catamounts303

You're easily going to get critical care RN, sometimes they play a game to fill slots and might try to talk you into med surg and say you can move over to icu immediately; don't do it stick to your guns they are just trying to fill a quota; they will make an icu slot for you.

sammitate, with that academic profile you should be going to CRNA school, or applying to the Army's USGPANN active duty crna school.

Great questions. So the drug in most protocols used is lorazepam iv push 1 - 2 mg sometimes as frequently as every 30 minutes. Lorazepam has a short half life, it's also a benzodiazepine which in high doses can be dangerous causing respiratory depression. One thing you should read about is a medical called phenobarbital, it's a class of drug known as a barbiturate and originally manufactured as an anti convulsant. It is longer acting and allows for minimal dosing of lorazapm to suppress the dangerous effects of alcohol withdraw. It is administered IM or po.

Kegels are intervention and outcome is continence of urine. You will never ever use this stuff in practice.

You have a great shot and welcome to the profession. BSN backups are a great easy option, umass Amherst is awesome, check out umass Boston, and lastly mgh institute of health professions, mgh is costly but an excellent program.

Bottom line make them stop this and get all your pressors and sedation on infusion pumps. This must be so frustrating for you!

Heavy GI bleeds, ARDS, exacerbation CHF/COPD, and DKA. Progression to Septic shock, organ failure, from the aforementioned population. Exciting therapies now for ARDS and Sepsis. More patients surviving these critical illnesses.

So ya just flip em eh? Will give it a go. Work for a big county hospital, many uninsured so it's hard to get reimbursed on the KCI.

Hi everyone, Our ICU is starting to get really aggressive in identifying and aggressively treating ARDS patients much sooner. We have used the huge KCI beds that rotate with much success. With that said we want to try proning more patients sooner and much more often. The KCI just isn't feasible all the time. I was wondering is if anyone could comment/walk me through as to how they prone patients on the bed. Ive heard it can be done safely with a log roll and would be greatful to hear how you do it. Thank you all in advance.

MICU: Levo, Vaso, and then inotripics dobutamine for hearts dopamine for sepsis. Ionitropes selection may also be influenced by extent of AKI.

I don't think you really had a choice especially if fluid bolus was something you had to avoid. Levophed is at least our standard. Do you guys carry primacor drip ? The MD probably was just squeamish because of the chance and incidence of fatal arytmia with dopamine. But for a flight over you did the right thing.

Outstanding reponses. I've been thinking lately when cases do arise would this adult patient event benefit? So many are lung transplant receipients, ILD, and in full blown septic shock on Levo and fluid resuscitattion. But we still see a steady flow of the acute lung injury and somewhat stable ARDS patient so I do hope there is a push. I'm yet to see the machine I figure the concept is similar to the heart lung machine? That is a wild store having to prone the patient without the kci bed!

Good work laurel

Definately do the ACLS and their is also one called TNCC (Trauma Nurse Core Curriculumn you might find helpful). I can imagine you're probably good with Rythms working in tele. There is a book published by the AACN called Essentials of Critical Care Nursing. I would read the pharmacology section which will give you a solid background on sedation and the types of medicines used in critical care. And just have a good understanding of shock, the types, and how you would treat etc. You'll be more than prepared.

Hi everyone On our unit we've been seeing a lot of ARDS lately for multiple reasons. Usually things like aspiraton pneumonitis, fibrotic lung disease, acute lung injuries, trauma, etc. One of the treatments we have done has been of course the KCI bed that turns the patient upside down etc. However recently I've been hearing about putting a patient on ECMO allowing the lungs to heal while the machien can perfuse the body. I was wondering if any of your centers have used ECMO? I have heard a lot of the military hospitals have been using it. Just curious about the success rates etc. Maybe even some NICU Nurses could chime in on what its like to manage a patient on ECMO therapy. The idea seems awesome. Wonder if and when or if it is in fact going on in some of your hospitals?

I don't mean to neglect the point about unsafe staffing. I totally agree. As a new ICU though I was just wondering how the unstable STEMI ended up doing? Do you guys maintain the patient on a Heparin protocol and provide supportive care for the cardiogenic shock? IVF, arythmic management, pressors if need be?

are BSN RN's still working as CNA's in Boston?

Vital signs & chief complain for starters. If it's a cardiac and or critical patient you may want to look at recent labs and have those ready to rattle off or atleast be sitting in front of the screen. You may want to glance on the IV pole and familiarize yourself with an anti biotic or something they might be getting.

Gosh touchy subject ......

Hi there guys- I'm soon to be a new grad and will be off to some of my first interviews in a few months. I was wondering what you guys would wear to the interview? Button/color shirt/business casual pants? I was thinking a suit might be over-kill. I don't want to show up looking like a drug rep. Thanks again catamounts

Hi everyone- I'm on the final stretch of my BSN and was interested in doing a project relevant to SICU/MICU Nursing. Up to this point I've only worked in a trauma ICU as a tech but from that experience I noticed on the few times it occured that compartment syndrome might be worth investigating. Thinking back I remember one case where it was a 35 y/o male with an occlusive abdominal dressing post MVA. He started simply with the p02 dropping, then HR went up, and pressure down. I remember an RN obtaining a bladder pressure but everyone still wasn't too sure what was going on (especially the resident) till we had some more senior RN's in the room. I was thinking of investigating something allong the lines of "Compartment Syndrome: Early Recognition, Signs & Symptoms for the SICU Nurse" Maybe talk abotu the pathophysiology of whats happening and dedicate it to early signs & symptoms from the SICU nursing prospective. Let me know if that sounds like something you'd be interested in or maybe its a topic you've heard a lot about already. Not many of my faculty have SICU experience so I know this forum would be the best place to sound off about it. Thanks ahead of time for reading, any thoughts, or observations you might have. catamounts

Lisa so nice to meet you! I think its so cool to have three uvmers in the program. I too am from central MA. I also haven't heard anything about tuition, loans, etc just the medical forms. I'm not sure if I'm going to move to Worcester since i'm only 30 minutes away. Is anyone else relocating to be closer to the campus? Brian

Hi Smurfette, I did go to UVM! I graduated with a BA in 2003. I too am from central Mass just near the Marlboro area. Sometimes I really miss Vermont especially around this time of year. Just this past winter I went up and the campus has really changed. Maybe we know eachother? I took German for my major but also a lot of Psychology courses for the minor. I too am very excited about umass memorial. I worked there for a bit and remember how the nurses particularly on the intensive care units loved to teach. They also had tons of nurse practitioners who worked on all the different services. I'm so glad we're in a BSN program. There are so many options if we ever wanted to continue on for a masters.

hi everyone i'm in the same boat too. i really hope they send something soon along with a cost estimate for the program. the only thing i've received have been the medical forms and stuff. are you all from the central massachusetts area? i live locally but have been debating moving to worcester. either way i can't wait to start the program and meet all of you. i'm thrilled we will be doing a lot of clinical. worcester has some great hospitals especially umass memorial. brian

hi there, Are you by anychance attending MCPHS in Worcester? I'll be there starting January. Just yesterday I put in an online FAFSA and since I already have a bachelors I was rewarded nothing. However it did say it was an initial review and that the financial aid administrator at MCPHS has the final say. I too am curious as to the total cost of the program (I believe to be 30-40k??) I was wondering given the current circumstances on wall street if it will be difficult securing funding. Glad to have you in the class and look forward to meeting you! Let me know if you find anything out.