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This is a very grey area. I included the webpage from LifeSource on referral triggers. The catch is that if you are using neuromuscular blockade as part of your protocol, many of these tests for...

"Core Curriculum for Critical Care Nursing" by J. Alspach "AACN Advanced Critical Care Nursing" by K. Carlson "The ICU Book" by P. Marino (also the Little ICU Book, pocket sized, same author)...

I'm really sorry you're going through this. I don't want that for you. Things are much better in other places. You are dealing with a very unhealthy (read: toxic) work environment. There are many...

One other thing I might mention...a patient with CHF may breathe better without the ventilator. This is jumping way ahead (because I'm assuming that pulmonary edema is resolved), but being placed on...

I am a nurse in the medical cardiac ICU and I did hear that the hiring pause is lifted. It sounds like you have a great background. My only advice is perseverance. I have not heard of any automated...

I've heard through the grapevine that Mayo Rochester is looking into the feasibility and benefits vs. drawbacks of a nursing "residency" program. It's my understanding that nursing residency is a...

So, do you question the motivation of the family for wanting the monitor on? Do you think it's morbid curiosity? If the monitor is on, does that detract from a "good" death? Does having the...

If you're really Type-A, you may prefer a Cardiac Surgical ICU over a Cardiac Medical ICU. In Cardiac Surg, there is a lot of bean-counting...chest tube output, urine output, CRRT, titrate drip A...

Recently, I had a new nurse approach me and pose this question: How do I shut off all of my bedside alarms but keep the data on the screen? At first I wondered why in the world the nurse would want...

I have been a nurse at St. Mary's Hospital at Mayo Clinic in Rochester for 7 years now, and I wouldn't want to be anywhere else. I grew up in Southern California, and the job at Mayo is what now...

Virchow's Triad: 1. Venous stasis (not moving) 2. Vascular trauma 3. Hypercoagulable state Your question revolves around #1...even normally healthy people get DVTs on long plane flights. There is...

CCRN is absolutely not mandatory. You can work your entire career without CCRN certification and not have a problem. That being said, CCRN certification (or any specialty certification for that...

First of all, I'm sorry that you experienced this. It's really frustrating and hurtful. You are competent. Your rationale outlines that very clearly. Secondly, the situation outlines the "ethics...

Also, this is more like a troponin "flood" than "leak". No matter what your renal function, a trop of 6.4 isn't good. Even if it's "I" vs. "T", 6.4 is substantial. Especially given the patient's...

Full reference for norepinephrine vs. dopamine: NEJM 362(9): 779-89, 2010 MAR 4. DeBacker, D., et al.

...2010, DeBacker,et al) there has been a benefit of norepinephrine shown (over dopamine) for cardiogenic shock in terms of tachycardia and dysrhythmias. That said, this person was in dire straits...

Not sure why there's a second discussion posting on this, but here's my take (after reading previous posts): not sure there's a "presssor of choice" in a situation like this. The team is biting the...

IABP, what does the Echo show, ?inotrope, albumin, fluids. Sounds like an ECMO pt in the making...if there's anything left neurologically.

Continuous monitoring done via bedside monitoring...Usually 5-lead, but can do continuous 12. If something's fishy I usually request a formal 12-lead (different machine). Our institution has a order...

@hintzk83 Just off the top of my head, I know there are a couple of extended-stay hotels here in Rochester, so if you just need about a month of residence, they might be a good bet. One is Extended...

What we have here is a Class IV lorazepam deficiency.

Where in MN are you located, or where would you like to be located?

@BelgianRN Two populations that may benefit are those in which we expect more difinitive therapy for heart failure: pre-transplant and LVAD. In these patients, improved diuresis in the short term...

Be aware that the Mayo system has a very large pool of highly qualified BSN/BAN grads, so the only ADN grads that generally get in (to the inpatient setting, at least) are from two local community...

@belgianrn the evidence for "renal dose dopamine" is clearly negative with regard to mortality and renal failure...there is no conclusive evidence that it has benefit in either of these areas. ...