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Okami_CCRN ADN, RN

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

    Any advice on when to put in 2-wk notice??

    Make sure you read your healthcare organization's policy regarding resignation. Most places in healthcare actually require a 4-week notice instead of the standard 2-week notice in the general corporate world.
  2. Okami_CCRN

    Use of Bedside Supply Carts

    Just like Hoosier said, if the cart is kept inside the room it is considered contaminated, we place ours right outside the room. It is a six drawer cart where we keep IV primary/secondary tubing, blood tubing, central dressing kits, pads, IV/blood work supplies, and other misc. things that we utilize frequently.
  3. Okami_CCRN

    Use of Bedside Supply Carts

    Hey there, I was involved years ago with a project to utilize supply carts outside of our ICU rooms. I had to do a cost analysis to determine if supply cart utilization made financial sense, after the study we determined that the amount of waste was greater than the cost of the carts. We used to have to toss supplies after every patient, which is why we wanted to have carts right outside the room. We also had to break up the cost of the carts over 2 years, so we bought half the carts one year and the other half the second year.
  4. Okami_CCRN

    ICU Nursing

    I’m also feeling very much the same way, looking to leave critical care nursing.
  5. 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.
  6. Okami_CCRN

    Would you hang these IVs?

    LR vs NS is a topic of debate when it comes to fluid resuscitation. While LR can make an alkalosis worse with the metabolism of lactate it usually arises when it is administered as a bolus. NS on the other hand can cause a chloremic acidosis in large quantities. However, in this this post-operative patient I think LR is the more appropriate solution since it contains some extra stuff like K+, Ca++, and Na+ Soo.... this is a difficult situation because one of the treatments for DKA once the anion gap starts closing and their glucose falls below 200 is to add a dextrose solution. However, the problem here is that they have a head injury which takes priority. Can you tell me what kind of solution D2.5W is? How does the type of solution D2.5W is affect patients with a brain injury? What would be an appropriate IVF therapy instead?
  7. 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? )  

  8. 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.
  9. 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)
  10. 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.
  11. 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.
  12. 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.
  13. Okami_CCRN

    Passive Leg Raise pillow

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

    Challenge Nursing Board?

    void**
  15. 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.
  16. Okami_CCRN

    Does unit mortality rate affect my need for insurance?

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