cannie

Healingtouch We don't use levophed very much but see a lot of dopamine and dobutamine. The 2mcg renal dose of dopa dosen't seem to really have any effects on renal output and perfusion. Most often it's a small blood preassure increase that I've noticed...if anything at all. My main concern with dopa is that it not go in a peripheral line. Dobutamine patients seem to show more PVC's the longer they're on it. Epi is mainly used in emergent situations on our unit but is used as a bronchodilator at times. Some patients can get panicky and shaky when taking it. The more frail patients are prone to SVT. Hope some of this helps.

I work on a 45 bed CCU. We take acute and r/o MI's, 24hr post OH (lately we've been getting them just over 16 hrs though), cardiac caths with lines pulled by us, run all drips except levo, and trauma patients not sick enough for our ICU. Of course we see a lot of surgical, CHF, sepsis, and CVA's as well. All RN's float ICU/CCU but most of us "live" in one or the other. Our CCU is staffed 5-6pts to 1 RN and 1 LPN. In ICU they staff 1-2pts per RN. Acuity is always taken into account.

I agree with fergus. Call the person out, preferably with witnesses. Try to teach by example. If you have the time volunteer to do something for another nurse, frequently. If all else fails go to the cafeteria. Get one of those small packs of salt and tape it to the wall at the station. This is to ward off "slug nurses". Inevitably one of them sitting and staring at the wall will ask what it's for. Good luck, Cannie

It astounded me to hear of how the training is going now. I've been out for 7 yrs (and going back this yr) and feel that I had excellent hands on training. We had a checklist of procedures to do before we could graduate i.e. 3 IV's, 2 foley's, 1 NG etc. I did have to do a bit of pushing and searching to get these but we all managed. Now I work in an ICU so we don't get a lot of new grads. At this point though, I think all my co-workers would agree, I'd just be happy to have a pair of hands that wouldn't turn white and faint at blood and ooze. We all learn sometime so jump in and do it! Some, not all, nurses will be glad to let you perform a procedure you haven't done before. Let them try. If you know they haven't done it...give it to them. If our school's are putting nurses out there unprepared we, as a profession, have to help pick up the slack. I'd rather show them than have them covering my and my patients back sides unprepared in an emergent situation. My training never (and I don't imagine ANY do) covered clipping new open heart chest wires with a motorized saw so internal cardiac massage could be done. But one day someone handed me a saw......

You're not alone. Some nurses know when to seek treatment but I tend to minimize my ailments. Three years ago I had a HA for days that wouldn't go away and got progressively worse. Our insurance was bad so I tried to self treat. Finally, my husband forced me to the ER. I couldn't make my hands do what my brain was telling them to. I had meningitis. I take my kids in for just about anything (our insurance is much better now) and usually end up being told what I already know. Won't take a chance with my kids but I seem to be expendable in my own mind. I'm also unwilling, along with my employer, to take time off for illness. This isin't doing our patients any good but with the shortage there's an unspoken "You better be on your deathbed if you call in sick" attitude at the ICU I work in. This is very dangerous for our patients but so is overworking us. What can be done? Is there a solution? I like any comments on this subject. We seem to be in a catch 22.