Latest Comments by eCCU - page 2

eCCU, APRN, NP 6,069 Views

Joined: Aug 31, '10; Posts: 222 (36% Liked) ; Likes: 174

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  • 2
    Kssrn404 and RedInScrubs like this.

    1:1 only if they are on crrt, IABP and multiple pressors, otherwise we try to pair with a less acuity pt

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    So...we updated our IABP datascope to maquet touch screen. I love the new gadget because it is much lighter and more backups. However, in the last 3 months I have had 4 consoles just power off with no automatic restart. I am wondering whether anyone has encountered anything of the sort.
    No pt movement during incidents. Thank you

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    SmilingBluEyes and LM NY like this.

    I had sworn never date anyone from work! After seeing so much drama between people when they break up at work lol. Not to mention those residents that slept with any girl that thought was cute. One fellow slept with over 6 nurses on my floor! Imagine the drama when he married someone his parents preferred πŸ˜‚πŸ˜‚πŸ˜‚ it was hell scheduling assignments no one wanted to see the other πŸ˜‚
    I was the "mean scary charge nurse" that didn't flirt with the residents....or that's what one of the residents told me when he became the attending! I would rather have that title than some titles they gave nurses during their little parties!!!
    Met my hubby in comicon....yes I am one of those nerds😜 and love it!

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    TOF 1/4...2 is ideal 1 too much, 4 up the paralytic. We paralyze all pts on controlled mandatory ventilation, hypothermia therapy, extreme ards the list is long.

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    Dacatster and nurseactivist like this.

    ECMOs are 2 RNs to 1 pt. 1 RN just for ECMO. Otherwise they have to get us a circulatory support to run the ECMO. I don't see how you can have 2 pts. ECMO pts in my experience are " a hot mess πŸ”₯! "

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    The professor was very nice! I know a few professors that would have sent the students home with zero credit and an email to the dean!!

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    TX metropolitan areas $27+, 401k 5-6% 100% contribution, medical benefits. State and VA pension plans +contribution plans

  • 1
    delphine22 likes this.

    Quote from june2009
    So, I'm pretty sure I've got the alpha/beta 1 and 2 stuff down but I still have a question. One of my patients was hypotensive with a MAP in the 50's with heart rate 120's. Doctor orders norepi. If my pt. was already tachy, why not neo? We use so much norepi and only once have I had a pt. on neo. Is it physician preference?


    Was the patient in septic shock? If so then SCCM recommends norepinephrine as the first line of therapy after fluid resuscitation had failed aka 1.5-3 liters.
    Neosynephrine decreases SV and is only recommend as salvage therapy that is after 2 or more pressors have failed, pt had a high CO or norepinephrine has been evidenced to be a source of arrhythmia. ... there's is a whole long EBP on surviving since you know the MOA here is the order....first line norepinephrine, epinephrine can be used as an alternative to norepinephrine. Vasopressin can be used in combination with norepinephrine but not alone, dopamine is reserved for only bradycardia patients and is not recommended for so called "renal protection" dobutamine can be used to increase CO after attaining MAP and still in a hypoperfusion state. ... hope this helps.....

  • 1
    Riburn3 likes this.

    Quote from Jules A
    If we are concerned about the quality of our education I would urge the student/consumer to do their homework. In fact although I didn't realize that Vanderbilt was all that fancy what I can say is the educators at one of the above listed schools, with an excellent reputation, has what I would consider a lack of experienced practitioners running the program and teaching NP students.
    ......and that's probably why that person is running the program despite lack of experience. ...that does not mean they are not intelligent, as you said this person is a novice in this role or maybe teaching is not their forte, maybe their mentor in orientation was pathetic; we all know the results to that! Have you sat with them in person to express your frustrations to learn their perspective? ......after all let us be honest...the criterion is pretty competitive to get into such schools even though it is online, just go to JH and look at their DNP candidates it public you expect a new resident to be on the same level as the attending? Nope I hope not....nursing has always had a tendency to pick on each other instead of improving each other. This behavior has led to lack of respect from other disciplines....I am yet to see my 2 attendings going off on each other infront of their peers " went to UPenn I went to Harvard...blah...blah...blah who went where and who cares...." all I see is collegiate respect and yearning for more knowledge from each other all day long. They may not like each other but they have mutual respect for each other. On the other hand, all I see is nurses biting each other off......chew....chew....we shall continue.....unless we change it.....the end.....

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    PatMac10,RN, ~agape~, and Riburn3 like this.

    Quote from ghillbert
    I really don't understand the vitriol or superior attitude about B&M programs vs online programs. I went to a B&M program for my MSN, but honestly, what's the difference with "online" programs except that you don't sit there at lectures? I barely went to lectures anyhow - I don't find them useful, my teachers sent out the slides in advances, I went when needed for exams or if I had an issue with something. Online is just a delivery method like classroom teaching or anything else. You still have to do clinicals, physical exam and assessment etc in person for the required number of hours. Just another case of nurses (or NPs) fighting amongst ourselves instead of focusing on things we can and should change.
    Agree the top nursing programs offer online NP programs these include. ....Johns Hopkins, Columbia, Vanderbilt, UCLA and many more. .... so.... can we stop this unattractive behavior and try to improve the nursing situation? Thank you. ..

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    52 bed CV recovery with 4 beds pod design 1 charge for 2 pods 1 main pyxis for 2 pods/1 pharmacist 2pharm techs, 2 nurse educators. ....that's the largest one I have seen so far.....not counting perfusionists for ecmo pts and extra nurses for dialysis pts.....oh plus break nurses one of the best features. .... they came in at 10-5 for lunches....

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    adventure780 likes this.

    Have you thought of working in med surg pedi or adult? Its probably the best place if you are considering PNP or FNP plus the patients are more stable you do not have to stress when you leave work :-)

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    Esme12 and herring_RN like this.

    So sorry to hear that. wishing her a quick recovery.

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    essT and LakeEmerald like this.

    Quote from RNNCcicu98
    I am preparing a presentation on using propofol as a continuous infusion for sedation on vented patients. Although I have my own personal experience administering/maintaining this drug, I was hoping for some feedback and/or stories about YOUR experiences with propofol. My goal for this presentation is to educate and prevent unexpected adverse events.

    Our CICU uses propofol occasionally (midazolam is the drug of choice...), and of course we use an analgesic as well. I have researched this drug extensively, and am aware of the common side effects. BUT, we all know that experience brings information that at times is not found in research alone.

    What tips/cautions/lessons have you learned about propofol? Share away! Thanks so much for your contribution.
    AACN had a good article on "propofol infusion syndrome" published june 2008. I remember it because it was very interesting case study included and I presented it to my staff back then....worth taking a look :-)

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    sallyrnrrt likes this.

    Quote from delphine22
    I had a pt with an AICD that coded (PEA), and about 10 minutes after we pronounced him, it fired. Scared the crap outta me while I was doing my postmortem care!
    Hahaha delphine22.....that brings up some memories. ..very creepy