PJMommy

Question for those CCRNs out there..... I have about 15 mths ICU experience and am preparing to take CCRN. We do the whole gambit in our ICU - trauma, neuro, fresh hearts, surgical, medical. About the only thing we do not do are MI ruleouts (they go ...

I've done a search on this topic but can't seem to find an answer to the question I have.... I start a 5-week senior preceptorship this week -- 12 hour nights. For those of you who work 12s three nights a week, do you sleep at night the other four ni...

Hi all, I'm working on a project for class and am not certain about what is and is not allowed when a pt is on neutropenic precautions. The scenario is this: Pt is 60-something with leukemia. She finished 2nd round of chemo 10 days ago. Platelets a...

The parents who don't want their 15 y/o child to know about his/her terminal diagnosis. The family who wants "everything done" for the terminal patient - meaning tests, painful procedures, etc. One of my personal favorites...the doctor who wants a ...

I have four children so the staying awake at night thing doesn't work for me when I'm not working. I have to be awake when my family is awake. Here's what works for me -- go to bed at regular time the night before I go back to work and then set alarm...

BIS is useful when patients are also neuromuscularly paralyzed and you have absolutely no other means of assessing the level of sedation. However, you cannot rely on the BIS for sedation. In fact, trials and research have inconclusive results as to i...

IV Nicardipine works well - and as a Ca++ channel blocker, it reduces risk of vasospasm. As for beta blockers, our docs don't use them a lot on the heads because, with beta blocked, alpha is unopposed and causes vasospasm.

Your employer may say you've abandoned patients if you don't show for your shift but, legally, you cannot abandon patients for whom you have not taken report. Once you've taken report, you are legally responsible for the patient until you give anothe...

Well said

Okay...I have to speak up. First of all, sedatives are not pain medications. Two different things. I think we all know this but the discussion has spun off to a discussion justifying sedation because of the possibility of pain. If this "body of evid...

Amen.

I am married with four school-age children - went through a 12-month accelerated program. Have worked in the adult ICU of a major trauma center for two years since graduation. If I had done a traditional program, I'd just be starting out as a RN -- c...

Can't speak from the anesthesia perspective but can weigh in from the critical care perspective.... Sometimes, particularly with head trauma, we use NMB gtt to paralyze patients. Since paralysis doesn't equal sedation, we'll often use BIS to give us ...

Does the hospital have a CNS for critical care? How about a quality improvement team? A clinical practice committee? You could give any of these types of groups a good bit of evidence and research related to the items you mention -- or just make the ...

Personally, I do a lot of yoga and pilates. Get a DVD if you don't want to go to a class. I like a combo of both pilates and yoga and ideally you shouldn't need any special equipment. I find both activities to be excellent for core strength and condi...

I've said before and I'll say again...you cannot globally say that open visitation is good or bad. Yes, I want to be with my family when they are in the hospital. And yes, I have plenty of warm and fuzzy stories about wonderful families I've worked w...

Most ICU nurses I work with are: - confident (not arrogant) - stubborn, vocal patient advocates - strong personalities who aren't afraid to have an "animated discussion" about the best plan for a patient - outspoken - detailed - ALL are TEAM players...

Maybe you need to find a place that does self-scheduling. Or, better yet, bring it up at your current place of employment. If you Google and do a little research, you'll find it is beneficial because it increases nurse satisfaction and retention -- g...

I like students who ask questions and are interested in learning. I also like it when they take the initiative to request the opportunity to do or see things. I'm happy to teach, happy to explain, happy to demonstrate. However, I absolutely cannot s...

A left shift refers to the relative increase in immature forms of blood cells. The term actually comes from the fact that, if you go back to a patho book and look at the entire cascade diagram of how blood cells mature, the immature cells are on the ...

I think your grandmother needs to be seen by a doctor. Depending on how long she has had this diarrhea, she may be dangerously low on electrolytes and fluid. Water is always good -- maybe some Gatorade. Stay away from juice. But, if she has health pr...

We are beginning to use more and more email. We also have a communication book in the report room but it is a duplicate of emailed communication. It is expected that staff will check email at least 2x a week. But...as previous poster stated, you need...

FYI...here's a link where you don't pay and there are several photos as well. All four parts can be accessed here: http://www.boston.com/news/special/nursing/part1/page1.html

Absolutely great story. I look forward to the next three parts. I also received a "page not found" error. Just go to the Globe's website http://www.boston.com and register (free). Then do a search - the article is called something like "Crash course...

Verbal. Usually over the phone. If they need to get an unstable pt over fast, they'll give me the condensed version via phone (30 seconds worth) ...and the rest of the story at the bedside when they arrive.