nurselily3

There is some new technology out there at about 5 hospitals...Duke, Stanford and three others I can't think of right now. They are researching a liver dialysis type machine to prolong the life of those who need a transplant when a whole organ isn't available...and also to bridge those who need time to recoup from say a tylenol overdose etc (cause the liver regenerates its cells if given enough time and if it has a few good ones to regernerate). Its still in the works but they are testing it out on humans. You can google liver dialysis and check it out..do some research. I used to work in our SICU that recovered Liver transplants. Whether or not the patient was a drug user doesn't matter, lots of people get hep c from past drug use. Most have to test clean for a year before they are transplanted. And like the previous reply said, you must make sure you are at a facility that does liver transplants etc. I also don't recommend partial liver transplants or live donor transplants..in fact, our hospital only does whole organ transplants. I think there is a risk with morbidity and mortality. Liver transplants are pretty fascinating....if they make it through the first year with little to no complications they have a very good chance of having a normal life span. Ex. the olympic skier..can't think of his name. As far as the attempting suicide....these people aren't always lucid all the time, especially as their disease progresses. Their ammonia is high, and they are holding on to all that garbage in their system that a normal liver filters out. Depression is rampant...and a lot of those drugs are metabolized in the liver. My father had a lung transplant....very different from the liver obviously...but had to go through extensive psychological evaluation before he was placed on the list for transplant. Hope this helps

If the patient is a fresh post op or unstable (even the hearts), we do a full set of vitals, swan numbers with wedges q1 (for at least 12-24 hours). We get hemodynamic numbers q2 or q4 depending on stablity. We only use saline in our flush bags due to chances of heparin induced thrombocytopenia. We are allowed to only pull the swan, not advance it. We use CCO swans, not the VIP ones. I traveled to a hospital where they didn't use swans that much, and the ones they did were VIP...the went through this whole bunch of crap with iced saline to inject....and only did their numbers once a shift. What's the point. We use our CCO to titrate drips, fluid bolus, etc. In all the time I worked in CTICU and in SICU I've never heard of a patient in any of our ICU's having a blown PA from wedging the swan.

Our cooling blanket protocol was for anyone over 104F. Most of the time these people had a swan ganz to get a temp from or a temp sensing foley. When their temp reached 104 we paralyzed them (dr's order needed), put the blanket under them with a sheet between them and the blanket and turned the blanket to a temp to drop the patients temp slowly. Hope it helps.

Hey All, I'm beginning to think that I need to go back to school and get my masters. My current employer will pay for 6 hours of grad school credit a semester which sounds pretty good. I'm a little discouraged in my current job and am looking for a new horizon so to speak. I'm not interested in being a CRNA..don't want to do H & P's all day either. I think I might really like staff development. So, what kind of masters should I persue? I was thinking Clinical Specialist...but not so sure. Our University provides a MSN with an emphasis in Nursing Management/Leadership...although this really isn't what I want to do. Can anyone give me some advice. P.S. I'm also wondering what the starting salary will be about. And, how is the job market for this type of job?

We use SCD's on our patiens without TED hose. They stay on the patient until they become ambulatory. There is some controversy about how much protection you get from just the lower leg SCD's vs the ones that go up to the thigh. Our patients all get 5000u subq heparin bid as well. I personally like SCD's cause ours have a cooling button if the get to warm on the patient.

Since there seems to be a shortage of nurses in all different areas, most hospitals have training programs for new grads. I went through ICU training and OR training. It was 4 months for ICU and 6 months for OR. I think with this training you gain an understanding of what is expected. As with any job, those who have been doing it for a long time obviously know more and are more experienced. I think nursing in any area is like this though...we all start out with some very basic skills and must learn to be flexible in whatever area we choose to specialize in. New skills for new areas can always be built and/or added on to previous ones. Therefore, I don't feel that any nursing speciality can turn new grads away since we all have to be oriented and there are orientation programs available.

I work for a hospital that has magnet status. When we first acheived it, I didn't think much of it and a lot of other nurses complained about it. I thought I would find something better so I went traveling. I went across the country to a hospital that was supposed to be a leading research hospital etc...(that has been trying to acheive magnet but can't seem to...that is union, but the nurses don't seem very happy about that either b/c they aren't represented, their staffing was so bad that we travelers worked pretty much the whole hosptial)....everyone sung its praises. This particular hospital wasn't so great. I don't know if it was that the patients didn't seem as ill, or the nurses didn't seem as interested in learning new stuff. They certainly were treated like crap from the resident/attending staff. Needless to say, I couldn't wait to go home!! So, I've come home to the hosptial that I thought was so terrible and found that we are respected and valued for our opinions on patient care (at least in the units I worked). I found that we have this sense of pride that other hospitals don't. I don't think its just magnet. If I were ever sick, this is where I would want to be, and who I would want to be taking care of me. Sure, our hospital has problems...much like the ones talked about in the thread (staffing etc). It took awhile, but those problems were addressed. Patient:staff ratios are much less now than they were. Our shared governance committies are working..and that took awhile. When we complain, our CNO listens...cause she wants that magnet status protected. Nurses will always leave our hospital, in search of something better..just like I did. They will find that the grass isn't always as green on the other side of the fence...and ultimately come home.

To bad we didn't come through today. I hope we make a good appearance in the NCAA though.

I'm from Kentucky, did a traveling assignment on the west coast....were it seemed people thought I was stupid cause I had an accent....and OMG I WEAR SHOES....Just cause I talk slow doesn't mean I"m stupid!! I have a BS in another health related field and an ADN. I agree with what so many of you have already said, who cares as long as you pass the NCLEX and know what you are doing. I don't think we get the respect that we deserve as ADN's. I wanted to be a nurse, but the snotty BSN program and the university I was already attending was more willing to accept someone out of high school rather than someone who wanted to change their major. Whatever. I did what I wanted, and that was go to nursing school. And I"ll have to be honest, I worked 100 time harder doing a 2 year program PART TIME (because I had already taken a lot of the extras) than I EVER did the whole time I was going for my bachelors. And no, neither program offered that hand gestures class. What a hoot. I can't stop laughing at that. I'm just curious...whoever wrote that statement about how they think we should have bachelors degrees in something else and get our nursing degree as a masters....do you think that by doing that you are going to get more respect from admin? Docs? Other health care professionals?? My vote is NO. The field my bachelors degree is in gets little to no respect. My dad used to joke that he paid $40,000 for me to learn to cook and I couldn't even boil water.

I have been on both sides of this issue. I started out as a nurse tech/aide on a telemetry floor, then went to the ICU. I saw several people code, some survived, some didn't. At the time, I got an adrenaline rush from it - helping the nurses, saving someones life, or trying the best we could to defeat someones "time to go". Then, about a little less than a year of working my father had a lung transplant. He coded in the ICU after several bounces from unit to floor to rehab to floor etc. My mom called me on a wednesday to tell me he had been readmitted and was going to the unit. At 5 am the next morning she woke me up to tell me he was coding. Since I had seen people in the unit code several times before, I knew it was "controlled chaos" if you will. I asked to speak to the nurse. After she told me it had been 40 minutes, I knew it was over. I drove like I was at the Indy 500 to the hospital...hoping by some miracle that he would be alive when I got there, knowing he wouldn't be. We they let us in the room, he was cleaned up with a sheet over him, a mess of heplocks and stuff under the bed. All I could think about was what they did to him..just like I'd seen so many times before. I thought about that for a LONG time. NO, as an RN...I don't think this should be common practice..to let your family in to watch this traumatic event. It gave me nightly nightmares for months and I didn't even see it! People want to remember their loved ones in a good light, not laying blue with someone pounding away at their chest. In retrospect, this whole experience....HARD as it was...I feel made me a better nurse. Each family is different and being a nurse with good intution will make the right judgement call. I also think that this is exactly why people should be told what it means to be a DNR. SO many times patients and families don't want to be pounded on but still want to be treated....they don't understand exactly what it means we will be doing, or not doing.

I have gotten such a laugh out of this thread!!!! So, I thought I would add a little to the pot. I had a patient once, older lady, who called her genitalia her "kitty kat". I was helping her bathe and she said "Can't forget to wash the kitty kat"......oh my. And, the other day while I was asking my pre-op questions to my 15 year old patient (while his parents were standing there)...he says to me "Henry has to go"....who's Henry (thinking it was a family member). Well, aparently Henry IS a CLOSE member of the family :chuckle I just couldn't believe that he was say it in front of his mom.

When I was in college, doing a program other than nursing, we had a sort of similar beef with a professor. You can go to the ombudsman for the school and discuss this situation with him or her, that way it isn't with the dean of the college if you are worried about repercussions. The ombudsman is supposed to be an impartial party to problems like this. Needless to say, after a few classmates and I went and complained about our problem.....the problem was fixed. Besides, she is required to give you a syllabus at the beginning of the semester/quarter/whatever that spells out how he/she will be grading. If she doesn't go by the syllabus....then she is in "breach of contract" so to speak.

Just curious, don't you have sick time at your hospital?? p.s. I agree with who ever said to shake her hand. I would give her whatever it was I had and see if she called in sick!!! Geez, don't they know that its better for you to stay home and get well before you SPREAD it to all your staff, not to mention your patients and their families??

Please note that we are NOT and out patient surgery center. We are doing NASTY BLOODY TRAUMA!!! We are doing very large orthopedic cases, large burns etc etc. I don't mean to be impolite, but comparing a outpatient surgery center to a trauma center is like comparing apples to watermelon..all fruit, but not the same. I"m glad that you are happy with your current work situation. DO you also have residents doing your cases??

I have been so upset lately about our turnover times and the possibility that they are going to make the RN's mop the floors between cases I did a little research yesterday. We were told in our weekly staff meeting that our AVERAGE turnover time was 38 minutes. That it ususally took 12 for the nursing/scrub staff, 5 for housekeeping (which they are getting rid of) and 9 for Anesthesia. We are still having problems getting the docs to update their H and P's and make sure the consent is proper...answer their patients questions and all that jazz. So, yesterday I was doing some Oral Surgery cases, Lefort 1's and Fractures. They are usually between 2 1/2 hour to 4 hour cases depending on the difficulty. I had all my stuff ready and my scrub nurse and I were ready in the designated 12 minutes. That was from first patient out, to second case ready to come back....and it still took anesthesia 40 minutes to get ready!!!! But clearly, the problem lies with the room staff. Ok, just had to vent about that. I agree...you have to have everyone on board with a common goal. THE PATIENT! Sometimes getting anesthesia to do that is like pulling teeth!