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cardiac surgery ICU
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RNAEMTCC has 2 years experience and specializes in cardiac surgery ICU.

RNAEMTCC's Latest Activity


    Has anyone ever worked a "double shift" ie 16hr shift?

    ahh I double shift. I've been mandated into many of these unfortunately....many many many of them. Thankfully the new law came through in NY that we can no longer be mandated and I will never ever work a 16 hour shift again, I felt unsafe, I had to pee. I was exhasuted, dehydrated, and didn't have a break the entire shift and that was most of the 16's I worked, because when you're mandated it's already short... so you're not going to get a break. Sigh... what they do to nurses.

    Bringing the Nurses Back

    well... I know especially in my program the fail out rate is REALLY high, so looking at how many are enrolled doesn't tell you much, you need to follow the numbers of the ones who enroll versus those who make it through and pass their boards. It's nice to see so many people enrolling into programs though, there just enver seems to be enough nurses to cover the shifts.... and with mandation being now against the law where I work, that's a huge problem.

    Nurse Stereotypes and the White Cap...

    I would say the stereotype as a nurse as just a butt wiper needs to go.... we make critical decisions for our patients all the time..... take care of the critically ill... get them through their most difficult times... and somehow... we're "butt wipers." seriously. ***?

    Funny things that pts say

    So, I had a patient with a morphine PCA. he wasn't exactly the brightest bulb in the box. He would continually ask for boluses through the pca. except.... well he didn't call it a bolus it was a .... Bogus Bolo Golo Gogus Mogus molo Solo Sogus I then, got tired of trying to figure out what he was asking for, and wrote BOLUS in thick black permanant marker lettering and taped it to his overside table so he would just have to look at it. (and yes he could read) then then managed to come up with even more creative names for the bolus "double shot" "double pump" I gave up at that point... lol.
  5. Oh this is my favorite topic: I had a patient call 911 to request a new nurse. I had a patient demand that we find a mug for their coffee cuz he wouldn't drink it out of a sty cup. (we then asked. are we at the holiday inn?) I have had a patient ask me to lift up his.... cuz he didn't want to touch it I have had numerous patients ask me to place a dinner for them in outside restaurants (on very restricted diets) I had one patient demand that only one nurse could be her nurse and she wanted her there 24 hours a day (um hello?) I had a patient ask me to pull out the rest of the stool cuz he didn't want to "strain" (seriously?) I had a patient ask me to cath him cuz he didn't "feel like getting up and going in the bathroom" oh memories... lol

    SVT vs Atrial Flutter

    Hm. Well I don't entirely agree. I have seen irregular atrial flutter before. And a rapid atrial fib/flutter (where they go in and out of both) can come across your screen at 200bpm looking like flutter.... or SVT.... sometimes you just love your patients. I always slow the paper speed down (and then change it so you don't give the next nurse a heart attack) and then you can clearly see what you are looking at! as usual, the best is an EKG, or a trial dose of adenosine (it's kinda a diagnostic medication) that i've seen some docs use to slow it down long enough to see whats going on... of course it's acls, so depending on the hospital a decompensating patient will get it without an order anyhow. .... if not for that pesky "prolonged asystole" they warn about on the box it's a great drug.

    How To Determine ET Tube Placement

    don't be fooled! Breath sounds and end tidal co 2 measurment with a device can be decieving! By all means. WAVEFORM CAPNOGRAPHY is the best form folks. It's totally NON invasive, just ask the doc if you can monitor ETCO2 (they usually don't give a hoot if you want to) and you have a wonderful wave form of constant reassurance that your tube is in the right place. perhaps it's because i can also do pre hospital intubations and have come to love waveform capnography as a wonderful reminder of where my tube is. Given the wrong situation your color changer will be WRONG.... you can just barely right mainstem and still manage to get bilateral breath sounds. By all means, I still use breath sounds, but something about that waveform that comes up makes me feel so much better... besides it tells you so much about your patient! ok, i'm off my soap box now...

    Anyone else studying for CCRN exam?

    I am studying for them currently. If you have a chance to take the med-ed review, do it... she was amazing. My boss is even sending me back for a second review before I take my test. I worked in a cardiac step down unit for 2 years... but didn't have any swan/IABP experience (we did a lines, vents tho) so i moved to the CPICU recently, and am going to spend a few months with swans, fresh open hearts and the notorious off service "dump" to get the rest of the critical care managing knowledge I need and then take the test. I have a book also. but the class was by far the best thing I ever took! good luck to all!
  9. I work on open heart ICU.... our gold standard is stable, extubated within 4 hours and up to chair within hour of extubation. of course that is the gold standard.... many many times... well it just doesn't go that way as we all know!. our patients also have extended stay in the ICU as the doc doesn't trust anyone but the icu to care for his patients. haha....