ICUPrincessNurse

ICUPrincessNurse

Surgery, Trauma, Medicine, Neuro ICU

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All Content by ICUPrincessNurse

  1. nursing care for chest tube of cabg patient

    ICUPrincessNurse replied to Altin's topic in Critical Care

    Strip them.

  2. Pushing meds through NGT/OGT with the plunger

    ICUPrincessNurse replied to delphine22's topic in MICU, SICU

    I've done it both ways. Depending on how much time I have and if I'm giving a free water bolus as well. Neither is wrong. If I'm giving tube feed boluses which is basically almost never I'll use...

  3. Fluid bolus by gravity or pump?

    ICUPrincessNurse replied to delphine22's topic in MICU, SICU

    Depends. Through a PICC? Sometimes I'll use the pump if it doesn't flow. Mild hypotension/low UOP through a well flowing PIV or CVC? Gravity. Legit hypotension/code? Pressure bag....

  4. Acidotic patients

    ICUPrincessNurse replied to Go-GetterRN's topic in Critical Care

    I was typing mine out. Then read the above. So yeah. What he said. There's something magical about a pH of 7.2 that seems to magically make meds

  5. Flushing IV sites with pressor drips

    ICUPrincessNurse replied to ONE-TWO--'s topic in CCU, Coronary, Cardiac

    I'm mostly hoping the vasoactives are going through a CVC and not a PIV!!! I flush my PIVs and any ports on my CVC that I'm not currently using. If I have a drip running through it and my pump...

  6. do you mask/bag during DNI

    ICUPrincessNurse replied to SarahT1974's topic in CCU, Coronary, Cardiac

    I loathe DNI most of all when it comes to a code situation. We'll do Bi-Pap like whoa to try to avoid intubation but we try to be pretty clear to the patients/families that insist on full code but no...

  7. Are swan-ganz (PAC) still around in your area?

    ICUPrincessNurse replied to ninis's topic in Critical Care

    All of our CVICU patients have them. Our MICU and SICU (mostly MICU) will get them if they are worried about Pulm HTN. I've floated them in organ donors before when the choice is "float a swan or go...

  8. Neo/Levo

    ICUPrincessNurse replied to LNRN11's topic in CCU, Coronary, Cardiac

    Oh. Hail.

  9. "You are now a stepdown nurse too"

    ICUPrincessNurse replied to SummitRN's topic in Critical Care

    We get "floated" to tele/pcu sometimes but lately our patients have been so sick and there have been so many of them that we've been overflowing ICU patients into PACU so NOOOO ONE has been floated to...

  10. Question for trauma icu nurses

    ICUPrincessNurse replied to helpinghands93's topic in Critical Care

    Assess, turn, medicate, turn, chart, assess, turn, medicate, (eat????) turn, bathe, assess, turn, scramble, chart, turn. Somewhere in there are trachs, pegs, level 1 infusers, codes, poop, blood,...

  11. Should ICU get more pay than floor nursing?!?

    ICUPrincessNurse replied to francoml's topic in MICU, SICU

    My hospital gives a "shift diff" to ED and ICU. Mostly because we had the worst satisfaction scores in the whole

  12. Code rolee

    ICUPrincessNurse replied to NurseYe's topic in Critical Care

    When in doubt- record. Gives you a chance to learn the flow of experienced coders and know what comes next. Plus no one ever wants to record. Also...if the room is totally full- don't go in....

  13. Prolonged use of paralytics

    ICUPrincessNurse replied to ICUNurseStat's topic in MICU, SICU

    4 weeks once. Very unstable airway in a patient who needed a specially built trach with an extensive history of pulling out his ETT/trachs. Seriously. 4 weeks. He got his special airway, woke up...

  14. Proning ARDs patients

    ICUPrincessNurse replied to catamounts303's topic in MICU, SICU

    What he said. We've done that in the middle of the night when we couldn't get a hold of the bed. Otherwise...we use the RotoProne pretty much exclusively. What about the RotoProne has been...

  15. Verbal Orders

    ICUPrincessNurse replied to ktliz's topic in Critical Care

    It's not unreasonable for a computer to be close by if they're on call covering the unit. When we went all computerized we got multiple computers at each alcove, extra COWs and extra desktops all...

  16. Vigileo monitors

    ICUPrincessNurse replied to IheartICUnursing's topic in Critical Care

    We use vigileos often. It's part of our sepsis protocol to insert a presept catheter and monitor ScVO2 on them. Usually they end up with an a-line and we flo-trac that right on into our vigileo....

  17. Vasopressor and Inotrope Titration Orders

    ICUPrincessNurse replied to RN Nick's topic in MICU, SICU

    This. This is exactly what we do. We have the order to cover us but really...we do what we want. They're coding? Levo doubles. Triples maybe. Maybe gets maxed out. If it's that bad...we honey...

  18. Abandoned Patients?

    ICUPrincessNurse replied to Cardiolyte's topic in MICU, SICU

    It is what it is...sometimes you have to leave your patient. I always try to make sure that I leave my patient as low maintenance as possible. Bags full, calm, comfortable, clean. If the nurse...

  19. VAMP on CVP lines

    ICUPrincessNurse replied to AmorFati's topic in CCU, Coronary, Cardiac

    I use it on both all the

  20. Sedation Policies

    ICUPrincessNurse replied to kp616's topic in Critical Care

    I usually do mine first thing in the morning, as do most nurses I work with. There are a few patients that I'll wait for clarification from the docs because for whatever reason I feel like a sedation...

  21. New grads shouldn't work in ICU?

    ICUPrincessNurse replied to Kayla2013's topic in Critical Care

    One of our trauma surgeons holds that belief and is VERY vocal about it. On my very first day in the unit (straight out of nursing school, BTDubs) he told me I didn't belong there and should go work...

  22. Rapid response team nurses using I-stats

    ICUPrincessNurse replied to gardendigger's topic in Critical Care

    Your I-stat must be different than mine because my immediate thought is "in your hands". Ours is not terribly much larger than our blood sugar machines, which is to say- not large at

  23. Mobile/Cell Phones at the bedside??

    ICUPrincessNurse replied to nellymac's topic in Critical Care

    I'll use mine as a timer for heparin gtt timed titrations (like, turn it off for 30 minutes and then restart at 2 units/kg/hr less than previous dose). I also use mine alllllll the time for CRRT...

  24. How do you update families in your ICU?

    ICUPrincessNurse replied to psu4hld's topic in Critical Care

    Our policy is nothing over the phone aside from a "yes they're here, yes they're stable" (or yes they're here and you need to come NOW). I tell families from the get go that they're really only going...

  25. CRRT training, how much is enough?

    ICUPrincessNurse replied to Chisca's topic in MICU, SICU

    We have a two day class for CRRT. It covers set up, modes, charting, I/Os and flow setting- the whole shebang. Then at least 4 hours with a CRRT provider to make sure we understand what we're doing...