RN Joe 86

RN Joe 86 has 10 years experience and specializes in CCRN, MICU, CCU.

Latest Activity

1. Best ER Nurse quotes

   RN Joe 86 replied to JennyAS's topic in Emergency

   An exchange with a brand new intern after a woman coded and expired. Intern: So, what do I do now? Me: You declare the death. Intern: How? Me: Poke her with a stick and see if she moves. If not, declare the time of death. Intern: You're crazy. Me: I ...

2. CCRN with tele experience?

   RN Joe 86 replied to jennysong81's topic in MICU

   Why not take the PCCN since it is more specific to your specialty? The CCRN isn't a BETTER cert to have. I would assume most of the CCRN would be totally foreign to your specialty and irrelevant.

3. How do I protect airway when trach gets pulled out?

   RN Joe 86 replied to ahicks's topic in CCU

   Great question! Hopefully there is an obturator in the room. If not, most trach stoma sites are well developed anough that with a little surgilube you can place it back in. If all else fails and the RT or whoever isn't there to help, occlude the trac...

4. CODE! Need help

   RN Joe 86 replied to vincejojo's topic in CCU

   "Hello Doc. My patient does not a have a pulse. I need help in here." Yeah, that would probably suffice. :)

5. Need advice: I have bad anxiety before I go to work.

   RN Joe 86 replied to funnygirl01's topic in Neuro

   I think being a new nurse on nights is particularly difficult. Lack of resources, rounds and other learning opportunities can make you feel alone. Try exercising and reading a book or magazine before you go into work. It definitely helps ease my nerv...

6. Neuro ICU - Do you talk to brain-dead patients?

   RN Joe 86 replied to talaxandra's topic in Neuro

   Yes. They always have the best advice.

7. drips connecting at y-site

   RN Joe 86 replied to fiveofpeep's topic in MICU

   It actually does not matter if the gtt is y-sited in or not. What ever the gtt rate is set is what the pt. will recieve.

8. How do I know I would fit in an ICU?

   RN Joe 86 replied to Tink7586's topic in MICU

   1) Prioritize (Bed bath vs. PEA code) 2) Organize (scatterbrained vs goal oriented) 3) Able to function under pressure (High stress only if you let yourself get stressed) 4) Stay one step ahead of the patient and always anticipate the worst. 5) Eager...

9. Why do nurses do this?!?!?????

   RN Joe 86 replied to GucciRN22's topic in MICU

   I'm actually on orientation myself. My preceptor and I joke alot with eachother and are quick to laugh at ourselves and eachother. Try to keep it more light hearted. In any way you can, try not to take it to heart. It sounds like they should be more ...

10. checking NG tube placement

    RN Joe 86 replied to Lorus's topic in MICU

    Listen for the burp, initially. And, of course, a CXR.

11. what?...q 15 NIBPs with an art line???

    RN Joe 86 replied to ICUmama's topic in MICU

    Hmm, I think it's time to double check your protocol. That sounds ridiculous and painful.

12. Stroke volume variance

    RN Joe 86 replied to Lynda Lampert, RN's topic in MICU

    SV is contingent on preload. When a patient is dry, there is obviously less preload. LEss preload means that with each stroke there will be less afterload and altered filling. The altered and inconsistent filling will effect your SV and INCREASE your...

13. pressors and sepsis

    RN Joe 86 replied to diosadelsol's topic in MICU

    According to the fellow on my unit, the literature shows greater survival using levo for sepsis and SIRS. From what I could find, it does in fact. Dopa, at lower levels, has almost purely beta stim whereas at higher levels has almost purely alpha. Du...

14. The Dreaded Death Bath and a Moral/Ethical Dilemma?

    RN Joe 86 replied to Be_Moore's topic in MICU

    I know exactly what you mean. A month or so ago, me and another nurse decided to turn a DNR, DNI pt of her's and we turned him to his side and BOOM: complete desat. He was dead in 5 min. Fortunately, the family was in the lounge and close enough to c...

15. How high have you titrated levophed?

    RN Joe 86 replied to racing-mom4's topic in MICU

    Yikes! That sounds like a rough day. However, where were the other nurses? Just two weeks ago I had a new post code with sbp in the 50s and I had another nurse (teamwork!) help me out with her. We wound up maxing her on levo, dopa, neo, vaso, and epi...