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ObtundedRN

ObtundedRN

Critical Care
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  1. Only spent 5 days in the hospital after "coding." Right... And I'm sure the code team didn't think to try narcan if it was from the demerol.
  2. ObtundedRN

    what is considered high acuity?

    Where I work, I'm not aware of any unit using a scoreing system. If the patient is appropriate for your unit, then you take them. And the patient:nurse ratio depends on the level of care for that unit. med/surg has 6:1, tele is 4:1, progressive and ICU is 2:1. And there are certain criteria that will not let you below a certain level of care. Our progressive is basically an ICU, you only go to ICU if you are sedated or on titrated pressors. If you require high flow O2, are vented, on non-titrated sedation/pressors, on any other titrated drips, or require BiPAP for any reason other then a pre-existing home use for OSA, then you go to progressive. If you don't need any of that but need some tele monitoring or continous pulseOx then you go to tele. If you don't need any of that, then you go to med/surg.
  3. ObtundedRN

    topics about fundamental in nursing

    Fundamentals was more about nursing history, nursing process, how to do a care plan and use nursing Dx, and the hands on skills of injections, foley's, enemas, how to put on sterile gloves, that kind of thing. Ask what they're studying and what has and has not been covered. That why you don't talk about something too advanced, and don't cover something they've already done.
  4. ObtundedRN

    Having trouble with IV's! Can't get them to thread...

    My hospital's policy is to rotate IV sites every 72-96 hours, EXCEPT for those of us in the ICUs. Our standing orders state NOT to rotate sites. To keep them in for as long as they are free of s/sx of complications. But generally patient's end up ripping them out before phlebitis or anything else develops. And many of our patient's end up with central or PICC lines.
  5. ObtundedRN

    What paraphernalias a nurse must always have?

    My hospital doesn't supply the injector. I got it from the EMS agency I used to work for. They had both injectors for our narcs and I liked the tubex better, so I kept one, lol. The carpujects feel so cheap, and all that extra plastic is just unneccessary. And since both injectors work on those vials, why not use the better of the two.
  6. ObtundedRN

    What paraphernalias a nurse must always have?

    I hate it when i forget my hair clip . From my EMS training: "The most important tools are your brain, hands, and stethoscope." And for working in the hospital I like to add, good scissors (I like my trauma shears), pen, penlight, and sharpie. And while it isn't a "must have" I do always carry my Tubex injector (I find it to be much better than a carpuject). It isn't a neccessity for work, but it makes things easier when you have someone requiring lots of IV push narcs. And when I start my shift, I always pick up some alcohol wipes and those sterile red caps to keep unattached IV lines clean.
  7. ObtundedRN

    ACLS/PALS

    Before I answer this, I should probably state: 1. This question is asked very frequently and you could search for it on here for more info. 2. If you get a job on a unit that requires either ACLS or PALS, they will train you, and most likely make you repeat it with them if you already have it. And unless you plan to work in the ED or in pediatrics, you are kinda wasting your time with PALS. That being said... It isn't very hard, and it is doable in a 2 day class. As long as you already know EKG rhythm interpretation. If you can't easily read the EKG rhythm, then you will have a very hard time, and possibly not be able to pass. Everything else is knowing a few drug dosages, and memorizing a few algorithms. But I do know that at my hospital, having either of these do not give a new grad any hiring advantage, and you are required to repeat the class with the hospital's instructors.
  8. ObtundedRN

    Need help to convince parents!

    If your parents are going to pay for the 4 year college, then do that. Many places are going towards primarily hiring BSNs, making ADNs harder to get jobs. Plus, you never know if you'll change your major once you start. And right after highschool is the easiest time to get your 4 year degree finished. Not as much bills and adult life stuff is on your plate yet.
  9. ObtundedRN

    when do you declare a specialty

    Just thought I'd answer this, yes, ADN and diploma programs do an internship too. And for the OP: You can say that your specialty is whatever type of nursing you work in. Med/surg, ICU, telemetry, LTC, oncology, etc. That is your specialty while you work in that area, but you don't have to declare it as your "specialty" and only ever work in that area. You can always change specialty by changing jobs. As for certifications, you can get that after working in a specialty area and meeting the requirements to take the exam. Having that certification says you have experience, and proved that you have added knowledge to that specialty. But just because you have your specialty certification in L&D, doesn't mean you can't change jobs to ICU and that be your new specialty.
  10. ObtundedRN

    Any Remedies for Foot Pain?

    I would see a doctor ASAP. In the meantime, have you tried any kind of compression socks? They may help add a little support and help? Maybe? Or try picking up some Kinesiology Therapeutic Tape (name brand is KT Tape). Some people on here may have seen their PT department using it on patients. It is pretty cool stuff. You can pick it up at someplace like SportsAuthority for about $12. I know they have a way of wearing it for plantar fascitis. Google it and check out their website.
  11. ObtundedRN

    Did your nursing program cover 12 lead EKG?

    My school covered it in the last semester. We did 2 full days of EKGs. You need to start out with basic EKG rhythm interpretation, and after you know it well, then you can move to 12-leads. 12 leads its pretty much the same as basic interpretation, but you have to realize what parts of the heart you are looking at. Looking at what the OP posted as what is included in this class, and considering it is $700, I wouldn't waste my time. If your school doesn't cover it, and you get hired into a unit with tele, then you can take a class through your facility, have co-workers teach you, get books, etc. Try picking up "Rapid Interpretation of EKGs" By Dr. Dale Dubin. It is the best book out for learning EKGs, and is written in such plain english, that you can teach yourself with this book. It will start with basic A&P and how the electrophysiology of the EKG works, and then move into basic EKG rhythm learning, and go into advanced stuff and 12-leads.
  12. ObtundedRN

    Hypothetical New Grad Residency Pregnancy Question

    I know of a couple people who had their baby while in a new grad residency program. Being out with the baby during the actual residency program is where you could have issues. Most programs I'm hearing are as short as 12 weeks, and as long as 8-12 months. But many are set up differently. If you go out on leave during the program, you won't be able to finish the requirements with everyone. One co-worker of mine was out during the program, and when she came back had to finish the rest of her precepting time and testing. The other person had the baby right after taking her final testing, so she actually finished the program, she just has her 2 year contract to now carry out. Once you finish the program, you are just like any other employee, with rights to FMLA (don't think anyone can have you give those up?). You go out on maternity leave just like anyone else. You are just contracted to be an employee for the specified time, even if you're out on leave for part of it.
  13. ObtundedRN

    looking up a patients arrest records?

    I have looked up a patient a few times, after they've told me they were in jail for something, or they have a court date they will miss from being in the hospital. I've looked it up from being curious. I guess it is a conflict of interest if you treat your patient differently based on what you find. I treat prison inmates the same as any other patient, except for the fact they are shackled to the bed and an armed deputy is sitting in the room. lol I've found that the inmates can be the nicest patients as long as you give them some common respect.
  14. ObtundedRN

    looking up a patients arrest records?

    It's public record. You can look up mug shots online.
  15. ObtundedRN

    Prefilled Heparin/Lovenox syringes and cosigning

    We don't use prefilled heparin, but do use prefilled lovenox. We are required to have a co-signer for both.
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