Don't forget that coma is a generic sort of state which can be caused by a number of different things. The pinpoint pupils may be caused by narcotics, which could also be the cause of the coma. Dilated/fixed pupils are a late sign of high intracrania...
Janet Barclay replied to donnar232's topic in General Nursing
There is new legislation in Canada called Protection For Persons in Care. It requires that a criminal records check be done for all new employees prior to a job offer being made. There are of course differneces between a murder conviction and a shop ...
Janet Barclay replied to passing thru's topic in Management
:) Let's see... Arrive 45 minutes prior to shift change to make the assignment sheet, fill any gaps, etc. Arrange for the bedside nurse's breaks, communicate with the physician group . Attend rounds (3-5hours). Assist with patient care if necessary, ...
Janet Barclay replied to zacarias's topic in General Nursing
Not silly to think about fluid overload ever! Remember, though, that the crackles of pulmonary edema sound different than retained secretions or atalectasis- they are best heard at the bases, and sound like saran wrap rubbed between your fingers. Als...
Janet Barclay replied to NsgTiger's topic in General Nursing
Hi, I've worked in critical care for 15 years, and when you are starting out it is really hard to know how much information to divulge to families, espescially when you are still sorting the information yourself. Tell families only what you are comfo...
Hi, I have seen doses beyond the usual .01-.04 u/min, but only for severe GI bleeding (because I'm old :) ). It does cause serious ischemia including the myocardium, but it is coming back in vogue for sepsis. Janet
Janet Barclay replied to vanburbian's topic in Management
Nice Barb, I love the eye opening and insightful remarks. As a manager, please be honest, if I find out a sideways way, I will not hire. Good luck, and congratulations on your ongoing recovery
Janet Barclay replied to laurasc's topic in International
Hi, welcome to critical care. Thelan is a very good text book, The Journal of the CACCN is a good reference (also a good organization), a pocket guide to ECG's is a must, and Mark Hammerschmidt's on line guide is quite good, escpscially for beginne...
Janet Barclay replied to NeuroICURN's topic in General Nursing
Hi all, we have a 24 hr open visiting policy in our 24 bed combined Med/ surg/ neuro ICU, at the nurse's discretion, and only immediate family. Of course, if the pt is A and O they can designate other people to come in. We also have a handbook for fa...
Janet Barclay replied to IloveSnoopy's topic in General Nursing
Hi Snoopy, Sorry that you've been hit by the bug. Being sick is no fun. As a manager I have a few things to bring up. As much as I know that an employee is not faking being ill, or calling in on a Friday night, it is sometimes hard to keep smiling an...
Hi Hayden: Folowing several run ins with steno, MRSA, VRE and all the other nasties, we started doing a "terminal clean" on our rooms post transfer of patients. This includes washing the walls as well as the beds and surfaces and changing the curtain...
Janet Barclay replied to RNforLongTime's topic in Neuro
Hi, We level the transducer to the foramne of munro, halfway between the outer canthus of the eye an the pinna. Most of these policies are Doc driven, so whatever they want, and make sure all RNs are doing it the same way.