szerch

In our CVICU, all of our OHS patients have swans. One of our surgeons only wedges in the OR for placement, and then asks the RN's not to wedge on a routine basis, especially for the valve patients. He thinks the risks outweigh the benefits, and we use the pa diastolic pressure for cardiac profiles. With the other surgeons, we wedge on arrival from the OR, and q4hrs after that. We wedge more often if we are titrating gtts, or if he calls for a reading.:)

Help! I recently became a House Supervisor/House Officer. I am basically the house manager, and direct the flow of patients and staff. I work with the managers of the individual units during the day, but when I work evenings or nights, I am the only one there making decisions. This is not a problem. My problem is that I still work once a week in the ICU at the bedside. The nurses in the ICU's are my co-workers and friends. Yet, when I am in the role of House Officer, I am essentially managing them, and working with them in a different role. The other day I made an unpopular decision with the ICU staff (although it was the best decision for the patient). Still, I'm afraid I burnt some relationship bridges. How do I mend those fences? There will probably be other times this will happen. Has anyone experienced this before?