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Critical Care, PICU, OR

Content by MaleICURN

  1. MaleICURN

    I Am A Sober Nurse, But Only for Today

    One day at the time. Congratulations
  2. MaleICURN

    Ridiculous medical mistakes on TV

    Something new from "Dr. Kildare". This is from 1965-66. Already intubating patients. Pt. with approx. 60-70% 3rd degree burn first TRACH. Almost immediately able to talk (short sentences) occluding trach. After few days no trach (dressing), pt. talking without hoarseness, like nothing happened before. Surgery - this patient intubated. Another patient. Sudden PE (embolism, not edema). ACLS - chest compression about 20-30 compressions/min. On the screen fine VFib. Even student suggested shock. Dr. Kildare shocked his head as "no". In nest few seconds - asystole. Stopped CPR. No ABC, but only BC (pt. on facial mask, vent on "positive pressure")
  3. MaleICURN

    Ridiculous medical mistakes on TV

    Recently I'm watching very first "medical movie" from early 1960's "Dr. Kildare". Relatively few mistakes, of course there's 1960's so AMI 3 week bedrest, general anesthesia on mask, almost never ETT. For acute respiratory failure (even on the field) - trach (metal obviously). But yesterday I saw order: 10 mg Morphine SQ (patient not on vent) and 100 mg (!!!) heparin (way not specified). Hmmm
  4. MaleICURN

    funny charting errors

    Happened just minutes ago, Pt. with lots of ectopy. I charted" Frequent bigeminy and trigeminy". And.. "bigeminy" was automatically corrected for "BIGAMY".
  5. MaleICURN

    Syringe driver terror

    I had a beautiful 23 months old girl. Trach, vent. Unable to breath on her own, vent on AC mode. Days by days, rather hours after hours her PIP increased, finally reaching > 50 cm H2O. Family decided to withdraw treatment. We placed her on Fentanyl drip. In maybe 2 hrs she was gone. Having her that night only as one patient, I was happy, when my Charge Nurse sent me home after "all". It was probably my most difficult to accept night. I drove home with tears in my eyes. It happens few years ago, but I still remember HER.
  6. MaleICURN

    Ridiculous medical mistakes on TV

    So much horrible mistakes, so I decide NOT to watch any of this "medical" movies. Just a few most characteristic: 1. Always scream, newer talk (esp. in code situation). 2. Extubation WITHOUT weaning, ABG,s, just - suction, extubate and ... place pt. on O2 by NC (presumably 2 L/min). 3. Pt. on permanent HD - no AV fistula on any extremity (that was not medical movie). 4. And my most favorite (!) which I'll probably never forget: - Blood pressure dropping! (scream, of curse). - Start nitroprusside drip!! (scream). Ugh. Nipride for hypotension!!!! I saw in my imagination producer of this "movie" with BP 40/0 and with Nipride at 4 mcg/kg/min. No more movie.
  7. MaleICURN

    US RN to work in UK

    Hi all fellow nurses on both sides of the Atlantic Ocean. I've been an RN really for a while. Originally from Europe (no, NOT the UK), then Canada (Ontario) and since 1991 US (Texas with Compact RN license). I got a very nice offer from the UK, but their Board (NMC) is not happy with working with my US license (besides it's more expensive). They suggested, I should go back to my county of original license and start from there. To get back my license in my country, I need probably to go there and maybe work for few months. Any advice, how could I get the UK RN license from HERE (US, I mean)? Texas or Alaska size thank you in advance.
  8. MaleICURN

    "The Good Ol' Days!"

    Well, I graduated 1974. That would be a book, to catch all the differences. Let's try just a few. 1. Nurses BEHIND the doctor. NO questions. Doctor said: "20 mg of Morphine" - answer "Yes, Sir" 2. No disposable stuff whatsoever. Daily sterilization of syringes (glass) and needles (steel). Cleaning inside needles. 3. Bedpans, urinals - metal. 4. No IV pumps, I remember first IV pumps (very primitive by today's standards) used for pressors only. 5. 3 color charting - depends on the shift: morning - blue, afternoon - green, night - red. 6. Monitors on ICU, sometimes one monitor for a patient, no central monitor (however, sometimes happened a central, alarms printed with hyphens r/t number of the bed [bed nr 3 = ---], no differentiation for alarms, like the same sound for disconnected electrode or VF). 7. Smoking - patients, nurses, doctors - one exemption was OR, however in the OR lounge everybody smoked. 8. Very HOT OR - at least 98-99 degrees, no patient's warming blankets. 9. Only one nurse dispensing meds for the whole unit (except ICU). 10. Three 8 hrs shifts. 11. Gloves ONLY for the OR, specifically the surgical team. 12. Continuous staff cover for OR (no calls). 13. Making gauze dressings (today's 4x4's or 2x2's). 14. Celebrating coffee meeting for the whole team after each medium/big surgery (maybe except for little cases like T&A). 15 Long turn on surgical cases (see # 14). 16. In each and every hospital each unit had a physician present 24/7 (not on call), on occasion a physician present on unit called himself for help (e.g. emergency big surgery). and so on, and so on...
  9. 212 mg/dL BS is relatively OK, I don't know patient's big picture. Obviously doesn't look for a DKA. But K+ 2.7 IS very LOW. Patient is significantly HYPOKALEMIC. On my ICU even with patients on sliding scale KCl protocol, besides running K rider (40 mEq) we usually call the physician for (typically) back to back 40 mEq KCl. Again, I don't know the big picture. Maybe the patient was renal? His/her BUN/Creat???? But if renal, nephrologist should be contacted. Anyway, the biggest mistake was to admit such patient to MED/SURG.
  10. MaleICURN

    Help! How do I sign my name??

    Technically in CLINICAL settings you put the RN first: Jane Doe, RN, BSN In ACADEMIC settings is opposite: RN at the end: Jane Doe, PhD, MSN, CCRN, RN

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