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  1. Rosie_one

    PA catheter and parameters

    PA Catheters are used frequently in our CVICU. You will not see them in use in any other specialty, only cardiothotacics. The alternative option is a PICCO monitor, which I have used in MICU, but in Aus aren't used on a regular basis.
  2. Rosie_one

    Post-Extubation Policy

    Ventilation requirements are that pt. needs to be on Spont mode (no brainer really). Grade of airway should be noted in case of reintubation. PS 10 or less, PEEP 10 or less, Fi02 30% or less. Assess airway, has spont cough (strong) and gag. Has a audible cuff leak. Able to follow commands, strong enough to lift head off the pillow and able to take large Vt when instructed. Also have a decent pre extubation ABG. Extubate onto varying oxygen np, HM, HighFlow (my unit is quite varied in pts). Do a post extubation ABG 30mins after and obviously closely monitor. That's what we have a general rule. Obviously dependingon your unit there maybe exceptions. We have major neuro cases which don't always go completely to protocol prior to extubation, but the intensivist has clearly documented
  3. Rosie_one

    Med error . I’m devastated

    Glad your patient was ok and be glad that this error was not fatal. We have all been there. Looking into most mistakes, a lot of the time it's not just the nurse, but the environment that leads to medication errors. Systems in place in that unit, constant interruptions from drs and family members, the list goes on. Is it possible to change to preparing each patient's medication in front of them and not everyone's all at once. To me this is just an error waiting to happen. I'm sure you're not the first nurse in tgat situation to make a mistake, but honest enough to admit it. The worst mistake I made when I started nursing was not checking blood results before giving out meds. Patient was in renal failure and gave them potassium. Felt terrible and they had to get dialysed they ended up ok, but was mortified. It's made me a better nurse as I check absolutely everything before giving meds etc.
  4. Rosie_one

    Tips for nurses in their first year of nursing

    Nursie69, your forms at your place of work sound terrible lol. They have these stupid forms at my work that you have to fill in with the idea that it will help you pick up problems with your patients, it's quite funny, one is about whether they are conscious/unconscious, as if i needed a form to tell me somethings wrong haha, everyone hates them lol.
  5. Rosie_one

    does this go away

    Maybe you should chat to some of the other nurses you work with and debrief on the situation and what was good about your actions and what you could have done differently, so when this situations comes around again you're more prepared. The fact that you are worrying about your patients shows that you care. I used to be like this when I first started when a treatment etc didn't go as planned.I still go over things in my head when I've had a MET call, did i do everything I could have, what else could I have done? One nurse I worked with said don't stress about it, without a nurse they wouldbe dead, so everything you do give them a chance. I have gotten better over the years, but when I'm nursing in an area I'm not familar with I do get a bit more anxious. We all think this way at times, it's part of reflective practice and it's how we get better at what we do. I agree with the other posts, if this is getting too much talk to someone who understands and maybe if you don't like the areayou work in move to another ward until you feel more confident again.
  6. Rosie_one

    Tips for nurses in their first year of nursing

    *sorry about some spelling, grammatical errors. I shouldn't really write a post when tired lol
  7. Rosie_one

    Tips for nurses in their first year of nursing

    Thisthread has been great! Ihave a few more tips that I have found of great help...and made my work a lot easier in the long run. Always check with radiology,xRAY etc when your patient has been ordered a test to find out that they are on the list, approx time. Don't assume that they are always on the list I check vitals, drips, drains etc at start of shift for every pt, and ask about pain/nasea, any probs they are having. I never just go off what I've been handed over. Thept will often bring up other issues/concerns as you are an approachable nurse. Always document in notes your assessment after intial assessment on shift, everyone will then know if pt status has changed throughout shift/day/week etc. Don't just think about a pt in the acute stage, try and always do an holistic assessment, esp if elderly, as they may just be placed back into unsafe home environment and end back in hospital...worse than before. I make like to find out status of carer (if they have one) as they will open be fatigued from caring with no break...elderly are often abused/neglected by carer/family (carers are often unaware that they are doing this). Always be kind and curtious...even when other staff may not be back to you. Just focus on being the best nurse you can be for your pts.
  8. Rosie_one

    Let's introduce ourselves...

    Hi all! I'm Rosie and have a bit over a month before I finish my degree and become an RN. I live in Sydney, where I have been working as an Enrolled Nurse for 4 yrs (equiv to LPN). A bit of a different system here, we don't have to do a test to become registered. Just found out a week ago that I have a new grad position in inner Sydney hosp rotating in cardiothoracics. A bit nervous about the fact that I'm going to be looking after patients with heart/lung transplants:eek:, but good experience. Anyway, from a lot of posts on this site US is same as Oz, really hard to get a new grad position, everyone wants experienced RNs only. Would love to work in US once get a couple of years experience for a working holiday kind of thing. Good luck to all doing their final nursing exams:nurse:
  9. Haha. I have a Classic II se in carribean blue also with name engraved. I find it a great stethoscope for my needs. Can hear perfectly with it...and I have lost a little bit of hearing
  10. Rosie_one

    new nurse switching positions

    How about drug/alcohol at a private clinic, not public as that can be pretty demanding. Another option that could be community nursing.
  11. Rosie_one

    Scholarship thank you letter

    Congrats on the scholarship. I just sent my thank you letter the other day and just said how it was an honour to be the recipient of the scholarship and wrote how it would assist me with my uni expenses. Rosie:)