bellehill RN

I work in a 20 bed Neuro ICU. Our Quality Outcomes Manager came across this Advanced Stroke Life Support training from our EMS contact. We are a TJC certified stroke center now, has anyone heard of or completed this training? I did a search and it se...

We obtain a pupillometer reading on admission for all our neuro patients. Our protocol is to call the MD for: NPi CV %change >1mm difference between pupils We also trend the NPi and if there is a difference between R/L pupils of >0.7 or if the...

We recently started using the Edwards FloTrac for our Triple H patients. The first round went really well, the second round did not go as well. The problem we are having is the variability with the numbers. We are following the Stroke Volume Variatio...

Is anyone watching "One Born Every Minute" on Lifetime? It was taped at Riverside Methodist Hospital in Columbus. I work there (not L&D) and I love to see the exposure. Even if you don't work at Riverside, what a great opportunity for Central Ohi...

We treat any stroke symptoms the same with the standard benchmark goals. Door to doc in 10 minutes, door to CT in 20 minutes, door to CT read in 45 minutes and door to TPA in 60 minutes if applicable. Our hospital uses a "stroke alert". The important...

Grab a textbook, preferably by Hickey and look at it then draw it. I always learned better when I drew the subject (like the Circle of Willis). I think I drew the COW a million times when I was studying for the CNRN. If you can draw it you can visual...

An update: we are seeing great success using the Flotrac. Our goal is SVV40 and CVP>8 for non-vented and >12 for vented patients. If two of the three parameters are not in range we bolus the patient. No more swans...YEAH! Just recently had a p...

We have a Neo shortage as well, anyone else? We have been using Dopamine and Epinephrine.

Have you tried a bedside report? If you are having trouble remembering what happened during the day go in the room and talk about the patient. Chances are you will remember and the patient will appreciate knowing how thorough you were with report (if...

Our unit has a shared governance with 4 different quadrants: customer service, quality of worklife, practice and research, and education. Each quadrant has a chair and co-chair as well as the chair and co-chair of the shared governance. Ours meets on...

In our neuro patients it seems to work very sporadically. We were just inserviced on Precedex and it is not to be used for the patient when they are wild. Ideally, you would get the patient calm with Ativan/Haldol/Versed and start the Precedex drip w...

I worked in a busy Neuro ICU my entire pregnancy. I was supposed to work the night I had my child. It is like any nursing job. You take normal precautions just like you would with any patient, even if you aren't pregnant. If you want to try neuro the...

Thanks. We are going to be looking at the SVV, SVI and CVP. If 2 of the 3 numbers are below the parameters the patient will be bolused. This has worked well so far!

I agree with birdie22, go with the BSN and work as a tech. Nursing jobs are very competitive in Columbus.

One thing I see in new nurses on our neuro ICU is they do not understand the emotional toll they will encounter everyday. The neuro ICU is a sad place to work. We do have those cases that really lift you and and make you proud, but they feel far betw...

So what are you using to monitor fluid status and cardiac output? I certainly don't miss the swans, what a pain they were.

You did nothing wrong. I agree with the previous posters, 0.5mg of Ativan is like spitting on the problem. Neuro changes happen in seconds and you did everything you could for this young man. We always take patients like this home in our head, but pu...

We use Propofol in our neuro ICU simply because it wears off so quickly for our hourly assessments. Precedex is tried and we have seen that it tends to work better on some than others (not sure if it is a brain thing). We just had the Precedex rep do...

In our neuro ICU we do a neuro assessment together at the end of the shift. We are supposed to be going to full bedside reporting and I really don't see the harm. Of course there are some items that simply cannot be discussed in front of the patient ...

I am on 8 committees plus teaching classes to our med-surg nurses, CC nurses and EMS occassionally. Plus, I am supposed to do bedside hours each week to stay clinical. Sometimes I feel like I am being pulled in a million different directions but what...

If you put your clothes in the dryer on high for 30 minutes you will kill the bed bugs from clothing and linen. I would do this automatically for your own safety, especially working in home health. Bed bugs is a huge problem for my city and the hospi...

My hospital has a Critical Care Fellowship for new nurses and this is the only way we will hire new nurses to the NICU. I think the fellowship is a great way to experience every aspect of critical care and then decide which you want to focus on. Of c...

Walk in, tell the doctor your symptoms and how you feel. There is nothing more to it. What would someone who isn't a nurse tell their doctor? You are human and normal.

1)c 2)e...if the patient is mechanically ventilated we do oral, non-vented we do nasal 3)a 4)e...enteral feeding should be started as soon as possible, it is best practice for the patient 5)a 6)a 7)d 8)b 9)e...we hold tube feeding one hour for residu...

Our unit is open except for 6:30-8:30 and 1830-2030. This gives the shift coming in time to get report and an assessment done. I have mixed thoughts about open visitation, however, everyone has to keep the rules for all family members. That is our bi...