MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Wound Root Cause Analysis

    MunoRN replied to Cardiackid17's topic in General Nursing

    Ideally it shouldn't be about assigning blame, although there are certainly managers and other administrators who will view it that way. I do think it's appropriate to look into every event of...
  2. MunoRN

    Frustrating... ED is Not Critical Care

    MunoRN replied to bgxyrnf's topic in Emergency

    I've worked in 3 different ED's, and in all of them truly critical patients were 1:2 or even 1:1 depending on how much was going on with them. I keep hearing about EDs where they use basically the...
  3. MunoRN

    Frustrating... ED is Not Critical Care

    MunoRN replied to bgxyrnf's topic in Emergency

    "Critical Care" refers to a level of care that is usually required to be available in certain environments, including ICUs, ERs, ORs, Cath labs, sometimes PACUs. That doesn't mean that a nurse who...
  4. MunoRN

    Question about broviac! Urgent please HELP!

    MunoRN replied to dcnurse789's topic in Infusion, Intravenous

    A central line that lacks blood return is not a "non-functioning central line", it's a functioning central line that lacks blood return. Lack of blood return is certainly something that needs to be...
  5. MunoRN

    ARDS patient, dialysis

    MunoRN replied to zzyzx's topic in Critical Care

    While you can compensate to some degree for respiratory failure with kidney function or manipulated kidney function in the end you can't get rid of CO2 with even artificial kidney function, to remove...
  6. MunoRN

    Night shift and health issues

    MunoRN replied to shelw067's topic in Health, Stress Management

    Night shift work actually is a known "probable" cause, it's not just correlative. Cancer for instance was designated a carcinogen by both the WHO and the American Cancer Society in 2007, Known and...
  7. MunoRN

    Night shift and health issues

    MunoRN replied to shelw067's topic in Health, Stress Management

    Night shift work is a known cause of cancer, stroke, diabetes, and heart disease, so your feeling that it's bad for your health is well founded. The root cause for this generally though to be that...
  8. MunoRN

    Weight changes in IV pumps

    MunoRN replied to Steph41's topic in Patient Safety Issues

    You should not be changing the weights programmed into the pumps, weight based dosing is only for guestimating an initial starting dose which should be adjusted based on a more accurate assessment of...
  9. MunoRN

    Is it fianally time to retire NETY?

    MunoRN replied to hppygr8ful's topic in General Nursing

    I think the term is often incorrectly applied, but then these examples are then used to claim it doesn't exist. Pushing a new grad to succeed is not NETY, pushing them to fail is. I've worked in a...
  10. MunoRN

    to AMA or not to AMA?

    MunoRN replied to newnurse925's topic in General Nursing

    Our ability to hold patients is one of those things where nursing common wisdom is often way off, which most often isn't a big deal, until it is a big deal in which case I've personally seen a nurse...
  11. MunoRN

    to AMA or not to AMA?

    MunoRN replied to newnurse925's topic in General Nursing

    Considering Ativan reduces their withdrawal symptoms I would argue the opposite; anyone being discharged who is at high risk for worsening D/T's prior to being able to consume more alcohol should be...
  12. MunoRN

    RN rights and responsibilities

    MunoRN replied to Isedno2's topic in Patient Medications

    Since there is no significant harm in chewing immediate release dilaudid or Percocet I would give her a quizzical look but there wouldn't be any reason not to give them, I wouldn't however give her...
  13. MunoRN

    Urine specimen collection from indwelling catheter

    MunoRN replied to Miossy's topic in General Nursing

    I've never seen a non-sterile catheter drainage bag, all the ones commonly used in hospitals are sterile. Just like the catheter, once it's inserted and the outside of it comes into contact with...
  14. MunoRN

    NTI: Medical Marijuana

    MunoRN replied to allnurses's topic in General Nursing

    Marinol or dronabinol does not contain any of the components of marijuana that has been established to offer therapeutic benefit, which is why it hasn't replaced natural marijuana for medical...
  15. MunoRN

    Psych pts protocol

    MunoRN replied to joyful_wanderer's topic in Emergency

    The legal process for this is well defined by each state, although I have experienced working in facilities where these laws aren't well understood, which in one case led to a nurse losing their...
  16. MunoRN

    When Can I give more Tylenol

    MunoRN replied to nurseyah's topic in Patient Medications

    I don't understand why your coworkers are calling pharmacy to see when a patient can get more acetaminophen, you add up the cumulative dose of APAP over the last 24 hours and make sure it stays below...
  17. MunoRN

    AEDs in the Wild?

    MunoRN replied to Ruby Vee's topic in General Nursing

    Idiopathic VF, where there is no treatable underlying reason, has been reported to occur in 15% of VF cases in those under 40, and between 3 and 9% of VF cardiac arrest cases overall. While it's far...
  18. MunoRN

    AEDs in the Wild?

    MunoRN replied to Ruby Vee's topic in General Nursing

    The availability of an AED on average decreases the time to the first shock by 4 to 5 minutes, according to the AHA each this increases the potential for a meaningful recovery by 10% for every minute,...
  19. MunoRN

    AEDs in the Wild?

    MunoRN replied to Ruby Vee's topic in General Nursing

    I don't think it's pointless to have an AED in the middle of the ocean, it's probably not going to change the outcome of someone with a completely occluded LAD, but there are plenty of people for whom...
  20. MunoRN

    Manager reporting confidential info to state board

    MunoRN replied to geoda's topic in General Nursing

    I should add that these reporting requirements can also include some form of a self-reporting requirement, so I would avoid complaining to your nursing board that your manager told them something you...
  21. MunoRN

    Manager reporting confidential info to state board

    MunoRN replied to geoda's topic in General Nursing

    Only a lawyer can help you determine the legality of what occurred, but something to consider is that many states have laws requiring nurses to notify the board if they are aware of a substance abuse...
  22. MunoRN

    BS in Health Sciences Instead of BSN??

    MunoRN replied to anjapope's topic in General Nursing

    If your goal is to get an MSN then yes, you could get a non-nursing bachelor's degree to enter an RN to MSN
  23. MunoRN

    Emergency Titration Protocol ?

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

    The Joint Commission isn't the only option, we switched to DNV and the difference is like night and
  24. MunoRN

    Emergency Titration Protocol ?

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

    One of the major criticism of the JC is that they aren't very good about staying in their lane. Titration parameters are not a CMS regulatory issue, they are regulated by the State department of...
  25. MunoRN

    Wrong is right CPR question

    MunoRN replied to Floor_Nurse's topic in General Nursing

    It's worth pointing out that the AHA doesn't actually believe ventilation is of no benefit, nor do they believe that someone who really has a complete airway obstruction will benefit more from CPR...