zambezi BSN, RN

CCU (Coronary Care); Clinical Research

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All Content by zambezi

  1. zambezi

    Pregnant nurse here

    zambezi replied to GeeBeeRN's topic in Medical-Surgical

    I work in a CCU and am 24 weeks pregnant with my first- Congratulations to you by the way! I worked nights up until about 3 weeks ago...It was worse during the first trimester (but doable, for...
  2. zambezi

    Can you believe this ?!!?

    zambezi replied to bluesky's topic in MICU, SICU

    Don't feel bad, even if the family members were rude...it was a good call on your part and you were being an advocate for the patient...I always ask my patients to tell me how meds affected them if...
  3. zambezi

    What do you always try to put on an IV pump?

    zambezi replied to Aneroo's topic in General Nursing

    I basically put everything on a pump...even NS...I like to have an exact rate set...I usually put blood on a pump too... The only things I don't put on a pump usually are: albumin/hespan (post op Open...
  4. zambezi

    Abnormal PAP: I'm scared!

    zambezi replied to Nurse-o-Matic's topic in General Nursing

    Another chat site that I go to has a good motto: Don't waste a good panic...at this point, try not worry too much...my story won't reassure you so I won't share it right now but I will say this: The...
  5. zambezi

    **Organ Donation**

    zambezi replied to sirI's topic in General Nursing

    I too am an organ donor...registered through the state. I think that it is crazy that family can override that decision, when it is obviously my decision to register and have it placed on my...
  6. zambezi

    As bad as they say??

    zambezi replied to lancerRN2b's topic in Nursing Career

    I really enjoy nursing...as with any profession, there are good and bad points. I agree that it is not an easy job...because of the way that health care is today, many nurses feel the short end of the...
  7. zambezi

    Need some opinions

    zambezi replied to RaeT,RN's topic in Ob/Gyn

    This is what I tell our new grads (in a CCU not OB but the concept is the same)... We have a charge nurse that often "makes up" orders or doesn't call for things he should and vice versa...sometimes...
  8. zambezi

    Pain management after surgery for former addict

    zambezi replied to eandgsma's topic in Pain Management

    I would also recommend toradol- at least directly post-op (esp. if it is a same day surgery). Of course, there are some other considerations with toradol((allergies to NSAIDS, bleeding issues/ulcers,...
  9. zambezi

    Use of Morphine for end of life comfort

    zambezi replied to Wicherubgirl's topic in Patient Safety Issues

    1. Do you believe in using Morphine Sulfate for end of life comfort? Yes, definately! If the patient is dying, one of my jobs is to keep that patient as comfortable as possible. 2. In your experience...
  10. zambezi

    sedation protocol mechanically ventilated patient

    zambezi replied to rookreck's topic in CCU, Coronary, Cardiac

    Our clinical nurse specialist and policy committee (staff nurses that have been chosen or voluenteered) write our protocols and policies... These protocols are then reviewed by the lead pharmacist and...
  11. zambezi

    Dilute IV meds or not?

    zambezi replied to HappyJaxRN's topic in General Nursing

    Now that I reread this... The drug book does say that IV lopressor can be "given rapidly", though it didn't specify what "given rapidly" actually means...that said, unless I am doing our lopressor...
  12. zambezi

    Dilute IV meds or not?

    zambezi replied to HappyJaxRN's topic in General Nursing

    IV lopressor is a quick drug- it's onset is considered immediate...peaks in 20 minutes and the duration is 5-8 hours. PO lopressors onset is 15 minutes and the duration is 6-12 hours. We use a...
  13. zambezi

    sedation protocol mechanically ventilated patient

    zambezi replied to rookreck's topic in CCU, Coronary, Cardiac

    We also use the RASS scale to monitor sedated patients. We used the Ramsey scale up until about 1.5 years or so
  14. zambezi

    Drop off where?

    zambezi replied to IcantThinkofaName's topic in First Year After Licensure

    I also try to talk with the manager of the unit that I am interested in...our human resources department is horrible and lose apps all the time...I would send one to human resources/online and hand...
  15. zambezi

    sedation protocol mechanically ventilated patient

    zambezi replied to rookreck's topic in CCU, Coronary, Cardiac

    We use propofol 99% of the time in our unit. We titrate to effect...Occassionally on a longer term patient we use ativan for sedation...Our standard for post op hearts is propofol and fentanyl...Most...
  16. zambezi

    heparin protocol

    zambezi replied to rookreck's topic in MICU, SICU

    We also start with a weight based heparin bolus (I want to say 50 units/kg, but I can't remember so I could definately be wrong). Then we run the actual drip at 15 units/kg/hr. We do a PTT in 6 hours....
  17. zambezi

    what is your openion about DNR ( donot resucitate)

    zambezi replied to realnurse's topic in MICU, SICU

    I think that the DNR decision is one's own personal decision. That said, I think that doctors/nurses other health care professionals need to really really work on education of the public (particularly...
  18. zambezi

    Fertililty & cycle questions galore

    zambezi replied to nurse_wannabe's topic in Ob/Gyn

    Good advice so far, I would also suggest plotting the days of your period on a calander from start to finish each month for awhile. The first day of your period is the first day of the cycle. Most...
  19. zambezi

    2:1 (2 nurses to 1 patient) criteria

    zambezi replied to nursewratchet's topic in MICU, SICU

    It is in our policy's to have 2:1 nursing for VADs (which we haven't had in over 3 years) and CRRT with calcium citrate (only because it is a new policy for us- now that we have used it a bit we...
  20. zambezi

    ? for CVICU Nurses!

    zambezi replied to my2sons's topic in MICU, SICU

    for our post op hearts we use: fentanyl drip and propofol while on the vent. After extubation: MS 2-4 mg IV Q1 hour (we can give more if necessary, after other options) MS 2-12 mg IM Q3 hours Toradol...
  21. zambezi

    cardiac care/lab values

    zambezi replied to lcazgirl's topic in Cardiac

    fantastic replies, as usual... I will also add PT/INR and CBC (which have both been mentioned peripherally). We recently had a guy come in who had a slow gi bleed...his h/h got so low, caused his...
  22. zambezi

    Ventilator settings

    zambezi replied to willdgate's topic in Nursing Student Assistance

    there have been multiple threads on this subject with good explinations. check out the search function on the tool bar and type in vent settings. or check out http://www.icufaqs.com good
  23. zambezi

    what do you think of the doctors you work with???

    zambezi replied to MagicalThinking's topic in General Nursing

    I generally like most of the docs that I work with too...some are fantastic and there are one or two I wouldn't let treat my cat, but most are at the very least pleasent. They do have their temper...
  24. zambezi

    Being called in extra....do you go??

    zambezi replied to IloveSnoopy's topic in General Nursing

    I do go extra frequently...however, I hate being on standby (even though it is more money!)...the main reason I hate standby is that they can call me in for any unit in the hospital... If they call me...
  25. zambezi

    Day shift vs. night shift

    zambezi replied to lisa1130's topic in Nursing Career

    this pretty much sums it up. i personally think that everything about nights is better- except for the fact that it is at night- plus you get paid more (our differential is 4.50). i am switching to...