ICUPrincessNurse

Strip them. Often.

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 gravity. I've also taken the whole notebook writing ...

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. Code/trauma/bad GI bleed? Level I transfuser.

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 work.

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 isn't beeping because flow is occluded- I let it go (L...

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 intubation that in the event of a true cardiac ar...

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 to cath lab" to look at numbers for lung transpla...

Oh. Hail. Naw.

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 tele in years I think. But technically...we flo...

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, drama, traction, labs, care rounds, labs, meds, dail...

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

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. They have enough people. It's already enough chaos....

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 and got sent out of the unit. I'm assuming there wa...

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 unfeasible for you? We've been pretty successful with them...

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 over the place. They should understand that if they'...

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. We also use them on a lot of our sick traumas, sick...

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 badger it.

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 nearest to me isn't my most trusted neighbor I'll ask ...

I use it on both all the time.

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 vacation might not be the best thing for the pati...

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 med-surg to learn assessment skills and that I'd n...

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 all.

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 calculations- easier to use for me than the computer c...

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 to get information in person or if I call them an...

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 in a practical setting. In our unit there are only...