I would suggest to any new ICU nurse to find a resource pocket book. There's no way to remember everything. I use Kathy White's fast facts. Seems to be the ICU Bible for a lot of nurses. Easy to find information, simply put, etc. Good luck!
One of the Intensivists in our unit trialled all of the nurses on our unit on the vent. We each had a nose plug and a tube that we put in our mouth. He ran us through all of the vent settings. It was really interesting. Some of the nurses immediately yanked the tube from their mouths, it just freaked them out. Others, like myself, had no issues with it. So, I think sedation should be individualized. Just like pain meds, if someone looks liked their freaking out, bucking the vent or indicating that they're not doing well, by all means advocate to sedate. But, if someone's doing fine, why keep them down? I would hate to be sedated. But you would never know that I would do fine if you never gave me the chance to ask... Also, studies do show less days on the vent/delerium/PTSD/VAP...
At Kaiser in Portland we ambulate our vented pts once or twice daily with RT, PT (or another nurse) and the RN. The pts like it and they get extubated sooner. You use less sedatives because the pts are genuinely tired, less delirium, etc. I love it. Most of the nurses I work with love it too. Of course there are pts who don't qualify to walk, but a lot do. It's great, check it out!
I would suggest to any new ICU nurse to find a resource pocket book. There's no way to remember everything. I use Kathy White's fast facts. Seems to be the ICU Bible for a lot of nurses. Easy to find information, simply put, etc. Good luck!
One of the Intensivists in our unit trialled all of the nurses on our unit on the vent. We each had a nose plug and a tube that we put in our mouth. He ran us through all of the vent settings. It was really interesting. Some of the nurses immediately yanked the tube from their mouths, it just freaked them out. Others, like myself, had no issues with it. So, I think sedation should be individualized. Just like pain meds, if someone looks liked their freaking out, bucking the vent or indicating that they're not doing well, by all means advocate to sedate. But, if someone's doing fine, why keep them down? I would hate to be sedated. But you would never know that I would do fine if you never gave me the chance to ask... Also, studies do show less days on the vent/delerium/PTSD/VAP...
At Kaiser in Portland we ambulate our vented pts once or twice daily with RT, PT (or another nurse) and the RN. The pts like it and they get extubated sooner. You use less sedatives because the pts are genuinely tired, less delirium, etc. I love it. Most of the nurses I work with love it too. Of course there are pts who don't qualify to walk, but a lot do. It's great, check it out!