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can anybody confirm if NAU does not offer preeceptors anymore?

This is good to know! Here I am thinking that you can’t be do the FNP full-time if you don’t live in Flagstaff. Thanks for the update! Anybody in the program NAU/GCU willing to share their experience so far?

Hello all, I have been long curious about something. I’ve been working as a PCU-covid night nurse in a small hospital in AZ. I had a patient pass away, bless her soul, sometime before the spike of cases in Arizona and I was still learning about things then like plan of care, etc. A night before she passed away, pt was already on a nonrebreather, and somewhat tachypneic. Saturation would mainly be on the 85s, and rarely on the low 90s. But it got worse, went to the 70s then to the 60s and with her HR increasing. She was DNR/DNI. I received a bunch of orders, meds, breathing tx. I remember bringing up to the doctor about possibly switching to high-flow, because I’ve taken care of other patients that were placed on high flow in the covid unit. The doctor did not consider it, I remember him saying something like, it wouldn’t be beneficial with the patient satting the way she does, in the 60s. The next night I took care of the patient, she was on comfort care only. Can’t remember her medical history so I can’t provide that, sorry. But what I have been curious knowing about is if anyone can explain the possible reasoning behind the doctor’s choice of nonrebreather vs high flow? Is it because patient is DNR/DNI? What qualifies/disqualifies a patient from using high-flow? I am not an expert about nonrebreather and high flow but if anyone who has more experience with these that can share their knowledge I would greatly appreciate it.

sorry if I misinterpreted what I mean but I was at home and was coming back to work again and I did relay this concern to the nurse following me. I asked when I came back and pt is fine and the 3L was exactly what the doctor had wanted him to receive. I mentioned pt is AO, no edema, up and walking. So I don't know where you got the idea that pt is "that acute." This is my first post here and I was surprised how everybody responded in a positive way to my question, but there's always gotta be that one person who won't be. Guess who that is. I don't like drama so go ahead keep walking away. Thanks for responding anyway.

Thank you so much I will remember to inquire with the hospitalist from now on if this happens again instead of calling back the ED nurse. Thank you for clarifying that 1 bolus could mean 3L. I did not know that. Yes, they were looking at degydration causing the AKI.

Yes, that was the report that I got from the ED nurse that he is defensive when asked if he was homeless. I ask in a different way, but when pt got to me pt just keeps saying I am so tired, I can’t answer no more. ?

Pt is 48 YO, and he does not really have any past med hx, except psych DO and HTN. As we monitor him, his BP is below 100, that's why even if he was uncooperative, we convinced him for IV insertion to get him started on fluids. He was dehydrated also because he has been walking around and has not been keeping track of his nutrition. We think he is homeless, but pt denies, gets offended when asked.

Thank you so much. That's what I am going to do.

Good day, I am a new nurse and there is something that is bothering me. I work at a hospital and I received report from the ED nurse transferring the patient's care to me in medsurg floor (pt is med surg). I had to call the ED nurse back to clarify how many boluses the pt needs because the MAR shows 3 doses of NS 1L/hr. He said pt needs 3 of them and then I asked which bag of the 3 is currently running. He told me it was the first one. When patient arrived to our unit, pt's IV tubing is not connected to him. When I checked, IV is barely in the skin and you can see a big part of the catheter out. I tried flushing it because maybe it works, but pt flinched in pain. Pt is not very cooperative with IV insertion but I did it. I then started the 1 bag of NS bolus ordered that was scanned in ED but was never started. Then the other 2 after the first. He received a total of 3 L/3 hours. To my horror, as I was reading the doctor's notes it states there--will give 1 bolus now. Does this mean pt only needed to get 1 bolus instead of the 3 that was listed in the MAR? This is the reason why I clarified with the ED nurse, besides I have never given a bolus on my floor before as it is usually taken care of in our ED. If I was familiar with this ED doc only ordering 1 fluid bolus, I would have questioned the what was in the MAR. But I don't work with him and never really given fluid bolus before so I am not sure what is considered appropriate amount of fluids to what is excessive. Is 3L/3hrs of NS too much for a pt with acute renal failure and dehydration with creat of 5.5, gfr of 13, CK of 1042. I don't remember the rest of the labs. Another concern is that he is receiving continuous infusion of NS @ 125mL/hr as per doctor's order. I should add, pt is AO, no edema, no SOB, up and walking. I was just concerned that I may have messed up his electrolytes or something worse that I may not know about right now.