brissie

Just curious how often you check a K on a pt with a lasix gtt. I had a situation at work the other night where a pt was on a Lasix gtt at 10ml/h and apart from the occasional PVC was SR w/ no ectopy, well shortly after getting report and just as I was walking into the pt's room they had about a 8 second burst of V.Tach. Checked a K and it came back 2.8. I looked back and a K hadn't been checked for 16 hours. Last K was 4.3. Anyways just wondering if you had a unit policy for pt's on a Lasix gtt or if was just left up to the individual to check electrolytes periodically.

One thing that can lead confused/unsteady patients to get out of bed is needing to go to the bathroom. We did a little evidence based practice thingy on a unit I used to work on and we found that frequent toileting of the confused/unsteady patient lead to less falls and more sleep.

I only got 5... 1. Pursed lips 2. Tripoding (leaning forward at least!) 3. Core and peripheral cyanosis (I think) 4. Use of accessory muscles 5. JVD

Paramedics do not insert chest tubes rather they do needle decompression which of course is usually just a temporary fix. Chest tubes themselves are inserted by physicians. Intubation can be practiced by nurses trained in it, for example critical care transport nurses or certain nurses in NICUs. I do not believe that it is common place for ER nurses or ICU nurses to intubate. I think it's great that you want to expand your knowledge and skill base and I look forward to hearing what other experiences other members have to share.

I think you mean 0.09 not 0.9 lol. 0.9 and you would be pretty skunked!

Good for you for wanting to be safe and professional. I have worked with nurses with big egos how are too embarrassed to use a drug guide. I have been a nurse for 11 years now, mostly in critical care and I still keep reference books with me on shift. I work at a teaching hospital and on more than one occasion I have had residents ask if they can use my references, often times with a panic stricken look on their faces and an impatient looking attending on their heels!

It will take you at least a year to begin to feel comfortable. If your co-workers are helpful then that makes things easier. I have to agree with some of your co-workers; yes it is good to be scared. Complacency inevitably leads to errors, even the most experienced ICU nurse needs to be alert to everything going on with their patients and constantly assessing and reassessing. This high stress and intense environment is why most nurses go into ICU, we love the challenge and love to be a part of looking after the critically ill. If I had to go back to a med-surg unit I would shoot myself, don't get me wrong, I have total respect for floor nurses who have 6 patients who want everything done at once, I certainly couldn't do it. I really enjoy critical care nursing and teaching. Teaching new grads I have found helps keep my skills sharp and I love to watch people learn and become more confident. I think you will do well. The stress level isn't going to change, rather you will become more comfortable dealing with it as your knowledge and experience base develops.

Your license is safe. Your friend overreacted. You have treated the whole incident as a lesson learned and you will be a better nurse for having learned it. Good luck.

I applaud you for your efforts to help the next shift. You went above and beyond to provide assistance. Nursing is all about having unexpected things happen at inconvenient times, that is what we are paid to deal with. It has also been my observation that the nurses who gripe and whine about having to take over procedures you are halfway through are the exact same nurses who always leave on time themselves and never stick around to help and almost always have things left over from their shift for you too do. I remember on one grand occasion that I had a pt code at around 0645, when I would usually have been putting labs and new MARs in charts, well the oncoming nurse was miffed that her MAR hadn't been printed for the day and proceeded to walk into the room while I was doing chest compressions and berate me for not having the chart ready!

What is your status here in the U.S.? Are you a permanent resident or are you here on a student visa? If you are a permanent resident then you are entitled to federal loans. If you are here on a student visa then you will have to apply for a private loan, which in your case would be difficult to obtain.....sorry.

Best place for me to be as a nurse is home, watching TV with an ice cold beer.

Man, I would be hypnotizing patients all night...."you don't have a call light"....

If your manager can't take the heat she should get out of the kitchen! If you love your job hang in there, with all the PC stuff and "sensitivity" training that goes on in hospitals today she won't last long treating her nurses like that.

So many factors could be coming into play here. I am not offering excuses for their behavior, swearing is absolutely unacceptable behavior in a professional setting, yet maybe the nurse had been having a bad day or maybe the pt had been verbally abusive or manipulative towards the nurse. Anyways all I am trying to say is that I don't think that their are many nurses out there that have not thought this about a pt, yet most of us try to retain a professional demenour. I'm pretty sure if you confronted them about the bad language they would apologize and stop, often times when we are in the heat of emotion it takes an outside influence to check us and calm us down and to see reason again.

Kootenai Medical Center's starting pay for a new RN is $23.88. Deaconess Medical Center's starting pay for a new RN is $23.79. Sacred Heart Medical Center's starting pay for a new RN is $23.08. Kootenai Medical Center pays more than both major hospitals in Spokane. Kootenai Medical Center is a Magnet Hospital. The population of Spokane is (according to the Census Bureau) 446 706. The population of Coeur d'Alene (according to the Census Bureau) 38 388 with the total population of Kootenai County being 122 350.