richard1980

richard1980 has 7 years experience and specializes in SICU/CVICU.

Latest Activity

1. Am I qualified? I need your inputs

   richard1980 replied to ucdmc's topic in SRNA

   Take graduate level courses and get A's in them. From what I've heard, it's 'what have you done lately'. Admissions committees may overlook a low GPA from a decade ago if you've take multiple years of graduate level science work and have a 4.0. Do...

2. Does a hospital new grad fellowship/residency ICU program count?

   richard1980 replied to pamchris's topic in SRNA

   The question I have is how could you possibly be ready for anesthesia school if you're a new grad and have one year of nursing experience? You probably don't even take care of the sickest patients in your own unit yet. Get more experience and the w...

3. IABP removal

   richard1980 replied to SLP12's topic in CCU

   What a dumba**! Good for you for standing your ground and trying to go above him. All you can do at that point is document what you did and what he said. Kudos to you!

4. Precedex

   richard1980 replied to Stlcardsrock's topic in CCU

   It's useful if it's started in surgery and used as a bridge to extubation, its usually not started correctly. The patient needs to be kept in a dim quiet room without a lot of stimulation and usually helps if they're on a benzo and/or narcotic becau...

5. Levo and pH

   richard1980 replied to Maevish's topic in CCU

   Absolutely levophed is the first drug of choice but if she's further decompensating perhaps its cardiogenic and epi and perhaps a swan would be indicated. We uses swans every day in my unit. Vigileos are, imo, garbage. The pt can't be tachy or afi...

6. Levo and pH

   richard1980 replied to Maevish's topic in CCU

   I disagree, I think a swan would be indicated as she appears to be in severely decomponsated shock of some sort and doesn't appear to be responding to the treatment they were giving her, a continuous SvO2 monitor would be nice to see as well. (SvO2 ...

7. Milking chest tubes

   richard1980 replied to CleioRN's topic in CCU

   Addendum: In 6 plus years of taking care of heart patients I have never had or seen a negative outcome from keeping the tubes patent...only from letting them occlude by not being aggressive enough.

8. Milking chest tubes

   richard1980 replied to CleioRN's topic in CCU

   I will continue to strip chest tubes as needed as I have been instructed by my surgeon and are written into our post op heart orders. I think if theres any question, ask the surgeon what he or she wants.

9. Hospital paying for NTI? Really?

   richard1980 replied to NightAngelle's topic in Critical

   ....Weird.........

10. Sedation..Your thoughts?

    richard1980 replied to Da_Milk_of_Amnesia's topic in MICU

    It's our facilities policy that we cannot bolus propofol in a syringe but we can use the bolus feature on a pump and give them a few ml's at a rapid rate. I guess the highest rates of propofol I've seen is around 100 mcg/kg/min or so but usually we'...

11. can ICU nurse handle 2 pts on the levophed same time

    richard1980 replied to Snoopy54321's topic in CCU

    You got punked by a lazy nurse....

12. Ambulate with Femoral Lines

    richard1980 replied to Ruby Vee's topic in CCU

    Me too... yikes... In a couple words.. ABSOLUTELY NOT ARE YOU OUT OF YOUR FREAKING MIND???!!

13. Milking chest tubes

    richard1980 replied to CleioRN's topic in CCU

    "A class at Stanford" eh? When did they become the authority on CT management...? Just kidding. :-P All sarcasm aside, the competent nurse should use his or her judgement on the selection of gentle "milking" or aggressive "stripping." There is ...

14. Levo and pH

    richard1980 replied to Maevish's topic in CCU

    If she was that sick she needed a swan... and from the sounds of it tons and tons and tons of volume. How much volume is tons? Give it on pressure bags or with a Level one rapid infuser/warmer until you get to the downward trend of the starling cur...

15. Whats the most blood products you've given in a shift?

    richard1980 replied to richard1980's topic in MICU

    You get a good sick open chest with a BiVad and DIC and it can be a long night...