CarVsTree

What about Plano? Is that considered the Dallas/Ft. Worth area? I know it is nearby.

You know, everyone is telling OP to tell the doc. The same doc who yells at her regularly. Suppose he tries to make an example of her. These are the consequences: 1.) Verbal/Written Warning. 2.) Fired. 3.) Reported to the Board of Nursing for practicing medicine without license, falifying, etc. 4.) Doc that yells at her understands and appreciates her not calling him... OP, you have to decide how you think this will pan out. How long ago was it? I know it is important to be honest, but perhaps you should talk to someone you trust with experience and knows the doc, the management at your facility, etc. Also, I would be careful about admitting to wrongdoing on the internet. This is a public record. I never discuss details about what I do or do not do at work. I discuss generalities, occasionally, ask questions, but never details. Just a thought.

I believe the TED's were contraindicated, just like compression pumps are in a DVT. You didn't mention a heparin gtt. Why wasn't she on one? I've never heard of Lovenox to treat an acute PE.

Well I know I do more baths in critical care than I did on med/surg so why not?

OMG!!! I think your instructor should be flunked!!!! Talk about nurses eating their young! I would laugh if you weren't being so unfairly scrutinized. Practice, practice, practice, give her what she wants. Just know that in the real world, no one cares about water on a table (as long as you clean it up before the next shift comes on). Take care! Sue Z

I'm no expert on gases and am always learning. Base deficit/excess being my weakest area? What I do know is that base excess/deficit is calculated based on the values obtained in the ABG. It is not an actual measurement. Right everyone??? I'm pretty sure I'm right about this.... Basically, cardiac surgeon is wrong. The pt. is clearly (but not terribly) alkalotic.His base excess is negative because of the increased Bicarb (-ion). I do know that respiratory distress often starts out as respiratory alkalosis, then when pt. poops out they quickly become acidotic. Was your pt. is respiratory distress? Why was patient hyperventilated? He is almost fully compensated. It's really not a bad gas in the scheme of things... What was he upset about? What did he want done that wasn't being done? Was the patient on a vent? If so, that is a good time to consult your respiratory therapist regarding vent changes. They're really good with gases and can often fix the problem at the pulmonary level rather than the body correcting it metabolically. Perhaps this is what super surgeon was upset about? Too bad you weren't there... Or perhaps it was good that you weren't there. :icon_roll Take care!

Ditto!

that's what i was going to suggest. get new tubing. i've occasionally come across defective tubing. i even had defective primary tubing where it kept alarming upstream problems; when in doubt throw it out (the tubing that is). that's probably all it was. as for the posters who said what has to be in the pump, i'm sure it depends on your pump. ours is similar to yours we have bard pumps. put primary line through pump; secondary line connects prior to pump but must be higher. you had everything correct.

Are you applying for a new job in a different facility or transferring to a new unit in the same facility. If you're staying in the same facility, you're kind of stuck. I would talk to the manager of the unit where you made your error and see if you can convince her that you've learned from your mistake and what you'll do to avoid the same error in the future.

All of the above is true, but people have one similar lawsuits before. I too would be worried. I read on this website of a cardiac pt. who did not follow medical advise. His cardiologist had to pay 50% of the damages the family was seeking. The jury found the cardiologist 50% culpible despite the fact that the patient failed to get a stress test and left AMA several times. A good lawyer can go very far despite evidence.

Hi Jen, I understand your feeling bad and worrying about a lawsuit, I would be too. What were the circumstances of his original admission? What brought him to the hospital? Did you or another RN document that he was A&Ox3? Was there any ETOH on board? Disorientation & ETOH would be worrisome. Did the AMA form address the possible harm that could come to him being dischaged AMA? I hope all works out and remember that most people do NOT sue.

Many times the brush is not sufficient; the pipe cleaners really help to get the gunk out. Not much else to say.

OP, I don't believe that any of this situation falls on your shoulders. Your charge nurse blaming you is just shirking her responsiblity. Bottom line, Offgoing nurse abandoned his patient and can lose his license for this. As an RN it is our responsibility to accept or deny a patient, ask questions, etc. You were not given this opportunity. Should you have checked the assignment board? O.k. fine, sure. Should the Charge nurse be coordinating and making sure everyone is aware of how there assignment will change? yes, and it should have been done before 11p. She is wrong and offgoing nurse is wrong unless he reported to charge nurse. It falls on them not you! My advice: Report the charge nurse and the offgoing RN to the director of your unit and risk management. I hope you generated a pt. safety report for the pt. abandonment and elevated blood sugar. If you haven't already done so, you need to. The pt. was probably (o.k. definitely) harmed by the elevated blood sugar (didn't you say it was 1100+?). With that high a blood sugar pt. belongs in the unit. Was the pt. on an insulin drip prior to you "receiving" the pt? Imagine if pt. was on an ins gtt and got TOO MUCH insulin?!? The PCA could have found a dead pt. rather than one with an extrememly high BS. What was the outcome for the patient? I'm sorr this happened to you. REPORT IT, REPORT IT, REPORT IT!!! Take care, Sue Z

Wow!!! I'm sorry your son was treated so badly. Is your hospital a Level 1 or 2 trauma center? Standard of care for MCA at 50mph would be Primary survey, plain films, CT scans Head, C,T,L spines, Chest, Abd, Pelvis. How did radiology clear your son's C-spine? He needs a physician exam to clear C-spine. Also many fx's don't show up on plain films, CT is standard for spine. Wounds should have been debrided in OR and dressed. Bacitracin not nec. wrong, some burn docs prefer bacitracin, some prefer silvadene. And there's about a billion others. However, as you know, you can't just slap bacitracin on a dirty wound that needs to be debrided. If he had 2nd & 3rd degree burns, he should have been referred to a burn center (I think, but not sure if it is standard or not, since my hospital is a burn center, but I'm not a burn nurse). I would definitely report this to Risk management, Director of ED, ED director's boss, etc. That care isn't just a little off, it is apalling and extremely dangerous. What if he'd had a splenic lac or even worse a big liver lac. He could have died. Very scary, as I'm sure you're aware. Don't leave this unreported. I hope your son is feeling better. How are his wounds? Is a burn or plastic surgeon following him? He should not be followed by a general surgeon. He needs burn/plastics. Good luck. Sue Z

We also hire GN's in TNICU. We do not however, hire RN's with 8 months experience. An RN needs at least a year experience (two would be better since it is such a drastic change to go from the floor to ICU). They can than do the internship for experienced RN's. It has a different start time than the GN's and a slightly shorter clinical component. That's what I was trying to explain to OP. She may not be getting replies to her apps because she does not have the required experience.