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🩸 Heparin is derived from 🐄 lung & 🐖 GI mucosa 🥺
🩸 It binds to antithrombin (a natural anticoagulant circulating in our bodies already) and amplifies it 1000x 💪🏼
🩸 The official definition of 1 unit of heparin is….the volume of heparin-containing solution that prevents 1mL of citrated 🐑 blood from clotting for 1 hour following the addition of 0.2mL of 1:1000 CaCl. Phew how’s that for a definition!😮‍💨
🩸 The typical VTE prophylaxis dose is 5000u SQ BID/TID
🩸 You monitor heparin via your PTT or ACT. 
🩸 Normal PTT: 25-35 sec
🩸 Normal ACT: 90-120 sec
🩸 To reverse heparin you give ➡️ Protamine!
🩸 Protamine is derived from salmon sperm 🥴
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💾 Save this post for later!
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#nursingeducation #medicaleducation #crnaschool #srna #srnalife #srnaproblems #anesthesia #anesthesialife #icunurse #icu #icunurses
Student budget = 5 bikinis under $15 😱👙 Whic Student budget = 5 bikinis under $15 😱👙 Which one is your fave 1-5?! I’ve linked them all in my bio under shop my gram - free ship + returns 🛍

Sassy Anesthesia

Nursing

Stop Nurse Bullying

October 17, 2018October 17, 2018

Well isn’t it just sad I have to write a post about this topic. Nursing might consistently rank the most trusted profession by the community year after year, however – it is also considered extremely high risk for lateral violence. For those of you who haven’t heard the term “lateral violence” before, it’s basically nurse to nurse bullying. You always hear the term “nurses eat their young” thrown around, and unfortunately this phrase continues to be mentioned, acted upon, and passed down through the generations.

I posted a poll on my instagram asking how many of you have experienced nurse bullying – 78% of you said yes.

Recently, nurse bullying has been a topic of focus in the social media world and for good reason. This year, Becker’s Hospital Study determined that 43% of nurses were considered high risk for suicide, with 7% of nurses reporting self-harm and 11% reporting attempted suicide attempts. I’m sorry WHAT. That is just AWFUL, for a profession that is supposed to promote well-being and saving lives.

I experienced nurse bullying right from the start. Nursing school clinical rotations. Of course I’d have some awesome nurses that loved to teach students. And other days I’d have the nurse that would roll their eyes right in front of me as I introduced myself. Trust me lady, I don’t want to be here either after not sleeping last night, but here we are. And after the introductions were forced I’d run around trailing my nurse all day, staying quiet and out of the way so I didn’t annoy her more than she was already. Too scared to ask questions and actually take advantage of my precious clinical time. Which of course leads to lesser educated nursing students graduating with a predispositioned fear to ask questions as a new graduate RN… leading to unsafe practices and decreased job satisfaction r/t fear and anxiety…. AND possibly resulting in higher nurse turnover for hospitals because of it. Dramatic? Maybe. Accurate? Absolutely. Horizontal violence can cost a hospital anywhere from $30-100K per nurse (Jennifer Becher, MSN, APRN, and Constance Visovsky, PhD, RN, ACNP-BC). Per nurse! And close to $150K for a trained critical care nurse.

Being a new grad in the ICU was better than being a student I’ll give you that. But I still would get the occasional snarky correction while giving report, or even just body language that was so obviously degrading. Sometimes it was just the simple motion of being actively ignored. It’s terrible. And I get it, we all have strong personalities in the ICU. We’re all awesome in our own eyes. But it doesn’t mean we have to treat other nurses like they’re lesser than us.

And it’s not only confined to your home unit. Nurse bullying happens giving report to other floors, between nurse practitioners and the bedside nurse, between preceptors and preceptees. How many times have you heard someone complain about a report from another floor? “How did they not know that? They’ve been taking care of them all night…” Or, “those damn ED nurses bringing up this hot mess.” Now whether or not the comment was warranted is situational lolz. BUT. The fact that it was mentioned in front of other coworkers is nurse bullying. It creates a non-productive environment for everyone, even those who just hear the comment passing by. It promotes that behavior and deems it acceptable if it continues without consequence. New grads are listening – watching experienced nurses as an example to them. Other nurses are listening. People feed off of other people’s energies. Let’s keep it positive energy ya?

Lateral violence can lead to decreased well-being and depressive symptoms in nurses. Sleep disturbances, anxiety, PTSD…the list goes on. Why would we want other nurses just like ourselves to feel that way? And these symptoms not only affect the nurse, they can affect patient care and outcomes. A happy nurse is much more able and willing to provide excellent care than an anxious or intimidated nurse. Right?

So the reason you’re all here. What can we do about this? How can we change this culture that’s been around for so long? Now obviously I don’t have a mind-blowing solution to this issue that’s been a problem for so long. But we can start with acceptance and communication. Acceptance meaning, acknowledging that this IS an issue in the nursing field. A lot of people think that just dealing with nurse bullying “toughens you up for the job,” or prepares you for being a nurse. No. We need to accept that lateral violence in nursing is still an ongoing and unresolved issue in order to fix it. Those snarky comments are not a normal part of the job. It’s bullying. And it stops with communication and advocacy for yourself and others.

So DUH. The easiest answer in response to a nurse bully is to confront them, right? That’s what your charge or supervisor might say when you’ve made them aware of a nurse who was rude to you. “Why don’t you just tell them how you feel?” Of course they’re correct here – you should. But it’s not always that easy! Is it worth talking to that person knowing that if you make this an issue then you’ll have even more problems with them in the future? Better off to just take it you say. Bringing up a bullying situation is really hard! I mean that shit is awkward! But if you can scramble up some nerve to do it, most of the time it is well worth it. These people will be caught so off guard that you actually said something about it, that they may even respect you for it. Cause guess what? You’re probably not the only one they’re picking on. And most people probably aren’t saying something to them, thus they continue the behavior. There have been plenty of instances were I was just fed up and finally said something to someone. And since it was discussed, they were super nice to me afterwards – respecting that I had the balls to stand up to them.

So escalation of the issue. If saying something to them got you more grief that you bargained for, or if you’re just too scared of that specific nurse, bring up the issue to your manager or supervisor. These people are trained to deal with these issues and can address them in a way that hopefully resolves the problem. DO NOT be scared to bring up nurse bullies to your manager!! And DO NOT worry about the aftermath of the bully being called into the office, potentially knowing it was you that said something. Cause guess what. If they do anything post-you bringing this to a manager’s attention that is still bullying, just smile at them, and bring it up AGAIN to your manager and if necessary, HR. Smiling at those people kills them inside I swear.

 

stop nurse bullying

 

I’ve heard from some of you that you have brought up issues of bullying to your managers with no resolution. Either they make it seem like it’s your fault somehow, or that they just simply don’t address the concern in a way that solves the problem. Don’t let this stop you. HR is there for a reason. I know a lot of people that are scared to go up the chain of command to get what they need. They can help you. Mention being bullied to HR in person or even in an email. Keep a log of days and situations if this person continually picks on you and have it to show them.

AND IF you get nowhere after discussing with your manager and HR, and you still feel uncomfortable in your work environment, get outta there. Haha sorry… maybe not the answer I should be giving but in my opinion, there are SO MANY hospitals out there with zero tolerance for bullying/harassment, and you should be working there instead. Feeling bullied and broken at work is not a safe working environment – especially when you’re dealing with sick patients. It is not worth your emotional well-being at work, and the burden you carry with you home. Nursing is supposed to be a rewarding career choice, take your talents elsewhere if your facility can’t figure out how to treat their employees properly.

And what can hospitals do? There should always be someone you’re comfortable with talking to about work-related issues. My last facility had a voluntary mentorship program available to all new hires. I thought this was such an awesome program as it required 5 outside-of-work meetings that were paid for by the hospital. These meetings were simply to support the new hire socially doing whatever you wanted (going out for dinner & drinks, going on a hike, etc). When I was a mentor, I always asked my mentee if anyone was giving them a hard time at work. I was able to be that voice for them and bring it up to their supervisor since I was more familiar with them and it was easy for me to do so. Cause everyone I mentored had always replied with no… I didn’t say anything about it… which is to be expected when you’re new! It’s rough! So I truly believe that having a mentor program like this can help support those new staff by having at least one buddy at work, and someone to advocate for them if they are being bullied.

A glimpse into the future… I read a study called “Nurse Bullying: A Review and A Proposed Solution” (Castronovo, M., et al). They had a very interesting perspective and possible solution for nurse bullying. Basically they concluded that hospitals could have some sort of HCAHPS inspired survey for nurses to complete regarding bullying and their work environment. They believe that there needs to be some sort of incentive for hospitals in order to fix the problem. So, if surveys resulted in high levels of bullying, reimbursement would be reduced. Hmmm…

Nervous to confront a bully? Scrubs Mag has an anonymous form on their website that allows you to report them. They will follow up with your hospital and you can provide as little to as much information as you would like. How awesome. Link is below.

Report a Nurse Bully Here.

And lastly, sign the pledge here to help spread awareness of nurse bullying on the #Nursessupporttheiryoung campaign on Nurse.org.

We are all in this together. Nursing is a profession rooted in compassion, and fueled by teamwork, communication, and empathy. We can never pretend to know what another person is going through in life, so be kind to one another. We’ve all had shifts that make our heads spin, where we forgot something, where we gave a shitty report. It’s okay. It’s never excusable to be a bully, or to be bullied. Talk to someone, support each other. Let’s end the culture of nurse bullying.

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TAGGED WITH: critical care, icu, intensive care, medicine, nurse, nurse bullying, Nursing, nursing school, registered nurse
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One comment on “Stop Nurse Bullying”

  1. Samos
    January 2, 2019 at 12:05 am

    Great article! I’ve been an RN for over 24 yrs now, and I have seen the best and the worst. I still encounter new nurses all the time who are actually shaking with trepidation while beginning to give me report. My response: I usually touch them in a reassuring way and say “Its okay, I’m one of the nice ones, :-)” I actually really get a lot of satisfaction out of being kind and supportive to new nurses. …And let me tell you, two years later, they [usually] still remember it (and they might just end-up being your new boss…).

    When I first started ICU, I was often overwhelmed when giving a report in the morning to the “OG” day nurses. The death stare, no smiling, no blinking, no “good morning,” picking apart everything you say you did, or didn’t do while digging for errors. With the VAST majority of cases, I have handled this by calling them out on it. Letting them no how uncomfortable and how unsupported it makes me feel. Not only do they usually stop doing it, but they have frequently ended-up being some of my best relationships. Honestly, most of these type A nurses (despite female stereotypes), are usually horrified over the idea of ever having to “have a talk” about feelings with you ever again! They will avoid being unpleasant to you just KNOWING that you might actually confront them about it.

    The other practical thing I learned to do early in my career, was to always try and set-up the next shift as nicely as you can. Fresh IV bags/tubing, fresh linen, well cleaned patient, etc… The nurse most likely to write you up is the one to whom you have left the biggest mess…

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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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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
PROPOFOL FACTS🤍😴💤 Did you know the last 2 PROPOFOL FACTS🤍😴💤
Did you know the last 2 slides? 🤓
.
Don’t forget to save this for later!
.
.
.
.
.
#propofol #milkofamnesia #anesthesia #anesthesialife #crnaschool #srna #srnalife #srnaprobs #srnatocrna #futurecrna #icunursing #icunurse #icunurses
Nurse Anesthetist loaaaaadingggggg… ⠀⠀⠀⠀ Nurse Anesthetist loaaaaadingggggg…
⠀⠀⠀⠀⠀⠀⠀⠀⠀
4.5 months til’ the title!! 🎓
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
⠀⠀⠀⠀⠀⠀⠀⠀⠀
#futurecrna #crna #nurseanesthetist #anesthesiaschool #nurseanesthesiologists #nurseanesthesiologist #srnalife #srnatocrna
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