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NurseHeart&Soul

NurseHeart&Soul

ED, Critical care, & Education
Member Member Writer Nurse
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NurseHeart&Soul specializes in ED, Critical care, & Education.

NurseHeart&Soul's Latest Activity

  1. NurseHeart&Soul

    CCRN exam and Laura Gasparis lecture

    ANY course put on by Laura Gasparis Vonfrolio is worth the time and financial investment. Laura is one of the nursing greats! You will learn a ton and have a fun time while doing it. I highly recommend her courses. GO FOR IT and good luck on your exam.
  2. NurseHeart&Soul

    How I Wrote a Book and Became a Nurse Author

    Congratulations, Beth! You have so many gifts to share with the world. Thank you of taking the time to put your experience into print. Your book will help many nurses in the years to come!
  3. What Quick References do you have available at triage? For example, pediatric vital signs, ESI or other triage decision making criteria, Burn Rule of 9's, a picture of a hand with associated joints etc... More importantly, what do you wish you had access to that would help with your decision making or documentation?
  4. NurseHeart&Soul

    Dead or Alive: That is the Question

    Ellie G~. Sounds like you have witnessed some amazing recuperations. Thank you for sharing those stories that are obviously near and dear to your heart. Wonderful that they are both doing so well.
  5. NurseHeart&Soul

    Dead or Alive: That is the Question

    Thank you for your very thoughtful comments that clearly come from some great experience. Much appreciated!
  6. NurseHeart&Soul

    ESI practice thread

    Thanks for sharing! I love it when the opportunity arises to learn about the rare stuff.
  7. NurseHeart&Soul

    ESI practice thread

    AWESOME idea for a thread!!
  8. NurseHeart&Soul

    ESI practice thread

    Great cases Amy! Keep them coming! I'd make him level 2. Stat CT scan needed for sure. He meets the ESI criteria Decision point B for high risk situation and confusion.
  9. NurseHeart&Soul

    ESI practice thread

    Yes, level 2 and immediate continuous observation put into place.
  10. NurseHeart&Soul

    Dead or Alive: That is the Question

    BSN16, Thank you for adding in the point about the many patients who have a poor prognosis but who may or may never meet brain death criteria. That is wonderful that you are now working with transplant patients. The final piece to this donation series will be a story from a donor mom who knows first hand the value of donation. Thank you for the work that you do!
  11. NurseHeart&Soul

    Dead or Alive: That is the Question

    So glad your nurse friend is alive and well...and working! Awesome! I wonder if there was a confirmatory test done when the statement "no flow to the brain" was made. Sometimes terms are used loosely when in fact there is nothing loose about brain death, no flow to the brain etc... The clinical exam can certainly indicate no flow to the brain but without a confirmatory exam that's not an accurate claim to make. Regardless, sounds like she made an AMAZING recovery which is awesome!
  12. NurseHeart&Soul

    Dead or Alive: That is the Question

    sunny time~ Breakfast? Wow!
  13. NurseHeart&Soul

    Dead or Alive: That is the Question

    Ellie G- I definitely can't imagine being a patient and hearing the discussion about me possibly being an organ donor, and obviously I cannot personally speak to any of the cases mentioned in this article. However, these cases did bring to mind the number of times I interacted with physicians who were not comfortable with pronouncing brain death. A person is never "kind of" brain dead. There are very clear criteria that should be followed and physicians who understand brain death, the criteria, and the confirmatory tests should be the ones determining brain death. I'm not saying miracles never happen... Thanks for your comment.
  14. NurseHeart&Soul

    ESI question

    1) Triage acuity levels are determined by the information obtained and provided not with the help of a subjective opinion like "she is here all the time". That is the type of behavior that will get a patient killed and an ER nurse and facility caught in a legal situation. 2) The initial triage level should NEVER be changed (unless it is by YOU). Your supervisor could make the decision to document why the patient is being downgraded to a level 2 but you are the one with the initial visual of the patient who used your critical thinking skills, experience etc. to come up with the level 1 acuity. Books on triage (see Amazon) further clarify this point. I also agree with many of the other posters on the level 1 decision.
  15. NurseHeart&Soul

    Dead or Alive: That is the Question

    Risk Manager~ Awesome question! In my experience, and in working in the past with coordinators in other regions and states, the practice here tends to vary. The bottom line is when a patient is brain dead technically there is no need for general anesthesia. However, sometimes during the moving process, the donor may become hypertensive, and gas can be administered as a quick and easy way to normalize the blood pressure. Maintaining organ function and stable vital signs throughout the procedure is critical, so in essence anesthesia will often do their job as they know how best in order to maintain needed parameters. Monitoring ventilator settings, O2 sats etc. and adjusting accordingly is still a key role for anesthesia. On a side note, I will say I have seen paralytics given to a brain dead patient in the OR which truly was a comfort measure to the hospital staff not a need for the patient. Thanks for reading and for the great question!
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