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flo136

flo136

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flo136's Latest Activity

  1. flo136

    CRRT

    I did something similar years ago learning CRRT but forgot to document the fluid off amounts. I felt like rubbish because they thought I was a 'good' ICU nurse. However, the nurse in charge told me the problem, the solution; they fixed it up on the chart and said don't do it again. And they're right. As mistakes go, its not that bad and they've probably forgotten the event so you should too. Its really not that bad- there are far worse that goes on in ICU.
  2. flo136

    I want to quit during SICU orientation

    What happened?
  3. flo136

    Things you wish nursing school would have taught you?

    I wish I had learnt more about managing agitated and confused patients. I always felt so useless managing them, so ineffective. Making time to sit down and talk with a patient and their family. I still really enjoy that after nearly 30 years doing nursing. But work is usually so busy, so many tasks and demands. That basic element of nursing is not really filtering down to our younger staff.
  4. I'll be honest- the doctors on night duty lack much experience, let alone the guts to make big decisions. We often feel like we are just babysitting the patients until someone in charge with a clue can come in and actually make a definite plan. Its frustrating but it never gets better.
  5. flo136

    Open visitation in the ICU

    I love it when the visitors sit by the bedside for hours glued to their mobile phone. Or watch the whole unit work, not interested in their loved one in bed. Visitors- they drive you nuts! I've got my hands full enough already thanks.
  6. flo136

    does anyone regret this career?

    I don't regret it. There is so much variety, every day is different, and what we do is so important. But I am finding it harder, 20 years down the track. I love doing critical care but I find today's nursing not particularly patient-orientated. Some of the younger nurses are not even very kind. They like the 'kudos' of crit care nursing. But I think I'll stay in this career for another 20 years. My whole family has done various types of nursing for over 50 years, and that is something important to all of us: to 'keep going'. Maybe you are just burnt-out?
  7. flo136

    Burn ICU Question

    I worked in an Australian city public ICU that had a burns speciality for 3 years. A few random thoughts that entered my head when I read your note: The rooms are really hot, which is hard to work in when you are in scrubs/gowns. The smell is awful- they always get infections. The dressings take hours (sometimes 4 hours). The skin is slimy and some staff assisting have fainted. There are usually some psych issues that surface when they get better. Either spacing out on all the ketamine they need for dressings; or trauma and stress from the incident. It's a tough area, but it looks good on your CV; and you hear and see some amazing things! Good luck.
  8. flo136

    Why go into trauma/critical care nursing?

    I agree with all the comments of life-threatening situations: fast-paced, exciting, etc. But also I like the nurse:patient ratio and also the support available when things go wrong. I have equipment, manpower and expertise available instantly. It is scary initially, but it's a great place to learn about nearly every acute aspect of most specialities.
  9. flo136

    It will get better...right?

    Give it a good six months. I felt like I made so many errors when I started. The patient deteriorated, and it was all my fault? Of course not, but I could not see why. I was so tired and stressed, the whole anatomy and physiology of intensive care was beyond me. But after a while it did make sense. It did 'click' and I got good feedback from my mentor. It did get better. But the first few months were really tough, and I didn't think I was any good at all. 12 years later, still in ICU, clinical nurse specialist. Some days it is crap, other days I love it. :)
  10. flo136

    Titrating multiple drips

    I agree with the other posts about experience guiding inotrope titration. But also, with disease processes such as sepsis,or multi-organ failure, you will get a feel for how far to go up or down. For example, in sepsis, levo really can be moved up hard to get an effect.
  11. Help each other out, without asking. Little things like turning pts, suction- all the two-hourly things we do. It's just done in time for breaks. And done well. Using each other rather than the access/in charge people. Takes the pressure off everyone.
  12. flo136

    What does "Ao" stand for?

    I'd say also 'aorta'.
  13. flo136

    Burnout rate-experienced nurses reply

    I'd say 3-5 years. I start to get really low about hospital politics and procedures after 6 months (the 'they-do-it-better-elsewhere' thing); but by 5 years I am really taking a sick day every month for my own mental health! I do love the job though. Can't imagine anything else would be as exciting, and at nearly 40 years old- don't want to try either!
  14. I guess it depends if you believe in God! I agree we do prolong things now in ICU. And I do feel sad for those patients when you, and they, know the inevitable is coming. The hopelessness of it. But I am relieved when they do die, because ICU is a miserable place sometimes. Y'know- I often think 4 hours a day in a shop would be just great. Not thinking, or knowing, about ICU. But if you look at the stats for discharge out of ICU, and mortality, it's pretty optimistic.
  15. flo136

    Swan-Ganz Use

    We use Swans here all the time in Adelaide, Australia. The docs use them mainly for number-crunching. Seeing the trend in the numbers: SVRI not so much. More CI/CO. I don't think they are good. I have worked in the UK and larger Aussie cities that have managed on other clinical signs such as urine output and CVP for management. A lot of our Swans don't wedge. They let junior nurses use them which I find scary. I find PICCO is not considered an alternative either. It's all numbers here, but looking at the patient is better!
  16. flo136

    My moms CABG

    Here in my Australian public hospital, we do 4 CABG per day, 5 days a week. They do well. Some bleed and go back to theatre, but after that they're OK. Some come back on aortic balloon pumps, but after a few days they are off them. There are a lot of things they can do for cardiac patients if they run into trouble. In intensive care, we deeply sedate them for a few days, support all major organs and then move forward after that. The worst ones are the patients that are sick before theatre. Then you are fighting a compromised patient before the really big stressor of surgery. CABG are a hospital's "bread-and-butter". We do a lot of them everyday, and they all go well. They really do! Be brave for your mum.
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