matt2401 MSN, RN

Other posters have left some great information so I will try not to re-post. Here are some highlights of things I believe are improtant: Almost every single patient that comes in with critical high BGL levels are severely dehydrated. Expect all the ...

Precedex for induction is just plain insane. I can't see how any doctor in his right mind would look at either 1) the FDA labelling, 2) the mechanism of action, 3) the literature available and say "hey I am going to use this to intubate a patient. St...

DAMN STRAIGHT!!!

So, I take it from your post that you are happy with your 3% pay raises while the management gets HUGE increases? Heck, that 3% will be eaten up from the massive insurance increases HCA is rolling out. "rumor has it they have a year to get a contract...

These words are as true today as when Jack London wrote them: After God had finished the rattlesnake, the toad, and the vampire, He had some awful substance left with which He made a scab. A scab is a two-legged animal with a corkscrew soul, a waterl...

Hi all, recovering RN here. 4+ yrs clean. I personally did not use suboxone for my detox (I detoxed myself) but I see no reason why it can not be employed as tool in detox/recovery. I have seen many people successfully use suboxone for an extended pe...

I have been seeing ALOT of fairly health patients coming in with URI s/s then crashing HARD and ending up on a vent/oscillator, multi-pressors then dying (usually within 24 hours of admission but sometimes just languishing). They aren't technically f...

RSI is the best and safest way to go. I bring this expierence from my paramedic years of dealing with many, many ODs. Most are polysubstance and difficult to treat. If you give narcan you run the risk of reversing the narcotic component and causing v...

First, with the SpO2 remember it is giving you insight into only one component of the respiratory status: Inferred PaO2. Basically the pulse ox will give you a (usually) very good indication of what the PaO2 is. The rest of the compenents are: PaCO2,...

Hmmm, well the brain dead patients I have had were all organ donors and let me tell you....I was waaaaay too busy to sit and talk to them. Having said that I didn't have a desire or thought to talk to them. I did give a prayer of thanks for thier gif...

I went to Lake-Sumter on the Paramedic to RN bridge (which had us in with the LPNs so same program). AWESOME program, I can not say enough about it. I compared my expierence with people going to DBCC, SCC and VCC and I had it made. Send me a message ...

Anyone working at Florida Hospital (preferably Altamonte or South)? I am interested in what the staffing ratios are, mainly in ICU. Thanks! Matt

First a couple of things to realize. In this area, at least at my hospital; Oct, Nov and Dec are traditionally low census months. It picks up around now until April or so. If the census is low, it makes it easier for managers to justify a hiring free...

The only patients I have refrained from suctioning are the patients that are requiring high PEEP levels to maintain minimal PaO2s. In those patients when you break the circuit (the suction is going to break the PEEP) it is going to take 30 mins or so...

Wow, you get report? Lol, our hospital went to just faxing a report then the patient comes 15 mins later! Thats always awesome when a patient rolls in just as your other patient (or patients) are crashing. If it were me I would focus on what treatme...

Yes, the dosing schedule goes to 1mg/kg instead of 40mg (or 30mg with reduced CrCl). Still usually given SQ, although there is a dosing approved for IV in ACS. Lovenox has the benefit of no PTT monitoring required, and decreased risk of HIT. Back t...

Just remember, you can't cure stupid....its a terminal disease. Sounds like you are better off far away from that place!

I would say when all else fails follow your sponsor's advice, it sounds like good advice. You can always make a decision on who else to tell later. The big book does talk about what guidelines to use in terms of making 9th step ammends and if they wo...

My suggestion would be to self-report yourself to a peer assistance group. In Florida it is IPN, I know most states have their own version of it. If you try to wait it out, you are just going to delay the time it takes to get processed and cleared ba...

Hello, fellow addict/alcoholic here in a peer group in Florida (IPN). In my time in IPN (two years) I have found the people that do the best are the ones that really surrender and become completely honest. Those that try to get by in their own way se...

Wow, I think your nursing school director is taking full metal jacket to heart. I can imagine the discussion held in administration: "So, what can we do to the male students? We thought making them wear all white would break them down but noooo. I kn...

Our hospital got rid of 'call pay' ($4/hr) about 6 months ago. The new thing is 'flex scheduling'. The thing you should flex is your body habitus so you can assume the position. Basically the deal is this, if there is low census they will 'flex' some...

You have resigned yourself that the only reading material that is going to be available for you when you have to go to the bathroom is 'Cosmo' or 'Glamour' You have been working too long as the only male nurse when you actually read the article about...

Most of the good one have been covered, I will try to fit some in 1) Not only are you first on call for every lift and turn that needs to be done you are first for the code purple (unruly patient). 2) You really get a good giggle at the ability to bl...

Back a number of years ago the nursing home industry went crying to the state legislature that they needed malpractice caps because they were getting sued too much. They painted a picture of all nursing homes closing if they didn't get the legal prot...