MunoRN RN

Critical Care

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All Content by MunoRN

  1. MunoRN

    Hospital Policy Vs. Unit Rules

    Every EMR now has some form of patient summary, are you using something like that or are you manually retrieving bits and pieces of info from the
  2. MunoRN

    Obamacare? what are your thoughts

    I completely agree that dealing with overall costs needs to be just as much a priority as dealing with how we divvy up those overall costs. But even if we manage to cut costs far more than seems...
  3. MunoRN

    Hospital Policy Vs. Unit Rules

    I understand your frustration but you agree to do abide by whatever your superiors tell you to do (within your typically broad job description) when you take the job. This isn't always possible of...
  4. MunoRN

    Obamacare? what are your thoughts

    I don't think there is any expectation that you shouldn't be resentful, I think most people of all political views are resentful of those who take advantage of the system. The question is how far...
  5. MunoRN

    Obamacare? what are your thoughts

    I don't disagree that there are those who will get something for free that the rest of us pay for (although about 2/3 of those without insurance prior to Obamcare actually do work). But to cut out the...
  6. MunoRN

    rescue meds...or not.

    Send to the ER for proper symptom management. In general I'm opposed to SNF patients having to go to the hospital for end-of-life care; the unfamiliar, hectic environment of an ER and hospital is...
  7. MunoRN

    Obamacare? what are your thoughts

    I think the statement you're referring to pretty well captures the contradictory views I think we'd all like to believe were possible to exist simultaneously. I don't think anyone argues that ideally...
  8. MunoRN

    Prioritizing infusions

    If a doctor wants to view a nurse doing their job and advocating for their patients as a troublemaker that's their problem, it only interferes with you doing your job if you let it. In my experience...
  9. MunoRN

    Prioritizing infusions

    Writing the order isn't your call, but evaluating the appropriateness of the order certainly is, as well as helping to educate Physicians about the principles of blood product transfusion
  10. MunoRN

    Decrease in volume of Cath Lab cases?

    What specific change are you referring to? The only recent change to heart cath coverage was that the Physician reimbursement rate for interventional procedures was decreased 18% but that went into...
  11. MunoRN

    Let's talk: Nursing Shortage?

    I think we confuse 'nursing shortage' with 'vacancy rate'. There is a low vacancy rate in nursing, but yes there is a substantial nursing shortage. How large the nursing shortage is depends on how...
  12. MunoRN

    Current and former sacred cows in nursing

    I'd have to call the CO2 retainer/excessive oxygen issue a double sacred cow, maybe a siamese twin sacred cow. For some reason many thought that you could never give a CO2 retainer large amounts of...
  13. MunoRN

    Obamacare? what are your thoughts

    With a few exceptions, individuals don't get a better deal on healthcare services than insurance companies do, in fact they pay ridiculously higher prices. In theory it sounds great, in practice the...
  14. MunoRN

    Obamacare? what are your thoughts

    The car comparison is actually valid but I think you're applying it wrong. In health insurance the insurance "system" is ultimately responsible for all "maintenance and resulting damage" costs...
  15. MunoRN

    Obamacare? what are your thoughts

    There are hospitals that exist outside of the competitive environment that you're referring to; VA hospitals. In general I don't think the idea of changing all hospitals to government run are all...
  16. MunoRN

    iv antibiotics and maintaining line

    Something to keep in mind is the amount of medication being wasted. The initial priming of line typically results in 20+ ml that ends up in the sink/trash, then there's the volume that gets thrown...
  17. MunoRN

    iv antibiotics and maintaining line

    Personally I prefer to set up a primary/secondary even if all they are getting is antibiotics. I use a smaller primary bag (250 or 500cc) and use that to prime the line and flush it between...
  18. MunoRN

    Chest tube flush

    According to other threads here it sounds like are limitation in some states, although in my state the only thing nurses can't instill in chest tubes are sclerosing agents. Fibrinololytics and...
  19. MunoRN

    Obamacare? what are your thoughts

    You're referring to HCAHPS which actually pre-dates Obamacare, the initial HCAHPS implementation was in 2006. But I do agree, the perks and frill that are used in the private, for-profit market to...
  20. I agree on keeping the good ADN programs, adding whatever curriculum/requirements necessary, but I don't think we need to change their name. You seem to think that ADN graduates are ashamed that they...
  21. Since the cost is typically per credit, yes the cost would go up, but since the per credit cost of an ADN program is exponentially less than that of a BSN program they would still be significantly...
  22. As a related issue I agree that we don't know what it was about the programs nurses attended in the studies that produced better outcomes, and since not all BSN programs are identical we don't really...
  23. About $25k just for a brand name, that's why many wouldn't. And there's no evidence they aren't equal products now in terms of the nursing care they produce. There is evidence to suggest they...
  24. What are you thinking would be different, other than the
  25. If your argument is that given two equal products only a person with poor decision making abilities would chose the cheaper of the two then I'm not sure it's prospective students who can't be trusted...