sunshineCCRN

sunshineCCRN

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All Content by sunshineCCRN

  1. Our unit takes too many specialized patients!

    sunshineCCRN posted a topic in MICU, SICU

    Hi everyone, I'm new here, but I'm wondering if anyone else's unit has this problem. I work in a small hospital. Our ICU census is usually 8-11 patients. However, we take EVERY kind of patient short...

  2. When a doc refuses to co-sign verbal orders

    sunshineCCRN posted a topic in MICU, SICU

    We had a physician who refused to cosign a verbal order taken on night shift. This MD absolutely gave the verbal order, but since a bad outcome happened, he claimed "I never ordered that" the next...

  3. post op patients w/o TLC line placement confirmation

    sunshineCCRN replied to elizadream's topic in MICU, SICU

    darn right!

  4. how does your icu perform shift to shift reports??

    sunshineCCRN replied to christen13's topic in MICU, SICU

    we do not have a patient-free charge nurse and it is an issue (16 beds). our charge gives group report and briefly outlines all the patients on the unit. the whole staff listens and makes assignments...

  5. When a doc refuses to co-sign verbal orders

    sunshineCCRN replied to sunshineCCRN's topic in MICU, SICU

    it wasn't me, so i don't know all the facts, but yes, half the hospital administration was involved. thanks for your post, i feel a little better if i ever have to take one of his patients again....

  6. post op patients w/o TLC line placement confirmation

    sunshineCCRN replied to elizadream's topic in MICU, SICU

    our open hearts have closing films just before they come to ICU. we confirm swan placement by waveforms and CXR if there is a question (usually anesthesia is right there anyway). every patient...

  7. crystalloid recusitation on pt with wet lungs?

    sunshineCCRN replied to geekgolightly's topic in MICU, SICU

    You did a good job with him. Good thing you recognized a problem and acted--now you have a valuable experience that will probably come in handy sooner than you

  8. Good Critical Care Publications?

    sunshineCCRN replied to Dakkon76's topic in MICU, SICU

    i joined aacn. i find their Critical Care Nurse magazine really helpful. the Society of Critical Care Medicine has published guidelines for treating certain patients (end of life, neuromuscular...

  9. Doctor comebacks

    sunshineCCRN replied to NiceShot's topic in MICU, SICU

    oooh, reminds me of my psych clinicals! If they say something awful, ask (nicely, of course), "I'm sorry, what did you say?" (Makes them realize how rude they just were!) Then try to get to why they...

  10. ICU Nurses with OCD!!!

    sunshineCCRN replied to nursern20's topic in MICU, SICU

    I am completely anal at work, whether it's about washing hands or labeling/untangling IVs or having clean, disinfected counters. However, I do NOT understand why some nurses live to terrorize other...

  11. Ethical question about CCRN

    sunshineCCRN replied to King Bazald's topic in MICU, SICU

    our hospital tells our CNSs and managers that they shouldn't perform bedside care! i don't think that's ok for your manager to renew the CCRN if she didn't perfom all the requirements. why would...

  12. Our unit takes too many specialized patients!

    sunshineCCRN replied to sunshineCCRN's topic in MICU, SICU

    I like the "mandatory" specialty nurse idea. The problem is, we have such low volume of certain patients that there's little chance for an inexperienced person to become an expert. Does your unit...

  13. propofol infusion ONLY through central line

    sunshineCCRN replied to elizadream's topic in MICU, SICU

    We can give it peripherally where I work, but if I have a free port on a central line, I'll use that. Think of all those outpatient procedures that use a profpofol gtt! I doubt anyone would start a...

  14. Fentanyl/Versed on locked pumps ?

    sunshineCCRN replied to SusanRN321's topic in MICU, SICU

    What kind of locked pumps allow for fentanyl and benzos? I've only seen MS, dilaudid and demerol run at a basal rate on those PCA pumps--I didn't think they made compatible containers for benzos and...

  15. Our unit takes too many specialized patients!

    sunshineCCRN replied to sunshineCCRN's topic in MICU, SICU

    Yeah, she

  16. Our unit takes too many specialized patients!

    sunshineCCRN replied to sunshineCCRN's topic in MICU, SICU

    Thank goodness we don't have traumas. I guess it's just different in a small hospital. There have been nights when I'm the ONLY person in the house who can take a CVVH/IABP/CABG patient. So it ends...

  17. Our unit takes too many specialized patients!

    sunshineCCRN replied to sunshineCCRN's topic in MICU, SICU

    Thanks for your input, jbp. I guess it's just frustrating since our unit is lacking in experienced nurses. Only 1 or 2 people per shift are fully competent enough to take any patient in the unit....

  18. Go to ICU without MedSurg Experience?

    sunshineCCRN replied to nurse4theplanet's topic in MICU, SICU

    I went straight to ICU, and it was okay. I actually did 13 wks on med-surg after working ICU, and I was bored, frustrated, and stressed. I agree about finding a hospital with a good program. What is...

  19. Death by Arterial Line?

    sunshineCCRN replied to MarySunshine's topic in CCU, Coronary, Cardiac

    i would keep it in with wider parameters. we have VAMP attachments on our ART lines, so we draw hourly blood sugars from them, too. it saves a poke, and the "waste" is returned to the patient safely....