MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Public Comment on ANA Draft Position Statement: Workplace Violence and Incivility Issues

    MunoRN replied to NRSKarenRN's topic in Activism, Healthcare

    I don't have much respect for the ANA, but I don't think there's any arguing that lateral violence, bullying, eating our young, whatever you want to call it happens at a higher than average rate in...
  2. MunoRN

    Correcting low sodium too quickly

    MunoRN replied to Birdy2's topic in Patient Safety Issues

    The initial corrected sodium level was a little better than it appeared, 115 corrected instead of 113 uncorrected, but that is still a significant hyponatremia and won't be fixed by just treating the...
  3. MunoRN

    How did the 12 hour shift begin?

    MunoRN replied to anon456's topic in General Nursing

    12 hours shifts started in nursing just like they did in most professions that require 24 hour staffing; they're far better for most night shift workers and reduce overall fatigue, increase worker...
  4. MunoRN

    Would you send this patient to the unit?

    MunoRN replied to Birdy2's topic in Patient Safety Issues

    A sodium level of 109, particularly a drop to 109 from 120 in 5 hours, in my experience is well into the territory that suggests the need for 3% and very close serial monitoring of sodium levels....
  5. MunoRN

    AWD vehicle for nurses

    MunoRN replied to waiting4ivpush's topic in General Nursing

    I've lived in a couple of places where you could count on driving on snow/ice constantly from december through march. In both places SUV's are actually pretty rare during the winter, while subaru's...
  6. MunoRN

    To blood sugar or not to blood sugar. That is the question.

    MunoRN replied to lkoch002's topic in MICU, SICU

    There are likely facilities out there still using the old goal ranges which were typically 80-110 or 120. The recommendations were changed relatively recently (2013), but the current society of...
  7. MunoRN

    Would you send this patient to the unit?

    MunoRN replied to Birdy2's topic in Patient Safety Issues

    Part of what I do as a rapid response nurse is help make sure patients are going to the right floor out of the ED. The biggest issue I would have had with this patient going to floor, even a...
  8. MunoRN

    Question...Is Influenza A anaerobic or aerobic?

    MunoRN replied to bendyprissy's topic in General Nursing

    The virus itself is not technically aerobic or anaerobic since a virus is not technically a living thing and does not have the ability for cellular respiration and metabolism, instead it relies on the...
  9. MunoRN

    Patient Safety Question/Nurses Conduct

    MunoRN replied to ChrisMonty's topic in Patient Safety Issues

    I don't think there's anything inappropriate about telling a patient how they could potentially avoid the need for intubation. Patients with a TBI/concussion often don't have the ability to...
  10. MunoRN

    Sliding scale insulin...give or hold?

    MunoRN replied to Annie Wilkes RN's topic in Long Term Acute Care

    That was thought to be true up until the last few years, all current recommendations are for less aggressive BG control, typically 110-180. The 'old' 80-110 recommendations for some post-op and...
  11. MunoRN

    Sliding scale insulin...give or hold?

    MunoRN replied to Annie Wilkes RN's topic in Long Term Acute Care

    A correctional dose is to treat what their BG is right now and has nothing to do with eating. When used as a nutritional dose the patient does then need to eat, because the amount given isn't based...
  12. MunoRN

    social media problem

    MunoRN replied to Fruit Sucker's topic in Patient, Colleague Relations

    While employers do occasionally take action based on what they say on social media, I doubt any would base their actions on a ridiculous interpretation someone else made of your comments, they would...
  13. MunoRN

    Med compatibility

    MunoRN replied to Birdy2's topic in Patient Medications

    Our pharmacists treat "no data" as being compatible. The combinations of medications that have the potential to be incompatible is predictable, most commonly by pH differences. So combinations where...
  14. MunoRN

    Handover from OR/PACU to CICU

    MunoRN replied to dy3p's topic in CCU, Coronary, Cardiac

    I get hooking up infusions that aren't already running, but I don't get why you would replace drips that are already infusing with new ones, particularly using new lines, there's too much opportunity...
  15. MunoRN

    CNA impersonating RN

    MunoRN replied to Heaven-Leigh's topic in General Nursing

    It's not unusual these days for tasks that were formerly the domain of a "nurse" have now shift to non-nurses, even school secretaries with no health training whatsoever, so it's possible she works in...
  16. MunoRN

    Insulin questions

    MunoRN replied to ekendall10's topic in Medical-Surgical

    How you manage an insulin drip is based on trajectory as much as the current BG level. With the downward trend you've already got going, you really wouldn't want to speed that up any by starting the...
  17. MunoRN

    Hoping for some professional feedback on a product.

    MunoRN replied to EllyW's topic in Hospice, Palliative

    I don't really see how it would be outside of a nurse's scope, although I don't think it would be all that useful. The rectal vault can be quite cavernous and it often takes fingers to actually get...
  18. MunoRN

    DHH taking away our ability to practice and use critical thinking skills

    MunoRN replied to guestnurse's topic in Critical Care

    State surveyors aren't always the brightest bulbs and every once in a while we have one who makes this claim even though it doesn't appear to be an actual requirement in any state. Our standard...
  19. MunoRN

    Where are all of the holistic nurses?

    MunoRN replied to PaleoNurse's topic in Holistic

    "Holistic" nurses aren't hard to find since a holistic care focus is part of every nurse's scope. If you're referring to "CAM" nurses then that is entirely different thing, unfortunately the term...
  20. MunoRN

    Handover from OR/PACU to CICU

    MunoRN replied to dy3p's topic in CCU, Coronary, Cardiac

    We get report from the anesthesiologist about 30 minutes prior to arrival (I've never spoken to an OR nurse when landing a heart). When the patient arrives the anesthesiologists updates me on any...
  21. MunoRN

    "He wants his Ativan? Well I'm not giving it to him"

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

    That's not what "TID" means, at least based on how regulatory agencies allow it to be defined which is probably the most practical definition to use. "TID" and q 8 hours both mean that a medication...
  22. MunoRN

    Forgetting to prime peripheral IV line...

    MunoRN replied to lpnmommy86's topic in Emergency

    This is one reason why I never like to run anything outside of a pump, particularly on kids. There are a couple of things the OP can learn from this; it's certainly possible to start an infusion...
  23. MunoRN

    Nurses: You've Been LIED to about your Back and Body Mechanics

    MunoRN replied to Lynda Lampert, RN's topic in General Nursing

    Correct body mechanics will prevent injury, there has be no evidence presented to contradict that. The issue seems to be a poor understanding of what it means to "prevent" injury and how that term is...
  24. MunoRN

    "He wants his Ativan? Well I'm not giving it to him"

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

    Consider this a good learning opportunity for you as you become a nurse. Unfortunately, there are some nurses out there who for whatever reason see their role as establishing a position of power over...
  25. MunoRN

    Nurses: You've Been LIED to about your Back and Body Mechanics

    MunoRN replied to Lynda Lampert, RN's topic in General Nursing

    Sorry but you never actually offered any evidence at all to support your initials claims, which appeared to be that using proper body mechanics do not actually reduce your risk of injury. You offered...