JeffTheRN

I am interested in the responses to this as well. We have ST monitoring capabilities, however, it is not utilized in our facility.

Not a fan of Alaris pumps. We use Alaris pumps in the CTICU and we use Baxter in our ICU. I prefer the Baxter, just more user friendly. The Baxter has its "upstream occlusion" issues similar to the Alaris "air in line" issues though.

We have the exact same issue in our hospital (or should I say Customer Service Center) as well.

Our ICU has a small 3 ring binder in every room that has Excel sheets that lists our most common medicated drips with a lot of info including titration protocols. JCAHO wanted it, or should I say "recommended" it.

Ok....my turn....why do you ED nurses hold my admission right up until the change of shift and then send it when I only have 20 minutes left to go home? What, oh, when I read the EMR it says that patient was ready to be admitted 4-5 hours ago!?! Oh, because YOUUUUU don't want a new patient on the stretcher before YOUUUU go home. Got it. Thanks.

Connecticut - 16 Bed MICU/SICU. 8 bed CTICU. 1 CNA (PCT). They do all the blod draw sticks, temps and finger sticks. They also help with turns and general patient care.

I agree with everyone and we still continue to tape to ETT's until my boss tell's me not to. When anesthesia drops off a post op CABG or valve in the CVU, the OGT is free floating and not secured in any way, but they're usually extubated within a few hours or later that night anyhow. Thanks all.

Most of the attendings in our ICU do ultrasound IVC compressibility to assess fluid volume status.

Technically speaking, epicardial leads to an external pacemaker is not a PPM. But that's really just splitting hairs.

Just a general question...if you are a nurse that does charge duties as well, how much extra do you get paid to do so? Here, at my hospital, staff RN's only do charge on the weekends and have an assignment as well. We get an extra $0.75/hr to handle that stress. Our director said they are going to look into other hospitals and will hopefully adjust to stay competitive. Any input would be appreciated.

We usually, as a standard, tape the OGT to the ETT (still being able to visualize cm markers and tube size markers etc...). Anesthesia, now, does not want anything taped directly to the ETT. My question for everyone is, what is your standard for securing OGT's in intubated patients?

Know your rhythms and practice good time management. Tele units can get BUSY BUSY. Other than that, enjoy yourself and congrats on the NCLEX!

In our ICU/CVU we have our specific hospital policy and protocols (thank you State of CT for your constant visits and citations) for EACH and every titratable gtt (begin infusion at .... titrate by .... max infusion rates, etc...) Each room has it's own protocol sheets/book in the room.

Nope. I'm just not naive and don't think everything needs to be seen through rose colored glasses. I don't see the problem with calling a spade a spade. I'm also quite content in my career choice and fairly darn good at what I do.

"Anxiety, depression, fibromyalgia, chronic back pain, migraines etc..." = "blah blah blah I'M A MED SEEKER blah blah blah" Take it somewhere else, I'm not here to supply your habit and take your abuse.

My mindset is chart and act as if a judge & jury were watching you.

"Jeesh, I heard they were outsourcing for new nurses, but ...."

Here is my newest version. I shrink it down to 78% on the copier at work and then put two, side by side in a landscape page setup. That way I have both patients on one sheet. You just have to write small. LOL. RN Flow Sheet.doc

As I tell our new grad/preceptees to our MICU/SICU...I would be worried if you DIDN'T have lots of questions. Good luck and don't forget to have fun learning!

I took a screenshot (.png) of my sheet and posted it here as a picture.

Thank you very much for the advice.

Thanks to both for your insight. I shall follow through the next weekday my manager and I are on together. Regards

I work in a 16 bed MICU/SICU and an 8 bed CVU in a small "inner city" (this is CT. after all) teaching hospital. Some comments I have heard from some MD's in this last week have me in a bind. First, there is a surgical resident who was verbally blasting a nurse (without her present) to 3 other nurses, including myself. He was going on & on about how he no longer trusts her and cannot be comfortable knowing she is caring for any of the surgical patients, especially fresh post-ops. From what he was telling us, her prioritizing and also her level of problem solving has much to be desired; so much so that he cannot trust any info she provides him, (ie...low hourly u/o's, swan readings, I & O's, vitals etc...) Obviously there must have been previous occurences that have swayed his trust ( at least I hope so ). There was also an incident where I was in my patients room with one of the medical residents, she came in to ask me what the current CVP was. I told her it was 8, then she continued on by saying the night shift RN before me (I'm 7a-7p) told her the CVP was 16 and the one before that was 7. "...but it was JimBob, and I don't trust him anyway...", she stated (names changed to protect the innocent). I came to his defense and told her he is a very good RN and if she thought the 16 was an error, she should have told him then and there. She then says to me, "...[really? mmm, ok. But the other one, JohnBoy, is awful as well...]" The reason I bring up these scenarios is...WHAT DO I DO? Do I tell my unit manager that there is little trust between these RN's and MD's? If I tell these RN's in question, is there going to be hostility between the parties? Do I leave it alone? I am afraid that the quality of patient care (if already soured, according to these MD's) will decline even more if these types of non-trustworthy relationships continue. Any advice would be greatly appreciated. Regards & thanks in advance.

We use 1" cloth tape on our unit. The tapes are changed and the tubes are repositioned daily by R/T. CXR's are acquired every a.m. to verify placement/evaluate lungs. We are actually in the middle of a trial for the Anchorfasts by Hollister and so far they seem excellent. I am hoping the higher-ups open the wallets and budget for them...though I'd rather see new IV pumps first.

For our CCU, it comes in waves. Usually it is only the surgical residents that use it and very rarely at that. I assume it is not used often for the risks previously mentioned above and the fact that only a relatively small amount can be used for every 24h.