eamon66

Personally, I do think that when ppl post their feelings/advice thru internet forums these are often misinterpretted and come across as being negative and hurtful to other ppl. Maybe its the way we need to emphasise a point thru writing. I see it on other forums as well....even posted comments and then afterwards thot "god that was a bit harsh".

Listen really sorry abt your personal situation but the failing their is with your son's nurse. Still think that was an unbelievably ridiculous post & I stand by that. What gives patients/families the right to call the RRT? I'm lost on that! If wards feel they need to give pts/families the go ahead to contact the RRT then they shouldn't be nursing. Can't they assess their own patients and make decisions? sorry but this post makes my blood boil....I'm a realist....NOT a fantasist!

Heh well said! Without undermining the patient, the reality of the situation is that patients often do have unfounded concerns. If you can't identify a potentially adverse situation or help to alleviate their concerns or liase directly with the RRT then maybe nursing isn't for you. The RRT must be getting called every 5 seconds which would be a waste of their time. I'm sorry but the initiative needs to be taken by the nurse NOT the patient/family. I didn't do 4 yrs training for nothing!

Yeh inappropriate to say the least. She's showing unnecessary favouritism.

Hi, Afib is as a result of multiple foci within the atria whilst Aflutter is unifocal. Afib usually has an irregular ventricular rate (with the exception of when there is also a complete heart block). Maybe your instructor meant that the flutter rate was always constant but the ventricular rate can be both regular (1:1, 2:1, 3:1 etc) and irregular (called Aflutter with variable block).

You really didn't do much wrong. So you forgot to ask what her pain score was. The important thing is to learn by our mistakes. You'll remember next time. As for her refusal to wash.....that is every patient's right and must be fully respected. We, as nurses, appear to be obsessed with daily washing of patients and at the same time are taught to follow the patient's normal routine. As someone else commented, the elderly rarely tend to have full daily washes. Check what her normal routine is. Suggest that she lets you know if she changes her mind or would she rather that family members helped her when they visited. Good luck and all the best

I think the difference between fully and partially compensated is that the pH is not corrected in partial. As for the co2....i just figured out that you's must use mmHg in the US. We use kpa in the UK so oops. Guess that blows my theory!

At a guess think it represents a respiratory alkalosis with partial compensation. Although ph is still demonstrating an alkalosis (so only partially compensated), the Co2 is swaying towards the low end of average (alkalosis) whilst the body is attempting to compensate by shifting HCO3 which is leaning towards an acidosis. Then again could be talking complete and utter horse manure. Any other takers?

Thanks for your responses. Marianne, I've been doing cardiothoracics for 7 yrs now but mainly in high-dependency settings where swan ganz/doppler studies are rarely undertaken so didn't have the luxury of measuring CO/CI/SVRs etc. However, have been working in recovery/HDU setting for the past 4 months so this is now all new to me. Do any of you guys use SVO2/lactate measurements as a guide to overall tissue perfusion? As a rule of thumb, I personally think assessing effects on CVP during rapid administration of plasma substitutes (voluven, volplex, gelofusion etc) is very useful as a guide to whether low ouptuts/BPs is secondary to hypovolaemia. Thanks again, Eamon.

Hi, of all care aspects following open heart surgery, I think that the area of fluid management/haemodynamics is arguably the most challenging for nurses. Possibly because it needs particular attention to alot of fine detail. I just wanted to draw on the experiences of other cardiac surgical nurses. I've worked in a variety of different cardiac surgical areas and it's amazing how management can vary. What are your gold standards for care? What parameters do you particularly pay attention to when deciding whether to fill, offload, increase/decrease/commence inotropes? I know this is a huge area but I'm really interested in hearing of other people's experiences. Thanks

I never heard of IV Narcan given for anything other than opioid OD. Seen it used when a respiratory arrest caused by opioids is suspected. Ever seen the movie Trainspotting? Classic example of Narcan administration in that!

It was the late 80's in Ireland and all I had to look forward to was a lifetime on the dole. An aunt (a retired nurse living in London) phoned one day and suggested I gave nursing a go. To be honest....my initial reaction was to laugh. I just didn't think it was for me. There was the obvious stigma attached to being a male nurse and that scared me. However, the chance of a move to London and its social scene was very appealing so I gave it ago. Hands up...I was naive and never gave the nursing side much thought. But glad I took the plunge. It's been very rewarding and made me a much better person and I've been able to use nursing as a means to travel as I've spent 3 yrs in Aussie and NZ.