labman

If you don't want to work ICU you getting your CCRN wouldn't be too useful. In your thread you seemed more interested in ER so go for your CEN or TNCC. CCRN doesn't have much content, but more information on cardiovascular (shocks), and pulmonary concepts. Good luck

Thanks guys and gals for the answers. The funny thing is when they did this thransfer they only had 3 other paitnets downstairs. I am just sick of the MD comming up to the unit asking why the patient is in the ICU when they didn't see them in the ER and the ER just sent them upstairs. We will see what the manager says. I am sick of staffing being adjusted and people getting called in wasting the hospital money when this doesn't happen and also not able to treat the patient (because the only ER order is an x-ray). I can do much with atleast is gander at that x-ray from the ER. And whoever wrote the enema every hour thanks. That made me laugh...

So I work in a medical ICU and there has been an ongoing issue where Emergency room will send up patients to our unit without their physician seeing the patient and them writing orders. So many times we will get a patient transfered up to the unit without orders... Many of times we will change staffing because of this and when the physician comes to see the patient they question why the patient is in the ICU (along with us). Can ER do this?? They are notorious of doing this on shift change or when the patient is particularly overbearing or a lot of physical work... What would you feel about a patient comming to your unit without orders. Without them even knowing the code status. Does anyone else have this issue and if you do what have you done about it because it is getting pretty obnoxious...

:up:My fiance did have my back. He totally understood and said hey I can understand your frusteration but I couldn't have done anything. Thanks for the input I felt bad and just wanted to put this through to other nurses to get your opinion. Thanks so much everyone you eased my mind

Thanks very much. If **** would have hit the fan I would have been there but she was stable. Was tachycardic and hypotensive (but as a nurse what could I have done). Thank so much

So I went to a going away party for one of my finaces best friends (she was going to India) her parents were there and alochol was involved (probibly a glass of wine and social anxiety). Well it happened she passed out (I had my back turned but she didn't look like she had distress (people asked her where she was and to move everything and didn't look to have any stroke symptoms and people were crowding her. She also appeard very stable (a clear airway and just a little pale) So they called paramedics and they came really quickly So I thought she had some social anxiety and let her be because the poor lady was embarassed so much and had her family next to her. The situation is she called my fiance and told me she was upset that I didn't intervine since I am neuro ICU / trauma nurse that has a years experence. What do you guys think? I thought the situation was handled and I wouldn't/ couldn't have done anything except take her pulse and talk to her. Give her some water possibly breathe into a paper bag What do you guys think??? Was I wrong for watching her from the distance?? Or should I have stepped in can you tell me why you feel the way you do?

Hey congrats on passing NCLEX Advice I have for you is not to be too suprized about what any head injury says (the craziest things). What vasospasm is for cerebral aneurisms rupturing. How to diffuse difficult situations... Take care good luck

here are two sites that I found helpful one is http://www.neuroland.com/- I would go under index and see what you can find Also too http://www.waiting.com/ (good site helped me deal with families) Also too I think under the top two forums there is a lot of websites dedicated to neruo http://www.icufaqs.org/ (A good general ICU site I loved it) Good luck with your internship and hope these help

I would imagine a paperclip would be good. It looks neat and easy to unclip all the papers. This is my assumption and how I think it would look best. And good luck with the interview. Take a deep breath before and be yourself. kent

I will say I know your feeling of getting placed somewhere you don't want to be for your senior internship. When I was a senior we had a lottery and I wanted ICU sooooo bad, but we had a lottery system and I picked the last number. I got stuck in rehab. I really wanted to be a cardiovascular ICU nurse and this experence made my change my mind and I chose Neuro ICU and love it. So keep your mind open. Some things that are good to learn is ventilator associated pneumonia, sepsis, septic shock, acute respiratory distress syndrome and CHF. Those are a couple of diagnosis I can think of kent

Well I am glad you love neuro as a pre nursing student!!! I picked neuro because it is the system I knew least about (I am truthful), I felt you never have two patients with the same type of stroke that are similar and it is developing field. The part with neuro is families (it is scary knowing that an injury could change the persons personality and there is a possibility of them never being the same) and when you can't reason with patients due to their injuries. I would recommend doin gsome CNA work in neuro or a rehab and see what it is like as a CNA. There is a book called stroke of insight and it explained a neuro antatomist with an AVM hemmorhage in the left side and explains her recovery. It is fasinating and a very easy read Good luck any more questions feel free to post or PM me kent

Anyone think of ICU psychosis, or UTI or constipation. I never know these situations unless I look at the patient myself. If he was on propofol I am guessing he was tubed and how do you know he is more confused??

Ya I remember calling the doctors about an issue. They would immediately go to so is the neuro status ok. I also forgot to say neuro exam is probibly the most subjective compared to hemodynamics which is totally objective I guess I agree with pts eating. we have spurts where everyone is eating then no one is... Well good luck

I think I am preaching to the choir about this one. I feel a new grad starting in the ICU- It depends on the person and situation. I had a 6 month oreantation which around 4 months I felt comfortable. We also had classes and preceptors who were great. With everyone I went through oreantation with you can tell others get a lot easier assignments and us who get tougher ones.

I do work in a level one trauma center in there neuro ICU. IABP- We never have to do any of that and that would be scary. Hemodynamic wise we do not have too many people with swans. My year and a half in neuro we have only had 2 people I know of with swans. The main hemodynamic montior we carry is ICP monitor (ventric) or a licox. Usually an ruptured cerebral aneurisms we do triple HHH therapy which requires CVP (but our unit rarely uses pressors) When the brain herniates that is a hemodynamic game because they have no sympathetic tone and are ususally on 4-5 pressors. I say if you want cardiac do cardiac go for another hospital or maybe a medical ICU because there is not too many hemodynamics involved with neuro. Don't want to be a troll but just my 2 cents.