Latest Comments by BlueChocolateCat

Just like you prime an IV infusion, you prime the transducer set up to ensure no air bubbles and clamp the line while it is being disconnected and changed.

But I'm going to tell you right now, the NCLEX will not even have the word "transducer" or anything related to it within it's content. That is way too advanced fort he NCLEX.

I'll be starting right after I turn 25. Finishing at 27. When I start I will have over 2.5 years of ICU experience as a BSN, RN

Hi all!

I was accepted to CRNA school and I start summer 2017, just a few short months away. I want to get a head start on understanding some of these anesthesia meds at an in-depth level. My drug resource books from my undergraduate are very much lacking.

Does anyone know of any good online resources for studying and reference?

The only one I am aware of is openanesthesia.

I see you posted this a while ago, but I applied and was recently contacted to schedule an interview. I'm very nervous!

We do not have a solid policy. It really comes down to nursing discresion (unless the docs insist)

In our unit, we are able to give small neo pushes during moments of severe hypotension (MAPS <50) as rescue drug. I have most definitely gotten patients OOB to chair POD 1 on smaller doses of vasoactive drugs. And if they require a slight increase in dosage while in the chair? So be it. We rather maintain respiratory function, mobility, and skin integrity. However, if you have a patient that is extremely labile and you simply do not think they could tolerate the move OOB to chair, then notify the doc and wait until they are more stable.

In my cardiac surg ICU we prefer levo as a first line. If the patient isn't responding to levo (generally requiring doses over 10 mcg/min) we will add vaso. Amoung our ICU, there is some speculation that high doses of vaso may be linked to bowel ischemia?

Also, we will utlize vaso if the patient has persistant acidosis with a ph <7.30

I'm sorry if this doesnt pretain to your monitors, but on our monitors we are able to turn "pacemaker monitoring" on and off. Maybe certain monitors have this turned to OFF as a default?

I'm one of those nurses. I started off in a very high acuity CVICU as a new grad. I have worked here for just over a year and I'm still going strong. I know that I am improving as an RN every day. I have a lot of nurses around me that have worked here for many years and started as new grads. Ironically, some of the nurses that transferred to our unit from the medsurg/ SDU areas have really struggled with the vast difference in autonomy, critical thinking, time management, and prioritization.

I also am considering the pursuit of CRNA. Great thread!

Considering that lowering the patient's head of bed during an episodeo of hypotension is considered a solid NURSING intervention, that sounds very strange to me.

Generally, ICU nurses are allowed a slight increase in autonomy for obvious reasons.

If you have previous ICU experience at other institutions, I might consider presenting your observations to your nurse manager in an attempt to initiate positive dialogue. I am wondering if there is a group of nurses at this facility that have spent their entire careers there and simly do not know of how other ICU nurses function.

From reading this story, I don't think you did anything wrong at all. It sounds like you did everything right, and I probably would have given him the xanax as well. It was three and a half hours after a pain pill that he was tolerating well.

Out of curiousity though, did you give him the max dose rather than the minimum?

I read OPs first post and no others.

My impression of the situation is that you are working with a very burned out-short fused preceptor.

I don't think the situation with the wound-vac was your fault at all. For her to lose her cool so severely right in front of a patient is really not acceptable. I understand we are all human, but keep it together. I'd probably report this situation to your manager as your PRECEPTOR failed to offer guidance as required of her.

On the other hand, no need to appologize. You didn't act out of line.

Yet, I would advise you to pay special attention to some of your nonverbals and tone of voice. I know that at least for me, when I am particularly stressed, I have to pay close attention to my own body language as to not give off the wrong impression.

At my facility this would be grounds for immediate termination. Completely unacceptable.

I'm ready for the day that someone gets their chest re-opened at the bedside and we do direct cardiac massage.

I think the best one was the patient who was doped up on PCP or some crazy stimulant and was able to pick up a total care bed and actually throw it.

Move to Ohio.

I think the vast majority of my classmates are employed as RNs. I graduated in May 2014, passed my boards end of July 2014, and my first day of orientation was in the end of October 2014. I had two job offers. If you have experience, they will welcome you with open arms. There is definitely a shortage up here.

Moral of the story: I suppose the job situation can largely be related to your geographic location.

Cheez, that sounds like what YOU must be doing while you're at work