MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Patient White Boards - Recommendations?

    MunoRN replied to 5678kma's topic in CCU, Coronary, Cardiac

    Keep...it...simple. Too much info and it becomes useless as a way to keep patient's up to speed on basic information. I would also avoid putting POA/family contact info on the board all together,...
  2. MunoRN

    Revived when there was a DNR/AND code status

    MunoRN replied to ambersky004's topic in General Nursing

    I'm not sure the fact that she later consented to a different medical treatment really affects the issue with her code status not being clearly communicated. There were clearly issues with the...
  3. MunoRN

    Revived when there was a DNR/AND code status

    MunoRN replied to ambersky004's topic in General Nursing

    There aren't any states where healthcare workers are protected by refusing to follow a competent patient's refusal of treatment, and that can actually fall under the realm of a criminal act. If it is...
  4. MunoRN

    Working below your license

    MunoRN replied to happ09's topic in General Nursing

    Whether you're in an at-will state or not, insubordination is a fireable offense. If you're job description specifically states you wouldn't have to perform these duties, then it's not...
  5. MunoRN

    Working below your license

    MunoRN replied to happ09's topic in General Nursing

    I think people often misunderstand the concept of being held to the expectations of your license and interpreting this to mean they shouldn't perform the role of a CNA or other role 'below' their...
  6. MunoRN

    How do you communicate with work??

    MunoRN replied to Lpn1226's topic in General Nursing

    We use E-mail, texts, and phone calls, I ignore them all
  7. MunoRN

    Discharging by Wheelchair

    MunoRN posted a topic in General Nursing

    I've always been perplexed by the practice of discharging a patient, who will be independently ambulatory upon discharge, by routinely taking them to the hospital exit in a wheelchair. In my...
  8. MunoRN

    Former drug addicts becoming nurses?

    MunoRN replied to Emergent's topic in General Nursing

    So longer as she is truly a "former" drug addict then nursing might actually be an excellent choice. Those with a history of something tend to be better at dealing with those with the same problem...
  9. MunoRN

    Rapid Flu

    MunoRN replied to CapeCodMermaid's topic in LTC: Directors, Assistant

    Rapid testing is useful in early identification of those who are positive for the flu, but shouldn't replace more accurate testing since false negatives are quite common with the rapid tests. False...
  10. MunoRN

    Transfering patients

    MunoRN replied to kristine_bean's topic in General Nursing

    How to make patient transfers appease everyone involved has always been the holy grail of hospital problem solving, although it's not really all the complicated, we just manage to go out of our way to...
  11. MunoRN

    AF RVR + levophed

    MunoRN replied to zzyzx's topic in CCU, Coronary, Cardiac

    In general a pacemaker can add beats but take away beats. A common use of a pacemaker in A-fib is to facilitate rate control in the case of a tachy-brady A-fib. If a person's ventricular rate in...
  12. MunoRN

    I disclosed my disability and now they won't answer my calls

    MunoRN replied to LaneyD's topic in Nurse Disabilities

    The basis of "Reasonable accommodations" is that nobody is worse off by providing you with accommodations. The problem with the scenario you've provided is that working night shift is an established...
  13. MunoRN

    To Suction or Not To Suction, End of Life & Hospice Patients

    MunoRN replied to NickICU-RN's topic in General Nursing

    The No-bite V does not make suctioning less uncomfortable, it only prevents the patient from being able to defend themselves by biting down on the tube. If any of you decide to suction me while I'm...
  14. MunoRN

    Anesthesia for parkinsons patient

    MunoRN replied to Linemanswife14's topic in General Nursing

    It's a reasonable scenario to discuss as a general situation since it actually does come up fairly frequently, so as a general nursing topic the issue of how to manage procedural sedation in a patient...
  15. MunoRN

    Sometimes the five rights make us look dumb

    MunoRN replied to JBMmom's topic in General Nursing

    There are sources that claim there are 14 rights of medication administration. The whole point of the "5 rights" is that there is a need to identify a small group of high priority considerations when...
  16. MunoRN

    Sometimes the five rights make us look dumb

    MunoRN replied to JBMmom's topic in General Nursing

    I agree that the problem is complacency, and an over-reliance on habits that don't by themselves provide safety is a big source of this complacency. These processes only work when there is active...
  17. MunoRN

    Sometimes the five rights make us look dumb

    MunoRN replied to JBMmom's topic in General Nursing

    We're actually up to 14 rights of medication administration now, and it should be noted that "right patient" just means there is some reliable means of assuring this is the correct person to be...
  18. MunoRN

    When to give Narcan??

    MunoRN replied to climbeRN's topic in General Nursing

    The standard goal for titrating Narcan doses is a RR of 8 or greater, you actually don't want to over do it and you can definitely cause harm by giving narcan, it shouldn't be considered a 'when in...
  19. MunoRN

    Unit Clerk/Secretary entering Vital Signs in EMR

    MunoRN replied to berniehoganrn's topic in General Nursing

    Anyone can enter vital signs into an EMR, although when someone else is entering them a "taken by" note should be
  20. MunoRN

    Treatment supply storage

    MunoRN replied to Apentti's topic in General Nursing

    CMS doesn't prohibit patient supplies from being in the room, they also allow medications to be kept in the room although they must be secured depending on the medication and the setting, although...
  21. MunoRN

    IV left in arm after discharge

    MunoRN replied to mariok's topic in General Nursing

    It actually happens quite a bit. I have worked on floors where more half the floor is discharged every day, usually with admits already waiting for their rooms, so discharging is a bit of shitshow....
  22. MunoRN

    To Suction or Not To Suction, End of Life & Hospice Patients

    MunoRN replied to NickICU-RN's topic in General Nursing

    From what I can tell, the reason for invasive suctioning of secretions is that it's a way of putting the family at ease, instead of appropriately educating family about the dying
  23. MunoRN

    Ambulating post op day zero

    MunoRN replied to oceangirl1234's topic in General Nursing

    I get my post open-heart patients up within a few hours of coming out of the OR, so I don't think it's a valid blanket rule that patients can't stand or ambulate on the day of surgery. Obviously that...
  24. MunoRN

    I disclosed my disability and now they won't answer my calls

    MunoRN replied to LaneyD's topic in Nurse Disabilities

    If the position involves rotating shifts and you can't do rotating shifts, then there is no reasonable accommodations to be made, even if the reason you can't do rotating shifts is due to a protected...
  25. MunoRN

    To Suction or Not To Suction, End of Life & Hospice Patients

    MunoRN replied to NickICU-RN's topic in General Nursing

    For those that believe suctioning a death rattle is appropriate, maybe you could share your