matthewrn03

look frankly, i am appalled that some of you have to pair IABP's. sure, MOST of the time, the machine handles the timing but i have noticed these patients are "squirrely" (even intubated and sedated) and having personally seen a patient lose a leg with an IABP(not my patient thank god), i can not even imagine a scenario where i would accept a 2nd patient. as healthcare costs continue to rise, there is going to be a time where we all need to band together and say "enough" to management. find another way to cut costs; my suggesstion is cut back on HR and other admin's, lol.

ok to the person who said their IABP's are tripled??? ***** how can you possibly assure the integrity of the pump and maintain correct timing with 2 pumps, nevermind 3??? your manager is an idiot and clearly wants people to die. I don't care what Datascope says about their new pumps , the timing i frequently off.

So i keep reading horror stories about crazy CVICU and CCU ratios. i work in california where the ratio is ALWAYS 1:2 or 1:1. are you really expected to take 3 patients in other states? also how long are your fresh hearts 1:1 for. some hospitals here are 8 hours, others 12-18 hours...

well you can always refuse an assignment(i have yet to try this), but i would if, say they tried to give me a 2nd patient with a CRRT or IABP or Fresh heart....

wow, took me 4 months to get back to this site, lol.thanks everyone i decided to stay in SD until the market improves in SF(wasn't having a lot of luck with applications) i think one poster asked about the best ICU's to work for in san diego? Scripps(memorial, mercy, green) or Sharp(any) both pay about the same; UCSD, like a dollar or two more(but you have to pay for parking!). Kaiser pays very well, but you have to deal with a lot of Kaiser-BS( i think they call that the "Kaiser Golden Handcuffs")

LOL, please. if you are smart enough and willing to work hard and basically give up your social life for the first year, you can do ICU right out of school. Ignore what the "seasoned" nurses say to you(and trust me, you will run into a few). you don't need to "pay your dues" on Tele before you can handle the unit. and as for "your patients deserve better": your patients deserve a hard working, intelligent RN who will strive to learn everything he/she can in order to provide safe patient care; a nurse who will go home after a shift and research the concepts they don't fully understand etc. I can't tell you the amount of train wrecks i have received from Tele from "seasoned nurses" who didn't know what the f they were doing. Give me a smart, ambitious new grad any day over an average "seasoned" nurse with 15 years experience...

icufaqs.com is the best site for a new grad, it will give you lots of easy to digest, practical tips on everything you will commonly see and be expected to do. once you have "gotten your feet wet" move on to a more scholastic text, like "the icu book" by john marino. Basically you need to be doing about 10 hours a week of "extra" reading in addition to whatever training and education you are assigned. start slow and general and ease yourself into more specific topics. Straight up, its going to take 9 months to 1 year before you really feel comfortable. Don't worry, as long as you are safe and never give a med before understanding its effects and ask for help when you need it, you will be fine. But....you have to study! I went home every shift for my first 6 months with a little pad of paper, where i kept a list of topics and concepts to look up before the next shift. ICU is huge responsibility, its not tele or medsurg. you are expected to think and perform on a much higher level. but its also very rewarding. The Doc's often rely on you to "fix" or "clean up" the mess that patient is in due to lack of proper care on the floor. They will also speak to you professionally and A LOT of times you will be the one making suggestions at 3am, so you gotta know your stuff

LOL! the registry nurse was being lazy or didn't know what the hell she was doing(the more likely case). we all(icu) have had plenty of nights where both patients are on Norepi gtt's. its not that big of deal. i think you are going to find that while there are some awesome Registry Rn's out there, quite a few oversell themselves and can be quite dangerous....

Dobutrex is commonly ordered for augmenting or increasing a patients cardiac index. If you don't have any method for determining the C.I.(such as a Swan or continous cardiac output monitor) then you could use the patients MAP. this can be tricky though and ideally you want some way of monitoring SVR, if you are going to titrate a dobutrex drip

Move to california or a state with protected patient ratio's. 5:1 step down is insane. and you say "drips". are you titrating those drips? if you are actively titrating, than the patient belongs in the ICU.

Hi, i am a CCU/SICU RN in san diego with 3 years experience and CCRN certification. i am wondering if anyone knows how much, per hour, i would make in san francisco(night shift)? the hourly rates in san diego are not spectacular and i am only making about $37/hour. i want to move to sanfran, but with the cost of living increase, i am hoping to make around $50/hr. is this realistic?

CRRT and IABP and Fresh Hearts should always be 1:1. i am appalled that there are hospitals that allow you to take care of a balloon pump with another patient. maybe its because i live in california and that sh#% don't fly here, but come on! you should be constantly watching the timing on your IABP and i can't tell you how many times the CRRT machine has almost clotted off on me and thank god i was right there to stop it. You only get one license and if your facility is not 1:1 ing these patients, you are at serious risk. The vent 1:1 is a little ridiculous as the easiest assignment on the planet is 2 vents...