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mpccrn BSN, RN

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critical care nurse for 30 years

mpccrn's Latest Activity

  1. mpccrn

    Vent: MD visitors who are NOT intensivists

    I had a hospice aide sister of a patient once think she should dictate her brothers care in the ICU. She made soooo much trouble for me, reporting me to everyone and anyone that had to listen to her. Finally the nursing supervisor put an end to it by talking to the patient himself asking him if he was satisfied with the care I was giving him and if he had any concerns about his care. Thank god he was still oriented at that point! He asked if his sister was causing trouble again and when it was confirmed, he asked that she not be allowed in anymore. I was grateful to them both. While it was not difficult to justify my every action to superiors as I comply with standards of care, it would have been difficult trying to prove I did not 'threaten' my patient verbally as she accused me of, had the patient not been able to deny it.
  2. mpccrn

    H1N1 season and not taking the vaccine

    Welcome to ICU nursing! Yes, early in the flu season we had 2 staff people that got sick before a patient was diagnosed (they didn't yet get the flu shot). Actually we're seeing more influenza in patients that did have the flu shot this year than any other year.....guess they didn't pick well when compiling this years shot combination. It happens.
  3. mpccrn

    QI/ PI improvement project, anyone?

    I'm currently doing a QI project involving interruptions while pouring medication. I am gathering data for a 2 month period, tracking medication errors and will implement a 'no interuption zone'. While nurses are pouring meds, they will not be interrupted for anything or by anyone (short of a life threatening emergency) and see if the errors decrease. It's part of the 'just culture' trend. Staff members are excited by it as they can be easily interrupted by phone calls, doc questions, chit-chat, family members, etc 20 times or more during one pour. Another study we did recently was about OR patients being admitted post of to ICU with their name bands and T&C bands cut off them and taped to the chart. While we understand why it is important sometimes to remove the bands, it was unacceptable to not replace them. Another study we did was a smoking cessation education study. Were smokers given material they could use to quit before discharge? Was it documented. Same thing with CHF teaching. We did a study to reduce ER to ICU admit times. We documented the time we were called for the bed, the time the bed was given, who in ICU would be taking report, when they called for it, who they got report from, the time of report and finally the arrival time of the patient to ICU. It was amazing how the time was cut down once there were names of people who could be held responsible for unnecessary delays. Missed meds from pharmacy....funny while they knew they were being looked at, there were less and less meds missed but now that the study is over, the missed meds are back.
  4. mpccrn

    Policy development: Central lines

    That's exactly right. Our hospital policy states that only 10cc srynges can be used on PICC and Midlines. Anything smaller will generate too much PSI and can result in catheter rupture
  5. mpccrn

    Ob to icu?

    It all comes down to how bad you want it. Your experience could be invaluable as there are pre and post partum moms that require ICU nursing. Go for it! My current ICU manager was first an ICU nurse, then worked OB for years and she's the best manager I ever had.
  6. mpccrn

    What does an ICU nurse do exactly?

    In a single word......everything!
  7. mpccrn

    I'm so sorry....your spouse just died.

    When I was 17, my very best friend in the whole world died in a hospital. Her parents were called and told she was not doing well and they needed to come in right away. When they got there, she was dead. They beat themselves up for years afterward.....if I only drove faster......if I ran that red light......if etc. I later learned that Mary Beth was already dead when the call was placed and I promised myself I would never put a family through that. The news is always devastating to a family. There is no need to add guilt to it.
  8. mpccrn

    Sedation..Your thoughts?

    I would have left her there. She was comfortable and oxygenating.
  9. mpccrn

    Ativan IVP given undiluted into central line.

    I usually dilute it with NSS
  10. mpccrn

    Whats the most blood products you've given in a shift?

    148 units of prbcs in a 12 hr shift....MVA pt.....she didn't make it
  11. mpccrn

    What does "+++" mean in narrative charting?

    Who knows? I've never seen it on any acceptable abbreviations list.
  12. I was a waitress at a pizzaria before going to nursing school.......so a little! HAHA
  13. Hmmm its a toss up. New Years eve got a call from the ICU director that Mrs. So an So died after I left that day and it looked like meningealcocal meningitis and I had to get back to the hospital ASAP for a dose of cipro. Then there was the time there was a shoot out at the hospital between someone trying to break out a federal prisoner and the guards.....one guard died.
  14. No. I work in ICU and assume families are there to visit, not care for the patient. The patient and his care is completely my responsibility. Visitors delivering care under my license does not work for me and I make that very clear from the start. I'm nice about it but make it clear that if the patient needs something I have not already addressed, visitors can and should verbalize it. I encourge visitors to ask about things they don't understand and give them guidelines as to what is acceptable behavior. Smilingly I tell visitors it's better to ask first then to cause their loved ones harm under the guise of trying to help.
  15. mpccrn

    What do ICU nurses do?

    What does an ICU nurse do? EVERYTHING! You keep your patient alive if that's the plan, you give them a dignified death if that's the way it goes, you take care of their families and you take care of each other and at the end of the day you walk out holding your head held high