Okami_CCRN BSN, RN

Critical Care
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Okami_CCRN has 7 years experience as a BSN, RN and specializes in Critical Care.

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  1. Okami_CCRN

    Charting

    medication administration needs to be documented in real time to prevent medication errors. If a medication is administered late it is prudent to include a comment explaining the situation; I.e. Vancomycin 1000mg/200ml administered at 23:15 due to IV...
  2. Okami_CCRN

    Why do so many nurses work multiple jobs?

    I like to work multiple jobs because it keeps my burnout in check and offers me the flexibility to work in one position more/less frequently. It also is nice to make the extra bucks.
  3. Okami_CCRN

    Nxstage CRRT Documentation

    I also let Epic calculate my IVF/Drip totals, and verify them for accuracy. We keep everything in the EMR because nephrology can view the CRRT progress remotely and call/secure message the primary RN with questions or concerns. Doing away with p...
  4. Okami_CCRN

    Delayed pain management before change of shift?

    What you describe definitely necessitates follow up. In our documentation system when a PRN medication is pulled from Omnicell/Pyxis it shows up in the eMAR as being pulled and "due" to be given. Our expectation is that every medication given be barc...
  5. Okami_CCRN

    Nxstage CRRT Documentation

    I use Epic for CRRT documentation, our critical care wide policy is to document on the hour (2200, 2300, 0000, etc), what was pulled the previous hour, as well as machine pressures, warming devices, etc. So if fluid removal was 148ml for 2100-2...
  6. Okami_CCRN

    IV Drug Compatibility

    I generally like to give albumin by itself or through a saline line; since most albumin (5% and 25%) goes in within 10-30 minutes. As other people posted when in doubt always refer to your hospital's compatibility guides (lexicomp and/or microm...
  7. Okami_CCRN

    Delayed pain management before change of shift?

    There probably isn't much, if any research on the topic because it would be inappropriate to withhold pain medication that is requested by the patient solely so that the next shift can give it. What aspect of the scenario you mentioned is your p...
  8. Okami_CCRN

    New grad cath lab?

    I am all about new grads entering specialties such as labor and delivery, critical care, and emergency care; but new grads do not belong in the cardiac cath lab or interventional radiology suite. As the previous poster mentioned the cardiac cat...
  9. Okami_CCRN

    Switched Jobs and Made A Huge Mistake....

    I have learned that the grass is not always greener on the other side after MANY attempts at escaping to the other patch. I think one of the major issues in their eyes was when you requested/declined to have advice/redirection during your proce...
  10. Okami_CCRN

    Hospitals charging nurses $100/month for parking?

    I purposefully avoid hospitals that charge staff to park on campus. I recall a few years back I applied to a well known hospital and when they offered me the job they mentioned that if I chose to park on campus I would have a pay deduction of $5...
  11. Okami_CCRN

    Freezing At A Critical Time

    I would expect looking for your preceptor during an emergency/unknown situation to be a normal response for a new graduate nurse who is still in orientation, especially if there was other staff responding to said situation.
  12. I would have politely requested that your manager remove the bit about picking up extra shifts from your evaluation prior to you signing the document, as picking up shifts in excess of your FTE status is not within your job description. With tha...
  13. Okami_CCRN

    Can I travel in L&D after only 1 year?

    You are absolutely not ready to travel in a high stress specialty such as labor and delivery after one year of experience. As a travel nurse you are expected to be an expert in your specialty, and be able to function with just an orientation to...
  14. Okami_CCRN

    NaCl 23.4% for hyponatremia?

    That is highly unusual, we only use 23.4% sodium for neuro patients who are at risk for herniation at my facility and it is reserved for critical care. I would reach out to pharmacy and administration regarding the safety of infusing that on a ...
  15. Okami_CCRN

    Feeling burnt out. Looking for advice.

    When I am feeling burned out, I start to actively look for other jobs. I have also switched to part-time, which has improved my work-life balance and done wonders for my mental health. I know not everyone can afford to go part-time (neither can ...