richard1980

richard1980

SICU/CVICU

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All Content by richard1980

  1. Still a newbie, but this was COOL

    richard1980 replied to Mommy_of_3_in_AL..RN's topic in MICU, SICU

    First open chest huh? Yeah it's pretty fun. If someone's having sternal dehiscence, no matter the reason, in my facility, it's standard procedure to place a vac over it. There's no negative effects on...

  2. CABG

    richard1980 replied to richard1980's topic in MICU, SICU

    Whats the pay like out there? Where I work now after 3+ years I make 32/hr plus shift diff and weekend

  3. TNCC

    richard1980 replied to gypsyeyes's topic in General Nursing

    They've changed it and made it very difficult. Be sure to read your book very carefully. All the questions are directly from the book. I would estimate that 1/3 of my class failed their first test....

  4. EKG training and ACLS

    richard1980 replied to MistyDawnRN06's topic in MICU, SICU

    I couldn't agree more. IMO I don't know how and why hospitals hire new grads to work in a SICU. Are they that despirate for nurses? I can understand other places like PACU, stepdowns, etc. I was...

  5. How high have you titrated levophed?

    richard1980 replied to racing-mom4's topic in MICU, SICU

    Well. That works if you have a inotrope/pressor that you haven't added or tried already....

  6. How high have you titrated levophed?

    richard1980 replied to racing-mom4's topic in MICU, SICU

    When you crank up your pressors like that they usually start to lose affect quicker and quicker. I've found myself going up by 10-20mcg/min of Levo. You will see an initial effect but the effect...

  7. Accurate Blood Sugars

    richard1980 replied to Lucyinthesky's topic in MICU, SICU

    I hate dealing with residents... i know they have to learn somehow but it's like you have to always point them in the right direction and watch out for crazy orders. In my unit we are expected to...

  8. New RN...help!!!

    richard1980 replied to IrishRN84's topic in MICU, SICU

    it might just be me but....I get nervous when people just out of orientation say they feel comfortable. Everyother time you feel like you know exactly what's going on and become complacient there's a...

  9. How high have you titrated levophed?

    richard1980 replied to racing-mom4's topic in MICU, SICU

    Whatever the case -- wet/dry septic/chf - dude needed a swan to figure out exactly what was wrong. I suggested Primacor over Dobut b/c of less side effects when he's so sick already. Probably could've...

  10. Calcium drip

    richard1980 posted a topic in MICU, SICU

    Anyone ever seen a Calcium gtt used as a last resort in someone thats circling the drain and they didn't want to put a VAD in because it was too late? I guess you just ignore the calcium level and...

  11. looking for some cardiac experts

    richard1980 replied to Guest219794's topic in CCU, Coronary, Cardiac

    Next time that happens just say, "you really don't know how to do your job, huh?" Just kidding...refer them to Dale Dubins Rapid Interpretation of EKG's. Explains it from a physiologic standpoint and...

  12. help

    richard1980 replied to lovemydogs's topic in MICU, SICU

    Hopefully they'll give you a 2nd chance, just don't get into bad habits like that b/c they'll stick with you and someday a patient could die because of

  13. How high have you titrated levophed?

    richard1980 replied to racing-mom4's topic in MICU, SICU

    Yeah, definately. Sick pts never belong on cpap. As far as MD being present, yeah....he should've at least come and seen the patient. And if she didn't like his answer, she should've made the...

  14. To suction the ETT, or not?

    richard1980 replied to CactusFlower's topic in MICU, SICU

    Wow I didn't even know it was up for debate. Suction and suction often. Haven't those people telling you never to suction ever heard of

  15. How high have you titrated levophed?

    richard1980 replied to racing-mom4's topic in MICU, SICU

    WOW! Hospitalist apparently doesn't know what the hell he was doing. He should lose his license. Just a couple of things....If you're running a pressor you should have a A-line, also you wouldn't have...

  16. Pwave from .16 to .42?

    richard1980 replied to mamason's topic in Cardiac

    If it's just showing up in 1 lead it's probably

  17. Autonomy

    richard1980 replied to Hoozdo's topic in MICU, SICU

    They still have residents to run care in ICUs? And they let them sleep? LOL ;-) In the facility I work at if residents come to SICU they are basically holding hands with one of the intensivists. We...

  18. What are your ICU visitation hours???

    richard1980 replied to Nacki's topic in MICU, SICU

    We have a locked unit. There's no visiting for an hour before and 2 hours after shift change and we limit visitors to 1 or 2 at a time. Also we can just say no visitors right now or if you do let...

  19. What has been your sickest patient

    richard1980 posted a topic in MICU, SICU

    I haven't been in SICU that long, but recently I had the sickest pt I've ever had helping out on a 2:1. He had a MVR/AVR and dropped his pressures in the OR so they gave epi and he developed "stone...

  20. Inappropriate ICU transfers

    richard1980 replied to BlueEyedRN's topic in MICU, SICU

    That sucks, I guess I'm pretty lucky. 99% of our patients are POD 0 or 1 cabg/valve, sick sick AAA's (they normally hang out in PACU overnight), sick sepsis or resp failure post surgery. The...

  21. What has been your sickest patient

    richard1980 replied to richard1980's topic in MICU, SICU

    I bet, did they have to do it off pump because of his/her

  22. What has been your sickest patient

    richard1980 replied to richard1980's topic in MICU, SICU

    It was my first LVAD, not sure what kind it was. I'm guessing the perfusionist turned the flow down to nothing. We didn't turn up the IABP we changed it from 1:1 to 1:3 to see if he was beating on...

  23. Nurses pulling chest tubes?

    richard1980 replied to lizzieB05's topic in Cardiac

    I work on a CV surgery stepdown unit. Our PA's or surgeons pull them along with mediastinal JPs and TPWs. For our CABG pts the CT usually comes out on POD 2 and wires and JP on 3. Am I the only one...

  24. Yes. another ECG question

    richard1980 replied to poohbear1968's topic in General Nursing

    A great book for starting out with EKG's is Dale Dubins Rapid Interpretation of EKGS. Easy reading, starts from the begining and leads to more complex

  25. Yes. another ECG question

    richard1980 replied to poohbear1968's topic in CCU, Coronary, Cardiac

    A great book for starting out with EKG's is Dale Dubins Rapid Interpretation of EKGS. Easy reading, starts from the begining and leads to more complex