The parents who don't want their 15 y/o child to know about his/her terminal diagnosis. The family who wants "everything done" for the terminal patient - meaning tests, painful procedures, etc. One of my personal favorites...the doctor who wants a ...
I have four children so the staying awake at night thing doesn't work for me when I'm not working. I have to be awake when my family is awake. Here's what works for me -- go to bed at regular time the night before I go back to work and then set alarm...
BIS is useful when patients are also neuromuscularly paralyzed and you have absolutely no other means of assessing the level of sedation. However, you cannot rely on the BIS for sedation. In fact, trials and research have inconclusive results as to i...
IV Nicardipine works well - and as a Ca++ channel blocker, it reduces risk of vasospasm. As for beta blockers, our docs don't use them a lot on the heads because, with beta blocked, alpha is unopposed and causes vasospasm.
Your employer may say you've abandoned patients if you don't show for your shift but, legally, you cannot abandon patients for whom you have not taken report. Once you've taken report, you are legally responsible for the patient until you give anothe...
Okay...I have to speak up. First of all, sedatives are not pain medications. Two different things. I think we all know this but the discussion has spun off to a discussion justifying sedation because of the possibility of pain. If this "body of evid...
I am married with four school-age children - went through a 12-month accelerated program. Have worked in the adult ICU of a major trauma center for two years since graduation. If I had done a traditional program, I'd just be starting out as a RN -- c...
Can't speak from the anesthesia perspective but can weigh in from the critical care perspective.... Sometimes, particularly with head trauma, we use NMB gtt to paralyze patients. Since paralysis doesn't equal sedation, we'll often use BIS to give us ...
Does the hospital have a CNS for critical care? How about a quality improvement team? A clinical practice committee? You could give any of these types of groups a good bit of evidence and research related to the items you mention -- or just make the ...
Personally, I do a lot of yoga and pilates. Get a DVD if you don't want to go to a class. I like a combo of both pilates and yoga and ideally you shouldn't need any special equipment. I find both activities to be excellent for core strength and condi...
I've said before and I'll say again...you cannot globally say that open visitation is good or bad. Yes, I want to be with my family when they are in the hospital. And yes, I have plenty of warm and fuzzy stories about wonderful families I've worked w...
Most ICU nurses I work with are: - confident (not arrogant) - stubborn, vocal patient advocates - strong personalities who aren't afraid to have an "animated discussion" about the best plan for a patient - outspoken - detailed - ALL are TEAM players...
Maybe you need to find a place that does self-scheduling. Or, better yet, bring it up at your current place of employment. If you Google and do a little research, you'll find it is beneficial because it increases nurse satisfaction and retention -- g...