Florence NightinFAIL

Thanks for the responses all. Marienm, that makes so much sense. Thank you.

Does the weight not change for those patients who are in ICU for weeks or months? Since they are getting tube feeds, their weight gain would be due to more than edema.

I'm a PACU nurse that has been redeployed to ICU a few times past 3 months. I'm wondering for the weight based infusions, what weight do you guys enter and how often do you update? Actual weight, ideal weight or lean body weight? So far, I've taken over patients who already had drips running so I didn't have to enter a weight but I'm wondering if you guys change the weight daily based on their actual weight? I know there would be accuracy issues with using actual weight with patients that are third spacing/edamatous but I haven't had this addressed yet.

Switched from medical surgical before the pandemic with 4-5 acute patients to maximum 2 patients on PACU. Will never go back to regular bedside. PACU is EXTREMELY BUSY. I might have 6-8 patients a day, but maximum TWO AT ONE TIME. So it's mangeable. Look into it.

http://www.icufaqs.org/ If found this site helpful. I loved it so much, I ordered the book.

Let me just ask... Were any of these patient's wealthy and you were hoping they will leave you something in their will? Otherwise it doesn't make sense. Event the most LOVING offspring don't do what you do.

You lost me at nightly foot soak and 2 hours to get to bed.

After all, they are just sent back home to quarantine and rest anyway. That’s such a waste of a test. Everyone is already being told what kind of distancing and precautions to take. I feel like those tests are wasted of either asymptomatic individuals or individuals who are sick but are not sick enough to be hospitalized. If they stopped doing those wasteful tests, then maybe those who really need it, like healthcare workers would be able to get them. Am I missing something here?

What if you refuse? What can they do? Would they really fire or send you home when they are desperate for nurses?

If I had the resources, I would not feel an iota of guilt in quitting. Not an atom's weight. They are already training your replacement.

Good luck. I'm nervous starting a new job during the pandemic too. I'll be going for orientation for PACU but they will be sending me to ICU so I'm not sure how that will effect my orientation. I already had the classroom portion of the orientation cancelled ahead due to covid concerns. In my ten years of nursing, the best brain sheet is the one YOU make yourself and personalize. It's best to Google "ICU report/brain" sheet and customize to your liking. Things will flow better that way when you have your own system. I also like to look at other nurses' brain sheets and if they have a printable template, I usually ask for a copy to observe. I also recommend to watch Youtube videos on "ICU nursing assessment" "Giving report in ICU" etc. There are lots of good videos. Tips to keep in mind: - Trends are more important than absolute values - Look things up regularly - policies and procedures - If you ever have "downtime", chart, chart, chart. Pee, then chart. You should always strive to be caught up in charting because things change very quickly in the ICU and you don't want to be remembering things that happened hours ago Good luck! Keep us updated on our experience ? ICU report template 1 patient.docx

This is what I used for med-surg. It's for 4 patients, I doubled it and print it double-sided to account for discharges and new admits. Please share your own brain sheets. It's always helpful to see how others organize their cheat/report sheets. medsurg_report4pts.docx

I'm one of those people who are obsessed with making my own brain sheet template. I used ideas from my unit, Google and from all-nurses. Attached for anyone interested. Please share your own files if you can. I'm always interested in seeing other's templates. It doesn't matter what unit or how many patients. icusheet_anotherone.docx

I'm still in training so I have no clue. I should probably check that first LOL. Thanks.

Have any of you seen this or it happened to you? Due to the coronavirus scare, elective surgeries are being halted and some PACU nurses are being quickly oriented and floated to ICU units to help with the shortages. Can they say no? I would like to hear from personal experiences.

Thank you for the responses.

Hello, I've been nursing for 10 years in med-surg and currently going through critical care training to work in PACU. For the past ten years, my life has depended on brain/cheat sheets to get through the shift. Is there such a thing in the PACU? I know the turnover is very fast and you might have some patients for only 2-4 hrs, but how do you organize your time with that patient? Do you guys have a template to share? Is there a point to a brain sheet in PACU or do random scribbles on a blank sheet sufficient for a such a fast-paced unit?

I created this after literally looking through more than ten online versions. The trick is to use them as inspiration and make it your own to fit your specific needs. ICU_cheatsheetMAIN.docx

Do you check pedal pulses on all your patient's regardless of their diagnosis or history? Example: for a pt that came in with diarrhea and is otherwise independent with history/risk factor for dvt/PE/PVD. I was discussing head to toe assessment with some nurses and some of them said that they sometimes don't do a full head to toe assessment at all. They just do a focused assessment if a pt is stable. Ex: if a pt came in with cellulitis of the leg, they wouldn't listen to their chest or abdomen, ETC. I was really surprised.

Have you guys heard about Green Smoothies? I've recently been seeing a lot of nurses carrying weird looking greenish concoctions and they claim to have a lot more energy. Which is very appealing to me since I have veggies and I'm in desperate need of an energy boost during my shifts. I'm always sleepy and groggy for hours after lunch. Do you guys drink them and what are your recipes? Noticed any changes? How about the whole Superfoods /protein shakes trend (maybe trend only to me)? Do you believe in it and which ones do you swear by? Yes, if you are wondering, I'm trying to find the lazy man's way to good health. Instead of changing my whole eating habits I want to mix up some powders and have miraculous results!

Wow. Is this discussion only SCARY to me???!!! In my area (I've worked at 3 hospitals), giving oxygen to pt is a nursing order up to 10L. Even if it isn't, I would never leave a pt is resp distress without providing what the OP has done. It's very easy for a person who is desatting/having difficulty breathing to go down rapidly - why take the precious minutes you have and waste on walking to the nursing station, looking for the doc's number, call him up, explain the situation, then get an order. That can happen AFTER! Now, I'm not sure if the situation OP experienced is as dramatic as I'm describing, but still...

Good old vaseline. Make sure your hands are wet/damp so that it can lock in the moisture. I have severely dry hands (made worse with nursing) and I'm still trying out lotions and so far none of them have yet kept me moisturized longer than 2-3 hours before I need to reapply. I keep lotions everywhere though - bedroom, bathroom, kitchen, purse, work bag, car so that I'm always reapplying which really helps. I've started to use Lush's massage bars and I find them very moisturizing compared to creams & lotions. Read some of the reviews on the website.

Maybe it would be better deactivate that account and set up a secret one with just the people you really are close with. That's what I did - so when they asked - I truthfully answered that I deactivated the account and didn't want to open in anytime in the future. I went from 200 'friends' to about 40.

"When the manager said that nursing was so easy, even a dog could do it, I really thought she was joking!"

Good ones! Some more... - Whenever I reposition pts, I flip over the pillow. Every single time. - If I pull them up in bed and their gown is touching their neck - I have to pull it down or else I'll have this weird sense that something is choking MY neck . Whether or not they ask. They never ask - I caviwipe commodes even if they are clean. - I spray odor control spray on bedpans and urinals before and after use (really cuts down on odor). - If I'm spraying a room - I'll make noises to try to cover up the sound so that they don't get embarassed.