dah doh

dah doh BSN, RN

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All Content by dah doh

  1. Would Like Input - CABG

    It sounds like your patient is heading toward a trach. Hopefully the trach will be temporary and used for safer vent weaning. It happens and can't always be predicted. But I will advise you to stop...
  2. travel nursing as a couple.

    I met married couples and best friends who traveled together. It can work out. Give it a try. Good
  3. Didn't get senior practicum in NICU

    I didn't even get an ICU opportunity in nursing school, but do ICU now. Just hang in there! Once you get your license, you can try for a NICU position. Even though you aren't particularly interested...
  4. Would Like Input - CABG

    PFTs are not routinely ordered as pre-op for CABG. Your patient sounds like they were high risk pre-op. Do you know why exactly the patient can't get extubated? Are they fluid overloaded? Do they get...
  5. My first quarter of nursing school we practiced bathing and hygiene on each other; we picked our partner so you got a "friend". We wore swim suits or shorts & tank tops. The beds had privacy...
  6. Albumin/fluids and svr

    They tend to run our hearts dry; so immediate post-op they often need albumin to help with preload, cardiac output, or hypotension; of course blood is best! You could try some with high SVR, but we...
  7. Delayed Sternal Closure?

    I do adults only. Yes they can leave the retractor in the chest, but it's rare. They do leave chests open sometimes, usually if the bleeding was horrible or they had to over fluid resuscitate so the...
  8. I just watched a new medical show called "Monday mornings" or something like that. In the show, the neurosurgeon was doing brain surgey on a child when the patient went flat line. The neurosurgeon...
  9. Weekend shift premiums???

    I don't receive a weekend
  10. Try not take it as a personal attack. If a negative comment or concerns about new grad status or your internship in a different specialty come up, find a way to make it a strength to convince them you...
  11. not that it really matters....

    Whatever is appropriate per your facilities dress code policy is what the facility deems professional. Sometimes it's a specific color or type. Our facility doesn't allow denim or tennis shoes. We...
  12. Do patients question your expertise?

    A few did early on in my career, but I just answered honestly. Just last week, an attending physician called the patient's daughter and left a message. When the daughter called back, she said "I...
  13. Just being silly

    Yes & Yes. You only have one back so protect it by getting help. As to the other, I admitted a s/p cath lab patient with an IABP that had to go immediately to surgery for open heart. The...
  14. Ever "rip 'em a new one''?

    Mmmmmm...yup (hand raises in air guiltily)! Unprofessional behavior from an intern related to patient safety AND because I am NOT his mother or maid! Both the intern AND attending physician heard it...
  15. How your unit orients new grads is a good question to ask during your interview, but very few people actually ask it. That is unfortunate that you don't have a designated preceptor because this makes...
  16. The majority of new grads work night shift to start; that is if they are lucky enough to get a job! You are extremely lucky to get an interview in an area of interest prior to graduating nursing...
  17. What would you do??

    The question should be: where do you want to work? What type of patient population interests you more? What would you decide if both jobs were offered at the same time? What are your long term goals...
  18. Do you have a clever way to do IS teaching?

    For smokers, ask them to take a "drag" from a cigarette. Pot smokers do exceptionally well. For non-smokers, ask them to imagine its a very thick milkshake that needs to be sucked through the straw....
  19. Runny nose during shift

    Me too! Very annoying! I've seen my GP, a pulmonary doctor, and an ENT. No success. Next is an
  20. DEMEROL or MORPHINE for PANCREATITIS?

    Real world...neither one! Fentanyl usually. For NCLEX: pick the one that is not Morphine! (Demerol is rarely used anymore except for post-op or hypothermia
  21. Precepting in ICU/CCU

    Sounds like its going well! Keep it
  22. New to CVSICU...cardiac gtts

    To AMAC8487: "everything is compatible in the world of anesthesia"...sorry, that's my little joke! But you will find that it seems true! Although it may vary at your facility, generally, all the...
  23. Why can't nurses intubate?

    No reason for it at my facility! Some of our experienced respiratory therapists can still intubate. We have medical interns and residents, pulmonologists, some attending doctors, and also have a...
  24. titrating FIO2

    Some patients tolerate more titration/weaning than others; it depends on their condition and comordities. Your doctor, RT's, and other more experienced nurses can assist you in your learning process...
  25. Wasting

    You should have wasted in the Pyxis right away or immediately after you gave the dose but definitely before you discarded the remainder of the vial. It isn't always possible immediately but you should...