picurn10

we've had more than a few pts on ECMO who were so unstable, or their cannulas were so precarious, that we didn't turn at all, but its more typical to have to do small turns because they are unstable. We don't seem to have one set standard for our kid...

I floated to NICU and my pt got NEC and likely won't survive. I have to float to NICU frequently (usually once a month) but we typically get feeder/growers assigned to us. I feel like I caught the symptoms early, but OMG, it was lightning fast and r...

why not do trophic feeds and keep them on TPN until they're term, or closer to term?

I agree that it is often the boyfriend, but we've had several recently (and my most traumatic case) where it was mom. That case was so chilling because we did the first brain death exam, and afterward she just asked me for some washcloths, got into h...

Thanks, everyone. It really makes me feel better to read your responses.

see, our unit NEVER bans the family. I hate it! They say winter, particularly christmastime is busiest time for it. I've also heard the economy is leading to a rise in abuse lately

It's always the little moments for me. When you can tell you've made a difference for someone. Certainly after a code or a hard fight to save someone. Or even a meaningful end of life case. One that stands out was a baby I had for two straight weeke...

Any one else dealing with this at their hospital? We were told that our call lights were being audited from now on. In ICU we rarely have call lights (we're typically in the pts room or very close by, and the pts can't usually use them). Now anytime...

my thought is that these hospitals with a focus on customer service need to have a pt consierge! They could run around fluffing pillows, bringing ice to pts, snacks to families, and all manner of butt kissing so that I can be free to actually provide...

wow, that RN tracking thing is INSANE! I think I'd quit at that point. Turnover in our unit is super high as it is. interesting to know that other places do this as well, I though it might just be my director's idea. Sarakjp, I know! huge pet peeve...

I always knew I wanted to do ICU and work with kids. I thought I wanted to do NICU, until I had clinicals and realized there wouldn't be much variety (NICU babies seem to have the same set of problems). I LOVE what I do because I never know what I'm ...

our hospital's NICU just picked black for their scrub color and I was shocked! It seems like such a harsh, non-kid friendly color. Honestly, there is tons of research into colors and public perception and even specifically when working with kids. I'm...

how does your unit handle weighing pts? Our standing policy is daily weights for all pts. We have about half our beds that actually have scales, for all the rest we have to put the pt in a sling scale. It can be painful for the pt and dangerous in my...

In the ICU, everyone can typically handle high acuity. If the pt is just a train-wreck from the get go, they will typically reassign the nurse's first pt to someone else so that nurse only has one pt, or the charge nurse ask us to help take care of p...

hmmm, that sounds terrible. Our physicians write an order and a paper order prints, and an electronic copy is sent to pharmacy. At most it takes 10mins for it to show on the emar and the pyxis. If its longer than that, I just call to pharmacy and the...

In my unit we typically have one nurse "open for an admit", meaning one actual assignment, and one empty bed. They don't actually decide which room until there is a pt on the way, but its near the nurses other pt. I'm in ICU though, so that may be di...

Sorry if my post came across that I was offened, not at all! I was just explaining why we can't pick up many of the pts. The more feedback I'm reading here, the more I realize it is unreasonable to weight them every day.

yes, bedside report is part of the "customer service model" that is proving to have dangerous pt outcomes, but because they government and insurance companies are starting to reimbure on "pt satisfaction scores" (the biggest load of bs ever) we're go...

babybluenurse, how do you lift a 50kg intubated pt w/ ct's, drains, on CRRT, or whatever the case may be? We have kids from 0-21yr and so other than a sling scale there isn't a way to lift them up. We have some pretty big kids too. I had a 85kg 9yr ...

lol, I didn't pick up on the "snot" vibe, but apology accepted :)

dont always defer to "more experience" or "the expert" when you feel like something's wrong. I had a situation not too long ago where this was highlighted: Both the attending and two residents incorrectly assessed the situation, but I knew I was righ...

lol, I do understand the concept of zero'ing a bed Ashley is gettting what I'm saying. So, day 1 the pt bed is zero'd w/ a sheet and one pillow. No one writes down what was on the bed. Day three I come in to weigh the pt and now there are 15 pillows...

there is a really cool poster out there somewhere (we have them in our hospital but I've seen it online) that shows the difference on the hub under the bioluminecent light at 5, 10, and 15 seconds of scrubing. Its a great visual. I have read recently...

I'm sorry but you have the pathophys on this all wrong! We aren't worried about stroke from air in the line, we're concerned about air embolism. This can be caused by a pocket of air entering the right atrium/ventricle (prior to making it to the lung...

Very interesting to have the other perspectives, thanks! Janfrn, just to be clear, I do understand how zero'ing works Our problem is that often the nurse zero'ing the empty bed forgets to list what it was zero'd with, so then as the days pass and mo...