biancocm

Where I work its pretty standard for intubated patients to be on both a fentanyl drip ( use mcg/hr) and propofol. We generally start fentanyl at 50-100 mcg/hr and adjust from there. That being said some of our really sick patients that we need paralyzed and sedated for different reasons like high ICPs or ARDS we will go as high as 700mcg/hr, but that is with a physician specifically ordering that amount and not us titrating.

I personally don't agree with peer evaluations, they are all my hospital bases anything on. On my last review they had given my review to a couple nurses I didn't get along with on a personal level (it never effected my quality of care) and they gave me a bad review because they didn't like me outside of work. I go to work to do my job, i'm not there to be everyone's friend. Because of my review I had to have a one-on-one meeting with my supervisor every month for a year. Peer evals overlook the core skills of being a nurse and employee and turn it into a popularity contest.

I work in trauma now and so there are very few stories that shock me anymore. However when I was in school I worked as an aide on a GI surgery floor. We had a patient who had a lot of GI problems (i never knew her back story, as an aide I wasn't told), she ended up having a colostomy from her surgeries. I was in there to empty the bag and I was just explaining to her about how you empty it and basics like that since it was new to her. She then started asking me a lot of questions about other care for the colostomy which i defered to the nurse but her last question was if it was possible to have sex through the stoma and if it would be similar to anal sex. I didn't even know how to respond other than to ask the nurse or Dr.

I just got back from vacation, I went to visit family in Myrtle Beach. I was staying with my aunt, counsin and my cousin's kids. I got to my aunt's house and all I wanted to do was go jump in the pool, before i could even set down my bag my cousin's 4 year old daughter was asking me to play "nurse" with her. So much for escaping work on vacation.

It depends on why they want the patient on heparin, is it a heparin drip or sub-q heparin. Our Dr's will often keep giving a patient sub-q heparin if they are anemic but no signs of bleeding. I've even had a rare case of a patient anemic and bleeding internally being started on a heparin drip because she had a mechanical valve. If a patient has a low hemaglobin and its been low or is dropping and the doctor wants to start heparin, there is nothing wrong with asking why they want to start it. when in doubt ask

we are intense about bathing patients in my icu. when patients are admitted they get bathed, when they come back from the OR they are bathed, literally one nurse is hooking the patient up to the monitor and another is starting to bath, while the nurse getting the patient and doctors are assessing the patient. However if a patient is a/o x3 and they refuse we generally don't force them and for them when I work nights i try to offer their bath early in my shift like before midnight. our doctors joke with us and refer to our baths as soon as the patient gets to the room as our " life saving bath" lol

I didn't have this happen with an IJ, but they placed an introducer into my patient's groin and it went into the femoral artery instead of the vein. We had to go based off gases, the patient had an a-line and another central line (verified in the vein) so we had to compare to see which it matched up best with. We also used ultrasound to see if they could see where it was and also tried to transduce a waveform. It did end up being in her artery and we couldn't remove it because she was in DIC so it ended up really bad.

I got hired as a new grad into a level 1 trauma center trauma icu and can't picture myself working anywhere else. I applied to probably over 150 jobs before I got this one (i was applying all over the country). I just kept call HR's and basically annoying them until they gave me an interview.

I graduated nursing school last year and started in the trauma icu, I only had 5 1/2 weeks of orientation, we were short staffed and they felt i was ready for my own assigment. During my orientation my preceptor was often put in charge near the end of my orientation so i would have my own assignment with her supossed to be looking over me. My best advice is to ask questions, if you don't know something or are unsure just ask.

The hospital I work at only the patient or RN are allowed to push the button, we actually had a incidence on a floor at my hospital a few years ago when i was doing my clinicals here as a nursing student where the boyfriend was pressing the patient's PCA and the patient ended up dying of an overdose