TLCinCICU

TLCinCICU

cardiac ICU

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All Content by TLCinCICU

  1. Does your facility aspirate blood before removing a sheath?

    TLCinCICU replied to ALCCRN's topic in CCU, Coronary, Cardiac

    It's policy where I work that you must aspirate from a sheath before pulling it. The theory is that any clot at the tip could be stripped loose as the sheath is pulled. It (in theory) could then...

  2. How high have you titrated levophed?

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

    Our facility runs Levophed at mcg/min, where many run at mcg/kg/min. The highest I have ever titrated Levophed was beyond our formulary max of 300 mcg/min. (My Kathi White reference notebook says 30...

  3. Obama's health plan

    TLCinCICU replied to futureRNJaz's topic in General Nursing

    I attended a small gathering hosted by a physician that had the sole purpose of contrasting the healthcare plans of each of the two candidates. A healthcare economist spoke. His materials came from...

  4. Survey for Sociology Paper...Will you help me out?

    TLCinCICU replied to EMT_to_RN's topic in Men in Nursing

    1. how long (years) have you been a nurse? 8 years 2. what is your annual gross income? less than 30k, 30-40k, 40-50k, 50-60k, 60-70k, greater than 70k 60-60k 3. do you have an associate or bachelors...

  5. Reasoning against pushing meds through a-line?

    TLCinCICU replied to mummer43's topic in CCU, Coronary, Cardiac

    The reason is simply anatomic. Arteries flow outward from the heart. Vein flow toward it. You get systemic distribution of the drug using a vein. Using an a-line will send the medication away from...

  6. Going to day shift? What's the difference in how I'll......

    TLCinCICU replied to kyboyrn's topic in General Nursing

    Between my prior position as a lab tech and my first few years as a nurse, I worked night shift for 12 years. I thought I had always handled the night hours well both physically and emotionally. I...

  7. Do you accept tips?

    TLCinCICU replied to 987!'s topic in General Nursing

    It's wrong to accept any kind of monetary gift/tip for our care from patients or families. Just think of how it could be if tips were allowed. Those who could afford to tip generously would receive...

  8. do any of you like codes??

    TLCinCICU replied to ryanfocker's topic in Men in Nursing

    Codes do give me a bit of an adrenaline rush, but I am much more pleased with myself after a day where I've felt like I've spent the shift about 15 minutes away from a code at any given point. I...

  9. Male nurse career advice

    TLCinCICU replied to piscesguy's topic in Men in Nursing

    Nursemike - you and I think a lot alike. I would enjoy working by your side. I've had those same warm-fuzzies when a patient & his/her family asks "Are you back tomorrow?". You're also right...

  10. IV pump placement/Room set up

    TLCinCICU replied to TulsaTime's topic in MICU, SICU

    Running IV lines across a patient isn't a safe thing to do. I've seen patients get disoriented and pull on the lines, resulting in the IV pole falling into the bed with them - and sometimes hitting...

  11. MRSA and Isolation

    TLCinCICU replied to tgirl84's topic in General Nursing

    I half-expect that anyone who provides direct patient contact will be cultured for MRSA at least yearly. They could even choose to treat us "for prophylaxis" periodically in the pursuit of keeping...

  12. CRRT question

    TLCinCICU posted a topic in MICU, SICU

    We have just recently purchased PrismaFlex (made by Gambro) CRRT machines to replace our prior - outdated - Prisma machines. My only experience in caring for CRRT patients has been using the M60 or...

  13. Pronation and pressure sores.

    TLCinCICU replied to dissle's topic in MICU, SICU

    Whenever pronation is ordered in either of our ICUs, we rent a specialty bed from KCI called the "Rotoprone". Before that, we used a brace called the "Vollman Pronator". It required multiple staff...

  14. Problem with preceptor and night shift.

    TLCinCICU replied to CallieAnne's topic in MICU, SICU

    I would chafe just as much with that preceptor. And as a preceptor, part of our duty is to allow/encourage you to chart and point out areas where you might not address required charting (like...

  15. TPA didn't infuse

    TLCinCICU replied to JeffTheRN's topic in MICU, SICU

    Thanks for sharing the story. Out of curiosity, what was the brand/maker of

  16. How frequent BP's on vasoactive meds?

    TLCinCICU replied to nursecass's topic in CCU, Coronary, Cardiac

    I'm with you. I've found the NIBP cuff set for Q60mins on vasoactive patients, and VS documented on CRRT patients Q60mins - when those patients are "hemodynamically unstable" by definition. I...

  17. thoughts on only Paralytic while intubated....

    TLCinCICU replied to MassED's topic in General Nursing

    Our standard is to begin with propofol as sedation for intubated patients, even in the ER. It almost follows an algorithm. Propofol first, then it will get combined with fentanyl if it appears that...

  18. are you or were you Medical Laboratory Technologist?

    TLCinCICU replied to aqua123's topic in General Nursing

    I was an MLT for nearly 15 years by the time I got my RN license. I debated going back to school to become a nurse for close to 5 years. Each time I had nearly decided to go for it, I would go onto...

  19. INTRA AROTIC BALLOON PUMP RATIO/RN/PT

    TLCinCICU replied to mror44's topic in CCU, Coronary, Cardiac

    Our assignments are all based on acuity. The only patients we have that are 1:1 by policy are CRRT (CVVH) patients. IABP patients are paired with the more stable ones - like the standard...

  20. Is the pay really that bad??

    TLCinCICU replied to myty23's topic in General Nursing

    That part alone says you should go for it! I also felt something like a "calling" to make the career change - and I've never looked back. It's been one of the best decisions I've ever made in my...

  21. What would you do for this patient?

    TLCinCICU replied to UM Review RN's topic in CCU, Coronary, Cardiac

    This scenario reminds me a bit of what a nursing school instructor said "Treat your patient, not the numbers!" Some of our little cardiomyopathy patients are on such high doses of beta blockers, ace...

  22. Care Plans - What's their purpose? - What do you think of them?

    TLCinCICU replied to jjjoy's topic in General Students

    Ugh....clinical pathways...the least favorite part of my workday. To me, they aren't anything even approaching a valid "care plan". They are a checklist to make sure we do the things that a) get us...

  23. Work all night -School during the day, can it be done?

    TLCinCICU replied to myty23's topic in General Nursing

    I worked 40 hours/week on night shift for the duration of my ADN program. However, I only had to take nursing classes during that time. My previous degree (for the lab job I worked) had many of the...

  24. In your experience.......when a seemingly "stable" patient tells you they are

    TLCinCICU replied to JennRN65's topic in General Nursing

    You can chalk me right up there with the crowd. I've had several patients make a comment about dying soon and then have it happen within hours. I've also developed something of a "sense" or strong...

  25. Nurse fired for calling police

    TLCinCICU replied to Runman1914's topic in General Nursing

    There's a little reheorificed tirade I've had in my mind for years that I've never had the guts to actually say: "You are NOT on public property. You do NOT have the right to act however you want....