luvtheOBX

Thanks for the help bullydawg. I am happy to say I passed the test!

I've never heard of this. The only thing I encountered was that if you didn't stay for 18 months you had to give back your signing bonuses, prorated to how long you did stay. I would be very worried about the climate in that hospital if there is so much turnover that they had to institute this policy. Here's a novel idea...why not offer a retention bonus to stay over the 2 years?

So, what are the best drugs for right sided MI's to increase preload? Or do you just give fluids?

I am foolishly taking the CCRN exam today and while I get the general concept of the affinity of oxygen and hgb what confuses me are the 2, dpg things. I had written in my notes that 2,3 dpg is what makes the hgb stick to the O2 so would more 2,3,dpg shift the curve to the left? My notes say the opposite, I am just trying to make some sense here. .

Or you could try offering sign on bonuses. Sorry, I've been studying too hard (i take the CCRN exam today) so forgive my momentary craziness. We also use the Rotoprone bed. I was wondering though, while I was studying for this test the book said ARDS patients should have a low tidal volume and a high PEEP. I am pretty sure we use a higher TV also. Which do you do?

We often triple also. The nursing supervisor will say its because we have several patients to go out (PCU or medical patients) then within a few hours when there are ICU patients in the ER or someone needs to be transfered in they miraculously find beds and now we are tripled with ICU patients! It drives me crazy that they staff us like the census doesn't change in a 12 hour time period.

My question would be, how was the order written? Did it specifically say the Diprivan was for seizure control? Typically our diprivan orders are written, "titrate to maintain Ramsey of 3" No where in the Ramsey scale does it mention seizures. If this neuro doc does this again then get him/her to write a specific order. Thin it will be his a** is on the line when the pressure bottoms out. Or I suppose you could call him at 0200 to see if he wants the diprivan titrated then call every 15 minutes to see if you can titrate it again, "sorry to call again Dr God but the patient is still not having seizures at 20 Mcg of Diprivan and his BP is 80/40 can I titrate down?"

I definitely feel for you. I would say to document everything then take it to your manager if she/he does not do anything to help then go to the PIA nurses manager. I think it would be most helpful to treat it as an educational piece saying something like, "while doing QI on our RR calls we have noticed there are some nurses who have called for the team for non-emergent reasons and we would like to do some education." We have just started doing RR at our hospital and it is assigned to an ICU nurse daily. We still have our own patient assignments on top of this. We find this to be very stressful. What is it like in your hospitals?