MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Could this be construed as "abuse"?

    MunoRN replied to Pat_Pat RN's topic in Patient Safety Issues

    If she's refusing the procedure then yes, from a legal standpoint it is assault. If she isn't capable of refusing then there is a legal process that must take place to legally remove decision making...
  2. MunoRN

    Sepsis as Hospice Diagnosis

    MunoRN replied to lpoore's topic in Hospice, Palliative

    Neither debility or AFTT will be allowed as the primary hospice admitting diagnosis. The specific medical condition must be used or the condition most likely to cause death in the case of multiple...
  3. MunoRN

    Sepsis as Hospice Diagnosis

    MunoRN replied to lpoore's topic in Hospice, Palliative

    My understanding is that AFTT is no longer an acceptable hospice diagnosis starting Oct 1. Many hospices have previously used sepsis a supporting medical condition for AFTT, which will now need to...
  4. MunoRN

    prn med help

    MunoRN replied to EricaRN2015's topic in Patient Medications

    Generally the MD's intent in ordering both scheduled and prn pain control is that the prn is to be given at any time the scheduled pain med is not providing adequate pain control. If it's ordered...
  5. MunoRN

    Pressors with diuretics

    MunoRN replied to psu_213's topic in Emergency

    This is where a CVP can be useful. It's possible for a patient to have excessive fluid outside of their vascular space, such as wit pulmonary edema, but still have insufficient fluid intravascularly....
  6. MunoRN

    epic nursing communications vs epic orders

    MunoRN replied to Lvuv's topic in Patient Safety Issues

    I'd write that as an order then. If meds can only be entered through CPOE then I'd tell the doc to put it in as an
  7. MunoRN

    epic nursing communications vs epic orders

    MunoRN replied to Lvuv's topic in Patient Safety Issues

    What was the specific
  8. MunoRN

    prn med help

    MunoRN replied to EricaRN2015's topic in Patient Medications

    It's always up to the nurses discretion whether or not to give a med, but I'm not totally clear what your rationale was. Generally you start with the least aggressive intervention for pain, unless...
  9. MunoRN

    Confront or do a slow burn!

    MunoRN replied to rich5clark's topic in Patient, Colleague Relations

    It's certainly not just Europe, I've worked 5 different facilities (in the US) and all of them actively encourage naps. I'm still astounded that a facility would be that ignorant of basic knowledge...
  10. MunoRN

    prn med help

    MunoRN replied to EricaRN2015's topic in Patient Medications

    It's always good to try non-pharmacologic treatments first, such as repositioning, but the problem seems to be that you didn't actually assess if that had worked and move up to other interventions...
  11. MunoRN

    Confront or do a slow burn!

    MunoRN replied to rich5clark's topic in Patient, Colleague Relations

    I can see that it would be reasonable to fire someone for sleeping on the clock, but not while on a
  12. MunoRN

    Confront or do a slow burn!

    MunoRN replied to rich5clark's topic in Patient, Colleague Relations

    I don't see why an employer would be opposed to napping on a break. This is a pretty well studied topic, and there are various recommendations that naps on a break can significantly reduce fatigue,...
  13. MunoRN

    Family members recording nurses doing pt teaching

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

    Discharge teaching starts at admit, so a large portion of patient teaching basically discharge teaching, but either way I'm still not sure why any patient teaching shouldn't be able to be recorded by...
  14. MunoRN

    Confront or do a slow burn!

    MunoRN replied to rich5clark's topic in Patient, Colleague Relations

    It seemed like the OP was referring to napping while on a break, not while
  15. MunoRN

    Family members recording nurses doing pt teaching

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

    We actually specifically ask family members or the patient to record the discharge teaching. Recording discharge teaching has been show to reduce adverse outcomes post-discharge and reduce...
  16. MunoRN

    Confront or do a slow burn!

    MunoRN replied to rich5clark's topic in Patient, Colleague Relations

    I've never heard of this, what's the
  17. MunoRN

    Lining and labs/ hemolyzed specimens

    MunoRN replied to psu_213's topic in Emergency

    I think there's a common misconception that high hemolysis rates off of PIV draws are due to the use of the IV for drawing, when actually the research shows stronger connection to technique when...
  18. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    There's always a tug of war between risk managers/other management and patient advocates such as nursing. If risk management had it's way no patient would get any sort of intervention, medication,...
  19. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    We encourage patients to bring in and use their own equipment. A problem with their equipment or their therapy parameters is far more likely to be noted when the patient is receiving the level of...
  20. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    I'm not sure how prohibiting a patient from using their home CPAP prevents the patient from using a dysfunctional home CPAP machine. You realize they are going to use that machine when they go home,...
  21. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    The basic problem I see is that when notified of an issue or problem, there are those who try and figure out how they can help, and there are those who try and figure out how they can avoid being...
  22. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    I have seen many patient home CPAP machines because we highly encourage patients to bring in their own CPAP machines, even in the ICU. Again, we're talking about using Vision Bipap circuits on CPAP...
  23. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    Again, the OP was quite clearly referring to use of their home CPAP machine, we're not talking about using a home CPAP machine for patients who actually require more than their home CPAP machine or...
  24. MunoRN

    Understaffed Surgical Unit

    MunoRN replied to rnz17's topic in Patient Safety Issues

    Other than mandated ratios, there not much to be done about it, so long as management calculates they can save more money than they'll lose due to the effects of understaffing. Keep in mind that safe...
  25. MunoRN

    CPAP on the unit

    MunoRN replied to canoehead's topic in General Nursing

    I can't find anything that says this is a "trend", maybe you could direct me to a source? There are certainly compelling reasons not to allow home CPAP, but it's based on billing, not safety. The...