burn out

we used it the first time the other day but it didn't help. the patient still needed 100mcg fentanyl and 70/mcg/kg/min of propofol and still breathing on cpap on vent.

If you really wanted to impress me, know what is normal i.e.lab values, vital signs, sinus rhythm,hourly urine output. because everything we deal with will be abnormal.

yep... versed or propofol for sedation and amnesia and fentanyl for pain. Propofol in OR is a different ballgame and in the hand of CRNA or Anesthesiologist a totally different scope of practice.

You knew something needed done, now so you called the neurosurgeon but then you didn't complete the order you obtained. The order did not need to be approved by the fellow, you should have just done the ct scan.

Yes physical therapy is vital early in patients that have been extubated because they are weak as kittens. However, how do you get active rom out of someone that is sedated and how do they bear weight? I really don't want to reseach something I think is ludicrous.

Please show me the research that intubated/sedated patients on vents that are put in chairs result in less trachs than those kept in beds turned q2h and the hob up.

You have to be a control freak because you control everything about your patient, their heart rate bp, breathing,pain, urine output, if they eat if they don't, if they move, if they poop...kind of get the picture?

It sounds like we all are doing a bunch of different things out there with propofol,versed and fentanyl. Is there no universal protocol? When we use propofol or versed we use the Rass scale of -2 or -3 . Propofol max is 50mcg/kg/min and fentanyl max100 mcg/hr. We combine either propofol or versed with fentanyl but never propofol with versed.

i've watched but can't really relate to her. She makes it look like nurse take their patients narcotics and have affairs wih co-workers. Definitely not a reality show.

I guess it may depend on the reason for the line, I kept a c-line 6 months in a patient in home care to receive chemo. It was removed because the chemo was over. No infections no problems.

Show me a Hamburger Helper Dinner that does not use milk and do you really think I am going to go in the back yard to milk a cow to get that milk.(My milk supply dried up a long time ago.) I take much pleasure in knowing that my milk has been pasturized and is safe to drink and I can buy it at the store. Read the post on the Athelon product that is in use in India for filtering out viral diseases such as HIV, Hep C and some tumour producing toxins. They mention that the failure of their product is based largely on financial risks, lack of funds for government testing and approval not to mention to supply the amount of devices that will be required.

My first day off orientation in ICU 20 years ago, my first patient on my own..the end of the day... a patient that was considered stable 12 hours earlier... sedated on a vent with a Blakemore tube, Swan Ganz cath, 16 units of blood, pressors galore on his way to surgery and survived later on. I have never had that bad of a day again. Now I feel the "rush" but I know I have to get things done or else my patient is going to die. The doctor may order the stuff but I am the one doing the stuff and I have to work fast.

The most dangerous nurse is the stupid nurse that doesn't know they are stupid and refuses to ask questions.

I am sure when Salk developed his polio vaccine, and Pasteur developed penicillin and homogenized milk people wondered how in the world would the amount required to vaccinate every person, produce enough antibiotics to treat every person, and how do to treat all that milk from all those cows for all those people was considered quit a financial and heroic challenge. Where would we be today if the challenge was not taken up? We owe it to future generations to continue to pick up the gauntlet and overcome our challenges...that is why the human race has survived..it is all about survival not just of one person but the whole of mankind.

I don't usually tell people what I do unless it comes up in conversation because unless a person has walked in a nurses shoes do they really know what it means to be a nurse. My family does not nearly comprehend what I do in a days time. Strangers have their own preconceived ideas and I am sure they do not even come close to the reality of nursing(perhaps even would be insulting). My patients however know I am a nurse and it doesn't matter to them if a nurse is a RN or LPN but they can tell the good ones from the bad ones and they let you know. If you are even on this website I think that says that Nursing is more than what you do, it is who you are.