Are my pts "brain dead"?

Nurses Relations

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I apologize if I am sounding stupid now,but I am just curious. We have all heard about the case in California with the 13 yr old,and how she is brain dead. Of course,she is on a vent,and the family wants her to get a trach and gtube.

I have several pts that are "unresponsive" meaning they don't talk, blink their eyes, nothing, no purposeful movement, nothing. All but one is on a vent, and all have trach and gt. At least one doesn't even use a gtube. She has been on Tpn for 1.5 years now for all her nutritional needs. One boy is a Dnr order, but with the understanding that we are to rescucitate him using the Ambubag, but if his heart stops, we do nothing. (I haven't seen a Dnr order like that before, and this is the first one I've seen like that)

It also says "at parents discretion", meaning that they could change their minds and make us do chest compressions. (according to nursing supervisor). This same boy had an EEG,and it shows no activity.

Anyway,I'm not seeing the big issue with the California case as I have several kids with vents, trach, and gtubes that are well...I'm not saying the words.

Specializes in Complex pedi to LTC/SA & now a manager.

There are MANY free nursing ceu's at medscape and even nurse.com. Nurse.com had frequent discount codes on their site & Facebook to get a year if unlimited CEUs for less than $30.

Many PDN agencies in NJ offer CEUs but ONLY if you ask HR for access. Many of the multi state agencies offer free CEUs for their employees from day of hire.

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Specializes in Pedi.
My agency has NEVER,EVER,gave continuing education courses except for new vents. They only require a one yr inservice. I wouldn't even know how to find info on nursing conventions,and I don't have $$$ to pay for them either. Private Duty isn't know for paying out $$$. The agency isn't going to pay for it,I know that for sure.In the original post,I did state that my nursing supervisors didn't know either.....most have said the children mainly have AW/AS cycles,and we are supposed to chart that under activity.In any event,they aren't in a PVS either.

You could try Google for information on nursing conferences. I completed all my CEUs for free this year. I collect them as the opportunities arise. My alma mater held a lecture, my agency hosted a few education events and the rest I completed (for free) on medscape. Even if you don't need CEUs for your license, it's your professional responsibility to educate yourself on your patients' conditions and care.

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Specializes in Oncology; medical specialty website.

I use many sites, but one I really like is medpage. All you have to do is read a brief--very brief--article about the topic, then answer two questions. You get ~0.55 CEU for each article. You can bang out an article and quiz in 15 minutes. A half credit doesn't sound like much, but they add up fast. They have CEU for every specialty.

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Specializes in Complex pedi to LTC/SA & now a manager.

Just make certain your state accepts 0.5 CEU credits. Not all do and can be an issue if audited.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
My agency has NEVER,EVER,gave continuing education courses except for new vents. They only require a one yr inservice. I wouldn't even know how to find info on nursing conventions,and I don't have $$$ to pay for them either. Private Duty isn't know for paying out $$$. The agency isn't going to pay for it,I know that for sure.In the original post,I did state that my nursing supervisors didn't know either.....most have said the children mainly have AW/AS cycles,and we are supposed to chart that under activity.In any event,they aren't in a PVS either.

The internet is an amazing thing. There is tons of knowledge right at your fingertips. I can tell you that on a daily basis, I'm researching and reading about things in which my knowledge is lacking in my job and area of nursing. There's no excuse for not being an expert at what you do.

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Specializes in Oncology; medical specialty website.
Just make certain your state accepts 0.5 CEU credits. Not all do and can be an issue if audited.

I checked the FAQ and the link with information about CEU, and neither has anything stating stating 0.55CEU would be unacceptable. Thanks for the heads up, though.

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Specializes in Public Health.

Also, join your states nursing association. They have many ways to earn CEUs for free. You are an adult and google is your friend.

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I am STUNNED that a RN working with traumatic brain injury and similar patients does not know the difference between legally brain dead and PVS and other similar conditions. This cannot be for real.

OP, you need some major remediation. Please leave your defensive posture at the door, and for the sake of your patients, get some education regarding your patient population and patients such as the adolescent in Oakland who has made recent news.

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Specializes in Pain, critical care, administration, med.

The brain stem is what determines life or death. It is responsible for those unconscious functions of the body such as breathing . As a former critical care nurse I am concerned that they are saying brain death and it may actually be persist any vegetative. All the years of experience I have with those declared with brain death generally die regardless of the ventilator and/ or pressors. The body will ultimately die on its own. She has been "alive" way too long since it was evaluated.

Funny when the Karen Ann Quinlan case made headlines about 30 yrs ago they said she was brain dead too. She lived another 10 yrs after she was removed from the vent.

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I am STUNNED that a RN working with traumatic brain injury and similar patients does not know the difference between legally brain dead and PVS and other similar conditions. This cannot be for real. OP, you need some major remediation. Please leave your defensive posture at the door, and for the sake of your patients, get some education regarding your patient population and patients such as the adolescent in Oakland who has made recent news.
I think a few of us are feeling the same way.
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Specializes in HH, Peds, Rehab, Clinical.

Nope, mine never did either. Continuing Ed is up to each nurse to seek out on their own, out of their own pocket as well usually. Fortunately you can find TONS of free CEUs online!!

My agency has NEVER,EVER,gave continuing education courses except for new vents. They only require a one yr inservice. I wouldn't even know how to find info on nursing conventions,and I don't have $$$ to pay for them either. Private Duty isn't know for paying out $$$. The agency isn't going to pay for it,I know that for sure.In the original post,I did state that my nursing supervisors didn't know either.....most have said the children mainly have AW/AS cycles,and we are supposed to chart that under activity.In any event,they aren't in a PVS either.
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I am STUNNED that a RN working with traumatic brain injury and similar patients does not know the difference between legally brain dead and PVS and other similar conditions. This cannot be for real. OP, you need some major remediation. Please leave your defensive posture at the door, and for the sake of your patients, get some education regarding your patient population and patients such as the adolescent in Oakland who has made recent news.
Whatever.......nurses don't know everything.Geez. I see nothing wrong with admitting you don't know something. Yes,I googled it before when Terri Schiavo was in the news,and even then some were reporting she was "brain dead". Which she wasn't.For what its worth,I did mention that I've never seen a diagnosis of Pvs on any facesheet I have come across.You do realize some nurses at my job were saying the same thing I'm saying here about the 13 yr old in California,that she should just a a trach and gt?(Of course,I don't say anything)As I pointed out,even my supervisors don't know.So like I said,whatever......
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