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A massive IVH could cause the brain to shift, causing debilitating injuries or brain death with a very very very slim chance of ANY recovery. Family probably didn't want her to suffer, especially with her PMH.

haha, a minute before posting this, I just asked my finance how to spell conscious for another post. Just a funny coincidence

Honestly, I have one of each. I work in neuro, so you need a good one to assess pupils. I usually only use the LED one on pts who are intubated/sedated/etc to get a better assessment on someone who can't talk to me. I would never shine that LED light in someone's eye who is awake and conscious... that would be cruel.

Being in the hospital can be very disorienting, especially when it comes to the date. I barely know the date myself, I couldn't imagine what it would be like if I were in the hospital, being woken up day and night and being sick. I generally just ask people what month/year it is.

Something like this just happened a couple months ago. I've had several patients die, but this one just hit me harder. It was a 99 year old woman just told told me how wonderful she slept the night before. I left the room and no more than 2 minutes later, I heard her monitor going on. I head in there, and the monitor was dinging V Fib, and the pt wasn't breathing. Luckily she was a DNR, but it just hit hard, because I wasn't expecting it. I called another nurse in there with me, and more came along to help with calling the doctor, the family, doing paperwork, etc. It is hard. Some deaths are easier than other's, and it always helps to have coworkers there by your side. Hang in there. :)

Most major cities have a free clinic (or several) who rely on and love their volunteers. I know it isn't as glamorous as going overseas, but they tend to always be short staffed, and there is a lot to learn in the clinics. Just a thought :)

I suppose the area of nursing you're going into affects the amount of poo and other bodily fluids you see... but the bottom line is if you're going into floor nursing, you're going to get your hands dirty... sometimes literally. Expecting a CNA to clean your patients up every time is a good way to get people not to like you.

Painful stimuli is a good indication... Also if the patient repeats something you've said during the midst of the "seizure"

You'll be surprised by how much you know when you get out there, and if you don't know something, ASK. There's no shame in it. I think just about everyone felt like they didn't know anything when they first started. Heck, some days I still have that feeling. As a new grad, you're expected to learn when you first start out. No one starts off knowing everything. As for feeling young, I was in the same position. When I was a new grad, I was the youngest on the floor, including the CNAs. Overall, I had no issues with it. We're all professionals. Good luck with everything!

I've seen it done only once. It was a patient who had a trach, then was decannulated. A few days later, they went into resp distress. So he used lidocaine through the trach stoma, then intubated orally. I'm not sure for the reasoning behind this.... It was my first intubation at the time, so I wasn't sure of the "norms". Looking back on it, I think it's so he didn't have to paralyze the patient. He just gave a large dose of Morphine, and then the lidocaine. But of all the other intubations I've seen, no one else has used lidocaine

I use biopatches currently in NC, and I also used them in Ohio when I lived there.

I completed the ECCO program. We were to complete it at home. We did get paid for it, although we would not get paid overtime for it. We just had to turn our CEUs in from that particular section, and got paid however many hours were on the CEUs. At times it was overwhelming because it is a lot of information, but I'm really glad I did it.

Hey everyone! I was wondering how everyone deals with a patient who has a poor prognosis, but family insists on everything being done. Sometimes I feel like we're torturing these poor patients. Despite explanations from doctors, and educations from nurses, sometimes it just doesn't get through these families' heads. I support optimism and hope, but when we're allow human beings to live with no quality of life it tears me up inside. Recently I had a patient with hypoglycemic encephalopathy who many doctors told the family that if she ever does "wake up", she won't have a functioning life, and would most likely spend the rest of life in a bed in a nursing home/LTAC. So the family decides they want to trach/peg her anyways. I understand the family is going through a rough time, but so many times they execute their wishes instead of the patients'. So my question is, how do you deal with these situations? I have been in many of these (working in an LTACH then a neuro ICU), but they still seem to get to me. I come home and just break down thinking of these people's lives, or lack thereof. I don't know if I'm being overly emotional, or if other nurses deal with this also. Thank you :)

Thanks, I LOVE this! :typing

Sorry if there has been previous threads discussing this. I currently work in an adult ICU setting, and I was considering a change and looking for a job in NICU. Are there any current NICU RNs out there who started off working with adults? I was just curious on how difficult it is to change from dealing with adults to tiny babies. Any input would be appreciated! Thank you :redbeathe

I worked in a LTAC before working in an ICU, and I felt it helped me a lot. You get all sorts of experience with vents, lines, and all sorts of other things. I was told (and agree with, at least in our unit) when I was interviewed that the acuity of an LTAC was in between an ICU and an ICU stepdown (progressive).

Started off with one boy out of 50. He dropped out after the first semester, so 0 guys in my graduating class.

Thank you for sharing that, AliRae. It was very touching. As for me talking to brain dead patients? Sure do. I also like to give them a good bath and shave if needed before we withdraw.

I had the same problem. I started my job about 7 months ago, and had been on nights up until 2 weeks ago. Night shift is a great way to get in and learn the ropes of the particular unit, but I couldn't do it anymore. I felt like crap all the time, had headaches, slept waaaaay too much... Since these couple of weeks on day shift, I haven't had a headache yet, and I feel great!

I think most hospitals in NE Ohio are phasing out LPNs. There may be small hospitals that are hiring LPNs, but none that I can think of off the top of my head.

I moved from Ohio where COL living was less expensive, and I still took a pay cut coming here to NC. When the HR rep told me my pay, I asked her why it was so low, and she just told me that is competitive for the area... Still ticked about it. Making less, paying more, and benefits are a joke...

Whaaaaa? Every place I've worked there had to be a person to hand over the blood to (be it RN, NA, secretary). I wish we could do that though! It'd make life just a little bit easier!

The cooler and ice packs are usually reserved for our trauma unit. If there were an emergency then we could get it, but it doesn't happen on normal basis

That's what I usually do. But I still have to convince these blood bank people that without a doubt that I would administer BOTH units of FFP within 20 minutes. I spend more time down there convincing than walking there and back. I just feel that if the blood bank is so strictly enforcing this, then maybe it needs to be added to our hospital's policy.

Ok, I have this gripe with our blood bank... Whenever you need to go down and get your blood (or FFP/platelets/etc) and request more than one unit at a time, they ask if the units will be administered within 20 minutes. This just baffles me. Our policy states that we cannot return something to bloodbank after 20 minutes of being distributed, but it says nothing about administering it within 20 min. So has anyone dealt with this before or heard anything about it? Usually if I'm running multiple units of something, I like to get 2 units at a time so I"m not running back and forth a million times. But the people down there says after 20 min bacteria starts to grow... but what about our policy that says we have 4 hours to get something completely administered? I don't understand this. I'm just peeved with them. You have to practically sell your soul to them to get more than one unit at a time.