sweetsmiles10363

tegaderm and benzoine on the cheek works best for me. i've also found that after the commercial strips have lost their stickiness, small strips of silk tape stick like they never have before! We don't have CNAs either, but we still turn our pts every 2 hours on the dot. then we go and complain to the boss about how much our backs hurt! hasn't worked yet. i use other nurses, our RTs, the x-ray techs when their around, families, or anyone else i can get to help me.

The Survey: Years in Nursing__1.5______Years in Critical Care __1.5______ What does the "culture" of critical care nursing mean to you personally? when i think of 'culture' i think of the people i work with. I would not have survived if they had not been there and supported me. I love that i can ask any question and i'll get 6 different people answering with 6 different responses. I love that someone always has my back and that i never feel alone. this is very much in contrast with floor nursing (at least in my experience). In your opinion, what do you thnk are the barriers to open communication in this profession? for myself? simple apathy--i've tried to communicate with my managers before many times, and nothing was done. why try again? i'd rather just go somewhere else. I don't have too much of a problem communicating with the critical care MDs, just the hospitalists who like to get in over their head. What do you think could be done to improve communication between staff, physicians and families? having the physicians coming around at a set time so the families would know when they would be available for questions. if the public in general had a better understanding of the hospital (try educating them with something other than TV dramas). Do you consider the ICU to be a "high-stress" environment? Why or why not? YES!! i could have killed 3 different people last night and it wouldn't have been difficult. insulin drips, potassium, septic pts, the list goes on. plus, i work in the middle of tragedies--and being human, i can't help but be effected by that. Do you ever feel "burnt-out"? Have you ever considered leaving the nursing profession due to stress or behaviors exhibited by others? i feel burnt out right now. i'm already contemplating what i'm going to do when my contract is up (5 months). I'm burning out due to the stress of taking care of critically ill patients.

I've never heard of a nurse not being able to give sodium bicarb either. i just gave some magnesium sulfate last night, through a central line of course, but we routinely push bicarb in codes.

yeah for the CCU!! H&P from a severe COPD'er: 'pt states last cigarette 1-2 hrs ago, but denies any attempt to kill himself' "**** happens. sometimes it happens before you can get your pants down" Rectotomy: cutting the nerve connecting your eyes to your rectum so you don't have a ****** outlook on life Propofol: nursing and pharmacy's date rape drug (LOL) "that's the sound of wild sputum" "sometimes you know your in before you even poke them" ---IV's!!! "life is always better with a sparkling laxative" "I'm balls deep with the suction and still can't get a gag" "what did the pt overdose on?" "Tylenol PM. that's why he's asleep" "we don't get paid anymore to be upset" (new admit) "we'll just gang bang her" "pt came back from surgery a little oozy" "what kind of close did they do?" "she was naked"

pandora.com is my favorite!!! you can go to the website and set up a station that only plays a certain type of music. I play an 'enya' or "david Lanz' station for end of life pts and agitated pts on vents. it always seems to relax them.

pt with a post AAA, we did serial cardiac enzymes (every 8 hrs post surgery 3 times) and the first 2 were wnl, however the last one was elevated (troponin of 9.6, previous 1.5, CK and CKMB were very elevated as well). Surgeon was notified, but it didn't really seem to matter to him. I looked this up on google and couldn't find any real reason (other than cardiac tissue ischemia, renal failure--which the pt did have, or CHF) that would falsely elevate the troponin. EKG hadn't changed, BP was fine, everything else looked generally good. my question is what would cause this random spike in the cardiac enzymes? both MDs i asked about this almost seemed unconcerned about this random spike, neither of them wanted to do anything about it. i'm just wondering if i missed something?? thanks!

just finished my 1st year of nursing (went into the SICU right out of school). My best advice is make sure you get a good orientation! You'll probably do just fine wherever you want to go; yes, its very stressful, but you can get through it as long as you have support! as for finding your 'niche', have you looked at the ICU? it's impossible to be bored there, there's always crazy things to see and you get smarter by osmosis!!! (all those old smart RNs). If you like machines, are a control freak, don't mind working in constantly depressing situations, don't get grossed out by huge wounds, and want the education to keep rolling in...it's your niche! Plus, after 2 years in an ICU, you can go anywhere. and i mean anywhere--cruise ships only hire ICU trained RNs, great bunch of knowledge to have anywhere in the hospital or out of it. good luck!

i had a pt the other noc, 100% occluded--running only on peripherals, scheduled for a CABG in the am. Heparin and nitro gtts, obviously. Sharp, sharp woman. she was nauseous during the night, so vagaled down with SBP up to 200, than came right back down in the 140's. Well, she started having some expressive aphasia at about 3 am, disoriented, ect. I called the doc, got a CT scan ordered (course he said "are you sure somethings wrong, and it's not just the morphine you gave her 4 hours ago??") and what did they find? tumors and bleeds. Surprise!!! Doc called the family, and 24 hours later, the patient was dead. She didn't even get to say goodbye to her husband. And i think i'm still in shock from the whole thing. it's not supposed to happen like that. she's only supposed to be in the hospital 5/6 days. I'm not supposed to dose her with a drug that will shorten her life to the point that she can't even say goodbye to her family! i'm supposed to keep her safe. I know i did everything right...i did my job well, i just feel awful. 5 tumors in her brain and lots of bleeds. another tumor in her lung. i'm going to her funeral in a couple of days, God, i hope her husband doesn't recognize me, i wouldn't know what to say. i feel like it's my fault...i hung that heparin, she deteriorated on my watch, and it happened so fast. My brain keeps saying that it's not my fault, but i don't now how to get rid of this feeling. thanks for listening guys, i'll update when i'm less depressed *don't ever quit smiling. If you force yourself to act happy, eventually,that's what you'll become*

I think it's ridiculous that nurses, of all professions, are being taught customer service. we who are the most 'caring' and 'trusted' of professions. why is it even being brought up? Because pts are unhappy with our services; they feel 'uncared' for. possibly this is due to the decreased time we are able to spend with them, the small amount of education we can give them, all our other pts, how frazzled we become because our job is stressful and there's always more you can do, few breaks, worry over pts, worry over ourselves, and the million other reasons nurses burn out. nurses don't need customer service training--anyone willing to work with the sick and disabled has to be compassionate and self-sacrificing. the industry needs to change to help nurses do what we do best--care for our pts.