LoraLou

depending on the area of the country you are in there is the option of a cinical nurse specialist. The education for that is more towards the education, resource nurse type focus. I know they are common in some areas and not in others. I'm kinda in the same boat as you, although I have been out longer, I know I don't want CRNA and I'm not really sure that I want to be an NP either.

How do you guys deal with the death and the dying of the young? I am an adult open heart recovery/icu nursing and my patient die and while its difficult to deal with I can cope by knowing usually the person has lived their life and its time for them to move onto where they need to be. Last week my friend's younger sister died from cancer, while it was an 'excpected death' it wasn't at the same time because she was just 16. It just got me to thinking how do you deal with your patient's that you lose? lora

I've had a 0.9, quite a while ago ended up putting an IABP in. Sounds like yours needed a dilator with svri that high, thats pretty tight for the heart to be pumping against. Once that's lowered the ci should come up.

Around the area that I live LPNs are not being hired into hospital work. If there is an lpn that has worked in the hospital they are not being fired or anything like that, but cannot even transfer to other floors, once leaving the floor where they are they can no longer find hospital work.

I have not personally worked in a unit like that but a few local hospitals have started units similar to that, however it is a bit different. What they do is once a patient enters a room they don't leave until they are discharged. If they are a tele patient upon entering the hospital, and get transfered to ICU care the nurses change but not the room. To me it sounds confusing and really hard to do staffing, but once again I haven't worked there so I can't offer direct comments.

Maybe she's thinking latex allergy if you're wearing latex gloves? Only thought that I could think of, regardless if a patient is an isolation patient gloves should be worn.

You don't have to work as a CNA, just take the CNA classes.

I have actually seen it mess up the monitors, only once and that was a while ago. I worked with someone who said the really old cell phones would mess up the iv pumps at the facility that she worked at. What I have heard is that they only mess up the equipment when the phone goes into analog roaming which is extremely rare with the newer cell phones. I don't know how true that it is. I always tell people that its not very common, but it can sometimes happen and wouldn't they rather be safe than sorry with their loved ones and there is usually not a problem. As far as the docs go I have seen them using cell phones at the desk on occasion which is usually more than the 3-5 feet away it says, I have never seen them use them in the rooms.

I personally wear a scrub top cuz I want the pockets to keep my pens, hemostats, and other various supplies in them, but I don't think it looks bad to not wear one.

on my unit we would use BIS only if the patient was paralyzed and sedated. We had a scale if they were on sedation only as far as awake and calm, awake and agitated, easily arousable, etc. but if somebody is paralyzed that is not going to work, so we would slap a BIS on them to make sure they were not awake underneath the paralyzation. As far as it ranging from the 60s to 90s I'm not sure, we would occasionally experience a smaller drop or rise and would just adjust the sedation accordingly. At least on our monitors a quality indicator number would pop up alongside the bis, so if that read between 90-100 we knew our BIS was accurate, if it was low you would need to try pressing down on the pad areas where it is reading and also think about changing out the whole set, that should be changed at least every 24 hours. Lora

our policy is TPN through a central line only, the only thing we are able to run with TPN is insulin, and there PPN (peripheral parenterl nutrition) that is prepared to run through a peripheral line.

We have different docs that like it different ways here also. Probably just where they did their residency.

if you were asking about working in the eICU which I believe that you were saying something about hands on care vs monitor watching, as a nurse working in the eICU you would not have any hands on care, you would be sitting at a monitor screen looking at many many tele strips, at the eICU where I am at (I work in the ICU utilizing them not the eICU) the nurses have 4 computer screens I believe, can camera into the rooms pull up lab values, and have the tele's of all the patients they are assignedto watch, which I believe is somewhere around 25. my personal experience the nurses on the other side of the monitor, not so helpful, the attendings (only staffed during night shift) very useful esp. when you're in a teaching hospital and are mostly dealing with interns on night shift.

I've done it and it works, not on a long term basis but I had a young patient who we were waiting for father to get in to say goodbye before letting her go and we were maxed on pressors with a continuous bicarb gtt running and I'd push an amp of bicarb her pressure would go up to 110 or so and hold for a short while her pressure would start dropping when it got too low I'd push another amp and she would respond and come up, vicious cycle, thankfully her father was in before too long and we stopped pushing amps and she was soon gone.

stressors would pretty much be equal, a Medical ICU is medical type patients, you'll be getting pnemonia's, people on gtts, anything requiring ICU care except for surgeries, it will be a catch all unit. CTICU will be mostly surgical patients, I currently work in that and we take any surgical patients that the cardiothoracic surgeons do, thoracotomies, Open Heart Surgery (cabg and valve), cartoids, thoracic aneuyisms, etc. As for which you should go to, go where you have the most interest, you'll learn much more and function better in a unit where you have a true interest in the type of illness your patients have. Lora