MurseNeutron

okie, yesterday i get a trauma patient from down range. female type. we extubate her in like the first 5 minutes of my shift. the anesthesiologist puts an epidural in the thoracic for pain relief on a broken left fibula head, broken left ankle, chest tube insertion for a hemothorax, left flail chest. anywho, c-spine is cleared by cat scan, but upon removal of the miami collar the pt is having tenderness with flexion to her chest. the on call doctor orders an MRI of the cervical spine and a controversy insues over her eipdural. at first glance it looked as if though it was a catheter, but it appeared to be a wire inside the cath. threaded into the back. i am aware that a stylet is used for epidurals and is removed, but is a wire inside the cath? i have always called it a wire. so, i call anesthesia back and they come over with no idea if it is a wire or not. the on call doc has no clue and neither does anyone else. we take the stock number of the type of epidural used, which is braun "perifix" continous epidural anesthesia tray and look it up with no results. now the box says that it is an opaque catheter with out any mention of a wire. it being opaque it shows up on x-rays, right.... finally the rad orders a Chest x-ray to determine, "how opaque the catheter is." yeah, nothing not even a shadow of the wire. we call the head radiologist the results and he flips, of course, im sitting in the middle with the on call doc pressing it down my throat to get the mri; im not wanting to put my patient any where near a risk with an mri that could burn the hell out of her, not to mention, the wire is stuck in her spinal column.... anywho, the radiologist comes in fussing about not being sure and not wanting to do it, which in the evil end wasted my time because i told the two they needed to figure it out which, of course, ended up us not getting the mri done in the end. im just curious has anyone else taken a patient to MRI with an epidural? whats the scoop on it? is it a wire or just a metal looking cath? arn't they opaque? any protocols?? hit me up.

a cma is certified medication assistant, right? sounds like your doing your job... the question was about cna's, which have no training in medication assistance. if your problem is with the nurses sounds like you need to suck it up and do the math. perhaps a little grammar too

i have only worked military and large cities aka houston, washington d.c., new orleans. depending on shift and weekends 24 and up.

how many mg of demerol did you give?

next time she tries to micro-manage take a 10cc syringe filled with air and nicely say with a smile on your face, 'if you dont get off my back ill stick this in your neck and walk off.' i bet she'll leave you alone then, lol. i found when i first got into icu nursing the nurses have a pride about them and they def. dont like new comers, but thats all nursing. just keep your head down and your ears open. soon patience and good work ethic will put you in the position to look up and be like remember when..... my turn :)

Nursing assistant def. the biggest part of nursing job is your movements and reactions with the patients. the more contact hours the better. always remember you have to learn the job before you learn theory. nursing school is basics, but you have a whole other world ahead of you. if you're interested in cardiac strips have someone show you the basics with the intervals and basic dysrrythmis and go to town on your own. there are so many books even web sites where you can identify one after the other. strips are nothing, but repitition

yeah im def. not ricky rescuer when i leave the hospital, but i would never hide the fact. if my neighbor asked me to look at his private parts i think i might laugh in his or her face and tell them to get insurance. that would take family. sounds like you need to either take some time off or work on your seperation from job to personal life. maybe keeping your mind busy or doing cross word puzzles to get your mind off work when you leave. if you enjoy your job just let it go. about the doctors: if its bothering you with their confrontation try the opposite of what disturbs you. embrace it.... when you first walk in tell them your a nurse and either go really overboard with it (i gurantee they wouldnt want to talk about it then because they know it wouldnt be an issue, plus as a bonus probably very amusing to yourself) or tell them flat out i dont feel like talking about it. im sure youll make it through playa, keep ya head up :)

i can't believe this is still an issue on this forum, wow. how often does this happen?

as an officer coming in for the army you have to have an identifier to your MOS to work in the ICU, which im sure can be added through your command or andy retention OIC. Im pretty sure that this goes through with any branch of the military. As long as you are not currently deployed they are willing to send you icu course to add the identifier, unless you have exp., which im sure they would work with you then. your three choices need to be your home base of record. unfort. going over seas you prob wouldn't be able to bring your cats right away, but arriving shortly after you would probably be living on the economy in your parenting country, which at that time your cats could be shipped over. its a little work, but anything is possible just need to know who to ask. bring these situations up with your recruiter and they will so work with you. unfort. sometimes in the military you have be the politest pain in the ass as possible so dont take no for an aswer! if you want something though go get it and id be glad to help if i can. believe though even if you were to start on a med/surg floor acls, icu short course/courses are available. thats the brilliant part about the military is that you control your own education (sometimes they force it on you, lol ) but all the time the classes are there to take and no one will ever deny you taking them (and all free!) though you might have to do some on your own time. hit me up and tell me how it goes.

an appletini, lol, i asked her, but she wasnt sure. after she got done with him or her im sure it was a straight double jack :)

sorry i accidentally posted twice. i have to run and dont know how to cancel it so read this:) and feel time wasting away, sorry.

cna's dont have the training for passing meds. i recall having to remember an ungodly amount of meds and study for a few years to pass meds. how long does it take to get a cna license? thats your rear end on the line my man... i have had cna's i wouldn't let pass a mv tab, much less considering colace. i hoped to goodness your not letting them pass blood pressure medication thats down right scary. figure this. you hand a cna 100mg of lopressor. he or she walks in the room. say they even take the bp it ends up 100/60 c a heart rate of 60. would he or she give it. hell yeah!

my first deployment was in the icu. i went straight from school and bam. believe me the icu course, acls, tncc, abls, pals etc... you will get them. the military has recurring courses for each class every few weeks to months and plenty of people to teach them. if you want experience and are willing to be flexible (highly flexible) its the way to go. especially if you can get germany. the icu here is amazing..... believe me though no experience is required as long as you got that lisence and two there is no such policy about not being able to deploy for a year. if you go active you best be picking where you want to go because you will be deployed. if your serious about your career and want to learn though it might be a sacrafice you can make. my learning curve has been straight up for a few years now and i have been around the world including japan and all over europe dealing with everything from cardiac to 90% burns..... think about it, but make a plan, much dedication involved, but it forces you do learn and work at top speed. its a good stepping stone.

a friend of mine i work with was called by the local bar next to the hospital with the complaint of a person in a hospital gown and id tag ordering drinks......

lol, one night i was passing meds and i had a cna run up to me almost yelling that one of my patients had 'escaped' i followed his trail all the way outside to the front of the hospital where the patient was sitting across the street on the corner indian style watching traffic go by. Note: this is about 11:00 at night. I sat indian style next to him, offered him a cookie, and small talked him for a few minutes all the way back to bed. i dont think he realized what had happened until i had left to go home a few moments later. wuhahaha.