MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    To medicate or not to medicate

    MunoRN replied to SuperMomBob's topic in Patient Medications

    Everywhere that I've worked it's a general rule that evening shift does not give prn's for sleep, if you do you'll get chewed out by the night nurse who will usually demand that they be the ones to...
  2. MunoRN

    To medicate or not to medicate

    MunoRN replied to SuperMomBob's topic in Patient Medications

    Maybe it's different in Canada, but in the US there is a legal process for medicating someone against their refusal, and just having dementia doesn't automatically allow us to medicate someone despite...
  3. MunoRN

    Anticoagulant Preventing CVC Insert?

    MunoRN replied to betterinthesun's topic in MICU, SICU

    I've never had a doc hesitate about putting in a central line just because they were on VTE prophylaxis heparin. They prefer the IJ to a subclavian if the INR is elevated and might like some FFP to...
  4. MunoRN

    New grads in specialties without the basics

    MunoRN replied to Emergent's topic in General Nursing

    I think if you're having a new grad just off orientation taking high acuity ED patients, that's the problem, not that they are a new nurse working the ED. In terms of acuity the median ED acuity is...
  5. MunoRN

    Question about IVPB

    MunoRN replied to PVL_RN86's topic in Patient Medications

    Intermittent infusions, particularly antibiotics, should be run as a secondary, which means it attaches to the secondary port of the primary or carrier infusion which is the one above the pump. This...
  6. MunoRN

    Infusion Caps and Rapid infusion

    MunoRN replied to GhosttRN's topic in General Nursing

    The most 'constricting' connector I know of is the microclave, although even that can handle 600 ml/minute or 36 liters/hour. Typically it's going to be the IV itself that is the limiting factor. If...
  7. MunoRN

    Stroke hemorrhagic conversion

    MunoRN replied to lassenlake's topic in General Nursing

    Hemorrhagic conversion/transformation is actually pretty common after ischemic stroke, with or without rtPA. The use of heparin or LMWH is not actually recommended, but rather it's tolerated by...
  8. MunoRN

    Are care plans valuable?

    MunoRN replied to Nurse Beth's topic in General Nursing

    Whether or not care plans are valuable is completely dependent on how we are defining "care plan". If we're talking about the old-style care plan that gets written as a stand-alone component and put...
  9. MunoRN

    Associates or Bachelors??

    MunoRN replied to Xar25's topic in Diploma, ADN, BSN

    I also had a BS in biology prior to a BSN, and while it wouldn't have made any difference in time to complete the degree I'm not sure I'd still chose a BSN over an ADN given the cost difference. I...
  10. MunoRN

    New grads in specialties without the basics

    MunoRN replied to Emergent's topic in General Nursing

    There certainly are some ADN programs that exist in an area with over saturated clinical availability, and there are some BSN programs that enjoy wide-open clinical opportunities, but that would...
  11. MunoRN

    New grads in specialties without the basics

    MunoRN replied to Emergent's topic in General Nursing

    It's really not that unheard of. My facility has gone through various periods where there was a freeze on hiring BSN grads due to the extended training period that they've required in our experience...
  12. MunoRN

    It's not my job to pray with you.

    MunoRN replied to kickatthedark's topic in Spirituality, Religion

    I can't tell if you're just willfully ignorant of the historical context of Islam or if you're so arrogantly religiocentric that it's actually overridden basic facts and rationale in your mind. Yes,...
  13. MunoRN

    Patients wants a back rub

    MunoRN replied to Oceanpacific's topic in Patient, Colleague Relations

    I think that's fine so long as nurses know how it's actually being received by some patients, specifically that's not unusual for some patients to see it as essentially be serviced sexually. And...
  14. MunoRN

    Nurses found out what im making, dont know how ?

    MunoRN replied to arack05's topic in General Nursing

    Was your position not
  15. MunoRN

    Nurses found out what im making, dont know how ?

    MunoRN replied to arack05's topic in General Nursing

    Typically a posting will list the salary that it pays, so it's not particularly hard to figure out how much someone gets
  16. MunoRN

    Family refuses care

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

    There is nothing wrong with declining medical intervention. Not all medical interventions are for curative purposes however, and typically stabilization of a fracture can be appropriate purely for...
  17. MunoRN

    I'm a nursing student and have Guillain-Barré Syndrome

    MunoRN replied to Becky96's topic in Pre-Nursing Students

    Your link and every source I'm aware of, doesn't actually list Guillain-Barre as a contraindication, it's listed as a precaution, which are two different
  18. MunoRN

    Patients wants a back rub

    MunoRN replied to Oceanpacific's topic in Patient, Colleague Relations

    I'm all for "touch" when it has a truly therapeutic indication. I do work with a couple of nurses who like to give out "touch" a bit more freely and often share with me on report how much their...
  19. MunoRN

    Worst/silliest/are you serious pt complaint you've received?

    MunoRN replied to odaat's topic in Patient, Colleague Relations

    What you experienced is called recovery agitation (among other things) and giving versed along with ketamine has actually been shown to reduce the psychological distress that ketamine can cause (which...
  20. MunoRN

    Involuntary Admissions in Inpatient unit

    MunoRN replied to Cookchow's topic in General Nursing

    I've never known anything different than what you describe since I've never known of an inpatient psych unit that accepts patients that have not been medically cleared. So if they are a patient who...
  21. MunoRN

    I'm a nursing student and have Guillain-Barré Syndrome

    MunoRN replied to Becky96's topic in Pre-Nursing Students

    You should be OK since many if not most hospitals allow workers to decline for personal reasons and wear a mask during flu season. The issue would be if a hospital you want to work at only allows...
  22. MunoRN

    I'm a nursing student and have Guillain-Barré Syndrome

    MunoRN replied to Becky96's topic in Pre-Nursing Students

    A history of Guillain-Barre is not a contraindication to getting a flu shot so it's not a medical exemption, it would be considered a refusal for personal
  23. MunoRN

    Withheld meds

    MunoRN replied to demo24's topic in General Nursing

    No order for what? If the PEG is clogged the nurse should discuss with the MD if they want to use an alternate route or tube, but no order is needed to allow the nurse to not put medications down a...
  24. MunoRN

    Withheld meds

    MunoRN replied to demo24's topic in General Nursing

    If a Physician writes an order that I can't follow then I don't need an order that says I don't have to follow it, I not only have the ability as a nurse but it's required as a nurse that I not follow...
  25. MunoRN

    Withheld meds

    MunoRN replied to demo24's topic in General Nursing

    I don't know that you really need an order, although writing a clarification in the chart can be helpful (prescribing MD aware PEG is obstructed, no alternate route/tube ). But you don't really need...