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  1. Okami_CCRN

    Bare bones staffing

    If there are only 1-2 patients in the ICU we are required to have at least 2 RN's present at all times. If an RN has to go off the unit another nurse must be present for relief.
  2. Okami_CCRN

    How long did it take you to find out your dream specialty?

    I think we all go through something similar, I started off in critical care four years ago, now I am burned out. I'm actually thinking of making a switch to OR nursing.
  3. Okami_CCRN

    Infusion times....in a pickle...

    You should follow your hospital's policy regarding medication administration. With that being said our current policy and practice is to infuse Zosyn over 30 minutes both the 4.5g and 2.25g doses.
  4. Okami_CCRN

    Passive Leg Raise pillow

    We prefer to do the 250ml IVF bolus challenge instead of the passive leg raise.
  5. Okami_CCRN

    Challenge Nursing Board?

  6. Okami_CCRN

    Pts refusing to weigh

    We do our daily weights on the bed, so often patients don't even know they are being weighed. One of the most important things you can do is explain the importance of being weighed, from management of CHF to proper dosing of medication. And if they continue to refuse, document and inform the attending/resident.
  7. Okami_CCRN

    Does unit mortality rate affect my need for insurance?

    Never skip personal professional liability insurance, regardless of specialty or unit mortality rate.
  8. Okami_CCRN

    Writing doctors orders without an actual doctors order

    I have witnessed nurses who thought they were doing right by their patients by placing order for lactates, ABG's, and chest x-rays when they were "missing". Well a nurse once placed an order for a some lab that came back critical and when she went to inform the physician his reply was " I didn't order that test, who ordered that?", it was a VERY awkward situation and thank god he didn't escalate it, but sternly told the nurse that he should be called prior or orders being placed.
  9. Okami_CCRN

    Please Help! Abandonment and Retro Pay

    You should look up what your state's board of nursing considers abandonment; more often than not you must have to accept a patient assignment and then abandon your patients by not reporting off to another RN. Thus leaving the patients without a nurse to care for them. In regards to your retro pay, if you did not have it in writing then you can not prove that it was offered. Chances are you will not be able to obtain retro pay as it was not mentioned in your hire paperwork.
  10. Okami_CCRN

    Can PT or CNA feed a stroke pt

    Legally, yes the CNA and PCT have the ability to feed patients. The real question here is should they? If a stroke patient has such difficulty swallowing that they require more assistance than increasing the HOB >60 degrees and utilizing thickened liquids, then the RN should feed the patient for the first few meals to assess their ability and determine what is the best possible way to feed them to prevent pocketing and aspiration. If you are noticing that the patient is coughing between bites it may be time to have speech re-evaluate their ability to swallow.
  11. Okami_CCRN

    A and P over Summer?

    When I was in nursing school we were advised not to take any classes with clinical nursing classes. I had classmates that decided not to listen to the advice and they either failed the nursing course, the gen. ed course, or both. Personally, I hate taking science courses in the summer as I would be in school 4 days a week. Our science courses in the summer session was a 3 hour lecture twice a week with a 3 hour lab twice a week.
  12. Okami_CCRN

    Transfers out of ICU

    In order to satisfy throughput our target time is one hour from the moment the patient is assigned a bed. Obviously this doesn't always work out especially if the floor cannot take report, but our ICU has such high patient turnover that it is not uncommon to transfer 5 patients out and get 6-8 admissions.
  13. Okami_CCRN

    Critical care med drips

    If you are already working in a critical care unit your best bet is to contact the pharmacy for policy and procedure regarding drip concentration and max rates. You will find that many facilities utilize different max rates and concentrations. At some institutions vasopressin is non-titratable, in others it is. Some places max out norepinephrine at 10mcg/min while others max out at 30mcg/min. While a drug guide can give you great information regarding drug classes, actions, etc you should always follow hospital policy and procedure.
  14. Okami_CCRN

    Which comes first,

    A good way to remember is to put your credentials in the order of least likely to lose to most likely to lose. For example; John Doe MSN, RN, CCRN.