sunshineCCRN

sunshineCCRN has 3 years experience.

Latest Activity

1. post op patients w/o TLC line placement confirmation

   sunshineCCRN replied to elizadream's topic in MICU

   darn right! :angryfire

2. how does your icu perform shift to shift reports??

   sunshineCCRN replied to christen13's topic in MICU

   we do not have a patient-free charge nurse and it is an issue (16 beds). our charge gives group report and briefly outlines all the patients on the unit. the whole staff listens and makes assignments out together (~15min). this is very good because...

3. When a doc refuses to co-sign verbal orders

   sunshineCCRN replied to sunshineCCRN's topic in MICU

   it wasn't me, so i don't know all the facts, but yes, half the hospital administration was involved. thanks for your post, i feel a little better if i ever have to take one of his patients again. (legally, doesn't matter--just sounds like a pretty j...

4. post op patients w/o TLC line placement confirmation

   sunshineCCRN replied to elizadream's topic in MICU

   our open hearts have closing films just before they come to ICU. we confirm swan placement by waveforms and CXR if there is a question (usually anesthesia is right there anyway). every patient receiving a central line (IJ or SC) should have an imme...

5. When a doc refuses to co-sign verbal orders

   sunshineCCRN posted a topic in MICU

   We had a physician who refused to cosign a verbal order taken on night shift. This MD absolutely gave the verbal order, but since a bad outcome happened, he claimed "I never ordered that" the next day. What is the legal ramification for nurses? He...

6. crystalloid recusitation on pt with wet lungs?

   sunshineCCRN replied to geekgolightly's topic in MICU

   You did a good job with him. Good thing you recognized a problem and acted--now you have a valuable experience that will probably come in handy sooner than you think!

7. Good Critical Care Publications?

   sunshineCCRN replied to Dakkon76's topic in MICU

   i joined aacn. i find their Critical Care Nurse magazine really helpful. the Society of Critical Care Medicine has published guidelines for treating certain patients (end of life, neuromuscular blockade, sepsis, etc) which are the gold standard in cr...

8. Doctor comebacks

   sunshineCCRN replied to NiceShot's topic in MICU

   oooh, reminds me of my psych clinicals! If they say something awful, ask (nicely, of course), "I'm sorry, what did you say?" (Makes them realize how rude they just were!) Then try to get to why they were rude: "So you're upset because [the patient i...

9. ICU Nurses with OCD!!!

   sunshineCCRN replied to nursern20's topic in MICU

   I am completely anal at work, whether it's about washing hands or labeling/untangling IVs or having clean, disinfected counters. However, I do NOT understand why some nurses live to terrorize other nurses when the issue does not affect patient safety...

10. Ethical question about CCRN

    sunshineCCRN replied to King Bazald's topic in MICU

    our hospital tells our CNSs and managers that they shouldn't perform bedside care! i don't think that's ok for your manager to renew the CCRN if she didn't perfom all the requirements. why would anyone be motivated to get their CCRN if it doesn't m...

11. Our unit takes too many specialized patients!

    sunshineCCRN replied to sunshineCCRN's topic in MICU

    I like the "mandatory" specialty nurse idea. The problem is, we have such low volume of certain patients that there's little chance for an inexperienced person to become an expert. Does your unit actually call them in on their days off when you ge...

12. propofol infusion ONLY through central line

    sunshineCCRN replied to elizadream's topic in MICU

    We can give it peripherally where I work, but if I have a free port on a central line, I'll use that. Think of all those outpatient procedures that use a profpofol gtt! I doubt anyone would start a central line for those! :chuckle I always wonder...

13. Cvvhd

    sunshineCCRN replied to dv8rn's topic in MICU

    CRRT is any continuous renal replacement therapy, and could mean CVVH, SCUF, CVVHD, CVVHDF, etc. Someone correct me if I'm wrong.

14. Cvvhd

    sunshineCCRN replied to dv8rn's topic in MICU

    I'm having a hard time with your posts, suetje. Most ICU nurses run CVVHD only occasionally. Even if it was all they did, a 10-minute setup is almost impossible, especially if you have to prime twice. Yes, a stable patient with a smoothly-running, mi...

15. Fentanyl/Versed on locked pumps ?

    sunshineCCRN replied to SusanRN321's topic in MICU

    What kind of locked pumps allow for fentanyl and benzos? I've only seen MS, dilaudid and demerol run at a basal rate on those PCA pumps--I didn't think they made compatible containers for benzos and fentanyl.... Our regular infusion pumps have a loc...