EP 204: What Does a Flight Nurse Do with Madison Vawter

EP 204: What Does a Flight Nurse Do with Madison Vawter

What Does a Flight Nurse Do with Madison Vawter

What does it take to be in a different nursing path? Nursing is a vast field to explore. If you are not too keen to work as a bedside nurse, you can always find a different nursing field to pursue. One of these paths is being a flight nurse.

A flight nurse cares for critically ill patients in a plane or helicopter as they are transported from an accident scene to a medical facility. They also ensure their patients don’t go into code while transported to long-term care. 

Qualifying as a flight nurse is easy. You need a nursing license in your state and experience in critical and trauma care. If you’re interested in a fast-paced environment like this, you may qualify to be one. But is that all that it takes to become a flight nurse

In this episode, we would like to introduce you to Madison Vawter. Madison is a flight nurse with an ER, ICU, and Trauma background. We talk about what a flight nurse does, how to become one, and how to build confidence. 

Question for Our Guest

The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.

Looking forward to our conversation!

These are the questions you had in Calendly. We’ll go off your questions and wherever else our conversation goes.

  1. Can you give us a brief background about yourself and How you got into flight nursing?
  2. What are the responsibilities of a flight nurse? 
  3. What education is needed to become a flight nurse?
    • Is it a competitive market to find a flight nurse position?
  4. What are the keys to building a solid resume as a nurse?
  5. What are your thoughts about bullying in nursing? 
  6. What do you think is the key to building confidence as a nurse?

Ending Questions

Before we end the show, we have one last question we like to ask all our guests. If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why? 

Connect with Madison and follow her journey through her Instagram at @madrose.v.

Do you have what it takes to be a flight nurse? Check out the full episode here 👇👇👇

TIMESTAMPS:

00:00 Introduction
01:27 About Madison Vawter
03:54 What is a typical day in the life of a flight nurse like?
05:50 What tasks fall under a flight nurse’s responsibility when there are no patients?
08:01 What other healthcare professionals accompany a flight nurse?
10:48 Who makes the decisions about orders, and how are they communicated?
12:42 What does the team do when they receive an emergency call
17:42 Cases that Madison enjoys addressing
19:18 What does it look like working inside a helicopter
22:02 The most memorable experience
29:43 What is required to enter the field of flight nursing?
32:38 The very competitive field of flight nursing
37:20 Hospital vs. Company based program
38:24 How does the onboarding process look like
41:00 Does a flight nurse need to get familiar with aviation?
44:00 Can a flight nurse care for patients of any age?
45:19 Tips for building self-confidence
53:23 The challenges of a flight nurse
57:42 Wrapping up the show

EP 203: 10 Tips Every Nurse Should Know

EP 203: 10 Tips Every Nurse Should Know

10 Tips Every Nurse Should Know

Do you know the tips every nurse knows? A nurse’s job can be challenging. We deal with different people and patients and work with other healthcare professionals. We execute our nursing care plans with knowledge and skills, and even though we feel pressured, we always smile no matter how demanding the situation is.

Indeed, nurses are the nurturers and healers of healthcare. But how can a nurse last long in this profession? How can we overcome every obstacle that comes our way? 

This episode will discuss the ten tips every nurse should know. Being a nurse is no easy profession, but these tips can help you make it easier to overcome obstacles that nurses face in healthcare. 

10 Tips Every Nurse Should Know

1. As a nurse, know how to eliminate negative self-talk and remain calm. 

  • Are you aware of internal dialogues, how you speak to yourself, and your worries/fears/concerns?
  • If you need help, ask, don’t whine about it. No one likes a complainer. For example, during floating – stay positive and try to have a good shift; your energy helps the unit.

2. As a nurse, you should learn to prioritize. 

  • Prioritize the things that you must get done.
  • Learn to delegate when you can. 
  • Write a list of things you need to do – color code your notes if you need to. 

3. As a nurse, know how to ask questions and when to ask for help.

4. As a nurse, you should know how to prioritize when you need your self-care 

  • For those that don’t work in California, take your break! Don’t be that nurse who never needs a break during your first year.
  • When if it’s just 15 minutes to recharge, accept the break. Who’s a fan of minute 15 min power naps? That mental clarity also helps you improve focus.

5. As a nurse, you should know how to Establish a routine. 

  • Figure out and establish the best routine in your current unit/contract. Get to work early if you need. Get the supplies you need. Look up your patient prior. 

6. As a nurse, you must know how to take notes and be organized. 

  • You can be pulled aside and overwhelmed with demands and requests from your patient and co-workers at any second. It’s unavoidable. Have your favorite report sheets. Eventually, you can ditch taking notes and remember things on the go.

7. As a nurse, you must know how to care for yourself!

  • Hydrate from start to finish of your shift
  • Nutrition matters; plan your meals and carry healthy foods/snacks
  • Strive for a balance between all your pursuits, and make time for things you enjoy to have fun. 

8. As a nurse, you should know how to listen to your patients.

  •  Listen to your patients; they know their bodies better than the clinicians or the knowledge that you know about their disease process. Pay attention to what they tell you.

9. As a nurse, you should know how to ask for feedback.

  • You can’t improve if you don’t know what to improve. Your IV skills. The way you perform a duty. Be receptive and grateful when a colleague gives advice or offers a suggestion. 

10. As a nurse, you should know how to Become efficient at charting. 

  • Learn the charting system as soon as possible. Time is valuable in nursing; it should be utilized in patient care, not sitting behind a computer. 

To learn more about these tips, click here to watch the full episode 👇👇👇

TIMESTAMPS:

00:00 Introduction
01:53 1. You should know to eliminate negative self-talk and remain calm.
03:01 2. You should learn to prioritize.
04:50 3. You should know how to ask questions and ask for help.
07:30 4. You should learn how to prioritize yourself.
10:08 5. You should know how to Establish a routine.
12:29 6. You should know how to take notes and be organized.
15:20 7. You should know how to take care of yourself too!
18:06 8. You should know how to listen to your patients
21:01 9. You should know how to ask for feedback
23:58 10. You should know how to Become efficient at charting

EP 201: Lab Values to Know as a Nurse

EP 201: Lab Values to Know as a Nurse

Lab Values to Know as a Nurse

What are the lab values to know as a nurse? Lab values and what they show could mean so many things. They are used to determine the patient’s overall well-being and health and on nurses to base their care plan.

Different factors affect the patient’s lab values result, but the most common factors affecting it are the patient’s age, race, gender, medical history, and presence of any underlying conditions. Knowing and understanding lab values is essential in your nursing career.

There are different lab values to know as a nurse. In this episode, we will talk about all the different labs we look at in the hospital. We will go over their normal values, what they signify, and what can happen if they are out of their normal range.

This will be a good refresher episode for everyone who deals with labs and a great one for any nursing students because these are the labs you’ll need to know to pass some of your classes and the NCLEX.

Electrolytes

Potassium K+

  • Potassium is one of the most important minerals in the body. It helps regulate fluid balance, muscle contractions, and nerve signals. 
  • Normal level: 3.5-5 mEq/L
    • Hyperkalemia signs: heart arrhythmias, numbness, and tingling, breathing problems
    • Hypokalemia signs: muscle weakness, fatigue, heart arrhythmias
  • Clinical problem
    • Increased level: Acute renal failure, Crushed/burn injury, acidosis 
    • Decreased level: vomiting/diarrhea, dehydration, malnutrition, gastric suction, Diuretics 

Sodium Na+ 

  • Sodium plays a key role in your body. It helps maintain normal blood pressure, supports the work of your nerves and muscles, and regulates your body’s fluid balance.
  • Normal level: 135-145 mEq/L
    • Hypernatremia signs: lethargy, myoclonic jerks, confusion, nystagmus, tachycardia
    • Hyponatremia  signs: nausea and vomiting, lethargy, seizure, neurological deficits
  • Clinical problem
    • Increased level: Dehydration, severe vomiting, diarrhea, Heart failure, hepatic failure, Cushing’s disease 
    • Decreased level: vomiting, diarrhea, gastric solution, D5W, SIADH,

Calcium Ca+ 

  • It is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium enables our blood to clot, our muscles to contract, and our heart to beat. About 99% of the calcium in our bodies is in our bones and teeth.
  • Normal level: 8.5 to 10.2 mg/dL
    • Hypercalcemia signs: bone pain, muscle weakness, excessive thirst, lethargy, nausea
    • Hypocalcemia signs: numbness and tingling in digits, muscle cramps, wheezing, fatigue
  • Clinical problem
    • Increased level: Hyperparathyroidism, malignant neoplasm of bone, lung, breast, kidney, multiple myeloma, and prolonged immobilization. 
    • Decreased level: Diarrhea, malabsorption of calcium, Hypoparathyroidism

Chloride CI- 

  • Chloride is one of the essential electrolytes in the blood. It helps keep the amount of fluid inside and outside of your cells in balance. It also helps maintain proper blood volume, blood pressure, and pH of your body fluids.
  • Normal level: 95-105 mEq/L
    • Hyperchloremia signs: diarrhea, vomiting, fatigue, dry mucous membrane
    • Hypochloremia signs: diarrhea, vomiting, weakness, dehydration
  • Clinical problem
    • Increased level: Dehydration, hypernatremia, head injury, metabolic acidosis.  
    • Decreased level: Vomiting, gastric suction, diarrhea, hypokalemia. 

Magnesium Mg+

  • It helps to maintain normal nerve and muscle function, supports a healthy immune system, keeps the heartbeat steady, and helps bones remain strong. It also helps adjust blood glucose levels. It aids in the production of energy and protein.
  • Normal level: 1.5-2 mEq/L
    • Hypermagnesemia: diminished deep tendon reflexes, flushing, headache, nausea, drowsiness.
    • Hypomagnesemia: muscle weakness, twitches, or tremors; irritability, insomnia, drowsiness
  • Clinical problem
    • Increased level: Severe dehydration, renal failure, leukemia
    • Decreased level: Protein malnutrition, malabsorption, cirrhosis of the liver, alcoholism, hypokalemia

Phosphorus 

  • It is a mineral that makes up 1% of a person’s total body weight. It is the second most abundant mineral in the body. It is present in every cell of the body. Most of the phosphorus in the body is found in the bones and teeth.
  • Normal level: 2.5-4.5 mg/dl
    • Hyperphosphatemia signs: osteoporosis, cardiovascular disease
    • Hypophosphatemia signs: changes in mental state, bone pain/fragility, fatigue, weight loss, weakness
  • Clinical problem
    • Increased level: Renal failure, hypocalcemia, hypoparathyroidism 
    • Decreased level: starvation, hypercalcemia, hypomagnesemia, chronic alcoholism

Ammonia

  • Ammonia is a waste product made by your body during protein digestion.
  • Normal level: 15-50 μmol/L
    • Hyperammonemia signs: Lethargy (ETOH Pt), rapid or heavy breathing, Altered mental status 
  • Clinical problems
    • Increased level: Hepatic failure, High protein diet with liver failure, acidosis. 

Uric acid 

  • It is a chemical created when the body breaks down substances called purines.
  • Purines are usually produced in the body and are also found in some foods and drinks.
  • Normal level 0.18-0.48 mmol/L
    • High signs: Joint pain, joint stiffness, redness, and swelling. 
  • Clinical problems
    • Increased level: Gout, alcoholism, severe eclampsia, renal failure

Creatinine

  • Creatinine is a waste product produced by muscles from the breakdown of a compound called creatine. It is removed from the body by the kidneys.
  • Normal level 0.8-1.3 mg/dL
    • High signs: Nausea, muscle cramps, vomiting, fatigue, HTN
  • Clinical problem
    • Increased level: Hypothyroidism, CKD, intense exercise, dehydration 
    • Decreased level: Renal impairment, hyperthyroidism, ALS

BUN 

  • BUN is the end product of protein metabolism and is excreted by the kidneys
  • Normal level 8-21 mg/dL
    • High signs: Frequent urination, itching, muscle cramps, fatigue. 
  • Clinical problem
    • Increased level: Dehydration, GI bleeding, prerenal failure, Acute MI, sepsis, shock
    • Decreased level:  Severe liver damage, overhydration, malnutrition

Specific Gravity

  • A urine-specific gravity test compares the density of urine to the density of water. This quick test can help determine how well your kidneys dilute your urine.
  • Normal level 1.010-1.030 
    • High signs: Dehydration, Diabetes, Proteinuria, SIADH
    • Low signs: Polydipsia, Diabetes Insipidus, Diuretics, early stages of CKD

LDH 

  • Lactic dehydrogenase (LDH) is an intracellular enzyme in nearly all metabolizing cells, with the highest concentration in the heart, skeletal muscle, liver, kidney, brain, and RBCs.
  • Normal level 50-150 U/L
    • Increased level: Acute MI, P.E, Sepsis, shock, CVA, sickle cell.

Hematology

RBC 

  • The reticulocyte count is an indicator of bone marrow activity
  • Normal level 4.5-5.0 million
    • Increased level: sickle cell, hemolytic anemia, leukemias 
    • Decreased level: Anemia, radiation therapy, post hemorrhage, cirrhosis of the liver (alcohol suppresses reticulocytes)

WBC 

  • White blood count, part of a complete blood count, is composed of 5 types of WBCs 
  • Normal level 5,000-10,000
    • Increased level: Acute infection, Inflammatory diseases (RA, gout), Tissue damage (acute MI, burns)
    • Decreased level: leukemias, immunosuppressive agents

Plt 

    • Platelets (thrombocytes) are essential elements in the blood that promote coagulation.
  • Normal level 200,000-400,000
    • Increased level: Polycythemia vera, trauma, acute blood loss, Metastatic carcinoma
    • Decreased level: Multiple myeloma, Anemias, Leukemias, liver disease, lupus, DIC, Cirrhosis 

Hgb 

  • Hemoglobin responsible for the transportation of oxygen
  • Normal level 
    • male 13-17 g/dL
    • female 12-15 g/dL
  • Increased level: Dehydration, polycythemia, COPD, HF, severe burns
  • Decreased level: Anemias, Hemorrhage, cirrhosis of the liver, Leukemias, Hodgkin’s disease, kidney disease

Hematocrit 

  • The hematocrit is a ratio of the volume of red blood cells to the volume of all these components, called whole blood. The value is expressed as a percentage or fraction.
  • Normal level Male 40%-52% Female 36%-47%
    • Increased level: Dehydration/hypovolemia, severe diarrhea, diabetic acidosis, burns.
    • Decreased level: Acute blood loss, anemias, RA, lupus, CKD, cirrhosis

PTT 

  • Partial thromboplastin time (PTT) is a blood test that looks at how long it takes for blood to clot. It can help tell if you have a bleeding problem or if your blood doesn’t clot properly.
  • Normal level 25-35 sec.  If on Heparin 1.5-2.5x normal
    • Increased level: Hemophilia, cirrhosis, vitamin k deficiency, Von Willebrand disease, DIC. 

PT 

  • Prothrombin Time. It is synthesized by the liver and is an inactive precursor in the clotting process.  
  • Normal level 11- 14 sec
    • Increased level: Liver disease, Clotting factor issues (Factor 2 deficiency), Heart failure, leukemias
    • Decreased level: Thrombophlebitis, MI, P.E 

INR 

  • The international normalized ratio (INR) is a laboratory measurement of how long it takes blood to form a clot. It is made to monitor patients receiving warfarin. 
  • Normal level 0.9-1.2 If on Coumadin 1.5 – 3

Reticulocytes

  • Reticulocytes are immature red blood cells (RBCs).
  • Normal range  0.5-1.5%

Neutrophils 

  • Are the most numerous circulating WBCs, respond mainly to inflammation & tissue injury.
  • Normal range 2-8 x 10^9/L

Bands 

  • Basophils increase during the healing process
  • Basophils are white blood cells that defend your body from allergens. Basophils release histamine
  • Normal Range < 1 x 10^9/L

Lymphocytes 

  • Increased during chronic and viral infections
  • Normal range 1-4 x 10^9/L

Monocytes 

  • The second line of defense. More extensive and more substantial than neutrophils can ingest large particles and debris.
  • Normal range 0.2-0.8 x 10^9/L

Eosinophils 

  • Increase during allergic and parasitic conditions 
  • Normal level < 0.5 x 10^9/L

HBA1C 

  • The hemoglobin A1c test tells you your average blood sugar level over the past 2 to 3 months. It’s also called HbA1c, glycated hemoglobin test, and glycohemoglobin.
  • Normal level <6.5%

Glucose 

  • Simple sugar is used as an energy source and is stored as glycogen in the liver and skeletal muscles.
  • Normal level 70-110 mg/dL
    • Increased level: DM, Diabetic acidosis, adrenal gland hyperfunction (Cushing’s) 
    • Decreased level: Hypoglycemia, malnutrition

Gastrointestinal

Bilirubin

  • Bilirubin is formed from the breakdown of hemoglobin by the reticuloendothelial system and is carried in the plasma to the liver. Bilirubin (unconjugated or indirect) is bound to serum albumin and transferred to the liver, which is conjugated to glucuronate by glucoronyl transferase. Conjugated (direct) bilirubin is excreted into the bile.
  • Normal level 
    • Direct Bilirubin 0-6 µmol/L 
    • Total Bilirubin 2-20 µmol/L
  • Increased level: Obstructive jaundice caused by stones, hepatitis, cirrhosis, liver cancer
  • Decreased level: Iron-deficiency anemia. 

Albumin 

  • Albumin is a protein made by your liver. Albumin helps keep fluid in your bloodstream so it doesn’t leak into other tissues. It also carries various substances throughout your body, including hormones, vitamins, and enzymes.
  • Normal level 35-50 g/L
    • Increased level: Dehydration, severe vomiting, severe diarrhea 
    • Decreased level: Cirrhosis of the liver, acute liver failure, severe burns, severe malnutrition, preeclampsia, renal disorders, prolonged immobilization. 

ALT/AST

  • ALT/AST is an enzyme found primarily in the liver cells and is effective in diagnosing hepatocellular destruction.
  • Normal level 5-30 U/L
  • Increased level: Acute (viral) hepatitis and liver necrosis (Drug or chemical toxicity).

Amylase 

  • Amylase is an enzyme derived from the pancreas, the salivary glands, and the liver. Its function is to change starch to sugar. 
  • Normal level: 30-125 U/L
  • Increased level: Acute pancreatitis, obstruction of the pancreatic duct, acute cholecystitis, diabetic acidosis, diabetes mellitus, renal failure. 

Lipase 

  • Lipase, an enzyme secreted by the pancreas, aids in digesting fats. Appears in the bloodstream following damage to the pancreas. 
  • Normal level: 10-150 U/L
  • Increased level: Acute and chronic pancreatitis, cancer of the pancreas, and obstructions. 

Hormones

Hydroxyprogesterone 

  • IHydroxyprogesterone is a hormone made by the adrenal glands, two glands on top of the kidneys. A 17-OHP test is used for Hydroxyprogesterone levels to help diagnose a rare genetic disorder called congenital adrenal hyperplasia.
  • Normal level: 0.2-1 mg/L

Adrenocorticotropic ACTH 

  • Adrenocorticotropic hormone (ACTH) is made in the pituitary gland. It is needed for your adrenal glands to work properly and help your body react to stress. ACTH stimulates the release of another hormone called cortisol from the adrenal gland’s cortex (outer part).
  • Normal level: 4.5-20 pmol/
  • Increased level: Addison’s disease, Stress, pituitary neoplasm, pregnancy. 
  • Congenital adrenal hyperplasia (CAH) refers to a group of genetic disorders that affect the adrenal glands, a pair of walnut-sized organs above the kidneys. The adrenal glands produce essential hormones, including Cortisol, which regulates the body’s response to illness or stress.

TSH 

  • Thyroid-stimulating hormone is a pituitary hormone that stimulates the thyroid gland to produce thyroxine (T3), and triiodothyronine (T4)  which stimulates the metabolism of almost every tissue in the body.
  • Normal level: 0.5-5 mIU/L
  • Increased level: Hypothyroidism, acute thyroiditis, viral hepatitis, myasthenia gravis, preeclampsia
  • Decreased level: Hyperthyroidism

Thyroxine

  • Serum T4 levels are commonly used to measure thyroid hormone concentration and the function of the thyroid gland. 
  • So, if your T3 and T4 levels are too low, the pituitary gland will release more TSH. If they’re too high, the gland will release less TSH — but this give-and-take system only works if everything functions properly.
  • Normal level:
    • Free T3 0.2-0.5 ng/dL
    • Free T4 10-20 pmol/L
    • Total T4 4.9-11.7 mg/dL
    • Total T3 0.7-1.5 ng/dL
  • Increased level: Hyperthyroidism, acute thyroiditis, myasthenia gravis, preeclampsia
  • Decreased level: Hypothyroidism, Protein malnutrition.

Follicle-stimulating hormone 

  • FSH, a gonadotropic hormone produced and controlled by the pituitary gland, stimulates the growth and maturation of the ovarian follicle to produce estrogen in females and promote spermatogenesis in males. 
  • Normal level:
    • (FSH) 1-10 IU/L (M/F) 
    • 5-25 IU/L (ovulation) 
    • 30-110 IU/L (postmenopause)
  • Increased level: Gonadal failure such as menopause, Pituitary tumor, Turner’s syndrome, Klinefelter’s syndrome 
  • Decreased level: Neoplasms of the ovaries, testes, adrenal: polycystic ovarian disease, hypopituitarism; anorexia nervosa. 

Growth Hormone 

  • Human growth hormone (hGH), a hormone from the anterior pituitary gland, regulates the growth of bone and tissue. 
  • Normal level: (fasting) 0-5 ng/m
  • Increased level: Gigantism (children), Acromegaly (adults), major surgery. 
  • Decreased level: dwarfism in children, hypopituitarism

Progesterone 

  • It is secreted by the corpus luteum, a temporary endocrine gland that the female body produces after ovulation during the second half of the menstrual cycle.
  • Normal level 70-280 ng/dL
  • Increased level: Ovulation, pregnancy, ovarian cysts, tumors of the ovary or adrenal gland. 
  • Decreased level: Gonadal dysfunction, luteum deficiency, threatened abortion, placental failure.

Prolactin 

  • It is a hormone produced by your pituitary gland, which sits at the bottom of the brain. Prolactin causes breasts to grow and develop and causes milk to be made after a baby is born. 
  • Normal level: < 14 ng/mL
  • Increased level: Pregnancy, breastfeeding, pituitary tumor, amenorrhea, hypothalamic disorder, endometriosis, chronic renal failure, Addison’s disease.
  • Decreased level: Postpartum pituitary infarction

Testosterone (male):  

  • Testosterone is the primary male sex hormone and an anabolic steroid. In male humans, testosterone plays a crucial role in developing male reproductive tissues such as the testes and prostate and promoting secondary sexual characteristics such as increased muscle and bone mass and body hair growth.
  • Normal level: 10-25 nmol/L
  • Increased level: Adrenal hyperplasia or tumor, polycystic ovaries in females
  • Decreased level: Testicular hypofunction, Klinefelter’s syndrome (primary hypogonadism), Alcoholism, hypopituitarism

Lipids

LDL 

  • LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
  • Normal level: 85-125 mg/dL
  • Saturated fat and cholesterol in your food make your blood cholesterol level rise.

HDL 

  • HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body to your liver. Your liver then removes the cholesterol from your body.
  • Normal level: 40-80 mg/dL

Triglycerides 

  • Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. The triglycerides are stored in your fat cells.
  • Normal level: 50-150 mg/dL
  • Increased level: Hyperlipoproteinemia, acute MI, Hypertension, cerebral thrombosis, hypothyroidism
  • Decreased level; Hyperthyroidism, hyperparathyroidism, and protein malnutrition.

Total chol 

  • A measure of the total amount of cholesterol in your blood. It includes low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol.
  • Normal level: 3-5.5 mmol/L

Cardiac Markers

Creatine kinase

  • Creatine kinase is an enzyme found in the heart, brain, skeletal muscle, and other tissues. Increased amounts of CK are released into the blood when there is muscle damage. 
  • Normal level:  25-200 U/L
  • Increased level: exercise and inflammation of muscles, called myositis, and myopathies such as muscular dystrophy. Rhabdomyolysis.

Troponin 

  • Troponins are a group of proteins found in skeletal and heart (cardiac) muscle fibers that regulate muscular contraction—used for cardiac disease diagnosis of acute MI.
  • Normal level: 0-0.4 ng/mL
  • Increased level: MI, myocardial damage

C-reactive protein 

  • It is produced in the liver in response to tissue injury and inflammation. 
  • Normal level < 5 mg/L
  • Increased level: Chronic infections, cardiovascular and peripheral disease, acute MI, Stroke, inflammatory bowel disease, RA, Lupus, bacterial meningitis.

D-dimer 

  • D-dimer is a fibrin degradation product, a small protein fragment in the blood after a blood clot is degraded by fibrinolysis.
  • Normal level: < 500 ng/mL
  • Increased level: DIC, P.E, Thrombosis, COVID 

BNP

  • Brain Natriuretic peptide is a neurohormone secretion primarily in the cardiac ventricles and will increase in response to volume expansion and pressure overload.
  • Normal level:  < 100 pg/ml
  • Increased level: Heart failure, Left ventricular hypertrophy, myocarditis, AMI, Renal failure, prolonged systemic hypertension.

Tumor Markers 

Alpha-fetoprotein 

  • Serum alpha-fetoprotein (AFP), a screening test, is usually done between 16 and 20 weeks gestation to determine the probability of twins or to detect low birth weight or severe birth defects, such as neural-tube defects. 
  • Normal level: 0-44 ng/mL
  • Increased level: Cirrhosis of the liver, hepatitis, Spina bifida, Fetal death, fetal distress, Turner’s syndrome
  • Decreased level: Down’s syndrome, absence of pregnancy

HCG 

  • Human chorionic gonadotropin is a hormone produced by cells that surround a growing embryo, which eventually forms the placenta after implantation. The presence of hCG is detected in some pregnancy tests. Appears in the blood and urine 14-26 days after conception.
  • Normal level: <5 IU/I
  • Increased level: Pregnancy, Chorionepithelioma of pregnancy is a malignant tumor originating in connection with pregnancy. 
  • Decreased level: Nonpregnant, dead fetus, postpartum (3-4 days)

CA 19-9

  • Cancer Tumor Markers (CA 19-9) is a cancer antigen in diagnosing pancreatic, hepatobiliary, gastric, and colorectal cancer. 
  • Normal level: <40 U/mL
  • Decreased levels = Effective response to treatment, benign disease
    • There are also different tumor markers. You won’t need to know all of these, but we thought we should include them. 
    • CA 15-3: Metastatic breast cancer, ovarian, lung, pancreas, cirrhosis, colon cancer.
    • CA-27.29: Recurrence of breast cancer
    • CA 50: Gastrointestinal tumor, biliary tract tumors
    • CA 125: Ovarian breast cancer, uterine tumors, pancreas, breast, colon, lung, cirrhosis, pancreatitis.  

CEA 

  • Carcinoembryonic antigen (CEA) has been found in the gi epithelium of embryos and has been extracted from tumors in the adult gastrointestinal tract. 
  • Normal level: <4 ug/L
  • Increased level: GI tract (esophagus, stomach, small and large intestine, rectum cancer), leukemia, Ulcerative colitis. 

PAP 

  • Prostatic acid phosphatase (PAP) originates in the prostate and usually is present in small amounts in the blood. 
  • Normal level: 0-3 U/dL
  • Increased level: prostate cancer, testicular cancer, leukemia, and non-Hodgkin’s lymphoma.

 

PSA 

  • Prostate-specific antigen (PSA) is always present in low concentrations in the blood of adult males.
  • Normal level: <4 ug/L
  • Increased level: Prostate cancer

Vitamins 

Folate 

  • Folate is one of the B vitamins needed to make red and white blood cells in the bone marrow, convert carbohydrates into energy, and produce DNA and RNA.
  • Normal level: 7-36 nmol/L
  • Increased level: Pernicious anemia (is a deficiency in red blood cells caused by lack of vitamin B12)
  • Decreased level: Folic acid anemia, vitamin b6 deficiency anemia, malnutrition, malabsorption syndrome (small intestine), pregnancy, liver disease.

Vitamin A 

  • It is a Fat-soluble vitamin absorbed from the intestine in the presence of lipase and bile. Vitamin A moves to the liver and is then stored in the body as retinol.
  • Vitamin A is vital for normal vision, the immune system, reproduction, and growth and development.
  • Normal level: 30-65 µg/dL
  • Increased level: Hypervitaminosis, Chronic kidney disease
  • Decreased level: Night blindness, liver, intestinal, or pancreatic disease, chronic infections, cystic fibrosis, protein malnutrition, malabsorption, celiac disease

Vitamin B6

  • Vitamin B6, also known as pyridoxine, is a water-soluble vitamin your body needs for several functions. It’s significant to protein, fat, and carbohydrate metabolism and the creation of red blood cells and neurotransmitters.
  • Normal level: 5-30 ng/mL
  • Decreased level: Malnutrition, chronic alcoholism, gestational diabetes, pregnancy, lactation, small bowel inflammatory disease, renal failure.

Vitamin B12 

  • Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia.
  • Normal level: 130-700 ng/L
  • Decreased level: Pernicious anemia, malabsorption syndrome, liver diseases, hypothyroidism (myxedema), pancreatic insufficiency, Crohn’s disease.
  • Increased level: Acute hepatitis, leukemia.

Vitamin C 

  • Ascorbic acid is a water-soluble vitamin important for forming collagen and certain amino acids for wound healing and withstanding stress, injury, and infection. 
  • Normal level: 0.4-1.5 mg/dL
  • Decreased levels: Scurvy, malabsorption, pregnancy, cancer, and severe burns. 

Vitamin D

  • Vitamin D is a fat-soluble vitamin occurring from exposure to the ultraviolet rays of sunlight and is absorbed in the presence of bile and stored in the liver. Vitamin D helps regulate the amount of calcium and phosphate in the body. These nutrients are needed to keep bones, teeth, and muscles healthy. 
  • Normal level:  5-75 ng/mL
  • Decreased level: Malabsorption, cirrhosis of the liver, rickets, osteomalacia, hypoparathyroidism, celiac disease, inflammatory bowel disease

Miscellaneous

Rheumatoid Factor

  • RF factor is a screening test used to detect antibodies (Igm, IgG, or Ig)
  • Normal level:  <25 IU/ml
  • Increased level: Rheumatoid arthritis, lupus, tuberculosis, leukemia

ESR 

  • An erythrocyte sedimentation rate (ESR) is a type of blood test that measures how quickly erythrocytes (red blood cells) settle in unclotted blood in millimeters per hour. 
  • It can show if you have inflammation in your body.
  • Normal level: >2 mm/h
  • Increased level: RA, rheumatic fever, AMI, Hodgkin’s disease, multiple myeloma, bacterial endocarditis, gout, hepatitis
  • Decreased level: Polycythemia vera, heart failure, sickle-cell anemias, factor V deficiency

ACE 

  • The ACE test measures the level of angiotensin-converting enzyme (ACE) in the blood.
  • Normal level: 20-50 µmol/L
  • Increased level: Sarcoidosis, Diabetes Mellitus, hypothyroidism, Respiratory distress syndrome
  • Decreased level: Therapy for sarcoidosis, diabetes mellitus, hypothyroidism

Lead

  • Found in lead-based paint, unglazed pottery, batteries, leaded gasoline
  • Normal level: < 25 IU/ml 
  • Higher levels can damage the kidneys and nervous system.

Refresh your memory and relearn the lab values by watching the full episode here 👇👇👇

TIMESTAMPS:

00:00 Introduction
01:21 About the episode
02:35 Electrolytes Potassium K+
Sodium Na+
Calcium Ca+
Chloride CI-
Magnesium Mg+
Phosphorus
Ammonia Uric acid
Creatinine
BUN
Specific Gravity
Lactic Dehydrogenase (LDH)
17:02 Hematology
RBC
WBC
Platelets (thrombocytes)
Hemoglobin (Hgb)
Hematocrit
Partial thromboplastin time (PTT)
Prothrombin Time (PT)
International Normalised Ratio (INR)
Reticulocytes
Neutrophils Bands
Lymphocytes
Monocytes
Eosinophils
HBA1C
Glucose
27:25 Gastrointestinal
Bilirubin
Albumin
ALT/AST
Amylase Lipase
30:40 Hormones
Hydroxyprogesterone
Adrenocorticotropic ACTH
Thyroid-Stimulating Hormone (TSH)
Thyroxine Follicle-Stimulating Hormone (FSH)
Human Growth Hormone (hGH)
Progesterone
Prolactin
Testosterone
36:57 Lipids Low-Density Lipoproteins (LDL)
High-Density Lipoproteins (HDL)
Triglycerides Total Cholesterol
39:11 Cardiac Markers
Creatine kinase
Troponin
C-Reactive Protein
D-Dimer
Brain Natriuretic Peptide (BNP)
41:56 Tumor Markers
Alpha-Fetoprotein (AFP)
CA 19-9 Carcinoembryonic Antigen (CEA)
Prostatic Acid Phosphatase (PAP)
Prostate-Specific Antigen (PSA)
44:15 Vitamins
Folate
Vitamin A
Vitamin B6
Vitamin B12
Vitamin C
Vitamin D
48:12 Miscellaneous
Rheumatoid Factor (RF)
Erythrocyte Sedimentation Rate (ESR)
Angiotensin-Converting Enzyme (ACE)
Lead

EP. 198 Guide to Personal Finance With Anthony Swain

EP. 198 Guide to Personal Finance With Anthony Swain

Guide to Personal Finance With Anthony Swain

Personal finance must be your top priority. The nursing profession is indeed a lucrative job. It has its perks and advantages, mainly if you choose to be a nurse in a specific field like travel nursing.

If you’re a student nurse right now, you’re probably thinking, “I want to be a nurse because it pays well, ” While this is true, this should not be your end goal. Just because the job pays well, that’s all you’ll ever chase.

Being a nurse is more than just the dollar sign; being a travel nurse requires time and dedication. And if you want to do both and get the paycheck you deserve, you must also learn how to build a solid financial foundation.

Remember, you will not be a nurse forever, and learning to manage your finances as early as now will help set your future. What can you do about it? And what are the benefits of having a solid financial foundation?

In this episode, we would like to introduce you to Anthony Swain. Anthony has been an RN since 2014 and works as a travel nurse and Nurse Finance Coach. He recently released his new e-book, The Travel Nurses’ Guide to Personal Finance.

The goal of his book is to help nurses & other healthcare professionals develop a solid personal financial foundation so that they can be empowered by money rather than be hindered by it. His mission is to help others reach financial independence. 

QUESTIONS FOR OUR GUEST

The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.

Looking forward to our conversation!

These are the questions you had in Calendly. We’ll go off your questions and wherever else our conversation goes.

  1. Can you please give us a little background about yourself?
  2. Before we dive into some financial tips, what was your favorite unit to work on?
    • What was it like working with liver and kidney transplants? What did the day-to-day look like?
    • When it comes to liver and kidney transplants, what are some protocols you follow or things you pay attention to? 
  3. When you started travel nursing, what really surprised you? Were you surprised by how little focus is placed on investing and saving for your future?
  4. Is working overtime worth it? Doesn’t a lot of it get eaten away by taxes?
  5. What are the most critical systems to put in play when travel nursing? 
    • Where should people start to put their money?
  6. In your book, you mention asset and investment allocation; what are they, and are they different?

ENDING QUESTIONS

Before we end the show, we have one last question we like to ask all our guests.

If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why? 

Connect with Anthony through his Instagram at @financially fit.rn Or check out his book titled The Travel Nurses’ Guide to Personal Finance

SPECIAL CODE: CupofNurses25 for 25% off for the entire week of the podcast episode 

Want to learn more about managing your personal finances? Click here for the full video 👇👇👇

TIMESTAMPS:

00:00 Introduction
01:44 About Anthony Swain
03:37 Travel nurse financial lesson
04:48 Financial tips for new grad nurses
10:02 Possible modifications to make student loan repayment easier
14:25 Financial advice for nursing staff who want to do travel nursing
17:16 What to do with the money you’ve saved?
18:32 The journey of writing a book
20:31 What’s inside the book
21:50 How to begin building financial stability
24:54 How to track your finances
30:35 What to do with your extra money
33:36 Can a nurse retire early?
36:45 Difference between Asset allocation and Investment allocation
38:01 Where are Anthony’s Investment
40:57 Difference between an Index Fund and a Stock
45:38 Universal Life Insurance vs. Term Life Insurance Policy
50:12 Wrapping up the show

EP 196: What is Sports Psychology With Sean O’Connor

EP 196: What is Sports Psychology With Sean O’Connor

What is Sports Psychology With Sean O’Connor

Sports psychology is a practical skill that helps address athletes’ optimal performance and well-being. How can this be used? And what do you know about sports psychology? 

Traumas and repressed emotions can affect us in the long run. Some of us can handle these emotions well, while others displace them, creating more trauma, stress, fear, anger, resentment, depression, and anxiety.

How can people heal from this? Is there a way to work through these feelings? 

In this episode, we would like to introduce you to Sean O’Connor. Sean is a licensed mental health counselor (LMHC) at Peaceful Living Mental Health Counseling in Scarsdale, NY.

He specializes in sports psychology and trauma-informed counseling to help adults and athletes overcome anger, depression, anxiety, PTSD, and stress. 

To treat his patients, he uses a combination of EMDR therapy, mindfulness, meditative science, polyvagal theory for nervous system regulation, and neurofeedback when working with clients.

Sean loves working with athletes and survivors of past trauma to help them heal from the past, love the present, and have hope for the future.

Questions for Our Guest

The questions below are some we’d like to tackle. We often go off-topic, so we don’t expect to hit them all. If you have any ideas, please let us know.

Looking forward to our conversation!

These are the questions you had in Calendly. We’ll go off your questions and wherever else our conversation goes.

  1. Can you give us a little background about yourself?

2. How did you get into Sports Psychology & what is sports psychology?

3. How do Athletes cultivate their identity? 

4. What does it take to improve your mental health?

  • What is the simplicity of happy living?
  • What are some common stigmas in mental health?

5. How does holistic health play a role in mental health?

6. What is the Polyvagal theory?

7. What is the problem with the age of information? 

8. Martial arts

ENDING QUESTIONS

Before we end the show, we have one last question we like to ask all our guests. If you had the opportunity to have a Cup of coffee with anybody one last time, who would it be & why? 

Connect with Sean through his Instagram @peacefullivingcounseling Or visit their website at https://www.peacefullivingmentalhealthcounseling.com/. 

Do you want to know more about sports psychology? Click here for more 👇👇👇

TIMESTAMPS:

00:00 Introduction
02:11 About Sean O’Connor
08:41 What is the language of an Athlete
12:13 The most frequent problems that athletes face
15:35 What transpires when an athlete leaves their sport
17:37 How to guide struggling athletes
22:34 What are the traits of an athlete
25:27 How to overcome extreme pressure and performance anxiety
30:38 How to communicate to a person who is tense and fearful
36:02 How important is physical health to mental health
40:16 How to recognize danger and when it exists
43:25 How our emotions make our consciousness
48:18 The negative impacts of the modern age of information
52:31 What makes EMDR more efficient
58:43 How martial arts enhance both mental and physical health
01:08:03 How martial arts foster self-control
01:11:45 The significance of a warm community
01:19:48 What separates an elite athlete from the rest
01:22:13 Wrapping up the show