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Critical Care
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Okami_CCRN has 4 years experience as a ADN, RN and specializes in Critical Care.

Okami_CCRN's Latest Activity

  1. Okami_CCRN

    OG tube securement, or NG?

    If a patient is intubated we usually insert an OGT and secure it to the ETT using clear tape (transpore) so that the markings on the ETT can be visualized easily. Some of the literature out there shows that NGT in intubated patients had an increased risk of sinusitis associated with insertion and maintenance.
  2. I wanted to ask you about the PureWick product use in your facility.  Do you have a written protocol? Does it spell out use of the suction canister (emptying, changing, measuring? )  

  3. Okami_CCRN

    Conflicted with New Grad ED/ICU job offer

    Any specialty, be it medical/surgical, mother/baby, emergency, critical care has it's share of anxiety and skill set. It's absolutely normal to feel overwhelmed. I started my career in critical care, and I'm still there. One of the most important factors in the successful transition from student to professional nurse is a nurse residency that includes support, mentoring, didactic and clinical learning experiences. The best part of nursing is both the upward and lateral mobility.
  4. Okami_CCRN

    Conflicted with New Grad ED/ICU job offer

    Congratulations on the two possible job offers! Only you can truly decide what is important for yourself. With that being said some of the things that are important when starting a new position for myself are: -Money (I have student loans that need paying) -Schedule Flexibility (I prefer to work every third weekend) -Benefits (PTO, Health Insurance, 403(b), pension, etc) -Specialty (I work within critical care)
  5. 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.
  6. 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.
  7. Okami_CCRN

    Challenge Nursing Board?

  8. Okami_CCRN

    My First Day at the Neuro ICU

    Interesting that you bring up doing neuro checks while the patient is sedated, When I work in the Neuro ICU patients are sedated to a RASS score of 0 to -2. We usually pause sedation for a few minutes and do a neuro check and then resume sedation when complete.
  9. Okami_CCRN

    Workplace Drug Test

    Very few facilities utilize hair for drug testing, I have always had to submit a urine sample.
  10. Okami_CCRN

    Fall prevention

    As MunoRN mentioned, delirium is a huge component to falls. Assessing your patients for delirium and instituting ways to cut down excessive noise and stimuli may help decrease your fall rates. With that being said ensuring that your patient have non-skid fotowear/socks on/available is important. Getting patients out of bed and walking is also important and helps develop and maintain a steady gait. Also, educate patients about utilizing the call bell when they want to get out of bed to ambulate to the bathroom, educate them on sitting on the edge of the bed for a few minutes before standing up to prevent postural hypotension.
  11. Okami_CCRN

    Delegation/Legally responsible

    As the license holder you are ultimately responsible for the tasks you delegate. It is important that you evaluate the skill and competence of the person you are delegating to. What I usually do is observe someone perform a skill, once I have determined that they are competent and able to perform that skill I delegate appropriately.
  12. Okami_CCRN

    ACLS &PALS, Tax Deduction?

    usually your employer pays for BLS/PAL/ACLS certifications. Usually they say something like must obtain ACLS & PALS within 6 months of hire.
  13. Okami_CCRN

    Nursing in Compact States

    Wherever you plan to practice is where you should seek licensure.
  14. Okami_CCRN

    Thoughts on Caldwell University

    Before transferring to a school make sure you look at their tuition and fees. Caldwell University is a private college and as such has a pretty high tuition for both resident and commuting students. Also because you are transferring you may not be eligible for certain scholarships that incoming freshmen students would be eligible for. I recommend you speak with the financial aid department and nursing department before transferring. Also speak to an admissions counselor, as a transfer student you would be bring credits with you. Many colleges have caps on allowable transfer credits (usually 60-66) you will also be responsible for core nursing courses as well as general education courses. Higher education is getting more and more expensive you should evaluate the cost and whether or not you can afford it. Many have made the mistake, myself included in taking on a massive amount of student loan debt to cover costs. Use websites like glassdoor to see what new graduate nurses make in the area which you think you will practice and go from there. My ultimate advice, don't just blindly transfer somewhere because the requirements seem fair or easy. Do your research and plan for the future. Best of luck.
  15. Okami_CCRN

    Break nurse residency contract

    If you break your contract chances are you will owe some type of monetary compensation to the institution for the time and money they invested in you. If I were in your shoes I would stick it out and plan to visit family or have them visit you more often.
  16. Okami_CCRN

    Non opioid pain options

    Ofirmev or IV acetaminophen works quite well, especially in the post operative patient. I have seen huge ex-laps on 1 gram q6h and rate their pain 1-2. Of course as other people mentioned ofirmev is quite expensive and is used sparingly for that reason, the risk of causing liver failure is the same as PO tylenol so the max dose is 4g/24 hour period. My facility utilizes three pain medications for a patients PRN meds. For example, a post op patient may have Tylenol 650mg PO Q4h for mild pain (1-3), percocet 5-325 q4h for moderate pain (4-7) and percocet 10-650 q4h for severe pain (8-10). This way all the bases are covered.

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