NPOaftermidnight

NPOaftermidnight MSN, RN, NP

Pediatrics, Women’s Health

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All Content by NPOaftermidnight

  1. Are we doing good for our patients?

    NPOaftermidnight replied to GeologistRN's topic in MICU, SICU

    They wanted to d/c sedation on a paralyzed patient? I'm glad you stood your ground, and I hope you took that over the ordering physician's head. That's like ICU 101. Your moral distress is the...

  2. Does your ICU provide sitters?

    NPOaftermidnight replied to sjalv's topic in Critical Care

    That is so unsafe that they deny you appropriate staffing to sit with a patient that needs one on one. Our hospital will always ensure that we have staffing so that we can have a sitter - usually we...

  3. New grad starting out in ICU?

    NPOaftermidnight replied to DCtooRN's topic in MICU, SICU

    Lots of ICUs hire new grads. I started out in the ICU, and I'm very glad that I did. The most important thing is that the facility you're starting with has a nice, long, thorough orientation period....

  4. ICU nursing stethoscope

    NPOaftermidnight replied to Rich_'s topic in MICU, SICU

    I have a Littmann lightweight as well as a Littmann classic. I swap them out once in a while when I feel like it, or when one temporarily walks away from me. They both work great and allow me to...

  5. Scared!!!

    NPOaftermidnight replied to novicenurse1384's topic in Critical Care

    I work in a busy trauma/surgical ICU, and we hire a lot of new grads. The ones we worry about are the ones that aren't a little scared. Take full advantage of your orientation and your preceptor....

  6. Cleaning up lines

    NPOaftermidnight replied to nursingjudgment's topic in Critical Care

    This is one of those things that is going to get a LOT easier with time. Other have given you good advice, so I'm just going to leave you guys with this article.

  7. ER to ICU orders

    NPOaftermidnight replied to amys4304's topic in MICU, SICU

    We don't have any specific time frame that I'm aware of. We get all of our trauma patients right from the ER and they have always already been scanned and xrayed before they come up to us. Sometimes...

  8. Associates after Bachelors

    NPOaftermidnight replied to Infofreak411's topic in Diploma, ADN, BSN

    I have a BS in Sociology and I went back for an AAS in nursing. I wasn't aware of the one-year accelerated programs at that time; if you can spend one year getting your BSN as opposed to 2 years...

  9. How to pass CCRN?!?

    NPOaftermidnight replied to bmarie27's topic in Critical Care

    You have to watch the Gasparis DVDs. It's all I studied for endocrine/hem/renal/GI and I got 100% in 3 of those sections. Cardiac/pulmonary/neuro require more, I really liked the Ahrens Critical Care...

  10. what is the best practice for rotating the ETT

    NPOaftermidnight replied to icuRNmaggie's topic in Critical Care

    We are old school (or really cheap?) and use tapes, not tube holders, so we rotate q24h when tapes are changed. Compared to q2h/q4h this seems inadequate but we don't see ETT-related pressure ulcers...

  11. art line capped..

    NPOaftermidnight replied to shooklypeg's topic in Critical Care

    I have never seen this done. Arterial lines should be transduced at all times. You need to know right away if the line becomes dislodged, or your patient could lose a good amount of blood. You also...

  12. To blood sugar or not to blood sugar. That is the question.

    NPOaftermidnight replied to lkoch002's topic in MICU, SICU

    It is our policy to automatically check blood sugar q6h for anyone on tube feeds or TPN. The symptoms of hyper/hypoglycemia are not obvious in intubated and sedated patients. If they are fine for a...

  13. Torn between specialties

    NPOaftermidnight replied to FRNHEBRARD's topic in Critical Care

    Your nightmare should be that you don't get offers from any area. The new grad market can be tough. In my hospital at least, a new grad would never get hired into OR or dialysis (but are often hired...

  14. what to expect during a buddy shift?

    NPOaftermidnight replied to RNexplorer's topic in MICU, SICU

    I'm not familiar with the term "buddy shift" but I'm assuming you just mean your first day with your preceptor? I understand that you are currently an ICU nurse so I would imagine it to be similar to...

  15. Does your ICU have CNA's?

    NPOaftermidnight replied to Rose44's topic in Critical Care

    16 bed SICU here. We have techs but unfortunately they seem to get floated more often than not. We usually have one scheduled but occasionally there are two. When they are around, they get all the...

  16. How do I get into the ICU?

    NPOaftermidnight replied to TheNextCRNA's topic in Critical Care

    16.4%

  17. how to be a better team player when struggling with your own work?

    NPOaftermidnight replied to RNexplorer's topic in Critical Care

    This could not be farther from what I experience on my unit. We are always checking in with each other, whether it's for turns or getting people out of bed or help with a blood draw or checking...

  18. Pet peeve, bad practice, or overly critical?

    NPOaftermidnight replied to NewICU's topic in Critical Care

    Bathing seems to be the first thing people jump to, and sometimes they get too focused on that when there are other (much more pressing) things to do. Especially the new grads/orientees. Some nurses...

  19. Most drips at once

    NPOaftermidnight replied to delphine22's topic in MICU, SICU

    The most I've had (minus MIVF/abx, etc) at once is 10 - levo/vaso/epi/versed/fentanyl/nimbex/insulin/bicarb/heparin/TPN, on CVVH. The patient actually lived and came walking through the unit a few...

  20. Yay can't wait!

    NPOaftermidnight replied to NurseEric81's topic in Critical Care

    Congrats! I started as a new grad in a surgical/trauma ICU about 15 months ago. You'll be amazed with how much you're going to learn. The one thing I wish someone had told me before I started......

  21. Charge nurse taking patients in ICU

    NPOaftermidnight replied to nightengalegoddess's topic in MICU, SICU

    I have only seen a charge take a patient once - and it was just one patient on floor orders awaiting a bed. What happens if you get a trainwreck admission or a patient codes? The charge should be...

  22. eICU

    NPOaftermidnight replied to delphine22's topic in MICU, SICU

    I have never heard of this before. I did a little searching around and the whole concept of an eICU seems so strange to me. I can see how it would be beneficial at smaller hospitals where there...

  23. How is your ICU staffing done?

    NPOaftermidnight replied to cmp424's topic in MICU, SICU

    We only very, very rarely will have a triple assignment and that's only if at least one of the patient's is on their way to the floor. The vast majority of the time we have a 1:2 or 1:1 ratio...

  24. Old/New Grad seeking ICU Internship (HELP)

    NPOaftermidnight replied to thisdoll's topic in MICU, SICU

    I would take the same amount of effort and determination you have been putting into an ICU position and find yourself a med/surg position. This would be much more valuable than any...

  25. blood transfusion and first 15 minutes

    NPOaftermidnight replied to valsalvamanuever2's topic in MICU, SICU

    I don't think anyone actually stays in the patient's room for the whole 15min where I work, but we definitely keep a close eye on the patient. I generally am in the room for about 5 minutes, and then...