MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Weight changes in IV pumps

    MunoRN replied to Steph41's topic in Patient Safety Issues

    Your ICU is correct in pushing back since what you are proposing is not good practice. Weight based medications, particularly in the case of CHF patients should be based on a euvolemic or "dry"...
  2. MunoRN

    NTI - How to Secure a Nasogastric Tube (NGT), Securely!

    MunoRN replied to allnurses's topic in General Nursing

    I've worked at places that have tried the bridles, then gone back to adhesive securement. The problem we had with the bridles is that patients can easily pull them out since they are made to release...
  3. MunoRN

    How to get into nursing school when the school picks people based on who knows who?

    MunoRN replied to alexisbord2's topic in General Nursing

    The ADN programs in my area typically don't admit below a 3.8, sometimes 3.7 in the core pre-requisites. A previous bachelor's degree used to just get you more points in the process, but in one...
  4. MunoRN

    DNR issue

    MunoRN replied to micstn's topic in General Nursing

    The bigger issue besides who's actually entering an order is that it was a social worker who was asking you to change an order for medical treatment. For instance, if a cardiac surgeon declines to...
  5. MunoRN

    It is a broken system - rant

    MunoRN replied to nutella's topic in General Nursing

    I am always surprised with how perplexed the family of a 95 year old can be with the idea that death is a real possibility at that age, but I haven't found age to be a particularly reliable predictor...
  6. MunoRN

    DNR issue

    MunoRN replied to micstn's topic in General Nursing

    Resuscitation is a medical intervention that isn't really up to the social worker or nurse to be independently in charge of, the MD needs to clarify if resuscitation is an option that should be...
  7. MunoRN

    Resident rights

    MunoRN replied to Sleejones's topic in Long Term Acute Care

    I am apparently understanding your question differently than the previous posters, if the patient has not been legally declared incompetent and is refusing all care from specific caregivers, and those...
  8. MunoRN

    How much do you pay for daycare?

    MunoRN replied to SaltySarcasticSally's topic in General Nursing

    We pay about $1500 per month for 2 kids, one they were younger it was over $2000 per month, and that's at the YMCA which is one of the cheaper places in town. That sounded ridiculous to me too at...
  9. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    I agree that she appears to have some bias towards organ donation and misconceptions about end-of-life care, even a broken clock is correct twice a day. I completely get the desire to just slam a...
  10. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    The text of the lawsuit:
  11. MunoRN

    Nurses smoking weed?

    MunoRN replied to bunnynurse's topic in General Nursing

    The majority of the judicial system doesn't agree with that as a blanket statement, if they did then the cases regarding state medical marijuana laws wouldn't have been based on the commerce clause...
  12. MunoRN

    Nurses smoking weed?

    MunoRN replied to bunnynurse's topic in General Nursing

    It seems like common wisdom around here based on how often it gets repeated, but hospitals are not legally required to enforce federal drug laws. Hospitals can, and some do, chose to only restrict use...
  13. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    While it's true that the donation process is different in the case of brain death, both sides appear to agree that this was a case of donation after cardiac death, which is how donation occurs in...
  14. MunoRN

    Nurses smoking weed?

    MunoRN replied to bunnynurse's topic in General Nursing

    The link doesn't work for me even if I'm already logged in to Medscape, what's the name of the
  15. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    I don't think there's any argument that there are no limits on the amount of opiate that might be legitimately required to treat distress after a terminal extubation, the question is whether or not...
  16. MunoRN

    Is it abandonment or taking a moment to collect myself?

    MunoRN replied to Mollythenurse's topic in Patient Safety Issues

    Abandonment only applies in situations where patients require ongoing care to avoid harm, in a clinic setting these are generally not patients reliant on continuous nursing
  17. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    Unless the patient just happens to expire before they get extubated during comfort care then they usually do need to be extubated prior to DCD since the normal comfort care process has to
  18. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    If the anesthesiologist was there to assist with organ donation then it's even less appropriate for them to be administering comfort care
  19. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    The "end goal" of comfort care is comfort, not death, death is passively allowed to occur. And yes, 500 mcg of fentanyl in a 50lb boy can certainly cause them to die. That doesn't mean it's not...
  20. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    Both UCLA and a representative for the Physician have publically responded to the allegations and made no correction to the dose that was given, so they seem to be conceding that 500mcg was
  21. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    The lawsuit seems to describe this as a single dose. It's not unheard of for a patient to require surprisingly large doses to treat distress after a terminal extubation, they might seem comfortable...
  22. MunoRN

    Fail to scan narcotics- tramadol

    MunoRN replied to aloha16's topic in Patient Medications

    I would clarify what they mean by a "missing dose" then, since you pulled one and gave one, there should be no missing
  23. MunoRN

    Fail to scan narcotics- tramadol

    MunoRN replied to aloha16's topic in Patient Medications

    Had you already taken the tramadol out of the pyxis when the patient refused it? If you did, whatever happened to that dose, did you return it in the pyxis, if not then that would show as a missing...
  24. MunoRN

    Police investigating use of opiates in comfort care case

    MunoRN replied to MunoRN's topic in General Nursing

    From what I can tell, the person who gave the fentanyl, an anesthesiologist, was a hospital staff MD not affiliated with the organ procurement service (One Legacy). Why this patients comfort care...
  25. MunoRN

    Wound Root Cause Analysis

    MunoRN replied to Cardiackid17's topic in General Nursing

    I should add that in most of the RCAs I do on avoidable skin events they turn out to be based on an incorrectly identified pressure ulcer, with suspected DTI's being the most common, we sometimes need...