So, I am a new nurse and new to the MICU. I love it so far and am starting my 4th week of orientation tomorrow. I have learned a lot so far and have had a good variety. However, I have had patients on 1 drip at a time, usually levophed for sepsis, but I have not had patients on 2 or more drips yet. (and have learned how to scribble things down on my little notepad b/c there's usually not time to chart right away lol). I read the icufaqs.org site on pressors and have a better understanding of ones that I have not encountered yet, but I think I really just need to study a good old fashioned drug guide, as well. My question is: how do you know how to properly titrate multiple drips? I'm so inexperienced at this point that I don't even know if this is a legitimate scenario or not, but say my pt is on levophed and neo at the same time? My understanding is that these have a very similar effect, so do you titrate the neo up first since it is less likely to cause tachycardia in your pt (more gentle than levo?). And if your pt becomes too tachy, titrate levo down, neo up? And, the docs would def. just try one drip first, right? If one drip doesn't work very well, why would adding one with a similar effect make any difference? I have only worked with 2 different drips so far. (levo and cardene). (I was surprised at how quickly cardene brings the pressure down, wow!).
In the MICU, how often will I have pts on multiple drips? Is this more of a CVICU thing? I will be asking my preceptor tomorrow, too. Is this just something that comes with experience, and I need I need to be patient? I just know I have a limited time on orientation, so I need to soak up as much as possible.