More2Learn

Very interesting! Thanks for the resource and discussion!

Thank you so much for your helpful reply! I have found a lot of conflicting info about steroid therapy. Several (apparently reputable) websites (trauma.org and Paralyzed Veterens of America) indicate EBP is NOT to give steroids...little benefit and a number of added risks. I see you mention this, so I am thinking it is still being done in practice and perhaps for good reason. Any thoughts on that???

I have a question about an acute SCI. If it's a cervical injury , am i right it is stabilized with traction initially, then probably to surgery and/or halo vest? If so, how soon is surgery done? If there is impingement of the cord, wouldn't it be done ASAP (that day)? What about a T-spine problem? What is done initially in the ED or in the first day to stabilize it? I know we are trying to get people off backboards ASAP...if the person is alert and cooperative is it enough to just have them on bed rest with logrolling? What if they are uncooperative...are there any other ways of stabilizing the spine before going to surgery? Thanks for any help from those who work in the field!

I have a question about an acute SCI. If it's a cervical injury , am i right it is stabilized with traction initially, then probably to surgery and/or halo vest? If so, how soon is surgery done? If there is impingement of the cord, wouldn't it be done ASAP (that day)? What about a T-spine problem? What is done initially in the ED or in the first day to stabilize it? I know we are trying to get people off backboards ASAP...if the person is alert and cooperative is it enough to just have them on bed rest with logrolling? What if they are uncooperative...are there any other ways of stabilizing the spine before going to surgery? Thanks for any help from those who work in the field!

You may feel ambiguous about going to your manager for your own sake, thinking you may have to "tough it out" with this preceptor. For your patients' sake - you need to. To expect a nurse with no ICU experience to be taking care of ICU patients without being taught how is archaic and very risky. Any manager who cares about patient care and safety in his/her unit will step in and assign you to someone else, and remove this person from being a preceptor. She may be a very capable nurse, but is unfit to welcome and train new nurses into the unit. Don't tolerate this! Let her know you have some back bone and you take being a patient advocate as your highest calling. It is very distressing that this goes on in our profession. It will continue to until we work together and stop tolerating it. It know it is easy for me to sit here and write this, while you have to go in there and do it. Know there are many of us out here cheering you on, and no doubt others in your unit who (maybe secretly) don't like it either and haven't had the gumption to address it. Good luck.