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KeepinitrealCCRN has 5 years experience and specializes in SICU,CTICU.

KeepinitrealCCRN's Latest Activity

  1. KeepinitrealCCRN

    Need Advice on Accused Medication Error

    I wonder if there were cameras? I would tell them to roll the footage! and then we can see who took it off in the first place. Also, in this case it is the instructor's problem as they are supposed to do everything with the student and you guys finalized the medication and put the mask on the pt and left together. The mask coming off happens in real life all the time - could be by RT or another nurse or the pt and sometimes we have to put it back on or stop the treatment just as you mentioned in your original post. I also think you did the CORRECT thing by telling your instructor first before taking it upon yourself to put the mask back on. Im glad you got to move on as this is so ridiculous. Good luck!
  2. I would resign if I had to work 8s and Id leave the profession all-together if that was the norm in all hospitals. There is no need for change! We shouldn't even put this out there in the world!
  3. KeepinitrealCCRN

    new onset afib

    new onset fib + CHF history = Telemetry admit
  4. KeepinitrealCCRN

    Platelet Administration

    I've always only hung platelets with special tubing (a filter) and it is hung by gravity usually goes in within 30 min.
  5. KeepinitrealCCRN

    Best sedation med

    I like prop/fent because you can bolus them and titrate them easily. I also love versed but it is not our go-to drug. Personally, I hate precedex because you can't bolus it, it doesn't really work and almost always causes bradycardia. Precedex is good to take the edge off or ETOH withdrawl but not great for intubated pts who need something stronger.
  6. KeepinitrealCCRN

    What separates great nurses from decent nurses?

    Number one would be critical thinking skills and a close second would be just caring about the patients. So many RNs lack these 2 even the senior RNs.
  7. KeepinitrealCCRN

    Shift Report: Listening, no writing...

    I also do not write anything down. I felt like when I first started I would and I would miss a lot because I was writing too much so I dropped that and just started listening; the things I forget I can always look up. I only really need to know events that happened overnight and the plan for the patient, everything else I am going to assess or look up myself whether they tell me or not. I work in the ICU and only have 1-2 patients, if I had 6 I think I would need to write some things down to stay organized.
  8. KeepinitrealCCRN

    Levophed works better in D5 vs. NS

    I believe levo in d5w holds its concentration better?/longer but I don't think it actually increases the BP more than being mixed in ns. That is my understanding of why it is mixed in d5w rather than ns ideally.
  9. KeepinitrealCCRN

    Racial Discrimination In The Nursing Profession

    "Less than 25% of the nursing workforce in the United States are minorities" This cannot be true. I think it is the opposite? Im not saying racism doesn't exist but the majority of my coworkers are minorities including our manager.
  10. KeepinitrealCCRN


    I def agree with the OP. I come across this very often in the hospital as well but I think its how you approach it that will get you through the day easier. I often use lines like "I only want the best for you as my patient". Oh your food didn't come out with the right amount of pepper on it?? Here is the number to the kitchen since that is not where I work and you can order something different. Oh you a&ox3 pt who understands what these meds are for and you still don't want to take them? Let me head to the computer for my note "pt refusing all meds at this time". Threatening to leave are ya? Here is the paper for you to sign and we will get you right on out of here. See you in a few days! I refuse to fight or argue with anyone who is of sound mind and body. I also refuse to get all worked up over any of this stuff. Sometimes if you take a different approach then the outcome will be different.
  11. KeepinitrealCCRN

    Struggling with report

    I will just add a few things. You can add a blank section to your brain sheet, or whatever you use, and there you can put updates so you remember to tell the night nurse at change of shift. You work on a tele floor so most if not all of your patients are cardiac so that should be where most of your focus is. History like appendectomy 20 years ago is not important, for cardiac patients any and all cardiac history, DM, kidney problems/HD these are important things to know in terms of history. Next what brought the patient in to the hospital and how they got to your floor. Then head to toe, I start with neuro and end with skin this way you won't miss anything, you are streamlined and it will also help jog your memory of things you may have forgotten. Then I do lines/drains/drips and then I do the plan for the patient and thats it. There will always be nurses that ask a million questions about things that are not important and saying "I don't know" is fine, if they want to know they can look it up themselves. You will get it over time but I find going head to toe is best.
  12. KeepinitrealCCRN

    struggling new grad: may not make it past orientation

    So you actually seem like you are doing well. You know your weak areas (these areas take time for everyone not just you) and you seem to be extra careful which is much better than not caring or not knowing when to address something or let another nurse/your preceptor know what is going on. Maybe you can request a meeting with your preceptor and the manager so you can really see where you stand and if there is something you need to work on or if its just the normal things all new grads go through. good luck!
  13. KeepinitrealCCRN

    Is the term multi-tasking now synonymous with working hard?

    You can definitely work hard without multi-tasking and you can also multi-task without working hard. We as nurses must do both at all times and how dare we take a break! Also staffing, upper management etc. force us into this and we are able to do it and adjust but it affects the patients. Yes, we can multi-task but the constant interruptions and having your mind change gears all the time causes room for errors and things falling through the cracks. I think your answer was a great one unfortunately she did not like it but maybe that wasn't the job for you and hopefully your new job is going great!
  14. KeepinitrealCCRN

    New Trauma Nurse Help

    TCAR is a great class. Also, you will learn as you go, every code is different and I am sure they don't expect you to know everything. Every code you are in try and do something different so you can get experience with it.
  15. KeepinitrealCCRN

    Any L1 Trauma Nurses Out There

    So it depends on the hospital you work in. I work in SICU and I love it but the sickest patients tend to be the neuro or surgical ones. The trauma patients can be as simple as a fall with a bleed in the brain that were just monitoring. If it is just a trauma ICU then you might like that but if it is SICU with mixed patient populations you might not be into the neuro and surgical pts which I love personally. To add on to the previous post a lot of the trauma patients even the ones that are flown in via helicopter go through the ER and then to the OR and then come to you so they are relatively stable but can still be unpredictable but as I mentioned a lot of the trauma pts are not this type but more the simple fall with bleed and maybe a few broken bones (not exciting to me).
  16. KeepinitrealCCRN

    Population and Turnover in the CTICU

    You are correct about CTICU/CVICU; pt turn over is very quick. MICU and CCU probably have the longest stays due to a lot of the population having chronic problems with multiple comorbidities followed by SICU in my opinion.

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