 Literally, I remember the doctor was walking out of the room taking his gloves off and I looked up at the monitor And the heart rate went from like 150 and all Senate was like 70 in our SNG podcast episode number 222 Welcome to the show today guys today. I am talking with my good friend Ashley Atkins Rn BSN Ashley and I have have been talking and working together for nearly two years now when she was still in nursing schools When we did our first podcast together and Ashley runs an incredibly helpful Incredibly resourceful YouTube channel if you go on YouTube and search Ashley Atkins Rn You can find all of her videos So I invite you to go over there and subscribe and had a lot of fun in this conversation We talked a lot about her journey in nursing what led her to where she is and her biggest tips and biggest advice for you as Nursing students, but before we get started with that I want to remind you guys again that you can get three days of access to NRS NG Academy for just $1 NRS NG Academy is our full complete suite of nursing education resources Including courses videos cheat sheets flashcards and tons of other tools and apps to help you really understand and Accomplish your goals of becoming our RN This is really the apex of our tools that we are offering to you can get three days of access for just $1 If you go over to NRS NG comm slash Academy, that's NRS NG comm slash Academy Yeah, so I'm Ashley Atkins. I have a YouTube channel called Ashley Atkins Rn That I started it's actually almost two years ago It's the two years in March and I do lots of YouTube videos Like personal videos on like stories maybe or like experiences that I had I do a lot of advice videos for Nursing students new nurses experienced nurses Just a variety of things That I enjoy talking about and you know a lot of people enjoy listening apparently So it's been kind of a fun hobby and also an outlet for me and just have built a great community through the My YouTube channel. So yeah, it's it's a fun fun thing and recently you hit a milestone there Do you want to talk about that? Yeah recently my channel reached over a million views It's actually funny because a nurse bass who has been on the podcast and a lot of people know him from YouTube He he actually messaged me the day I reached a million views and he's like congrats And I didn't even realize it because I I don't actually really pay attention much to all of my you know views or Subscribers and and so it's kind of funny that he messaged me about it But yeah, we reached over a million views. It's just crazy to think that I Reached so so many people my videos have reached so many people and inspired so many people and and that's really what it's All about and what keeps me making them is just that you know, I love motivating people and inspiring people I Know recently you kind of got a job in the ICU You want to talk about kind of how that worked out. I know a lot of people want to work ICU So how did that all come about? so My first year of nursing I worked primarily med surge and then I was relocating and So I started the job search and I was kind of torn between you know I well I like the ER I like the ICU so I ended up applying to both and the first interview I got was for the ICU so it was actually a webcam interview which was Quite interesting and fun. Didn't you did you stream your interview or something or is that I I did yes I actually have my live interview on my YouTube channel. I recorded just my face, you know, that's pretty cool So, you know people can hear the types of questions that were asked in my responses, but I got that interview for the ICU and You know within the week they contact me back and wanted to hire me and you know, I was like, well, you know I like the ICU. Let's just jump right in and let's just do it. And so I accepted that position and Started about a month later after I you know relocated and everything and got settled What kind of ICU is it medical is it general? What kind of what kind of floor is it? It's a medical surgical ICU and how many beds there are 24 beds in our ICU Yeah, and there's a CV ICU and a neuro trauma ICU as well. So you're seeing a lot of dka What other things you see in there? Tons of things dka's, you know chf exacerbation a lot of arts, you know respiratory failure A lot of people that had GI bleeds or you know need extensive surgeries and Um, so you guys have all the surgical patients too Yeah, okay. That's cool. I really like it because you know, I did med surge before so I had a little taste of All of these things but to see them on like a multi system multi organ Level is just you know, it's fascinating and I love it It just you know, it like increased the intensity about 10 times now that I'm in the ICU And how do you feel about liver patients? Well, they have just a beautiful smell. Yes, you'll never forget the smell No, that's cool. So, yeah, the neuro ICU I worked on we Because we had the three ICUs going too, but it also served as like the overflow for Surgical or medical and so got a lot of those chs chf exacerbations and the liver patients tended to go to us because they didn't want them, you know So we got a lot of those About a week ago you uploaded a video called my first code Uh, I was about I think seven weeks into my orientation. I was still on orientation and um As terrible as a person is this makes me sound. I was just anxiously waiting awaiting a code Oh, yeah, for sure one of that experience while on orientation while I had that nurse that was dedicated towards helping me learn and everything Um, I didn't want to be off orientation and like oh my goodness someone's coding So the my first code it actually wasn't my patient and it was actually a different nurse's patient And they called it on the overhead and you know, I went down and um, it was uh, I want to say quite I don't know if you start shocking, but not like how you picture it in the movies like they show You know, it's not great anatomy when it gets exactly exactly, you know, it was you know organized chaos There was a lot of people there and um But it was it was messy. It was very bloody messy And I just didn't I didn't anticipate that, you know, if they don't show that in the movies It's always like this perfectly little clean the bed's nice and made clear. Yeah Yeah, so um I for that first code I I observed a lot that I also helped, you know push meds and Both intensivists actually showed up and I was standing right in the middle of them So I got a you know bounce off ideas or things off of them and listen to like their reasoning and rationale behind things And you know, they they would say, you know, give this or give this med And I would you know be like, so why are we giving that or what's your rationale? Or you know, unless I knew why we're giving like epi I know I'm giving epi but So yeah, I mean it was a sad situation the end because the the patient ended up not making it But it was a good experience to see how everyone just came together For this patient to do everything and you know, the family was in the room, which I think was you know, obviously it's very hard for them But I think you know, they could see that we literally were doing everything that we could so Since then I've had quite a few more codes and I've had actually my own patient code a couple weeks ago, which was um And another interesting experience Do you remember the like the diagnosis of this first patient or was it you just showed up and started going? I just showed up and started going so I don't even remember Uh, what why they're there or anything like that. I was just an extra set of hands Yeah, so lots of things we could talk about with codes because I like first of all, I think codes and Rrt's we'd call them And different things like that are the areas that you learn the most, you know Because when medicine is working how it's supposed to work. It's it's by the book, you know, it's perfect, you know, but when Something goes wrong, you know, you're have to think on your feet and you have to really dig into You know the rationales behind epi like what's the right drug? We give it this moment or what do we need to do here? How can you fix things quickly? And I think you can learn so much in those instances. So what I would always do Both when I was precepting and a student and and when I would precept students and stuff is Anytime anything was going down like we'd run to the area so I could get them in there And I pushed the way through and I'd say just go do compressions if you can't do anything else do compressions Yeah, and just like be because anybody can do compressions just be in the room and be around it So you can start getting comfortable with with those and I think it helps you kind of keep your I don't know keep your wits when things start going bad. You know what I mean? Yeah, yeah, you got to have that exposure so you don't freak out You know and I think the most important thing to remember is that you're not alone When when someone codes and you're the only one in the room and you yell out code blue You're gonna get a ton of people in there really quick and so you know as long as you know what you should do immediately You know when someone's coding and doesn't have a pulse you start compressions And you just do compressions until more people show up and more things start happening And you know, it's not like you're gonna be the only one ever running a code You're gonna have a ton of people in there with a ton of knowledge that can help you Yeah, I mean codes are kind of Maybe I'll feel bad for saying this too, but For our ICU for our hospital too with three ICUs and stuff codes were almost like the social setting for ICU nurses It's like where you got to see your old ICU buddies and like how's things going down here, you know Definitely devastating for the patients and I don't ever want to act like we want codes to happen But like you said like almost anxiously Waiting like on edge when those things happen, you're ready. You're prepared and it's kind of a test of your knowledge You know Yeah, test of your knowledge and also you get to really see how well you function as a unit like the teamwork You know, you've got your respiratory therapist the cna comes in and helps out with compressions You've got nurses in there that are you know, just have so much knowledge and you really get to see How that your team comes together and that's really like, you know, what I don't know Gives me a good feeling inside when it's like, yeah, we really worked well together You know, we did this we helped save this person, you know, I go home and feel like I actually You know made a difference Holidays in the hospital. How was Thanksgiving? How was Christmas and everything? How is it going in the hospital with holidays? Good. I actually I was very lucky. I had Thanksgiving off and I not only had Thanksgiving off I had that Wednesday through Sunday off. I managed to somehow work that one in so I was actually out of town But I heard over Thanksgiving that a lot of nurses actually ended up getting called off because they just they were slower But I will be working this Christmas and I will be working new years And I'm actually, you know, I'm I'm kind of excited and I know you've talked about this too It's kind of um, you just feel different when you work the holidays like it's just a different vibe It's a little bit quieter. There's not as many, you know management people and all the, you know All the extra stuff. Yeah, exactly. And you can just really focus on your job and your patients care and um I I I don't mind working holidays one, you know, you get the extra pay I don't have kids yet. I'm married, but my husband's gone, you know deployed right now. So You know It I don't mind working the holidays because I would rather people that, you know, have a bunch of kids, you know Get to spend that time at home with their families. So sure Yeah, it'll be exciting It is neat because, you know, a lot of the hospitalists like they're they're preparing during the week leading up to Christmas for Thanksgiving And they're sending everybody they can home, you know And uh, kind of decreasing their admissions and then it just seems like patients Health conditions cooperate a little better on holidays. I don't know why but things are things are just kind of nice Like you have a minute you can kind of talk to your patients and and there's less people there and it's pretty well staffed and stuff So yeah, I do appreciate I I actually found recently Uh a christmas christmas card that a patient's husband had given to me on my first Christmas in the hospital It was really sweet because he would he sat in the room. His wife had just had a stroke And he kind of sat in the corner. They brought like their own recliner or something I don't know I remember him having like a Rocking chair or something in the corner and he would just sit there all night and write christmas cards to anybody that walked in the room What are the uh, what are the three biggest things that you think you've learned this year as a nurse? Kind of reflecting back throughout the year I think one of them that I realized especially while Working the ICU is that you can't be everywhere all the time You know, if you're in one room and your patient's really sick and you're tight trading drips And the pump goes off in your next room and you know that it could be your leave of fed that's you know, almost run dry and You sometimes you just have you have to learn when to ask for help And that's the biggest thing is you got to learn when you need to call on for help And that's something that I've learned is that as much as it'd be nice if there was three of me to do my job You know, sometimes we just do the best we can, you know in the situation that we're in Um, so that's one of them Learning what your Resources are too is another thing is, you know, like medications like where can I go up and look for IV compatibility and You know making sure that you're educated on the the medicines that you're giving especially in the ICU I mean, I know med surge. It's important too But a lot of times you're giving you know pills and med surge and in the ICU You're giving things that if you mess up on one extra cc That can be a bad day Absolutely So, you know, and then I guess that The next thing I've learned is just to and you learn this in nursing school but it's just really reiterated especially in the ICU is to Some even though you're in a sometimes in a fast-paced situation is to take a step back And and breathe and make sure that you're checking all your steps and making sure everything is What it should be right medication right patient because you know, you you really could Make a big mistake if you accidentally did that and sometimes you're just so busy and Sometimes you have two patients that have the same diagnosis and they're getting the same treatment in the same labs And you want to make sure that you're doing everything on that right patient. So that's another thing I I've always known but it's just been, you know, Reiterated I guess if that makes sense in the ICU Definitely and I mean to talk about that for a second because I I stress that a lot, you know as Is staying calm, you know and because you'll do so much more good for your patient if you Take one deep breath and and think about things before you just start screaming and yelling, you know And the only thing I can really think to share a story that is Is it the first time I saw vTAC on a monitor, you know, I flipped out, you know Just started running around flipping heart. How buddy, you know, my and my preceptor walks over and I'm like, what's wrong with her? You know, I was like, do they have the pulse and I was like, yeah, let me check and sure enough. They have a pulse, you know so You know, I I could think of those nurses that just stayed calm And I can think of the others that just you know, the littlest thing, you know, like Spilt milk, you know, they just lose it over and it's like, you know, because when things hit the fan and stuff, it's like You know, it was hard to keep them calm and then keep the family calm and keep the patient calm It was just too many people to try to keep calm. So I don't I don't even know how to teach that necessarily but No, and I think it just kind of something well I guess for some people it may never come but something that comes with time is just And I think the biggest thing in the ICU for me like starting out was learning what my next step is It's like, okay, I can recognize vTAC on the monitor now. What now, you know and you may be able to rationalize through that when you're Just sitting there, you know talking to your preceptor or thinking about or reading about it But then when it actually happens, you know, is your knowledge going to be there? And you know, I had a situation like I said a few weeks ago. I had my first patient code And a little background on the situation was they came up from the ER Struggling to breathe on bypass and non-working IV which is always fun. Yay. Here's your patient by the way. Yes and You know it it was they I called the doctor we intubated, you know, right away once we got a working line and Literally, I remember the doctor was walking out of the room taking his gloves off And I looked up at the monitor and the heart rate went from like 150 and all of a sudden it was like 70 50 So I checked a pulse and you know, I could only imagine there's no pulse so there wasn't and so Called the code and I remember the doctor just turned around and walked back But you know through that whole code and everything Afterwards, I kind of was debriefing with some of the nurses and the doctor about what happened and I was I said, you know, I'm actually I feel I want to say impressed, but I'm proud of myself because You always wonder, you know, you have all this knowledge But is it going to be there in a situation? Are you going to recognize it when something does go wrong? and I felt like I I recognize it and I initiated the correct steps and you know We got the whole team in there and coded and all what not but Yeah, it's it's one of those things that you have all this knowledge and you just wonder In the right time. Is it going to is it going to come to your head? For for me in that situation it did which I'm thankful for I'm sure there's going to be situations in the future where I I don't know or I do know but it's not coming to my mind and you know just staying calm and knowing what your next step is You know, and I think the best way to explain it is like as like a nurse and any nurse, you know And maybe especially in in situations like ICU or ED or trauma type situations You you have to kind of do two things at once that aren't really compatible You have to be walking a line of tremendous anxiety Anticipation and everything and at the same time you have to stay Massively calm like you have to be really calm But you also have to be like towing the line of anxiety, you know Like waiting for that next thing to happen But for right now everything's cool, you know Yeah, we had to anticipate it to know what you're going to do. Like even though things are all fine and dandy It's you got to anticipate. Okay. Well, if my patient's heart rate suddenly jumps up to 170. What's my next step? You know, exactly. So are you are you night shift or day shift? I'm day shift. Nice. All right So I wanted to ask you another question. This is kind of a more difficult question too, but Bring it. We're really we're grilling you today. So I wanted to ask what like now that you've been out of school for a little while You've had a couple jobs in a couple different settings If you could turn back the clock two years two and a half years maybe maybe Three four years when you're going into your freshman year of college As a nurse, what would you sit down and tell your freshman self? It's gonna be okay No, that's a great question. Um I think I would tell myself to really just Take things day by day, you know when you start off nursing school You're just so anxious just to get through it get through it get through it But you know telling myself take it day by day and really soak in all the knowledge that you learn and you know Nursing school does it prepare you for being a nurse to a certain extent? Yes, but you really learn most of your things, you know when you actually become a nurse But you know don't take The things you learn in that nursing school lightly because those are really the basic foundations of nursing and those big safety markers for keeping your patients safe So if I could look back and tell my young little freshman self It would just be you know take it day by day and don't be so anxious just to be To be done, you know, of course, you're excited to get through nursing school and move on to what you've been working for But you know, don't let that slide the things that you're learning Throughout nursing school. Absolutely. And what do you what do you study now? Like what are you doing to continue learning and things like that? So right now one of my biggest focuses is I'm really trying to become well versed in the all of the icu medications and drips And I mean, of course, I'm there's a bunch of other things as well But that's one of your focus. Yeah my main focus and you know every shift I try to look up one of the medications and really become well educated in it So that way when you're in a situation where let's say they say, you know, you need to go or hang leave of it You're not like, oh, what do I need to start this out? Is this weight-based or non weight-based, you know, so You know, obviously that comes over time with just experience and everything But I would say the icu drips the things that I haven't seen, you know Pathophys of course is you know another big thing that you're always learning but I feel like, you know I Doing med certified. I got a little taste of all the pathophys and now it's just on a grander scheme of things When things get a little bit worse. Yeah. Yeah, things get a little worse and involve a lot more systems and organs and everything but Yeah, definitely icu meds are one of the things that every shift. I'm looking up learning the compatibilities you know of all of them and Is another huge thing because you know, you've got so many medications running at one time Mm-hmm. Mm-hmm for sure. So where what's the what's the what's the plan with nursing now? What's the what's the five-year plan? Five-year plan. So I this is like a job interview. Actually, I know So I definitely want to go back to school to pursue my education and I think I would go the nurse practitioner route um, however, I just want to gain more experience in Um, you know the nursing setting and kind of figure out what I want to specialize in Um, because right now I just like so many things and I really really love the icu But I've also been only working the icu for three months So, you know things could change and I want to make sure that when I go back to school I know for sure what I want to specialize in Um, you know, do I want to be in the hospital setting? Do I want to be like a family practice nurse practitioner or you know women's health or whatnot? So I really want to gain more experience in the nursing setting and to be honest I'm I'm super happy with being a nurse right now at this point in my life. I really love my job I love the people I work with I get a great sense of work satisfaction and you know life satisfaction by going to work and You know, of course, I want to continue to progress and move forward But I also want to just soak in the moment if that makes sense. I love it. No, that's awesome I I have a flaw of always looking for the next thing and almost like to a flaw like I'm always like What's next? What's next? You know Where I I have a difficult time doing that But I think that would that advice and that that outlook you have is much more healthy And I think that's great. You like just take a minute to just enjoy, you know Like like you said, like you've been an ICU nurse for three months Like don't worry. Don't worry about the next thing yet, you know And just and just enjoy it and enjoy everything that you're going to be able to see and do And on that note, what how do you? stave off Burnout and compassion fatigue What are some things that you do or do you consciously do anything or? You know Um, I think I just you know while I'm at work. I'm at work and when I'm at home I enjoy being at home And I you know, I have a lot of hobbies and things that I enjoy doing so on my days off I spend my time doing those and you know, I try not to I mean occasionally I when I am at home, I will Look up something. I'm like, oh, I what was that medication again that I gave or you know Oh, I really you know, I'll be laying in bed at night. I'm thinking about something I'm like, let me look that up really quick. And so I'm not going to deny and say that when I'm at home I just totally don't think of work But I try to when I'm at work I'm at work when I'm at home when I'm at home and I enjoy doing You know going hiking I have two dogs. We enjoy going out to dog parks or you know cooking Keeping my house nice and tidy. You know, I enjoy doing all those things Um And so really I don't I don't think I consciously do anything. I just try to You know have that healthy balance so to speak. I also I enjoy personally for myself I enjoy working three days in a row and then having four or five six Whatever off, you know to pay right now I'm in a on day two of a six day off stretch So I personally like working, you know, kind of groups, you know Doing my couple days on a couple days off and everyone's different Some people get more burnt out by doing that and maybe over time I won't be able to do that. Um But that's what works for me. I like going to work and then I have a bunch of days off to decompress It's kind of hard when I have like one on one off one off because then you just don't really you just have one off It's like doesn't even count. You might as well just spend the night at the hospital exactly the next morning No, that's exactly how I felt too. It's like I would tell my wife and my kids I'm like I'm so I'm I'm absent for the next three days You know, you won't see me and then I'm gonna be home for six days eight days, whatever it was And uh, yeah, I love that. I love that so much about nursing, you know Is being able to really have the home time and have the work time, you know I never felt like a regular dad that's like going to work every day You know, I was able to be home with the kids a lot. So Yeah, I yeah, I joke around with uh, I was talking to my mom about it You know, I'll be like, oh, I'm off for the next six days and she's like it must be nice All right. Well, that's the beauty thing is I work my butt off those three days And and not that my mom doesn't or other people don't work their butts off at work But you know, you you get your butt kicked you work really really hard And it is really tiring and you get home after that third day and you're like, oh my gosh, thank god I don't have to go back exactly But then you have six days and by the sixth day, you're like, all right I'm ready, you know, you're gonna go back to the hospital and You know, there's gonna be mostly new patients or new things That's another thing I like is as nice as it is as it is sometimes to have the same patient consistently You know consistent for them consistent for you safer It's not I like the change and that's the great thing about the ICU is I know when I go back I'm most likely going to have different patients different things and get a learn different thing We'll tell everybody where they can find you I know you have an instagram account that you're pretty active on and your youtube channel, of course Where can people find you connect with you? What do you want them to say to you when they come say hi? So I would say, you know, if you go to my youtube channel, ashley adkins rn I have all of my social media, you know linked Below and so I have you know my instagram account I have my personal instagram and and nursing and I've got you know twitter and all that fun stuff. I would say Instagram is the thing I'm most active on so if people are wanting to Reach out to me ask me questions. I'm more likely to respond on instagram and youtube. I do respond on youtube as well Um Those are the places I'm most active, you know, I do get a lot of people emailing me questions and a lot of things and it's just It's very difficult when you have, you know Several several several questions a day and a lot of the same questions asked every day as well So usually when I have that I end up making a video video, right? Yeah um But yeah, so definitely I would you know leave me a comment on one of my videos Or my instagram say you came from you know hearing The nrsng podcast and you know that way I know where you you found me from and that's you know It's a cool little community that we have that we can you know, all be supportive of one One another and especially in in the nursing world because we we need that support Yes, we do very much. Well, I think you gave a lot of good advice a lot of good tips. Um I think you know, I've learned some things. I've learned, you know to try to live more in the moment I think that's I think that is really helpful and it's I have to remind myself constantly of that so What's some last partying advice last words or anything you'd like to leave with everybody? You know wherever wherever you are in your nursing journey, whether you're you know In high school just wanting to be a nurse or you've been a nurse for 10 years is just you know continually learn and grow and progress and you know but you know take it day by day, you know live in that moment and And just continue to grow because you're gonna get there if you work hard You're gonna get there and I know you just posted on your nrcg instagram about How hard work can sometimes over how was it? What's the quote? Yeah, sorry something about you know, how working hard It can overcome talent or something like that, you know That you can't replace hard work hard work beats talent when talent doesn't work hard Exactly. Yeah, exactly. So work hard no matter where you're at In your nursing journey and and you're gonna get there Guys, I want to remind you one more time to go over to youtube and search Ashley Adkins are in if you aren't already subscribed to her youtube channel You really should subscribe She's got a lot of really really helpful tips and tools and tricks and everything for nursing students and nurses And I really just want to thank you guys. I want to thank you for being here today I want to thank you for taking time out of your busy schedule to spend it with with us to spend it With me and Ashley you guys are really the heart and soul of everything that we do here at nrcg And we spend so much effort and so much time trying to provide you with this confidence and these tools that you need I want you to listen to suggestions given in this podcast to really apply them As you study and as you as you apply for jobs and as you work as a nurse All right guys with that said I want you to go out and be your best self today. Happy nursing