ktliz

Managing your lines is something that will come with experience. I remember being a new nurse, and tracing my lines over and over and over to make sure I knew where everything was going. We do the 3 labels thing, with one at the patient, one by the b...

A previous poster said they found the ICU over-stimulating. Personally the combination of routine and adrenaline in the ICU has been perfect for me. But, a couple years into my career, I'm starting to have more issues with inattention. Now that I'm m...

We are moving toward a paperless report in our unit, using the computer to look up information rather than referring to a written Kardex. Previously, the off-going nurse would make a copy of the patient's Kardex for the oncoming nurse to take report...

One of my worst days on the unit--up to 16 pumps running at once, including abx, electrolytes and blood products. Four stacks of four pumps each. Patient was on CRRT so I was doing hourly Is&Os, clearing the volume on every one of those pumps eve...

I've been told never to strip an intrapleural chest tube, but it's ok to strip the smaller, mediastinal drains.

Propofol is our go-to drug, usually with 50-100 of fentanyl Q1H PRN, or sometimes a fentanyl gtt. If propofol (max of 80) doesn't keep the patient adequately sedated, then we will go to midazolam. We don't check trigylcerides routinely, only if the p...

Propofol. Or sometimes fentanyl with prn ativan. We will use dex when trying to extubate a patient who wakes up WILD when you turn the propofol off. In our facility, dex absolutely cannot be used for longer than the fda-approved 24 hours.

Sounds about right. The completely wiped-out feeling does diminish with time, but will never completely go away. You just learn to work through it. I will say that the mental exhaustion seemed to get much better after a year. Now it is just the physi...

It goes without saying that to be a nurse, you need to have (or quickly develop) a strong stomach. But even with a stomach of steel, nursing kryptonite can leave you nauseated and gagging, even if only on the inside. I'm only starting clinicals next...

Sorry, Rhia, I didn't start at USA after all, due to finances. Hoping to start my MSN this fall but at a different school (with the help of tuition deferment!)

Just about 2 years of experience in the ICU. Highs.. -Making my patient as comfortable as possible. Whether that means a bath, getting up and sitting in a chair, allowing them a few hours of uninterrupted sleep or providing just the right PRN med. -W...

Was doing a little googling for my own information, and found this page explaining the types of ketoacidosis... http://www.anaesthesiamcq.com/AcidBaseBook/ab8_2.php

I think you may have missed the part where the OP states that the patient is a type I diabetic. Therefore, the patient does require insulin and the DKA protocol would be appropriate.

Great thread. Just this week I had a patient in torsades requiring compressions and defibrillation. Following the code, we started a milrinone drip with a loading dose. Apparently his heart did not like that loading dose because he went into a rhyth...

There may be a few tidbits that are outdated (meds, maybe?), but as every document on the icufaqs site states, it is not intended to be the "last word" on anything. It is a general overview of things you will encounter in the ICU, and still an excell...

True. So far haven't had this happen though. Often, when we withdraw care and the patient is too sick to go to hospice, they already have a central line/picc/port or something. If I lost IV access on my minimally conscious patient, I would be highly ...

If a patient is in the ICU, it's because they require close monitoring. Hourly vitals, Is&Os, q2 or q4 assessments. Constantly watching that cardiac monitor, spO2, etc. That is why they are 1:2. The only time I would accept a tripled assignment w...

I completely agree with Nalon1 that it is best not to get too attached. Luckily, I have always been the type of person who can feel extremely connected to someone in the moment, yet be able to say goodbye fairly easily when it's time to move on. Some...

You're right... I think chillceb's reply could be considered "hijacking" a post which leads to confusion. Chillceb, not sure if you realize it but this post is in the MICU/SICU forum.

You might get a better response in the hospice forum. In the ICU, our patients have IV access, so we use it. Hospice nurses will have more experience with PO or SL administration. Although, I probably would have given morphine instead of Ativan.

Almost nothing is autonomous in nursing. Just about everything is collaborative. Personally, I love my role. I will advocate for my patient all day and question doctors orders if necessary. But when it comes down to it, the brunt of the medical decis...

Have you been offered both of these jobs? What sort of feedback did you get from the hiring managers about the units?

You said yourself that you are happy there and the unit has offered you great opportunities. That, combined with the fact that your co-workers are getting accepted, makes me think you should stay. It doesn't hurt to show a little job loyalty, either....

I'm not sure what you mean by having the stopcocks open to both the CVP and the infusions. If you are getting a CVP reading, the stopcock should be turned "off" toward the infusion. If you are infusing, it is off toward transducer/pressure bag, and ...

It is the thick white kind. We are only supposed to remove it with daily baths using soap & water. There are some nurses who want to remove it with every clean- up but we are working on educating. We are also working on getting the clear cream.....