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Mommy_of_3_in_AL..RN specializes in MICU, SICU, CRRT,.

Now woking in ICU at Brookwood

Mommy_of_3_in_AL..RN's Latest Activity

  1. Mommy_of_3_in_AL..RN

    Rapid Response Team & ICU

    Our RRT is shared between all units. Basically each unit, CCU, MICU, SICU and CVSU take turns..rotating on a weekly basis. Each week the pager is transfered to the next unit. When a rapid response call comes in, any nurse from the assigned unit that is ACLS certified can respond, although it is usually a more experienced nurse, and if possible the charge nurse. the nurse that goes asseses the situation and calls in the RT or doc if necessary and arranges transfer if needed. I dont really like it because i feel it puts too much responsibility on one nurse, sometimes a nurse that isnt as competant to make those decisions. for instance, i will take ACLS in march, and i have been in the unit for more than 6 months, so as soon as i am certified i can and likely will have to run calls, and i dont know that i am ready to take on that responsibility
  2. Mommy_of_3_in_AL..RN

    You Know You've Had A Hectic Shift/Day At Work

    you leave work, get out of the parking deck and stop at the 4 way stop sign, and sit there for ten minutes waiting for the nonexistant light to turn green so you can go.....
  3. Mommy_of_3_in_AL..RN

    Nurses Say the Darnedest Things!

    BSE..maybe bedside eval?? just a guess since it was preceeded by PT/OT/ and ST. And reading these before going into a 3 day long ICU stretch was just what i needed :)
  4. Mommy_of_3_in_AL..RN

    pressors and sepsis

    Wow thanks guys! I have been in ICU for 9 mos now, and i always knew that Dopamine wasnt used as much because of the higher HR, but i never realized it had anything to do with O2..not sure if i just missed this information while working with these patients, or if it wasnt presented to me at all..but i know now! eh..i learned something after all :)
  5. Mommy_of_3_in_AL..RN

    Wildest lab values you've ever seen?

    Glucose 2300. Patient came to us from ER, with orders for IV insulin per protocol..ER started at 1 unit/hr!!! Needless to say on admission we started the correct infusion..but his SATs were in the 70s on 100% non rebreather, blood pressure 60-70 systolic, lungs were full of fluid, stat intubation. Oh yeah..he was a CHF patient and the doc came in and decided that he needed fluid resusitation to correct BP instead of a Levo drip. I argued but to no avail, doc took it upon himself to run 2 liters into this man, over about an hour...yeah you guessed it..patient literally drowned. Died about an hour after i left.
  6. Mommy_of_3_in_AL..RN

    Best Hospital for New RN Graduates?

    I work at Brookwood, and i am not sure how often they start the residency program, but from what i see on the calendar, as far as education days for new hires, it looks like they restart pretty often. I am in MICU there, and love it! Hey Leigh!!
  7. Mommy_of_3_in_AL..RN

    anyone know of places accepting new grads??

    brookwood in birmingham usually will for most all areas of the hospital. I started out as new grad in ICU and we just hired another 3 new grads for our unit and several other areas.
  8. Mommy_of_3_in_AL..RN

    Biggest mistake you've made in clinical

    We all make mistakes, and hopefully they do not cause the patient any harm. Anywhere from little mistakes to big ones, from students all the way up to upper management. They are all teachable mistakes and most can be corrected right away, hopefully removing any possible harm. I have made several, From taking the wrong mar to the wrond patents bedside ( i cout it before ever handing out meds), As a new grad nurse i was entrsted with keeping the running total of I/Os on the CRRT machine as well as trouble shooting the alarm. It was going ok until i realized that my numbers didnt add up at the end of the day, and i had to go back and put each number in again to make them add up...not really detrimental to patients safety, but i had to stay and go back on the machilne to make suer that each hour correlated, and when i finally saw where my mistake happened i fixed it..noone was harmed..it was a teaching/learning experience. Mistakes arent always avoidable, and the best way to deal with them is to admit your mistake, then try to fix it, even if you have to as another coworker to walk you though how to fix it right.
  9. Mommy_of_3_in_AL..RN

    Why Do Nurses Write: "no new orders received"?

    I always make note that orders were or were not received, anytime i speak with a doc regarding change of status, or even if the doc was a bedside with the patient. Its a definite CYA thing. I also chart what time i paged/called the doc, what time they called back, what info was given to them, and their response. In some situations, the doc will request that i notify a different doc of the situation, and i chart that too..basically every correspondence that takes place is charted. If a doc comes to the bedisde, i chart "Dr. X at bedside, assessed patient. No new orders received" or whatever statement applies. Its also a way to acknowdge that i saw and spoke with the doc, and that i reviewed the chart, noting the prescence or absence of orders, so it cant be said that i let those orders slide later on.
  10. Mommy_of_3_in_AL..RN

    What to expect during clinicals

    And whatever you do, when asked to do soething by someone, as long as it is within your abilities as a student to do or to help with, never, ever turn up your nose or act like you didnt hear the request. Always volunteer to help, or to at least learn and observe. I have only been in nursing since March (graduated in Decemebr and started in ICU in March), and already i am amazed at the number of students we have that come through, sit around the desk with their starbucks, and turn their nose up at any offer to assist or request to help thrown their way. We had one girl a few weeks ago precepting there, and in the middle of my patient that was crashing, my other very brittle diabetic had to have a glucose check. The other emplyees were busy with their very sick patients and the tech was off that day, so i looked over at her and politely asked if she would mind getting the suger, and she actually looked at me and said "i am here for management, and i dont have to do any thing with patients). I was appalled!!!! Sorry, but my nerves on this one are still raw..i can remember very well being a student, and looking for anything to do to help with, even explosive poop, just so that i would be appreciated. You know, how you act and perform in clinicals are a thing future prospective employeers look at. That is how i got my job now...i precepted in SICU and, as that was my only real experience, my manager contacted the nurse i was with, who gave me an excellent reference and all the best wishes, along with the comment about how she was sorry that they couldnt put me right there alongside them.
  11. Mommy_of_3_in_AL..RN

    The Dreaded Death Bath and a Moral/Ethical Dilemma?

    Actually, we faced this situation recently. Very unstable patient with severe pulm edema, ascities, very unstable respiratory wise, on multiple pressors, CRRT and a no code at that (actually, no compressions, no intubation..chemical code only.) He was a day bath so we got everybody in there to help (as he was also a large person), and started bathing. Mind you, we were trying to do so efficiently but carefully, as he was so unstable. After about 5 mins or so, we were almost done, securing the sheets and getting him situated, his O2 sat dramatically went down to about 30% on a non rebreather and HR decresd to the 20s as well. We bagged him for about 45 minutes, in order to see if he would recover without any other intervention. The doc was at the bedside and witnessed the whole occurance. He did recover and is still kicking on the pressors and CRRT, but now we have specific doctor orders to not turn. We can bathe him, but only the exposed areas that we can get to without turning. We were told that covers us in the event of breakdown, etc.
  12. Thank you..thats the most important. Sometimes we tend to get caught up with different things going on, and we always EXPECT to be helped, and usually forget to simply say thank you, or good job.
  13. Mommy_of_3_in_AL..RN

    Waiting to hear from CACC

    I graduated CACC childersburg in December. I got my letter in the second week or so of July, but it wasnt good news. I was wait listed. I was very upset, but i kept my head up..i still had a couple cores to take anyway..they called me the second day of orientation and offered me a slot!! So i took it! Really though, all this about how many applicants they had, and how many they take, and the point cut off is just hearsay, because noone really knows. I think they tell people things to shut them up. When i got acepted I had a 2.7 GPA...I had made As and Bs in the cores i had taken, and had 99 on my COMPASS, but i had started cores with a 1.3 because of slacking at my first school. So, that shows you that you dont have to have straight As and 4.0 to get in. I wish you all the best of luck, and if you need anything, just ask, and someone on here will help!! They did me many times!!
  14. Mommy_of_3_in_AL..RN

    Dealing with ICU visitors

    we usually do the same..but usually they call back in about 10 minutes...something about an "hour or s" just isnt comprehendable to some people!!
  15. Mommy_of_3_in_AL..RN

    Dealing with ICU visitors

    We have oopen visits, with certain "rules", that are never followed. Supposed to be open from 0830 to 1800, but we ALWAYS have familys rolling in at all hours, while were are trying to give/get report, and trying to hoard the docs while they are trying to take care of the patients. However, that doesnt usually bother me as much as those that, never fail, call everyday at 0700, right in the middle of shift change, and insisnt on talking to the nurse from the night shift, the day shift, and any docs that may be there. And, kid you not, want us to take the phone into the (comatose, vented) patients room so that they can "talk" to them...iwant to scream sometimes!! dont usually mind having family there, as long as my room isnt crowded, i can get to what i need to do,and you arent agitating my patient that is already in 4 point leather restraints (yes, i am dealing with this now..meth OD plus a little of everything else)..And do not,and i repeat DO NOT come track me down in the other patients room down the hall to ask me if i took your loved ones temp last hour or if i will take it NOW..i am about to code this other patient. Your afebrile daughter can wait one darn minute...oh yeah, and not to mention said mother UNLOCKED her daughters LOCKED restraints, cause she wanted to move around in bed...WHAT??? yeah...and with all that kicking and fighting she almost knocked ALL of us nurses and a few security guards out! (yes, the previous nurse was an idiot for leaving the key in the room and letting mom know where it was..that is being handled) Seriously people...seriously (yes, i work in MICU, but lately it seems like the catch all unit for all the psych/OD patients.....)
  16. Mommy_of_3_in_AL..RN

    Labs and vasopressors..new icu nurse needs advice

    I agree an A line is best, but in the real world..at least my unit,it isnt always there. Usually on a patient that has one or two pressors and are only expeted to have them for a short time, the docs wont place an aline if the cuff pressures are pretty accurate and consistent. Patients that are on presors long term, or whose pressures just arent picking up well with the cuff, or if they are on lots of pressors (like those that are on everything in the book and then some), they usually get an aline. However, these patients always have a PICC or a centrl line,so i try to place as many as i can into one or two ports, and try to reserve at least one port for antibiotics, IV push meds, and lab draws.