mattcastens

Latest Activity

1. What Do You Want To Hear When Receiving Report?

   mattcastens replied to rebelwaclause's topic in General Nursing

   I used to have that problem until I said, "you're an intellegent nurse -- read it yourself." I also broke the habit by simply not using the flowsheet to give report -- I do it all off the top of my head. If I'm not reading, they're not reading. Of...

2. What's your clipboard like?

   mattcastens replied to mario_ragucci's topic in General Nursing

   Actually, the only notes I take have to do with small tasks I need to remember. I've always just take mental "notes" when I'm listening to report. Of course, working in ICU I only have to remember stuff for one or two patients...

3. Encouraging AMA?

   mattcastens posted a topic in General Nursing

   I had a patient today that expressed the wish to leave AMA. I told him that he was well within his right to leave if he wanted to and that I would be willing to call his doc and get the paperwork ready. I also gave him the standard spiel about insu...

4. clinical question

   mattcastens replied to MIS's topic in CCU

   Dobutamine would be a better agent to use, possibly in conjunction with dopamine if needed. The only reason I could see to use nitro would be to keep the coronaries patent (spasm prevention) post-procedure, especially since you need a very high dose...

5. Floating Policy Help Needed

   mattcastens posted a topic in Neuro

   Does anyone out there work in a hospital that has a "closed" critical care float policy, that is, a policy where CC nurses only float to CC areas? I am currently on a committee that will be submitting a proposal to our hospital's Staffing Advisory Co...

6. Does health care in general do any good for our species?

   mattcastens replied to mattcastens's topic in General Nursing

   I know! What happened to AllNurses? Has everyone gotten civil? It must be just to impress Santa. Actually, I've been really enjoying what people have written. Since I started the whole thing, I should probably clarify that I don't belive the pre...

7. Question about gtt titration

   mattcastens replied to New CCU RN's topic in CCU

   Usually the neighborhood of 30mcg is the upper limit. If you get that high, watch for tissue necrosis in the extremeites -- you can be they aren't being perfused!

8. Taking Call

   mattcastens replied to Kansas_RN's topic in Safety

   At our hospital there is no mandatory on call for us (unless a nurse works in OR, the cath lab, or other possible emergent areas). If the census drops we are asked if we would like to take call -- if everyone says no, then so be it. If we are on ca...

9. Does health care in general do any good for our species?

   mattcastens posted a topic in General Nursing

   Does health care in general do any good for our species? By saving people from horrible illness and poor lifestyle choices, are we encouraging a weaker human species by going against natural selection processes? Discuss at will.

10. An interesting question about product placement

    mattcastens replied to mattcastens's topic in General Nursing

    Here's another example: I was watching "Scrubs" last night and noticed that the Pyxis machines in the background had a huge "Pyxis" emblazoned on them. Honestly, who's this going to influence? It's not like I'm going to go out and buy my own medic...

11. Self Study to learn ICU nursing???!?!

    mattcastens replied to 502Nurse's topic in MICU

    Not really any specialized training. Most hospitals have a very focused orientation once you've been hired into ICU, but if you're working on the floor and wanting to study before getting into critical care, I would recommend buying some self-study ...

12. Self Study to learn ICU nursing???!?!

    mattcastens replied to 502Nurse's topic in MICU

    Run as far away from this job as possible!

13. Nurses thinking multiple choice?

    mattcastens replied to mario_ragucci's topic in General Nursing

    Ah yes ... I remember that trickiness. Just wait until you get into the "real world" and your orientation tests expect you to correctly anticipate medical orders and procedures. That's when you'll point out that the "correct" answer is medically...

14. Code Training?????

    mattcastens replied to gambroRN's topic in Cardiac

    I think what Gambro was wondering was if other hospitals had a protocol for the response team to follow in order that all responding personel had and knew specific tasks. Certainly every nurse should be at least BLS certified and all critical care p...

15. Code Training?????

    mattcastens replied to gambroRN's topic in Cardiac

    We don't have any sort of code "protocol" for our cardiac/respiratory arrests ... the nurses and docs that respond are usually experienced enough to fall into place (except every summer when the new residents appear, then it's a mess for a while). We...