bruinlaura

We usually have 2 unless the patient is very critical. It is uncommon to be tripled in the ICU I work in but it does happen on occasion when staffing is poor. Usually a triple goes to a float or traveler. If not we have a list with our last time being tripled and whoever has gone the longest without one gets it. So even if there are triples you won't be the one getting them every time. Also triples are chronics and pt's awaiting stepdown beds. I have never heard of someone getting 4. At least in an adult ICU.

Was there a reason you couldn't use the cordis? We don't put blood in any of the ports in the swan but I use the cordis for blood and fluid boluses almost exclusively. We will use the medication port for drips and the proximal port for other meds but we never use the pa port for anything other than monitoring and svo2 sampling.

I work in a CTICU and we never wedge. Apparently there was an incident a few years ago where a pt was left wedged and died. It appears that any place that has had an incident doesn't wedge anymore.

I've worked at Sinai for the past year on a CSICU stepdown. I can't really say anything about the other units but you can PM me about mine if you'd like. Like every hospital some units are duds and some are great. The picketing was done during the contract negotiations. We just voted to approve the contract last week so no more picketing. The sick pay thing mentioned is 1 option so you can do the traditional thing if you want. it's really complicated to explain how it works so i'd rather not. it also doesn't start until 2009. pay increases of 3%/year starting now.

I just took acls and they say to mix amio push 150mg with 7cc NS. however, the drip needs to be in D5W with a filter.

I'm just wondering if it is any safer for the patient when the staffing is short with nobody doing overtime vs adequate staffing with people coming in for overtime. It seems like a catch 22 to me. The safest situation would be for the units that always seem to be short to hire enough staff that OT is not a common necessity.

I just worked a night with a terrible case of nausea. At one point I just told my patient "pardon me I'll be right back" and ran to the restroom. Fortunately I was ok and somebody had some pepto for me to take that took care of the nausea for the rest of the night. I suggest keeping a stash of whatever meds that work for you in your bag or locker. Unless you are in the middle of a sterile procedure or a code situation it won't be a big deal. The patient will understand. They'd rather you not hurl in front of them. :)

I lived in westwood/UCLA area for 4 years and loved it (and would be thrilled in end up in santa monica someday) but I think LA is only laid back in comparison with other big cities like NYC or San Francisco. Otherwise there are many other areas of Cali that are way more laid back than LA. I have several friends living in Long Beach. Also have a friend in Seal Beach who loves it there. I also suggest looking into the oxnard/ventura area. It's north of LA about an 1hr drive. I've only been there for weekend visits but I thought it was totally cute and the beaches are cleaner and not nearly as crowded as LA beaches. Definitely a laid-back vibe. I also suggest looking at cities along the central coast. Hope this helps.

this situation happened to me recently and i wish i wouldn't have ignored my gut and started looking for another job. i'm devastated. my self esteem hasn't been hit this hard since high school. if you can transfer to another floor, do so. if you are unionized by all means request a rep present whenever your manager has a meeting with you, another regret of mine. apparently smart, responsible, and hard-working isn't enough in some units. best wishes.

I wish you the best HughB! My sister has now been clean for 2 months and it has helped reduce her meth cravings ALOT.

Legionella exposure occurs through inhaling mists or droplets of contaminated water or micro-aspiration while drinking contaminated water. This seems unlikely to happen when working as a nurse unless you drink the water and you said they provide bottled water for both staff and patients. As a patient you should have been provided on of those "bath in a bag" things (your caregivers are so not cool for neglecting that) and you certainly could have used bottled water to brush your teeth (which they should have explained to you). No wonder you were uncomfortable. I would be pretty uncomfortable too after 5 days of no showering or brushing teeth. In addition, exposure doesn't mean you'll get sick. In fact very few exposures result in pneumonia. Those at highest risk are immune-compromised in some way (oncology, transplant, hiv, etc). So that's what I know. Good luck at wherever you choose to pursue employment.

Thanks for your kind words. I realize the chances of relapse are high with meth use and I am cautiously optimistic. This is actually about the 3rd rehab program she's tried and she relapsed countless times while in the others. I'm pretty used to it but it still hurts every time.

I found this article on google. http://biz.yahoo.com/bw/060621/20060621005309.html?.v=1 I've been hesitant to share this but after seeing a 5 page thread on methamphetamine use I figured maybe it will help someone. My sister is a meth addict. She has been on this program for a little over a month now. It involves an IV infusion (outpatient) for the first 3 days and then for 3 more days after a month. There are medications to take home as well, most of which are off-label use. I forget which one but she's on some sort of anti-seizure med (absolutely no hx of sz) as well as an antidepressant (however that isn't off-label as she has a hx of depression). Also her program has an outpatient rehab program component too (meetings/counseling). I don't know if it works long term but I do know that she has been clean for 38 days which is pretty much a miracle (and we test her even though the rehab does too). I've never seen her succeed for longer than 2 weeks. She claims she has only had 1 craving since starting the program. But most of all she is her old self. The fun, outgoing, likes-to-be-with-her family person that she was before this nightmare began. And for drugs being so much fun I've heard her laugh more in the past week (I'm home visiting) than the past 5 years. Ok I'm going to stop before I break down crying. I am very hopeful for this program and at this point I no longer care how sketchy it sounds to anyone else (and I did when learned my parents paid up the ying-yang for something not approved by the FDA).

Eliza, you start this week right? I hope all is well. p.s. I'll be joining you in september!

I would say definitely know side effects and contraindications. It is multiple choice. The calculations/conversions aren't bad. And know how to administer to different age groups. Basically if you follow the study guide you'll be fine. It's challenging but not impossible. I made flashcards and just studied them when I was riding public transportation or waiting for an appt, etc and then for a few days before the test I crammed. I think you get one chance to retake it and I doubt you can do it right then since they show you what answers you got wrong.