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NeuroICURN

NeuroICURN

Neurology, Neurosurgerical & Trauma ICU
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NeuroICURN specializes in Neurology, Neurosurgerical & Trauma ICU.

Married, with 1 kid and animals!

NeuroICURN's Latest Activity

  1. NeuroICURN

    transfering

    Why would you email? That just sounds a little cowardly. Why not tell her face to face? If you absolutely NEVER see your manager, then call and leave a voicemail.
  2. NeuroICURN

    What should be included when Charting?

    BTW....why wasn't this addressed by your preceptor? I know I read all the charting done by any orientee with me...then we sit and review what's right and wrong and she fixes what's wrong (thank goodness we have electronic charting). In the case of somewhere with paper charting....you probably should have done what I did in nursing school, which was write out my note on another piece of paper and have it reviewed before writing it. It would have taken a little longer, yes, but it would have saved a lot of headache now....agree?
  3. NeuroICURN

    What should be included when Charting?

    Just because they can get in trouble for it, doesn't mean it shouldn't be charted!! If you were actually told that...I would get the heck out of there!! I agree that charting in a LTC facility and a hospital are very different, but that being said.....I chart so that if I get called into court 7 years from now, I can look back at my charting and tell you exactly what was going on with that patient. And as my instructors once drilled into my head........"If you don't chart it, it didn't happen".
  4. I actually recommend telling your employer right away. Depending on the unit will depend on they handle it. On our unit, we don't make any of our pregnant nurses take ANY kind of isolation assignment. They could, but just as a courtesy, we don't make them do it. Also, we try to avoid giving pregnant women any combative or grossly overweight patients. Now, that being said...let me get a gripe out too. Pregnancy is NOT a disability. I hate when women use the excuse that they're pregnant to sit on their butt and only do the absolute bare minimum! There's usually no reason that you can't continue to do almost everything that you did before you were pregnant. Therefore, if you were doing a physical job before and you have a normal pregnancy, then there's no reason that you shouldn't be able to continue to do that job. I've also worked with many nurses who worked up until they delivered, with no problems. Even work with one now who went off her birth control to have a hip replacement and got pregnant before the surgery and now she's back to work; pregnany and really bad hip....now that's a strong girl! Now before anyone goes off and starts flaming...yes, I've been pregnant and yes, I continued everything that I did before...even competitive dancing early in the pregnancy and continuing to train till I delivered. Ok...just my two cents....
  5. NeuroICURN

    new neuro rn

    check the sticky, "neurosurgical resources", at the top of the main neuro ICU page.
  6. NeuroICURN

    Highest PEEP you've seen?

    I'm with Gwenith on this one..... On neuro patients, we rarely ever go above 5, but have seen as high as 10...then other vent. methods start being used....i.e. pressure control ventilation or whatever is appropriate. Now with these patients, our intensivists handle their vents, etc. On trauma patients, I've seen as high as 15, but that's about it. With those, the trauma service tends to handle all their own stuff.....medical management, etc....but I do see a little change coming with that. They've been using the intensivists more now too. Our intensivists are also pulmonologists (dual specialties), so our vent management is some of the best you'll ever see....those guys are AMAZING!!! IMHO, we have some of the BEST critical care medical management you'll ever see!!
  7. NeuroICURN

    propofol infusion syndrome

    Did they try 3% NaCl? A bolus (typically 2-4 mL/kg) and then start a gtt??
  8. NeuroICURN

    Have I displayed drug seeking behavior??

    omg...I can't believe I forgot to mention that! Thanks! Also, thanks to whoever mentioned about the PFO...I've seen a LOT of people with PFOs, but never knew there was a link with migraines. I'll have to look more into that. See....you learn something everyday.
  9. NeuroICURN

    Have I displayed drug seeking behavior??

    Not to get too nosy here....but have you had a CT (to check for any bleeding or tumor), and/or a CTA (CT Angio) done?? If not, and your symptoms are this severe, you NEED to have that checked. Many people don't often have a warning to the fact that they have a brain aneurysm....but those that do, it's often migraine headaches. Also, the migraine headaches beforehand can be a warning that it's going to rupture. If you do end up having one and it's giving you these kind of symptoms, you need to see a neurosurgeon ASAP.....because when brain aneurysms do rupture, more than 50% never live to see a hospital and trust me when I say, the sequalae after a rupture is brutal!!
  10. NeuroICURN

    ICU: Nurses Wash Patients + Make Beds?

    In our ICU, we are also responsible for all of the patient care (bathing, linen changes, etc.), but when we have an NA on, they will help you with that stuff. Our NAs also do our blood glucose monitorings, stock our bedsides and help us with our roadtrips. Our linens are stocked in a room, so other than an extra pad or pillowcase, we don't keep too much linen at the bedside. We do all of our own IV starts and blood draws, but there are techs that come around for EKGs and RT does our ABGs. As for our procedure trays, most of those come from central and it's the NAs job to make sure it's there. As someone previously explained, many ICU patient's have so many tubes and wires hanging out of them, that it requires a little finesse when doing even basic nursing care. A little interesting thing that we do with our crash carts is that ours are kept on the unit (we have 3) and have a little plastic lock on them (all you have to do is give it a little pull and it comes right off). Then, after a code, the US calls and central brings up a whole new, stocked and locked cart and they take the used one away. It's kinda nice because as long as you see the lock still on there, you know it's stocked and ready to go.
  11. NeuroICURN

    ICU or ER

    Personally, I would recommend an ICU. You'll typically get more experience with drips, lines, etc. Not that you don't get that in the ER, but you see it more in ICU because you don't have to deal with all the other stuff (i.e. flu pts, people just drug seeking, etc.) in the ICU. JMO
  12. NeuroICURN

    Anesthesia for HALO placement.

    Honestly....sounds like the patient probably freaked out a little and it was probably more anxiety (and drama), than anything else. I've done more halo braces at the bedside than I remotely care to discuss. We do ours with the neurosurgeon, the orthotics guy and us (we're conscious sedation certified). I've never had this type of reaction from a patient. Frankly, I'm a fan of fentanyl and a little versed....along with the lido, of course. However, there's no need for deeper sedation. Most remember it...but I wouldn't call it a recipe for PTSD. And whoever recommended ketamine....ugh. Most patient's report some discomfort (it's darn near impossible to get rid of all the pain of the procedure), but overall, it's a well tolerated procedure. Some patients require the hand holding and distraction/relaxation techniques, but hey, that's what we're here for anyway, right? Just my 2 cents.
  13. NeuroICURN

    Difference in masters degrees

    Ok, so I'm looking at different CRNA programs and one offers a masters in health sciences and the others are the typical masters in nursing. Have you found that one is better than the other? Does anyone really care, as long as you're a CRNA? I would love to hear all your thoughts on it! Thanks!
  14. NeuroICURN

    Funniest real orders you have seen in a chart?

    As many others have said....this is not unusual. I've given it to people who could feed themselves and put it down many NGs and GTs (best to open the can a while before and let it go flat)....our docs usually order it 1 or 2 cans with meals or TID. Anyway....I think it bears repeating that ETOH withdraw is the one kind of withdraw that CAN KILL YOU!!! Just about any other drug will just make you sick and feel like dying, but ETOH can actually make you do it.
  15. NeuroICURN

    Funniest real orders you have seen in a chart?

    I've been LMAO at this one for like 5 minutes now!!
  16. NeuroICURN

    Patient died from 8GMs of Dilantin

    Apparently someone failed to teach this RN the good rule of thumb regarding medication administration.....if you have to give three or more of anything (pills, vials, etc.) and you're not COMPLETELY sure, you'd better check with a pharmacist or MD!!
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