ashleigh_0804

I'm sorry. But I don't even get this question. Two people to do oral care on intubated patients? If your cuff is properly inflated, cass tube hooked to suction, HOB elevated greater than 30 degrees...I don't even get how oral care would be an issue, even for micro-aspiration.

What's a CNA?!? Haha, JK. Well, I work on a 28 bed neuro/med-surg ICU. We have one CNA whi works 36 hours a week, and I usually never see her when I work. When I do see her, she's taking temps and blood sugars. That's cool and all, but I can do that myself. All I ever want is somebody to help me turning patients and cleaning them. Heck, I'll gladly take the "dirty" side and do all the cleaning and wiping. I just physically not strong enough to do it all on my own. My manager can't figure out why we keep getting dinged for pressure ulcers. I DO turn my patients every two hours, more even. But it's impossible to completely get them all the way off their side by yourself. I shove the pillows under, I use the turn assist...but nothing beats a pair of hands to really help you do it. My fellow nurses would help, if they weren't so swamped theirselves.

I disagree with you only Bc when you accept a position, you are expected to be able to preform those duties. While the right to practice your own religion is a constitutional right, it doesn't mean that your employer is forced to excuse you from certain duties because of of your religion, especially when that duty is within your scope of practice. I can't get out of working Sundays to go to church, because when I accepted my position, working Sundays was part of my job description (a little different, I know.) She has a right to her own religion, but it shouldn't interfere with patient care and its not like hanging blood was some big surprise for her that all the sudden her employer was forcing her to do. It's a part of nursing. What if I was a chef and not washing my hands ever was a part if my religion...would a restaurant hire them to serve food?

Usually after anesthesia intubates a patient, we never hear from them again, so I don't k ow their opinion on it. Now, our RTs sometimes complain if we don't leave a 'courtesy' flap or cover up markings. A courtesy flap (in case you don't know) is when instead of fastening the last end of the tape to the ETT, you double back a little piece. This makes it so you can easily take it off. I can't see why they would ever care, except for if you don't leave this flap and you can't take the tape off, so it can't be repositioned. Our hospital doesn't have a policy.

I'm a newer ICU nurse and I have the best quote from a doctor. It was one of my first days off of orientation and I lacked lacked the experience and knowledge to realize exactly what was going on with the patient, but I felt like the doctor needed to actually lay eyes them. I was very shy and very apologetic about calling him into the room. But Ill never forget what he said to me. and this was an a-hole doctor too. But he looked at me and said "What makes an ICU "intensive" isn't because the care from the doctors is more intense, but because the care from the nurses is more intense." Never jeopardize the safety of your patient for fear of the doctors response. Better to get yelled at (that happens even when you are doing nothing wrong) and have a patient who is alive and be that annoying g nurse than to be that nurse whose patient died because she didn't speak up. Looking back now...I think I called him in over something silly too. Like their urine was green Bc I didn't know propofol did that

I don't know if this is right or now...but if a patient doesn't convert from amiodarone, should you consider switching to cardizem or another drug??

Is it unsafe, yes. Does it happen everywhere, yes. That's what makes nurses so important. We have to deal with cutbacks firsthand and learn how to adapt. So while it's unsafe...it's a hard reality.

Ask a lot of questions. Everybody has to learn from the beginning. It can be overwhelming and you will have moments of doubt. Take a deep breath. You have senior nurses to rely upon so you aren't alone. Also focus on the patient first. They will drill real time charting and charting on time, but take care of the patient first. If something seems scary, a low blood pressure bad rhythm, etc, look at the patient first. For example, pulse ox us reading 70s. Well, is your patient pink and talking to you? May just be a bad reading. Learn to trust your instincts. I remember having bad feelings about a patient and wanting to call a rapid response, but not because other people were like they are fine. Then the patient deteriorated. Yes, sometimes maybe nothing us wrong, but better safe than sorry.

Oops -- BP would be 220s/115 at times, all over the place but also with a very high map.

I have been an RN for about a year and a half. Recently transferred to an ICU and have been researching after work everyday to learn more about the cases I saw that day and gain better idea of patho and improve critical thinking skills. Recently had a patient going through DTs. While I know the usual treatment and things to look for...still trying get a grasp on the cause. Can you explain the effect of GABA and what it does during alcohol withdrawal? Also, I know we bolus these people to keep them hydrated. My patient was getting maintenance fluids and they kept giving him boluses...but his BUN was 3. If you are high, you are dry, right? So what's the logic behind adding boluses of LR, even if their BUN is so low it would indicate they weren't dry? Creat and GFR normal, urine output excellent. BP elevated (180's/90's). Was worried about fluid overload, but preceptor said not to. Not to mention all the fluids from electrolyte replacement and banana bags.