http://allnurses.com Critical Care Nurses talking and networking with each other about the many aspects of Nursing in Intensive Care Units. Please use the links to the many ICU forums below. en Sat, 21 Nov 2009 02:55:52 GMT vBulletin 60 http://img.an-file.info/misc/rss.jpg http://allnurses.com http://allnurses.com/critical-care-nursing/should-cvvhd-1-a-439329-new.html Mon, 16 Nov 2009 03:50:22 GMT Should it be required that pts on CRTs be kept at a 1:1 ratio? I have a very unstable pt on CVVHD... Should it be required that pts on CRTs be kept at a 1:1 ratio? I have a very unstable pt on CVVHD but also have to take on another pt cause my hospital doesn't require 1:1. I think it is ridic because my other patient gets super neglected while I'm constantly monitoring and managing this guy. We have a great suport system in my unit, but it all falls back on my nursing license. I can't seem to get my nurse manager to grasp on to my argument though... :cool: ]]> Critical Care Nursing kristenallene40 http://allnurses.com/critical-care-nursing/should-cvvhd-1-a-439329.html http://allnurses.com/critical-care-nursing/how-soon-too-438557-new.html Thu, 12 Nov 2009 01:37:50 GMT I am currently working on a surgical unit but really want to work in critical care. I graduated in... I am currently working on a surgical unit but really want to work in critical care. I graduated in may and actually got an ICU job right away in my hometown at a great facility, worked there for four months, then had to move out of state because of my husband's job transfer. In the state I live now, I was unable to find an ICU position so I had to take a Med-Surg job. My facility will allow me to transfer to another department after 6 months of employment. My question is should I wait the 6 months and transfer right away? I am concerned that my supervisor would be upset and think that I only took the job to get my foot in the door (which is basically what I did). My other option would be to apply to a different company altogether next may when I will have my year of RN experience that all the hospitals here are looking for you to have in order to get in the ICU. I really have no interest in doing med/surg and am very miserable. I feel like I am buying my time, but at the same time I am greatful to have a job at all and I don't want to rock the boat and get myself in trouble with my current position because I'll be trying to transfer so soon. This is all just very dissappointing. I went into nursing thinking that I could chose my path, but there seems to be so many loop holes to jump through. I feel like I have no control over my future anymore. Any advice would be greatly appreciated. ]]> Critical Care Nursing Angel_RN_1 http://allnurses.com/critical-care-nursing/how-soon-too-438557.html http://allnurses.com/critical-care-nursing/advice-icu-entry-436543-new.html Tue, 03 Nov 2009 20:32:04 GMT Hi! I'm currently enrolled in an accelerated "advance2BSN" program at my alma mater! I desperately want to get into ICU upon graduating. (my ultimate goal is to become a CRNA) Does anyone have advice on tips to better my chances while in school? Special volunteering?? above and beyond certifications? Thanks a lot... any bit of advice will help:) ]]> Critical Care Nursing MicheleLC http://allnurses.com/critical-care-nursing/advice-icu-entry-436543.html http://allnurses.com/critical-care-nursing/p-e-living-434894-new.html Wed, 28 Oct 2009 04:09:25 GMT My patient arrived to the unit with the report that she had bouts of SVT requiring cardioversion.... My patient arrived to the unit with the report that she had bouts of SVT requiring cardioversion. On arrival she was in sinus tachycardia. Within minutes; however, she bounced right into afib with a rapid ventricular rate of 160-220.This was sustained for more than three hours.

I decided to check a pulse to see how my patient could possibly be compensating with such prolonged cardiac output and noticed that the tapping reverberating against the pads of my fingers felt more like the slow trudge of bradycardia than the panicked thrumming of tachycardia. Sure enough, auscultation of the apical pulse revealed that the actual contractile beats were 1/3 to 2/3rds that of the electrical rate. IE EKG hr is 150, apical pulse is 50!

The only way I can think of this is that you know how sometimes P waves happen and they are nonconducted? Well in this situation perfect QRSs are conducted but they arent all leading to a contraction. They are noncontracted QRSs! This was evident on the a-line waveform which showed coinciding waveforms with only some of the QRS complexes.


What was this? Do you have any idea? ]]> Critical Care Nursing maggiofliore http://allnurses.com/critical-care-nursing/p-e-living-434894.html http://allnurses.com/critical-care-nursing/pccn-434277-new.html Sun, 25 Oct 2009 21:02:45 GMT writing pccn in 2 weeks .......... please help any advices please !!!!!!!!!!!! writing pccn in 2 weeks .......... please help any advices please !!!!!!!!!!!! ]]> Critical Care Nursing spcu nurse http://allnurses.com/critical-care-nursing/pccn-434277.html