MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Is it acceptable nursing practice?

    I think in general there's maybe a poor understanding of the difference between administering medications and assisting with self-administration. Typically in assisted living, residents are...
  2. Those aren't actually synonyms for bankruptcy. They're somewhat related terms but their basic meanings are different. If I plan on spending $10 for dinner, but end up spending $15, does that mean...
  3. MunoRN

    ADN's being pushed out

    They aren't as different as you seem to think they are. It's the same problem just on a different scale (that isn't necessarily a "vastly" different scale). We certainly should weed out the bad ADN...
  4. MunoRN

    ADN's being pushed out

    I didn't mean it as a joke. There are some obvious reasons why limiting nursing education to only the school that produced the very best outcomes would be unfeasible and would be harmful if not...
  5. MunoRN

    ADN's being pushed out

    If we're looking for best outcomes, it would seem likely that we can figure out what nursing school produces the nurses with the best patient outcomes, once we figure that out why not just close down...
  6. MunoRN

    I think this might be illegal!

    What was their reason for changing the pain
  7. MunoRN

    ADN's being pushed out

    While "some level" of clinical experience might be required, it's not sufficient to be considered adequate by nursing boards in 15
  8. MunoRN

    Levophed concentration and hospital policy.

    You have only 1 Physician on for a 400 bed hospital with 48 ICU beds? Even if this is (hopefully) only at night that doesn't sound like a hospital that should be taking
  9. The definition of bankruptcy: "Bankruptcy is a legal status of a person or other entity that cannot repay the debts it owes to creditors. In most jurisdictions, bankruptcy is imposed by acourt order,...
  10. MunoRN

    Issues with a Clinical Instructor

    Welcome to nursing school. My advice is to learn how to be your own teacher in addition to what you learn from the faculty and from other students. I went to one of the top nursing schools in the...
  11. None of those four exchanges are bankrupt. Many of the state-run exchanges have cost more to get up and running than initially expected, although they aren't "bankrupt". If cost overruns means a...
  12. The goal of the ACA wasn't just to sign everyone up on the exchanges, it was to protect and expand insurance through 3 main systems; reinforcing employer provided insurance, expanding medicaid, and...
  13. MunoRN

    No More ED Report?

    If just looking up the patient is sufficient then why do we do shift to shift
  14. Every state that I'm aware of applies BON oversight to patient care in only those situations where a patient/client relationship is established. Watching your friends kids doesn't fall into that...
  15. MunoRN

    Scrub the Hub

    I agree that a 3-5 second scrub is better than none, and based on the evidence may not be much different clinically than a longer scrub duration, and as a nurse who's worked 'level I trauma' ER and...
  16. MunoRN

    morphine reduction in dying

    Morphine can contribute to cerebral edema, but it's effect isn't typically all that clinically significant even in patients that already have swelling. Morphine and other prn opiates are part of...
  17. MunoRN

    What Would You Do?

    It is up to you as to whether or not you think it's appropriate to give the patient the med, although you generally should inform the MD of your decision. In general I would think being up and...
  18. MunoRN

    What Would You Do?

    If it's used for the purposes of discipline or for staff convenience it's a chemical restraint, if it's used to treat a medical condition or symptoms, including anxiety, mania, etc, then it's not a...
  19. That was the suggestion of the letter that appeared in the NEJM, although maybe it would help to clarify if we're talking about the same article. The recent article in NEJM that suggested we should...
  20. MunoRN

    Scrub the Hub

    We've found that pushing the scrub time recommendation longer than is actually necessary (there's not even good evidence that 15 seconds is necessary) actually backfires, nurses are actually less...
  21. MunoRN

    Scrub the Hub

    Is there a reference for that? It doesn't appear to accurately represent the current
  22. MunoRN

    morphine reduction in dying

    Thanks for the article. I deal with typically very short term end-of-life care, so the build-up of metabolites that can't be cleared is not typically an issue. We do typically use fentanyl rather...
  23. MunoRN

    ADN's being pushed out

    We seem to end up in these arguments over who is/isn't more likely to kill their patients which is pretty ridiculous when you remember it serves absolutely no purpose. For the sake of argument, let's...
  24. It's still approved for use in clinical documentation, and the International Lung Sounds Association (yes such a group exists) still lists it in the official terminology. The 'article' in the NEJM...
  25. MunoRN

    A&O x 3?

    I think that in general the "A&O x3" thing needs to go away regardless. Depending on the nurse, A&Ox3 might mean they are fully oriented, although another nurse might call a patient A&Ox3...