Endorn2012, BSN 588 Views
Joined: May 3, '08;
Posts: 5 (20% Liked)
; Likes: 7
1 No I do not get vaccinated. I am not anti-vax but I don't like being mandated to take something that is not proven to be highly effective. I don't like that they "calculate" what strain will be out there. If its that important then everyone should be vaccinated.
2 No but it's either take the vaccine or wear a mask for the season
3 as stated above the vaccine is a guessing game. I don't like the gamble. Also at my institution they enforce the mask policy on nurses but not doctors. So how effective is that?
4 no one has been let go
great learning environment
not seeing as many success as i would like
We use precedex on patients that have had difficulty extubating because of anxiety. Some of our attendings like to use it while others don't and they'll prefer to use very low dosages of diprivan to extubate. we have seen less success with it than we would have thought. Also the whole 24 hour thing makes it more complicated to use.
This is always a difficult situation that we encounter very frequently in my ICU. I think the most important thing to remember is that DNR/DNI does not mean do not treat. It sound like in that situation the patient is incapacitated and cannot make the decision. Will the surgery prolong the inevitable because of a terminal conditon. Did the family ever discuss with the patient the "what if" situations and what he/she wanted? Is it a palliative procedure? these are all questions that need to be addressed. If the patient had verbalized to staff that he did not want any measures taken and now the family has done the opposite is the staff willing to document their conversations with this person to support going against the family wishes? then there enters the ethical team. It is such a fine line and usually if it's a younger person versus the typical 80/90 years old patient people tend feel better about not tightly adhereing to a living will. besides living wills are really very basic and the important component, which often does not happen, is that the proxy has had discussions of the what if situations with the patient.
That has been my practice and I don't know if there is a specific policy about it but my institution recently started using an inline suction cath with a valve in it.
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