rookreck

Latest Activity

1. Insulin drips on the floor!

   rookreck replied to jackieRN03's topic in Cardiac

   My hospital would like to develop an insulin protocol. I am in charge of researching if medical surgical floors are safe and appropriate for insulin drips. I have mixed opinions. While, I think that the patients may not be critical enough to warra...

2. Floating of ICU RNs

   rookreck replied to braveheart's topic in MICU

   I just have to get in on this one. I work in a 120 bed community hospital also. I have been pulled to the floors 2 times in the last 9 days. It should have been 3 times, but I complained to my boss and I think that she felt bad for me and didn't p...

3. Noninterventional Cath Labs

   rookreck replied to RN12345656's topic in Cardiac

   I work at a rural community hospital in Pa. A little over 3 years ago the state of Pa required that interventional cardiac caths be done in a facility that had open heart surgery programs. But for a little more than 2 years now,they are doing a pil...

4. Atrial Fib. Noninvasive Treatment

   rookreck replied to thatoneguy's topic in CCU

   At my facility if the time of the onset is known and is a new occurence we anticoagulate and try to use drugs (IV Cordarone) to convert them. If the patient has been in afib for a long period of time we slow them down with Cardizem and Lopressor and...

5. sedation protocol mechanically ventilated patient

   rookreck replied to rookreck's topic in CCU

   I think if I worked in a large institution that a physician or an intensivist would be given the task of writing the protocol. I don't know if any of you have worked in a small facility. I work in a 120 bed hospital. We have one 8 bed intensive ca...

6. sedation protocol mechanically ventilated patient

   rookreck replied to rookreck's topic in CCU

   The management at my hospital uses the staff nurses for project management in many areas. It is actually very rewarding. I won't be doing this on my own. I will discussing the project with a pharmacist, pulmonologist, and anesthesiologist. Also th...

7. heparin protocol

   rookreck replied to rookreck's topic in MICU

   It is all weight based. I don't know the exact amounts.

8. heparin protocol

   rookreck replied to rookreck's topic in MICU

   We give a bolus with the initial start of heparin. So 99% of the time the first ptt is greater than 110. We then hold the heparin for 1 hour and decrease by so many units and repeat in 6 hours. It just seems like the patient is the one that suffers...

9. heparin protocol

   rookreck posted a topic in MICU

   At my institution we have weight based heparin protocal orders. We have a lot of trouble getting a therapeutic ptt. The patient gets stuck every 6 hours until we get 2 therapeutic Ptt's in a row. Then the Ptt goes to daily. It just seems like t...

10. NGT vs OGT in intubated patient, no sedation and AAO

    rookreck replied to treecy's topic in MICU

    In my institution we insert og tubes in all intubated patients. Our pulmonologist feels that ng tubes cause sinusitis which causes pneumonia. I have tried to insert og tubes in patients that are not on the ventilator and AAO and I think the patient...

11. sedation protocol mechanically ventilated patient

    rookreck posted a topic in CCU

    I am a staff nurse at a small community hospital. My boss would like me to develop a protocol/policy for sedating mechanically ventilated patients. I would apprectiate any copies of policies or protocols. Thanks G