MunoRN RN

Critical Care

Member

  • Content

    8,058

  • Visitors

    94,707

  • Followers

    9

  • Likes

    7,525

All Content by MunoRN

  1. MunoRN

    96 year old refuse treatment

    MunoRN replied to Vtachy1's topic in CCU, Coronary, Cardiac

    And actually a patient can be not alert and oriented but still be considered competent to make their own decisions. All they have to do is be able to express what is generally wrong with them, what...
  2. MunoRN

    96 year old refuse treatment

    MunoRN replied to Vtachy1's topic in CCU, Coronary, Cardiac

    If the patient is competent and refusing treatment then it would be highly unethical to provide that treatment
  3. MunoRN

    Which to follow: MD or Policy?

    MunoRN replied to Angeljho's topic in General Nursing

    It's a pretty common policy that all orders must be reviewed by the MD before being continued whenever a change in the level of care occurs. Just writing "continue previous orders" doesn't do...
  4. MunoRN

    Which to follow: MD or Policy?

    MunoRN replied to Angeljho's topic in General Nursing

    I cringe a little when I hear that. I review and evaluate adverse events, and every once in a while avoidable harm comes to the patient when a nurse followed policy perfectly, the problem is they...
  5. MunoRN

    Which to follow: MD or Policy?

    MunoRN replied to Angeljho's topic in General Nursing

    There's actually a third basis for decision making that takes precedent over both the MD and policy which is nursing judgement. In this situation I'm not sure there's much of an option, it's the MD...
  6. MunoRN

    Really dumb blood admin question

    MunoRN replied to Curious1alwys's topic in General Nursing

    50ml over the first 15 minutes is actually a pretty common practice recommendation and policy. The purpose of the first 15 minutes isn't to avoid a reaction, it's to elicit a reaction if one is...
  7. MunoRN

    cost of healthy meals

    MunoRN replied to kidzcare's topic in General Nursing

    There is research on this that can help answer the question: A healthy diet costs $2,000 a year more than an unhealthy one for average family of four: Harvard study | National
  8. MunoRN

    cost of healthy meals

    MunoRN replied to kidzcare's topic in General Nursing

    They are so long as the meal also includes proteins, fats, and other sources of calories that will take longer for the body to process. In terms of caloric intake a "healthy" meal will contain foods...
  9. MunoRN

    cost of healthy meals

    MunoRN replied to kidzcare's topic in General Nursing

    Simple starches such as sweet potatoes are very cheap which is why "cheap" diets are often less healthy; they tend to be largely based on simple starches and bad fats. Healthier complex starches,...
  10. MunoRN

    Medication Education... built into the EMR?

    MunoRN replied to Ewbok123's topic in Patient Education

    In most cases it's not a lack of access to educational material that causes low scores on the med education question on HCAHPS. More than anything else it's a time issue. A nurse who has 2 hours to...
  11. MunoRN

    sedation and anesthetics

    MunoRN replied to francoml's topic in Critical Care

    In every state and facility I've worked RN's can bolus propofol, I can't imagine managing a propofol drip without being able to bolus, that seems sort of pointless. What we can't do is give propofol...
  12. MunoRN

    FMLA and "on Call" shifts

    MunoRN replied to mp1025's topic in General Nursing

    There's no specific language in FMLA laws about employer policies for making up hours, but it does prohibit FMLA "interference" which includes anything that would discourage you from taking FMLA....
  13. MunoRN

    Illegal Drugs & HIPAA

    MunoRN replied to bagface's topic in HIPAA Challenges

    HIPAA doesn't actually allow a disclosure because someone is found to possess guns or brass knuckles. HIPAA is very specific that an exemption is only allowed for threats that are specific and...
  14. MunoRN

    what is the best practice for rotating the ETT

    MunoRN replied to icuRNmaggie's topic in Critical Care

    We do oral care every 4 hours (and prn) and the ETT is repositioned with oral care. Both RN's and RT share responsibility for oral care, when possible we alternate (RN does it q 8 hrs and RT does it...
  15. MunoRN

    Nonsedated Pt's equal self extubations

    MunoRN replied to RunninOnCoffee's topic in General Nursing

    Ideally there is no need for restraints or sedation, but in reality there is a need for balance, both to avoid excessive torture (beyond regular ICU torture) and to achieve good patient outcomes....
  16. MunoRN

    occupational health argument

    MunoRN replied to DeeaCatalina's topic in General Nursing

    I'm not "assuming", as I referred you to earlier, I'm repeating the World Health Organization's well researched data on the prevalence of the BCG vaccine in Eastern European countries. Thanks for the...
  17. MunoRN

    occupational health argument

    MunoRN replied to DeeaCatalina's topic in General Nursing

    I think you might be confusing discrimination with proper critical thinking. If the nurse had said that since you're from Eastern Europe, you probably have TB, that could be considered...
  18. MunoRN

    occupational health argument

    MunoRN replied to DeeaCatalina's topic in General Nursing

    It really doesn't matter which eastern european country you are from since there is not a single one that doesnt' have a comprehensive BCG vaccination program. The occupational nurse did not violate...
  19. MunoRN

    occupational health argument

    MunoRN replied to DeeaCatalina's topic in General Nursing

    It's not discriminatory to point out that all central and eastern european countries have comprehensive BCG vaccination programs, it's a verifiable fact:...
  20. MunoRN

    occupational health argument

    MunoRN replied to DeeaCatalina's topic in General Nursing

    I'm not sure I'd get all that upset about a potentially misread PPD since a PPD does not diagnose TB, it only suggests the need for further testing. I'm a little skeptical that you're from Eastern...
  21. MunoRN

    OR Nursing Call Response

    MunoRN replied to RNKeith's topic in General Nursing

    I would make sure to clarify that with them. For cath lab on-call I have 30 minutes, but that is from when the page goes out to when I'm in the cath lab, lead on and ready to go. I live about 10...
  22. MunoRN

    I heard today on the radio

    MunoRN replied to Vtachy1's topic in Activism, Healthcare

    Googling "Muslims exempt from healthcare law and radio show" produces a number of radio shows that have shared this myth, all are what could be described as some form of conservative
  23. MunoRN

    DDAVP administration with fresh hearts

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

    We give Amicar, it's my understanding that there is no evidence to support the use of DDAVP for this purpose. In my experience it's seemed like the difference in the rate of bleeders is more related...
  24. MunoRN

    Any hospital units that DON'T use telemetry?

    MunoRN replied to Nola009's topic in General Nursing

    We've gone full circle, from using telemetry only in critical care, progressive care, and cardiac floor to the entire hospital, and then back to just critical care, progressive care, and cardiac...
  25. MunoRN

    Protonix in GI bleed

    MunoRN replied to coleeliza's topic in Patient Safety Issues

    It's pretty unlikely the protonix was responsible for the BP change. Any extra few drips they might have gotten is nothing compared to the amount they get with bolus dosing and protonix has no...