EymieICURN 2,388 Views
Joined: Nov 2, '03;
Posts: 44 (36% Liked)
; Likes: 63
As the critical care educator, I developed a Critical Care lecture series. On the first Monday of the Month I would offer a one hour lecture (for CE). It was offered 2-3 times per day so more people could make it in. I covered medication, disease process and used case studies at the end to stimulate discussion.
bones that stick out of the skin, broken bones that crunch together when you touch them, joints out of alignments, I paid someone $5 to take an IO out of one of my patients. I am thinking of getting some therapy!
Assuming ATB stands for antibiotics...antibiotics are used to kill bacteria not viruses for those you need antivirals.
Have the nurse and anyone that witnessed the incident fill out an incident report. Where I work the risk management department sends the report to the responsible party/department and they have to address it....fill out enough of these reports and hopefully his provileges will be revoked.
My good friend used to say C=RN!
8 mcg X 130 lb X 1kg/2.2 lb X 250 ml/400mg X 1mg/1000mcg X 60min/1hr
I had this problem...A nurse actually manually stretched my cervix...that was more painful that anything else during labor. I went from being 1 cm for over 12 hours to 3 cms after she "streched" my cervix to delivering 4 hours later.
IN the heart failure patient;
Nocturia develops as edema fluid from dependent tissue is reabsorbed while the patient is supine.
A healthy person may have nocturia if the lower extremity valves are incompetent, or in my case, if you work on your feet all day and drink tons of water...The legs can store a lot of fluids (think about raising the legs on a hypotensive patient) and as you lay down that "stored" blood moves through the circulation and the kidneys making more urine. When I used to work the floor I tried to drink a lot of water...I would have to go to the bathroom a few more times a night after those days that on my days off.
In the Heart Failure patient:
In my experience the Filter size does matter! So, it depends what your hospital buys. I have worked in hopitals where we run lipids and TPN throught the same filters and some that you have to run the lipids in after the filter (so you do not clogg the filter up). Another reason can be the type of tubing. Some tubing needs to be changed every 12 hours when running lipids, and TPN can run for 24 hours before the tubing needs to be changed. I have worked in places that mix the TPN and lipids in the same bag, I have not seen that in the last few hospitals..I think a lot of what we do is dictated by what the hospital has in stock. I agree with one of the previous posters, call the pharmacy and ask the pharmacist... they can tell you why they do it that way in that facility.
I had a confused patient that spend half the night saying " Oh Lord, Lordy, Lord". I had a male co-worker call him on the intercom and say "MR...., this is the Lord, please get some sleep" and he did! I also had a confused patient that pulled his foley out. He was bleeding a lot so I said (can't believe I said this-it just came out), "I think you broke it" and he responded "Honey, it didn't work anyway!"
"Evidently you do NOT understand what it's like to offer a patient a bedpan every morning at 0645, explaining to them that you will be unavailable during report and this is their opportunity to use the bedpan, and to have them demand a bedpan at 0705 every morning anyway. Yes, the bedpan comment seems harsh, but I DO understand where the poster was coming from. Interrupting report every single morning to handle a demand that could have been handled BEFORE report is not only irritating, it gets everyone's day off to a poor start INCLUDING the other patients who now have to wait for breakfast because their fingersticks haven't been done.
And as far as mouthing words around the tube -- I can lip read things like "water", "pain", "bedpan" or "family", but a long soliliquy about your granddaughter's no-good boyfriend or your daughter's deficits in the parenting department are a bit much. I, too would turn up the white stuff."
Thank You Ruby and all of those that understand what venting is-I am glad someone gets it!
I posted the bedpan comment and reading so of the responces post reminds me of why I usually do not participate is posting. In my defense, I would never say any of those things out loud to anyone or deny my patient a bedpan. This, I thought, was a venting post and I was saying some of the things sometimes come to your mind when we are at our worst. When you have been putting your pt on the bedpan at least every hour for 12 hours so they can pass some gas, and asked them 15 minutes before shift change if they need anything else and they call for a bedpan 10 minutes after you start report you may be saying the same thing in your head...but what do you do...you get up and put them on the bedpan and hope that they let you finish report before they call again to be taken off the empty bedpan. An like Ruby said...I may be unable to read your lips as your try to explan to me about why you rather watch CSI Mmiami and not CSI NY, but I will give you pain meds and swab your mouth with some ice cold water.
I am very upset at the way I was attacked, I am a great nurse and treat my patients with respect, but since I am not perfect I do think inappropriate things sometimes-things that I would never tell a patient!
If you do not want to leave the room while I clean your family member, then grab some gloves and a washcloth and help me out!
I do not read lips! so stop wasting your time trying to talk to me with that tube down your throat. All I am going to do is turn up the white stuff and put you to sleep.
NO you cannot have a bedpan...can you see we are giving report!?
Even though the BP looked "fine" the fact that the HR was so elevated means that the heart is working really hard to keep the BP at that level. Once the heart poops out that BP will drop fast. Like the previous post notes...it is hard to make an educated guess without knowing the surrounding issues.
I worked as a NUrsing Instructor for 3 years and now I am the Critical Care Educator at a hospital in Tampa. I LOVE IT! I always loved education, so this was the right job for me. I did my MSN in a year...that was taking 10 credits per semester. I did a lot of it online. It was hard to work full time and go to school full time but doable. I figure I will work hard for a year and then I will be OK, before I knew it I was done. The Professors for the MAsters Program were great...I had to have emergency surgery my first Semester and I got married my last semester and they were very understanding.
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