meandragonbrett

meandragonbrett

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All Content by meandragonbrett

  1. Swan-Ganz Use

    meandragonbrett replied to TexRN08's topic in CCU, Coronary, Cardiac

    Some drugs are titrated based off of your hemodynamic measurements. Numbers you can get from a Swan include: PAS/PAD, CVP, CO, CI, EDV/I, PVR/I, SVR/I, EF, SV/I, and

  2. Titrating and Bolusing

    meandragonbrett replied to TexRN08's topic in MICU, SICU

    Gotcha. We typically just turn the vasopressin on or off....we don't titrate it. We would have worked to get rid of that dopamine even if it meant having to increase our levo and titrate it down...

  3. Titrating and Bolusing

    meandragonbrett replied to TexRN08's topic in MICU, SICU

    You mention fairly high doses of dopamine and norepi....what were they? What is "maxed out on vaso" at your

  4. Swan-Ganz Use

    meandragonbrett replied to TexRN08's topic in CCU, Coronary, Cardiac

    What types of patients are you seeing them used in? We inserted a lot in a unit I used to work in to assist with patient management in sepsis as the pulmonary and surgery teams didn't drink the...

  5. Certified Nurses

    meandragonbrett replied to JSBoston's topic in General Nursing

    Then what are you still doing here posting? Get busy. Do a few each day and it's over in no time. What's your big rush to become certified? What certification exam are you seeking to sit

  6. CRNA or Other Specialty?

    meandragonbrett replied to LMT2BSN's topic in Student Registered Nurse Anesthetist

    The ANA has nothing to do with certification or examination of nurse

  7. Titrating and Bolusing

    meandragonbrett replied to TexRN08's topic in MICU, SICU

    I would start by reading about the specific drugs you are titrating. Know how the drugs work is a key element in titration. You need to know onset, dosing, expected changes with titration, what the...

  8. Anyone else feel like they got "shafted" in clinicals?

    meandragonbrett replied to forgop's topic in Male Nursing Students

    I saw one lady partsl birth and I am good for life! I spent the rest of the clinical just trying to learn from the OBGYNs, the CNMs, and the

  9. What would you have done??

    meandragonbrett replied to Sun0408's topic in MICU, SICU

    It's mostly used in the peri-surgical CV population as it's much easier/quicker to titrate than Cardene is during a

  10. Why are you and ICU nurse?

    meandragonbrett replied to Ochin09's topic in MICU, SICU

    It is definitely doable. Being a new grad has nothing to do with success in the ICU. I have precepted both new graduate nurses and experienced nurses from med/surg, ER, OR, and even one from case...

  11. PACU orders

    meandragonbrett replied to nrsman1's topic in PACU

    We have : Dilaudid ____mg IV q___Min PRN pain. Max dose ___mg. Most of our docs and CRNAs write for 0.5mg or 1mg IV q5min with usually an initial max dose of 5mg. We also have standing orders...

  12. Unsafe Practices

    meandragonbrett replied to **LaurelRN's topic in MICU, SICU

    Just keep this in mind.....it's not just your facility. The ratio for critical care is quickly turning to 3pt

  13. Difference between cardiac tamponade and tension pneumothorax

    meandragonbrett replied to 2mochas's topic in CCU, Coronary, Cardiac

    Cardiac Tamponade can also be associated with a tachy-brady arrhythmia,

  14. Difference between cardiac tamponade and tension pneumothorax

    meandragonbrett replied to 2mochas's topic in CCU, Coronary, Cardiac

    Tell us what you know first of

  15. Question about nurses and prescriptions?

    meandragonbrett replied to rondo341's topic in General Nursing

    Primary care has nothing to do with prescriptive authority. There are ACNPs, WHNPs, CNMs, PsychNPs that all have prescriptive authority and do not necessarily provide primary

  16. Question about nurses and prescriptions?

    meandragonbrett replied to rondo341's topic in General Nursing

    There is no state that requires supervision of a CRNA by an anesthesiologist. Supervision and medical direction are two very things and are generally misunderstood. CRNAs DO have prescriptive...

  17. Use of cell phone apps on the job?

    meandragonbrett replied to SanDiegoCaliRN's topic in General Nursing

    My facility does not care if we have our phones with us as long as the volume is turned off and that use of them does not interfere with patient

  18. Does it bother CRNA's that MDA's get so much more...?

    meandragonbrett replied to ICU, RN, BSN, B.S.'s topic in Certified Registered Nurse Anesthetist, CRNA

    You've still not pointed this out to us. Inquiring minds would like to

  19. Does it bother CRNA's that MDA's get so much more...?

    meandragonbrett replied to ICU, RN, BSN, B.S.'s topic in Certified Registered Nurse Anesthetist, CRNA

    So, why don't you show us since you claim it is true. I'm pretty sure the anesthesia folks know their politics and scope of practice better than you claim to know

  20. Does it bother CRNA's that MDA's get so much more...?

    meandragonbrett replied to ICU, RN, BSN, B.S.'s topic in Certified Registered Nurse Anesthetist, CRNA

    Actually, CRNAs are licensed independent providers and function upon their own accord. They do not function UNDER an MD license in any state. They are independent providers and are responsible for...

  21. Why does ICU want to refuse the patient all the time?

    meandragonbrett replied to mikeworksRN's topic in General Nursing

    Coming from the perspective of a critical care supervisor who oversees 70 ICU beds on shift...... Beds are a valuable resource in the facility and must be used appropriately. We use a "Triage" type...

  22. New ICU nurse

    meandragonbrett replied to BloodyMedic's topic in General Nursing

    Put your CRNA goal on a side burner for now and learn to be a good ICU RN

  23. Transferring units: When and why did you do it?

    meandragonbrett replied to beeble's topic in General Nursing

    I tend to transfer semi-frequently. The moment I walk into work and I am dreading the day, the moment I am bored in my current position, or the moment where I dread going to work the entire week...

  24. Sedation..Your thoughts?

    meandragonbrett replied to Da_Milk_of_Amnesia's topic in MICU, SICU

    Increased risk of VAP secondary to increased ventilator days? There is plenty of research that has related depth/length of sedation to increased ventilator days. There is no reason to keep somebody...

  25. How does your unit orient new nurses?

    meandragonbrett replied to Schuur451's topic in CCU, Coronary, Cardiac

    Unfortunately my hospital has a cluster $@ approach of throwing everybody to the wolves. I had 36 hours of orientation to Surgical ICU with previous critical care