Virgo_RN BSN, RN

Cardiac Telemetry, ED

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All Content by Virgo_RN

  1. Virgo_RN

    Doctors are Bullies

    Virgo_RN replied to madwife2002's topic in Patient, Colleague Relations

    The problem with hositlity in the workplace is that it can interfere with safe patient care. If you have doctors that are so horrible to have to deal with, and nurses who dread having to call those...
  2. Virgo_RN

    Inaccurate Vital Signs- no one cares

    Virgo_RN replied to ilovenursing2009's topic in General Nursing

    Why in the world would you need evidence that accurate vital signs are basic to safe patient care?!?!? In addition to the great suggestion above, any piece of equipment that does not work properly...
  3. Virgo_RN

    How to give adequate care?

    Virgo_RN replied to DroogieRN's topic in General Nursing

    If everything is routine and nothing happens to upset the flow, then it's doable. But what happens when a patient starts having problems and you need to call the doc and implement new orders? What...
  4. Virgo_RN

    Treatment for cardiogenic shock?

    Virgo_RN replied to hollyberrys720's topic in Cardiac

    ...and sometimes shocked hearts have too much preload that the heart is not able to pump forward, thus you've got to either "pee it, park it, or pump it
  5. Virgo_RN

    My God, these family members!!

    Virgo_RN replied to SoundofMusic's topic in Patient, Colleague Relations

    I'm only responding because you quoted me. First, I'd like to say that I'm sorry you recieved such $#i**y care when you were hospitalized, but your description is not representative of the type of...
  6. Virgo_RN

    Treatment for cardiogenic shock?

    Virgo_RN replied to hollyberrys720's topic in Cardiac

    Sometimes vasodilators and/or diuretics would be used to decrease venous return/preload. Also remember that cardiogenic shock has a high mortality
  7. Virgo_RN

    Treatment for cardiogenic shock?

    Virgo_RN replied to hollyberrys720's topic in Cardiac

    Dopamine may be used to increase myocardial contractility, pressors may be used to increase MAP. I'd expect to see increases in BUN/Cr, lactate, and liver enzymes ("shock
  8. Virgo_RN

    Cardiac Stepdown Unit Meds...

    Virgo_RN replied to LovePurple's topic in Cardiac

    Your beta blockers and calcium channel blockers would be a good
  9. Virgo_RN

    Why are nursing instructors mean?

    Virgo_RN replied to 4everpeace's topic in General Students

    I had wonderful nursing instructors. Every single one of
  10. Virgo_RN

    Question regarding Medical Progressive Care units

    Virgo_RN replied to randygw's topic in General Nursing

    I'm on a cardiac PCU. We get post intervention, arrhythmias, and pulmonary patients. We also get a lot of medical overflow and "train wreck" type patients that have one foot in the ICU. We do not...
  11. Virgo_RN

    Vomiting coffee ground colored vomitus with PEG tube in place for 11 months

    Virgo_RN replied to iediethrlevingston's topic in General Nursing

    This is a sign of an upper GI bleed and should be reported to the doctor. An endoscopy would be appropriate to diagnose and potentially treat an UGIB. Is she getting enough free H2O? Does she have...
  12. Virgo_RN

    Patient wants to split doses of pain meds

    Virgo_RN replied to Cobweb's topic in General Nursing

    Medication orders with dosage ranges are designed to give a certain amount of flexibility to customize dosing for the individual patient. These types of orders are not illegal in my state, and they...
  13. Virgo_RN

    Snoring a sign of respiratory depression/oversedation?

    Virgo_RN posted a topic in General Nursing

    A comment in another thread got me thinking. I've heard this before, that if the patient is snoring, this can actually be a sign that they are oversedated. What if their respiratory rate is WNL and...
  14. Virgo_RN

    I Need Advice - MD Not Signing Order

    Virgo_RN replied to Andrew, RN's topic in General Nursing

    wtbcrna, it's not that you aren't raising valid points. The issue here is one of context. This is a new nurse who is working in a facility in which nurses writing these types of orders without an...
  15. Virgo_RN

    I Need Advice - MD Not Signing Order

    Virgo_RN replied to Andrew, RN's topic in General Nursing

    "IV Medications" by Gahart states: "0.5 to 1 mg every 3 hours as needed. May increase up to 4 mg every 4-6 hours if pain is severe." The OP gave the patient 2mg for 12/10 pain. This falls within the...
  16. Virgo_RN

    Having a hard time with less hygienic patients

    Virgo_RN replied to Manatee111's topic in General Nursing

    Yep, I've had my share of these folks too. I once had a LOL who lived alone. When I washed her back, there was so much built up gunk that it was coming off in sheets and turning the washcloths dark...
  17. Virgo_RN

    My God, these family members!!

    Virgo_RN replied to SoundofMusic's topic in Patient, Colleague Relations

    I might have charted something like "Summoned to room, requests ginger ale. States he has been waiting for "over an hour". This nurse explained inability to immediately fulfill request due to...
  18. Virgo_RN

    My God, these family members!!

    Virgo_RN replied to SoundofMusic's topic in Patient, Colleague Relations

    I document this type of behavior, in a completely objective manner, of course, focusing only on observable behaviors and not interpretations of those behaviors, and I use quotes. This speaks to the...
  19. Virgo_RN

    I Need Advice - MD Not Signing Order

    Virgo_RN replied to Andrew, RN's topic in General Nursing

    I agree with the above. Your facility needs to have written protocols and order sets in place, and for whatever reason, you are being called out on something that has been common practice for a long...
  20. Virgo_RN

    I Need Advice - MD Not Signing Order

    Virgo_RN replied to Andrew, RN's topic in General Nursing

    It may have something to do with the way the order was written. I might have added "per PCA protocol, as ordered by Dr. X", or something to that effect, indicating that what you were doing was...
  21. Virgo_RN

    GoLytely Prep, on a GI Bleed

    Virgo_RN replied to BertinaRN's topic in General Nursing

    Agree with the above. GoLytely simply evacuates bowel contents, it does not promote bleeding. The drop in H&H would be a/w the active bleeding, not the bowel
  22. Virgo_RN

    Warning-DNR forms are worthless

    Virgo_RN replied to Blackcat99's topic in General Nursing

    At my facility, the doctor must write a DNR order for the patient to be a DNR, POLST or no POLST. The POLST is for care outside the hospital. While in the hospital, code status is an MD order for...
  23. Virgo_RN

    blood pressure kit question

    Virgo_RN replied to hollyandsky's topic in General Nursing

    That would probably work. I don't know what your budget is like, but another option would be to buy the sphygmomanometer and stethoscope separately, so you could get a higher quality stethoscope for...
  24. Virgo_RN

    can nurses chart about this kind of things?

    Virgo_RN replied to Ms.RN's topic in General Nursing

    Agreed. I wouldn't chart "Day shift nurse neglected to position patient for comfort, am care not done, moaning in pain" or "Standing in middle of room, IV DCd and site bleeding, day shift forgot to...
  25. Virgo_RN

    can nurses chart about this kind of things?

    Virgo_RN replied to Ms.RN's topic in General Nursing

    Yes, I agree, Leslie. I don't make a habit of charting nitpicky little things that the previous shift may have overlooked, but I have been known to chart things that I felt were significant enough to...