wakaro

Hey all, Quick open forum to all nurses out there. What is your opinion on having self liability insurance. I know most of us have employer sponsored insurance but just want an open discussion about how you feel buying vs not buying one? thanks for your participation:)

Sorry about that situation my dear. Have not been to this site for a long time but am back. Nice to see another Kenyan on site. Anyway, kind of a past scenario,but i totally agree with most comments here. Red flag, first and foremost if the previous nurse had reported to the doc where was her documentation, i would check in nurses notes. secondly, this has always been in my nursing practice, so long as i feel uncomfotable or something is not right will always, always pick a phone and call the doc. I work at night, and you can imagine sometimes, how some docs will be if called at night. It does not matter to me safety of the patient first, they are paid and are responsible for these patient. Just say hey, doc X, just letting you know patient D, has csf leak, which per previous shift was reported to you, but am concerned about it. Dont forget to document all your actions and findings. CHEERS

Sorry for that. It has happened to many in the past. But next time if anything similar like this happens no matter what your charge says make an incident report before you leave the shift.

Have been an ICU nurse for about 7 years now. The 1st time i went to work there was literally terrified. I thought this was the wrong job for me. Worked in a 24 bed combined ICU with all the cases neuro, card,surg everything! But pray and hope you get a patience preceptor you will get used to it. If for some reason you do not go along with your preceptor ask your manager to give you another preceptor some of them can be mean and mind its a new environment for you so somebody needs to be patience. We all learn at different pace. Some are fast others are slow. Always have a small note book with you to jote a few important reminders. But do not feel threatened or scared to ask any questions however stupid it can be. You will love working in critical care after sometime, it might be challenging intially but you guys will get there. All the best in your new positions, and welcome to Critical care.

I would echo my collegues above. Just wondering whats the cause of hypotension? You stated not hypovolemia? Patient already maxed on dopamine and neo? Anyway, sometimes you will need to use a combo of sedatives, i do like an idea of versed + fentanyl if there are no contraindications to this. Some folks would love haldol, i do not know whats the age of your patient. I talked with one geriatric doc and do agreee with him if you have an elderly patient try to avoid ativan it makes this population crazy! You probably need more pressors on board though to continue sedating this patient. May be levo, vosopressin?? Hope this helps. 

Thanks iheartprisma.That sounds like a plan and really helpful.:)

Meds titration should be done in dosage not ml/hr. Idealy, we talk in terms of dosage but not mls. I think currently Its required for the docs to give you titration orders on how to titrate your drip. I do agree with all above we should use mcg/min BUT not ml/hr.

Hey guys our hospital is gonna start using above iv pumps next week. Went to inservice but we could not figure how to give lets say boluses like ibsulin or heparin from existing bag. For example your pt is on iv insulin, next hour blood sugar mandate you to give 6 units bolus and continue with regular or another rate? How do you set this on iv pump cause it will not let us give a bolus?