gradcare

gradcare LPN

gen icu/ neuro icu/ trauma icu/hdu

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All Content by gradcare

  1. Things Patients Have Taught Me NOT To Do

    gradcare replied to Trixxy's topic in Nursing Humor

    Super glue is not a good substitute for lube. If you forget this and end up gluing your urethra closed, it is probably best to present to the ED early rather than wait until you have not peed for...

  2. confirming NG placement

    gradcare replied to bennyboy's topic in General Nursing

    Also it must be remembered that many medications used to prevent stomache ulcers including H2 blockers can alter the pH in the stomache so pH testing can be unreliable (false negatives) additionally...

  3. Am I Crazy? Because I don't think I am!

    gradcare replied to ZooMommyRN's topic in MICU, SICU

    No, insantiy is only relative anyway (your familiy drives you crazy.....just kidding) New Rn's in the critical care environment can and has been done well preveously however there needs to be a...

  4. Is there a max dose of Levophed?

    gradcare replied to KevinS's topic in MICU, SICU

    Generally we need to remember that noradrenaline (or any other trope) is a poor substitute for adequate fluid reses. That said, in the setting of an adequately fluid loaded patient if you've hit 20...

  5. Using Propofol for sedation on vented pts?

    gradcare replied to Scrubz's topic in MICU, SICU

    To junebuggy re step downs using the "milk of human kindness". I'm presuming that these pts do not have an artificial airway and are not vented (that's what step down is to me). Thinking about how...

  6. Post-op to Critical Care

    gradcare replied to KayceeLeeRN's topic in MICU, SICU

    What sort of ICU are you looking for? Medical / Surgical / Mixed? Once you get your stuff together on the ward environment you can make the switch. Both medical and surgical wards will provide...

  7. RRT nurse

    gradcare replied to wino73's topic in MICU, SICU

    Have worked with 2 systems. 1 where the MET (RRN) nurse was included in the count but floating (no allocation). And the other where the Nurse had a case load. Response times didn't really differ...

  8. Strange things found on (or in) a pt.

    gradcare replied to squeakykitty's topic in Emergency

    poor

  9. Strange things found on (or in) a pt.

    gradcare replied to squeakykitty's topic in Emergency

  10. Funniest thing a new co-worker asked you?

    gradcare replied to fultzymom's topic in Nursing Humor

    How do I apply a fecal containment device (bum bag)? please note the instructions have pictures......... Should I call a code on this patient ??? (blue , no pulse no resps..was pink 2 min prior pt...

  11. Share The Weirdest Reasons Patients Push The Call Light

    gradcare replied to RN06-NP09's topic in Nursing Humor

    Attended pt who was crashing, me my doc ward staff etc with this pt when the pt opposite (in 4 bed bay) buzzes to tell us his obs wer 2 min late!!! Nice to be

  12. What is your day like?

    gradcare replied to FuturoEnfermera's topic in MICU, SICU

    "I'm feeling very discouraged with nursing after only two weeks of clinical. I'm in my 2nd semester of my BSN program. My clinical instructor thinks that I am way better suited for ICU so I'd love to...

  13. Acute Dialysis - CRRT : Role of Critical Care Nurses or Renal Nurses?

    gradcare replied to bluefabian's topic in MICU, SICU

    All units i've been involved in ICU will do CRRT until the patient is stable and able to tollerate IHD (if it is going to be needed post discharge). If the patient is going to need IHD post ICU...

  14. How high have you titrated levophed?

    gradcare replied to racing-mom4's topic in MICU, SICU

    38 with ccf. bad karma from the get go. You do what you can with what you've got. what was the ecg like? any chance that this was pure pump failure cardiogenic shock)? Any SVO2/ mixed venous /...

  15. Waiting Rooms

    gradcare replied to lori_alexis's topic in MICU, SICU

    Sounds like u need to either ban linnens or have a place for relatives to sleep. My current unit has 2 "slep rooms" for acute ie 1-2 nites only as we are the only unit with all the specialties for...

  16. Hit

    gradcare replied to ragincajunstudent's topic in MICU, SICU

    HIT(S) has been around for quite a while problem is you need to recognise and then test for it. Seen 3 cases in last 18 months, that said we tend not to use the low molecular weight heparins to...

  17. Parkland Formula Help

    gradcare replied to Dr.Nurse2b's topic in Critical Care

    Of course that all hinges on the estimation of burned area being correct. Have left burns behind me now but started seeing goal directed fluid strategies with the goal being urine output of approx 1...

  18. MICU/SICU - Vancomycin -peek and trough

    gradcare replied to BGmedsestra's topic in MICU, SICU

    We've been running on random vanc's for several years now used to to peaks and troughs now just do troughs approx 1-2 hrs prior to next dose. Though there seems to be an algorythm for bloods taken a...

  19. Re: Parenteral Nutrition(Lipofundin-Intralipid 20%)

    gradcare replied to Mcgyver's topic in MICU, SICU

    Have yet to see a "standard rate" of TPN administration as nutritional needs can vary dependent on disease state, weight temp etc. Also fat percentage (eg 10 % vs 20%) can be altered depending on...

  20. GSW..Severe IVC injury

    gradcare replied to ddoosier's topic in MICU, SICU

    contraindication purely relative. No access = dead. Hey you get it where you can. Very poor chest so sub clav line probably out, IJ perhaps but sounds like the vena cava was getting a little...

  21. am i getting burnt out?? long one!

    gradcare replied to sweetsmiles2007's topic in MICU, SICU

    Some times you feel "dirty" because you are advocating for the patient knowing full well what that entails even if they don't (doing everything for the pt with GVH taking over their entire bodies,...

  22. MICU/SICU - HIGHEST PEEP you've seen?

    gradcare replied to poppy07's topic in MICU, SICU

    Have "walked Peep up to 35 cm H2O as part of recruitment manouver On pt with puritan bennet bilevel [hi peep lo peep]. Short term only however (couple min only) BP tends to go "bye bye" as pts tend...

  23. MICU/SICU - HIGHEST PEEP you've seen?

    gradcare replied to poppy07's topic in General Nursing

    Have "walked Peep up to 35 cm H2O as part of recruitment manouver On pt with puritan bennet bilevel [hi peep lo peep]. Short term only however (couple min only) BP tends to go "bye bye" as pts tend...

  24. First Night Shift!!

    gradcare replied to HD-RN's topic in MICU, SICU

    All fun and games till that slow leakin SDH hits critical mass effect then it changes.

  25. do any of you like codes??

    gradcare replied to ryanfocker's topic in Men in Nursing

    pa, I don't think anyone is being disrespectful of the individual who has coded. The common theme is that for those who feel challenged in a positive manner by being in a code that it is sad that...