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acutecarenp's Latest Activity

  1. acutecarenp

    What do patients say that irks you?

    Ahhh yes... The innocent and idealistic fantacy world of the nursing student rears it's pretty head once again! I remember those days!
  2. acutecarenp

    Question regarding sudden tach in teenager...

    Dear Noso, Sounds like your son needs an EP study to see whether or not the arrhythmia is reproducible in the lab. The fact that he had these symptoms at an early age would sugges the possibility of a congenital abnormality. There are several congenital tachy-arrhythmias which are curable. What is necessary is an EP study to see if an irritable focus can be identified and whether or not it would be amenable to radio frequency abblation. Good luck! TM
  3. acutecarenp

    Lovenox IV & Acute Coronary Syndrome

    the use of enoxaparin IV is considered to be off-label, and as such, is not covered under the FDA approval of the drug. It should only be used in places where patient is enrolled in a clinical trial to study the efficacy of this route of administration, where there is a specific, IRB approved protocol and with the patient's informed consent. Off label use of any drug outside of a specific research protocol, could put you and the ordering physician at the defendant's table ALONE ! In my practice, I tend to stick with the more conventional, well studied, evidence-based approach to anti-platelet activity and anticoagulation. (GP IIb IIIa inhibition, ASA, SQ enoxaparin, unfractionated heparin,clopidigril, etc.). But that's just me....I'm funny that way! TM
  4. acutecarenp


    Also, I am an LVAD coordinator for a large transplant program. I'd be happy to answer your Qs if you want to e-mail me. acutecarenp@verizon.net tm
  5. acutecarenp


    Girl, It depends on the stata and status. go to http://www.unos.org This wiil help. tm
  6. acutecarenp

    Meds. to stop the Heart?

    In heart transplant, we use a solution containing high potassium and glucose at 0 degrees C. It is called UW as it was developed at the Univ. of Wisconson. Many CT surgeons prefer this as a cardioplegia solution. tm
  7. acutecarenp

    5:1 ....Sorry Ahhhhnold

    Cudos to the State of California for setting staffing ratios. http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2005/03/15/BAG73BP9SK1.DTL Arnold said that this will result in the closing of some emergency room doors!.. Where is he getting his info? He also said that these ratios would not be possible because there is a shortage of approximately 14,000 nurses... That's a long way from his earlier "set dressing" comment!
  8. acutecarenp

    Boneheaded Nursing: A Cautionary Tale

    With regard to the "CNA thing": I have been in practice for 23 (wow, that long???) years. I could not do my job with out the CNAs and techs that I work with. Of the many caveats I follow in my day to day practice, the one that is reinforced most often is the following: If the CNA comes to me and says "I just don't like the way that guy looks"...There is a pretty good chance I'll be transferring "that guy" to the ICU before the end of my shift! Oh.. and Cardio... Dixieland is lucky to have you! Tony
  9. acutecarenp

    Differences (Educative/Clinical) between NP & PA

    Zenman, If I ever make a concious decision to grow up....I want to be just like you!
  10. acutecarenp

    Should nurses have MSNs

    Well... It is clear that the above statement was made totally unencumbered by any forethought. It is just absurd.
  11. acutecarenp

    Vent about the oldest gripe around!!

    And to think... You have to take both a written and a practical exam...just to get a driver's license.
  12. acutecarenp

    In Trouble With The Bon!!! Please Advise Me...

    Wow!...Ouch! Well.. the frst thing I will say is that once again, my argument is supported! Hospitals that put new grads in critical care areas simply by virtue of the fact that they have a license and a pulse... may not be providing the best solution to staffing problems... Having said that, I will say that I feel for you as a colleague. As an earlier poster said, med errors are rampant. And unfortunately, if the order does not cover the full amount of the drug you signed out, and there is no record of waste, you are technically guilty of diverting controlled substances. Equally unfortunate is the fact that you are assumed to be intentionally deceptive until proven otherwise. The fact that you volunteered for a drug screen is a plus, but it does not prove a lack of criminal intent. If the institution has reported you to the BON, get a lawyer. If they have not reported you and they are going to handle it internally as an education issue, get a lawyer anyway. Prefereably on who is an RN,JD. Finally, no matter what, DO NOT LEAVE your position voluntarily. If you are reassigned, accept the reassignment continue to practice, and accept remediation as it is offered to you. I am sure that right now, you think that this is the worst thing that can possibly happen to you...But you will see, if you are truly innocent (and it's my hunch that you are).. this too shall pass. Tony
  13. acutecarenp

    Transplant Nursing

    Are there any nurses out there who are working in the area of organ transplantation? I have been involved in heart transplant in one way or another for the past 8 years. I have written to alllnurses.com to ask if they would consider adding transplant nursing as a specialty forum. Just wanted to see if there were any others interested. Tony
  14. acutecarenp

    /X@$# Banks

    What the heck is a quid???
  15. acutecarenp

    Funny Sign in slips

    "don't take my blood pressure in that arm!!!.. I got di-a-been-is in that arm!" "I ran out of dioxin and latex" "my cousin got the screamin-moanin' Jesus...(spinal meningitis)..and I wanna get checked out" Nurse: "Are you sexually active?" Patient: "Well.. I think I am...but my boyfriend says I just lay there."
  16. acutecarenp

    Your least favorite patient.

    I have 2 favorites: 1. The drunk who comes in with cops in handcuffs....who, by some miracle of having come through the doors of the ED, no longer needs police custody...or handcuffs! 2. The self proclamed "VIP" who works in the billing office and comes in with the 16 y/o daughter with a runny nose, and demands to be taken care of immediately.... when the Sh** is in the process of hitting the fan!... Hmm... this is Saturday night...Do you usually wear your hospital ID on your day off?