mced

Duct Tape...heals anything, holds everything.

Rabid Badger, What you are stating as your job description is what many nurses that work in modern day Medical/Surgical, Telemetry, and ICU stepdown units deal with continuously in the United States. It is a hard job, but people with adequate orientations and preceptorships negotiate these tasks and other complications each day they come to work!

Dude, Benner's Novice to Expert Theory is exactly that, A THEORY. Below are some publications that back up actual practice. New graduates with adequate orientation programs and preceptorships function and survive in a critical care setting without increasing M&M to the patients they care for. Almost everyone I am in school with now went straight in to critical care after graduating from their nursing program. None of us had any trouble functioning at a competent level after completing an orientation and preceptorship program mentioned above. Though my statement only speaks for a small number of nurses (n=19), the articles cited below show that when applied nationally, these programs work. Ihlenfeld, JT. Hiring and mentoring graduate nurses in the intensive care unit. Dimens Crit Care Nurse. 2005; (24) 4 175. Lindsey, GL. & Kleiner B. Nurse residency program: an effective tool for recruitment and retention. Journal of Health Care Finance. 2005; (31) 3; 25. Nibert, AT. New graduates a precious critical care resource. Critical Care Nurse 2003; (23) 5: 47. Reising DL. Early socialization of new critical care nurse. Am J Crit Care. 2002;11: 19-26. Seago, JA. & Barr, SJ. New graduates in critical care. The success of one hospital. J Nurses Staff Dev. 2003; (19) 6: 297-304 Thomason, TR. ICU orientation and postorientation practices: a national survey (Intensive Care Unit). Critical Care Nursing Quarterly. 2006; 11: 237

"no brand-spanking newbie nurse is going to be ready for the full on assault that is our tertiary care ICU wards. It would simply be unsafe". Are there any solid nonbiased studies that back up these kind of statements being made on this thread? I have not been able to find any.

I guess it is a good thing you live in Canada then.

Focker got the poison gimmick. Sugammadex is an upcoming drug. Basically it is a cyclodextrin that specifically encapsulates aminosteriods such as rocuronium, vecuronium, and to a lesser extent, pancuronium. It completely reverses paralysis regardless of the patient's twitch response. There is a professor in my program that has done a few lectures on this product. Hopefully will be out for general use within a year or so.

Law III: At a cardiac arrest, the first procedure is to check your own pulse. Things always run smooth after doing this!

Rat poison (coumadin) takes longer to reach a therapeutic level than lovenox. Once her INR is around 2-3 they will probably d/c the lovenox. In the meantime the lovenox helps to prevent any further clot development.

Anticholinesterases aren't given by CRNAs in your OR?

300 patent: 2.560.237, ESRD dude

Not all schools require a BSN but, you do need a BS in something before you can apply.

It has always tasted good to me, try washing it down with some acetylcysteine. Kayexalate is a good mixer too, but is a little counterproductive.

I think you are putting too much thought into this. If the patient is in distress, you will know.

I have heard that is should be available for general use within two years. Looking forward to its arrival. Giving someone poison to reverse paralysis seems a bit odd.

You are worried about "fatigue" from nursing at 21????? Before going back to school my routine was to work 3-4 consecutive 12 hour shifts a week and solid partying afterwards. Most of the younger guys I worked with followed this routine. Only old people are allowed to get this... "fatigue".