Chisca RN

Dialysis

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All Content by Chisca

  1. Chisca

    Healthcare is NOT a basic human right.

    Chisca replied to Asystole RN's topic in Activism, Healthcare

    Are you serious? Not that it really matters but I majored in American labor history at the Univ of Minnesota before I became a nurse and your arguments wouldn't pass muster in any class I have...
  2. Chisca

    Healthcare is NOT a basic human right.

    Chisca replied to Asystole RN's topic in Activism, Healthcare

    How incredibly ignorant you are of American history. Try reading a little more than Howard
  3. Chisca

    Clinical tidbits I wish someone would've told me.

    Chisca replied to Mully's topic in MICU, SICU

    If your cardiac monitors have ST segment alarms use them. Get into the habit at the beginning of your shift of checking for correct lead placement and setting ST alarms. It may be your first...
  4. Chisca

    Communicating with Doctors

    Chisca replied to Stephrnpitt's topic in MICU, SICU

    Do you have shared rounds? If not, why not? I have rarely found any attending that didn't respect me and my opinion when I was on solid ground and had all my facts correct. If you present a situation...
  5. Chisca

    Healthcare is NOT a basic human right.

    Chisca replied to Asystole RN's topic in Activism, Healthcare

    The constitution can be ammended and offers a process to do it. Pass an ammendment and have the states ratify it and we will have any right that we the people agree is important. But to circumvent the...
  6. Chisca

    How long until you felt comfortable in KD?

    Chisca replied to Eleven011's topic in Dialysis, Renal, Urology

    About a year for me but maybe I'm a slow learner. Really hard for me not to do a complete physical assessment on every patient and if I see something funny on the cardiac monitor I want to...
  7. Chisca

    ICU RN thinking about doing Acute Dialysis

    Chisca replied to amyla008's topic in Dialysis, Renal, Urology

    Guttercat pretty well covered it. I predict you will be bored but when you go back to ICU you will be the best CRRT nurse
  8. Chisca

    IJ catheter for Dialysis

    Chisca replied to kstec's topic in Dialysis, Renal, Urology

    Also worth mentioning that these catheters in the IJ are temporary ( as opposed to permacaths which are tunneled) and are held in place by stitches. I would be very concerned as to placement on a...
  9. Chisca

    Adjunct Faculty a.k.a. 'Academic Sharecroppers'

    Chisca replied to TheCommuter's topic in Nursing Educators, Faculty

    Which really begs the question why is higher education so expensive? An undergraduate microbiology course I took 5 years ago at University of Memphis was 1300 dollars in tuition. There were 100...
  10. Chisca

    Thirst-Something To Think About

    Chisca replied to NDXUFan's topic in Dialysis, Renal, Urology

    Medicare refers to 3x week dialysis as "adequate" and thats what they reimburse for. Insurance companies follow suit and pay for 3 x week. In many cases it is not
  11. Chisca

    Thirst-Something To Think About

    Chisca replied to NDXUFan's topic in Dialysis, Renal, Urology

    The 13ml/kg/hr formula would seem to argue against the three treatment a week ritual the government has us locked into. If patients were allowed more than 3 treatments a week maybe these higher UF...
  12. Chisca

    Not many Black/African American nurses working in the ICU's

    Chisca replied to i-njoy-being-a-nurse's topic in CCU, Coronary, Cardiac

    In the past certain immigrant groups founded hospitals that served their ethnic group. At the turn of the 19th century San Francisco had a German hospital, Chinese hospital, French hospital so maybe...
  13. Chisca

    Thirst-Something To Think About

    Chisca replied to NDXUFan's topic in Dialysis, Renal, Urology

    The critline monitoring sounds like a much better way of determining how close a patient is to crashing than pulling fluid to an arbitrary dry weight. I really don't see much science in dry weight...
  14. Chisca

    Future of Dialysis????

    Chisca replied to Fink's topic in Dialysis, Renal, Urology

    Name one politician that could survive an election promising to eliminate dialysis
  15. Chisca

    Nurse: Patient Ratios

    Chisca replied to aei09a's topic in MICU, SICU

    If you really want to fight this you will need the help of your coworkers, a willingness to measure and document acuity, and a lot of luck. There are acuity systems to measure the workload of nurses...
  16. Chisca

    Acute/ Chronic Renal Failure

    Chisca replied to nochka22's topic in Dialysis, Renal, Urology

    About the only thing that we can all agree on is this is a crummy question. PVC's signal nothing more than cardiac irritability. The real question is it because of cardiac ischemia, electrolytes, or...
  17. Chisca

    Acute/ Chronic Renal Failure

    Chisca replied to nochka22's topic in Dialysis, Renal, Urology

    PVC's are not life threatening. Metabolic acidosis is. This patient's kidneys have lost their ability to regulate acid/base and the pt is not going to last long without mechanical ventilation or...
  18. Chisca

    low heart rate during dialysis

    Chisca replied to celle507's topic in Dialysis, Renal, Urology

    Autonomic dysfunction? Especially if she has a history of
  19. Chisca

    The Silent Suffering of Dialysis-Peter Laird, M.D.-Physician on Dialysis

    Chisca replied to NDXUFan's topic in Dialysis, Renal, Urology

    the problem would be the "evidence of suffering" was subtle. you had to take time to notice it. i can easily see in the factory like setting of most dialysis clinics these small signs of suffering...
  20. Chisca

    Patient's question put me on the spot!

    Chisca replied to ICAN!'s topic in Dialysis, Renal, Urology

    Which is why higher flows are desirable at all, the belief that you can reduce treatment time by improving blood speed across the dializer. Mathematically it makes sense but it isn't reflected in...
  21. Chisca

    Patient's question put me on the spot!

    Chisca replied to ICAN!'s topic in Dialysis, Renal, Urology

    Higher QB's may cause more hemolysis due to the roller clamp crushing the red blood cells but that is not the reason higher flows aren't utilized. It is due to the effect it has on the heart,...
  22. Chisca

    Is Dialysis considered Critical Care?

    Chisca replied to nurseontheway's topic in Dialysis, Renal, Urology

    According to the AACN acute dialysis does involve directly caring for critcally ill patients and those hours count towards certification. It doesn't make any reference to "total" care and you would be...
  23. Chisca

    Blood and Dialysis

    Chisca replied to TE21's topic in Dialysis, Renal, Urology

    Depends on the strength of the patient's heart. PRBC's are going to act as volume expanders drawing fluid into the vascular space. If this patient has a low cardiac output or a low ejection fraction...
  24. Chisca

    Question re: OG tube - New in ICU

    Chisca replied to cm8816's topic in MICU, SICU

    AACN guideline on GT insertion.
  25. Chisca

    Sodium Modeling and UF profiling

    Chisca replied to Joni's Mom's topic in Dialysis, Renal, Urology

    They are tricks to attempt to remove more fluid. Sodium modeling involves setting the dialysate sodium to a level higher than the serum sodium and since water follows salt more water is removed....