Oh'Ello 4,850 Views
Joined: Jul 24, '14;
Posts: 227 (68% Liked)
; Likes: 932
There aren't really any "formulas". Its just algebra.
I never really "neck tilt" with intubated patients. If I'm having trouble, I elevate the head of the bed (which can be tricky hemodynamically with post-arrests sometimes), and then depress the base of the tongue with a depressor and slide that NGT right in.
In my facility, at least two I've practiced in, the volume is 250 ml. Even if it were 100 ml, OP's post still makes no sense and is not possible.
I don't want any of you as my nurses... BECAUSE I DON'T WANT TO BE IN THE FLIPPING HOSPITAL. (true story)
I personally am concerned of your perception that nursing management is going to provide you reprieve from being on your feet all day. My unit director, clinical nurse specialists, clinical educators and evaluators are probably on their feet as much or more than I am, as they don't have just "one" place to be in the hospital at any given moment. They're giving presentations, attending meetings in satellite buildings, responding to codes, going from floor to floor to do inservice. You might want to consider shadowing some of these people to see what its really like.
Our Director of Nursing is NEVER in her office. She has a bronzed PLAQUE on her door with her pager and email address on it that says "Wherever I go, there I am". I think you're going to be hard pressed to find something even "behind the scenes" that isn't going to require legwork on your part.
I had been refused a job (not nursing...this is way before I Was in nursing), over an undisclosed criminal record. Typically when that happens they have to provide you with the info they used to make that decision (which I requested). I had apparently not disclosed multiple arrests and charges including child abuse, negligence and abandonment, shoplifting, PROSTITUTION. All of these arrests and charges were filed in California, a place I had only visited once... for a week... and had my wallet stolen. It was all so interesting, because I HAVE NO CHILDREN. And I allegedly served time in a county jail in California. Hmm, must forgot about that during my week long beach vacation, didn't take any pictures of my cell while I was there.
Turns out my identity was also stolen, and an illegal immigrant from Colombia had assumed my identity, had opened credit cards, bank accounts, even had a drivers license with my info but her photo on it.
I know the situation isn't the same... but Lawyer up. It took years to fix this crap, likely because my credit was involved, but resolving this
may take more knowledge and elbow grease than you're willing to pony up on your own.
Not mentally checked out as you say...Worked ER as a LPN at a small rural hospital and that is what I long for again..just thought i would give floor nursing a shot..probably picked the wrong floor..been there for about 7 months a total of 3 or 4 IV sticks,,did have a lady with a wound vac but we dont manage those (only in a emergency) they have a wound care team/dept that takes care of all wounds on the floor minus some small dressing changes...I had a coworker that did have a order to hang blood and I witnessed this procedure but she said after being there for two years herself that is only the second or third one she had to do...so typically for our 12 shifts we usually do med passes, bathroom trips (because we are total care facility..No techs/pca's) and ted hose in the morning...if people are satisfied with this environment fine..but its just not for me.
You just have to make sure that you Y-site carefully. If you Have your heparin line directly to the patient and y-site a med into that line that runs at 300/hr you're essentially blousing the patient with heparin content of the y-site to the tip of the iv access. Just rearrange your lines so they make sense.
You know I thought of posting a similar scenario, but feared AN hatred for even having the thought. I was recently visiting my Grandfather, who is in a rehab/nursing home facility right now to recover from surgery. A patient (a rather young one) had an unexpected respiratory and subsequent cardiac arrest in the hallway. Being an ICU nurse I Jumped right in to help with the situation, bagging and performing chest compressions. When I suggested further ACLS interventions I was told "We can't give/do that without Dr.'s orders." This was kind of shocking to me as the patient was dead. It was also kind of shocking the profound unpreparedness the nurses displayed in the situation. At that point I questioned whether I should crack the otherwise unused crash cart and give the damned meds myself. And then I thought... "S***, can I actually be doing this at all?"
I always give notice in the schedule interval. If the schedule is made in 6 week intervals, I give at least 6 weeks. 2 months.... then at least 2 months. If its a 9-5'er where you don't have a "schedule".... 2 weeks it is.
Hairstylists, nail technicians, and long-distance truck drivers are also licensed and regulated. Furthermore, these hardworking people could not be replaced by just anyone off the street with no knowledge or training.
if its not accredited, don't attend.
Yes, I get vaccinated annually. Yes it is mandatory at my workplace. My only concern is how my immune system would handle the flu without the vaccine. I've had the vaccine almost every year for 12 years. I've gotten the flu 4 of the last 5 years and was very very sick. One of those times with ARDS requiring intubation (H1N1). Now I'm afraid if I don't get vaccinated the flu will actually kill me. I have seen individuals released from their jobs for refusing vaccination, as I work in Hematology Oncology. They were able to secure employment elsewhere in the hospital system though.
On some of the floors in our hospital system, nurses are required to do life support "competencies" in addition to getting their BLS certification every 2 years. Places that don't see a lot of codes simply lose the skills between the 2 years. In order to supplement that, they take a 30 minute block every couple of months to have these "at risk" employees practice what to do.
I usually assume people who use gravity method come from a long term care facility background. I precepted and was hired into the ICU as a new grad, I was always taught to use the plunger with syringe. If your vent patient starts to have a bronchospastic cough or anything like that your open flow method turns into a geyser of mess all over you and your patient.
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