bellehill

bellehill RN

Neuro Critical Care

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All Content by bellehill

  1. Nurse/pt Ratios, and Orientations

    bellehill replied to NurseSuzy's topic in CCU, Coronary, Cardiac

    In our neuro critical care the ratio is 2:1. Our preceptors carry 2:1 during an orientation, usually the most critical patients. The orientation period for a new grad includes a fellowship program...

  2. How should I handle this situation?

    bellehill replied to GrnHonu99's topic in General Nursing

    We have a nurse on our unit that I thought of immediately when you were telling your story. She doesn't mean to sound the way she does but just comes across as a horrible uncaring person. We have...

  3. How do you keep from getting too close?

    bellehill posted a topic in Neuro Intensive Care, ICU

    This past week I had a patient, a 55yo with an inoperable brain tumor. This pt was someone who was very aware of what was going on while still inappropriate. His main concern was that he was he was...

  4. Now I am really questioning nursing

    bellehill replied to socalirn's topic in General Nursing

    I love being a nurse, there isn't anything else I would want to do. That doesn't mean that I love every single minute of it or every single aspect of the job. Just when you think you can't go on one...

  5. Cell phones??

    bellehill replied to JustMe's topic in CCU, Coronary, Cardiac

    We have the same rules on all our tele units but I have never seen any interference. I would love to have the patients be able to use their cell phone in their room since they can't call long...

  6. How do you keep from getting too close?

    bellehill replied to bellehill's topic in Neuro Intensive Care, ICU

    Papaw John, Thanks for sharing your story. It is a privilege to be able to help these patients when they are so

  7. Protonix IVP

    bellehill replied to babynursewannab's topic in General Nursing

    We are told it is not compatible with any other meds or fluids, reconstitute it with NS and push over 2 minutes without a filter. If my patient has fluids running I stop the fluids and flush push...

  8. Dealing with on call Doctors

    bellehill replied to dinkymouse's topic in General Nursing

    I don't work LTC but this does happen in my ICU sometimes with the residents. The best thing is to know what you want when you call (which you did). We have the option of moving up the chain of...

  9. what a great night I had...

    bellehill replied to papawjohn's topic in MICU, SICU

    Those are the shifts that keep me going (probably all of us). Thanks for sharing your awesome night and good

  10. What shifts do you work? Do you like it?

    bellehill replied to TRINI_RN's topic in General Nursing

    I work 3 12's night shift only. I love night shift, more time to focus on the patient. I don't have a problem sleeping during the day but a white noise machine is mandatory. I don't think I could...

  11. ICP Transducers

    bellehill replied to Treb4K's topic in Neuro Intensive Care, ICU

    I work in a 18 bed neuro ICU, we use sterile technique when setting up the EVD, we never change the transducer after it is inserted. Our patients are always on Ancef 1gm q8h while the EVD is in as...

  12. End of Life

    bellehill replied to WakingLife's topic in MICU, SICU

    Our doctors will usually order Morphine and Ativan qhr for comfort. I usually turn off all my monitor alarms, I am going to be in the room anyhow and the family doesn't need the added stress. I try...

  13. ICU nurses- your thoughts on organ donation?

    bellehill replied to tankity's topic in MICU, SICU

    We have awesome procurement coordinators in central Ohio. I have never had a problem with any of the coordinators, they treat the nurses, the family and the patient with respect. The one thing that...

  14. Touchy, Feely Family Members

    bellehill replied to analiezel's topic in General Nursing

    I would assume "the stance" and maintain distance, especially if you have offered emothional support through other outlets. If it is one family member you could pull them aside and tell them you are...

  15. Appreciation for Nurses

    bellehill replied to LionsDen5's topic in MICU, SICU

    Comments like that are why I am a nurse.

  16. Pantoprazole IV question!

    bellehill replied to RNinRubySlippers's topic in General Nursing

    Slow IVP, no filter needed anymore. When it first came out we ran it IVPB over 20 minutes on a separate line with filter. We IVP Pepcid too which used to be

  17. Adjusting to night shift

    bellehill replied to ozarkmo46's topic in General Nursing

    Keep your 3 nights in a row, keep your room dark and use a white noise machine (a fan for me). It will take a few weeks to adjust so give yourself time and don't feel like you have to be up early on...

  18. mouth care/intubated patient

    bellehill replied to classicaldreams's topic in MICU, SICU

    We do peridex QID, mouth care with the Sage oral care products Q4h. The only thing I don't like about Sage is the mouth moisturizer is very gritty and the pts don't seem to like it. The Sage kit...

  19. New Graduates In The Icu?

    bellehill replied to Aaron Catmull's topic in General Nursing

    I wouldn't trade my 3 years of med-surg for anything. When I did transfer to the neuro ICU all I needed to learn was the critical care part of the unit, I already had a handle on the basic nursing...

  20. New Graduates In The Icu?

    bellehill replied to Aaron Catmull's topic in MICU, SICU

    I wouldn't trade my 3 years of med-surg for anything. When I did transfer to the neuro ICU all I needed to learn was the critical care part of the unit, I already had a handle on the basic nursing...

  21. Discussing patients condition /prognosis

    bellehill replied to undecided's topic in General Nursing

    If my pt is being sent for a test and they don't know why I will tell them. Our doctors round very early in the morning, not a good time for the pt to retain info. If they are waiting on test...

  22. Continuous Urine monitoring

    bellehill replied to Ashman's topic in General Nursing

    Our ICU does Q1h outputs, unless there is a miracle and we have a patient that can walk to the bathroom, then it is tallied after void. When I worked Med-Surg there was definitely a lack of concern...

  23. Neuro Assessment Form

    bellehill replied to joyful nurse's topic in Neuro Intensive Care, ICU

    Ours also has a section for cough/corneal/gag/swallow assessment along with a pronator drift check. Our flowsheet is also used in every

  24. Mannitol Protocol

    bellehill replied to Harjodi's topic in Neuro Intensive Care, ICU

    We don't have written protocol, but it is generally started at 25g IVPB Q6h with osmo draws before the dose. The mannitol dose will be held if osmo>315-320, depending on MD. Occassionally we...

  25. Overstimulation in comatose patients

    bellehill replied to derelys9's topic in Neuro Intensive Care, ICU

    I had a patient last week that I had to ask the family to stop stimulating because her ICP was >40, elevated HR and elevated BP. Keep in mind that if he is in the Neuro ICU he is being assessed...