MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    DNR and Hospice

    MunoRN replied to hppygr8ful's topic in General Nursing

    I'm guessing glycerine might be referring to you saying that your DNR order was in your living will. At least in the states I'm familiar with, a living will that expresses wishes to be DNR is not...
  2. MunoRN

    72 hour notice/AMA

    MunoRN replied to sassyann85's topic in Psychiatric

    Is that just for patients who have yet to be seen by the MD, or does that also apply to patients that have already had their admit done my the MD (or other
  3. MunoRN

    72 hour notice/AMA

    MunoRN replied to sassyann85's topic in Psychiatric

    There are various types of holds, but anytime a patient cannot leave by choice they are on a hold. You seem to be describing a system where not even voluntary admits can choose to leave, how is that...
  4. MunoRN

    72 hour notice/AMA

    MunoRN replied to sassyann85's topic in Psychiatric

    If the patient can't express that they are aware they agreed to a 72 hour hold then they didn't agree to a 72 hour hold. Everywhere that I've worked requires a patient's signature for this agreement,...
  5. MunoRN

    Tylenol ordered for pain.

    MunoRN replied to gouranga's topic in Patient Medications

    Part of what I do is assist with regulatory visits. There are two things you can always count on surveyors checking; restraint charting and whether PRN med indications exist and are being
  6. MunoRN

    Staying comfortable vs. hastening death

    MunoRN replied to RNMarykay's topic in General Nursing

    To give an example, I was orienting a nurse to ICU not long ago, we received a patient from the floor who had coded. The patient had end-stage COPD and had already been on a low-dose opiate to...
  7. MunoRN

    Staying comfortable vs. hastening death

    MunoRN replied to RNMarykay's topic in General Nursing

    The terminal condition will be the primary cause of death, but you'd have to ignore everything we know about these medications and how they affect patients to believe they can't and don't often alter...
  8. MunoRN

    Blue Pigtail on Nasogastric Tube

    MunoRN replied to mikeynizm's topic in Patient Safety Issues

    In the case of treating an "electrolyte imbalance", specifically hyponatremia, switching out water for NS can be indicated, but in the absence of hyponatremia it's not
  9. MunoRN

    Staying comfortable vs. hastening death

    MunoRN replied to RNMarykay's topic in General Nursing

    I completely agree that the risk of hastening death never supersedes the treatment of discomfort or distress, but do you really believe that these medications "will not" hasten the process? What...
  10. MunoRN

    Blue Pigtail on Nasogastric Tube

    MunoRN replied to mikeynizm's topic in Patient Safety Issues

    I searched "flush nasogastric tube with" and through at least the first 5 pages I can't find anything that recommends using NS, every single one says water. We all drink water regularly without any...
  11. MunoRN

    Unit nurses...how do you feel about an outsider becoming manager?

    MunoRN replied to klone's topic in General Nursing

    In general hiring an outside candidate works out better in my experience. The biggest challenge for any new manager is overcoming the entrenched "this is how we've always done it" views of staff,...
  12. MunoRN

    Staying comfortable vs. hastening death

    MunoRN replied to RNMarykay's topic in General Nursing

    I think there's widespread misunderstanding of the research on end-of-life care and the potential for hastening death. There is absolutely nothing out there that says medications for symptom...
  13. MunoRN

    Blue Pigtail on Nasogastric Tube

    MunoRN replied to mikeynizm's topic in Patient Safety Issues

    In terms of continuous vs intermittent suction, I've never worked anywhere that we didn't automatically change all NG continuous suction orders to intermittent. There is no benefit to continuous...
  14. MunoRN

    Cleaning up lines

    MunoRN replied to nursingjudgment's topic in Critical Care

    I get the purpose of labeling lines and even pumps if they aren't smartpumps, but I'm not getting why would label the tubing just above as well as just below the
  15. MunoRN

    ACA and PRN Staff--is there a waiver?

    MunoRN replied to fishman72's topic in General Nursing

    Your employer is free to have you sign a waiver and give you extra wages in lieu of health insurance. Each employer creates their own waiver, here is an example: Michigan Business & Professional...
  16. MunoRN

    Delirium in the ICU

    MunoRN replied to AngelaHarvey's topic in Critical Care

    Vanderbilt has a good research center on ICU delirium: ICU Delirium and Cognitive Impairment Study Group It goes into prevention, diagnosis, assessment tools, treatments, etc. Maybe look at that...
  17. MunoRN

    Cleaning up lines

    MunoRN replied to nursingjudgment's topic in Critical Care

    I agree but I am curious why you label the line "going into the pump and coming out of the
  18. MunoRN

    Adoption

    MunoRN replied to KcDawn's topic in Nursing Student Assistance

    Laws that give the birth mother the right to change her mind for a period of time immediately following birth are common and for good reason. In a voluntary adoption, everyone's goal is make sure the...
  19. MunoRN

    Elderly Neglect

    MunoRN replied to sarahd22's topic in General Nursing

    There are no specific answers to your questions as it varies by state and severity, in general you should avoid being the subject of such charges. Elder neglect requires that the neglect be clearly...
  20. MunoRN

    Every other weekend & holidays??

    MunoRN replied to LuciaRN2b's topic in General Nursing

    Are you under the assumption that the vast majority of RN's who work in jobs that extend outside the hours of weekdays 9-5 don't like to spend time with their families? Personally I also enjoy...
  21. MunoRN

    72 hour notice/AMA

    MunoRN replied to sassyann85's topic in Psychiatric

    AMA by definition means the patient doesn't need to be approved by the doctor, that why it's Against Medical Advice. The only time they can't leave AMA is when they are on a legal hold, which why I...
  22. MunoRN

    CPOE and still using paper UGH

    MunoRN replied to hes2371rn's topic in General Nursing

    I'm not sure why it is you feel you still need to do chart checks with CPOE? Generally, the purpose of chart checks is to review back over a specified time period in the paper chart and make sure all...
  23. MunoRN

    What is your opinion on getting the flu shot?

    MunoRN replied to Surg-OncRN's topic in Holistic

    Rush Limbaugh blames measles outbreak on immigrant children |
  24. MunoRN

    What is your opinion on getting the flu shot?

    MunoRN replied to Surg-OncRN's topic in Holistic

    You're right, you're not an "anti-vaxer". You're
  25. MunoRN

    72 hour notice/AMA

    MunoRN replied to sassyann85's topic in Psychiatric

    If the patient was voluntary, what's the legal basis for holding them for 24 hours despite their stated wish to leave? That sounds like an illegal