clarkheart

I have been looking at switching specialties from critical care to dialysis. What do you all find are the advantages/disadvantages? I am CRRT certified from critical care. I am interested in either clinic or acute care.

I've done a little bit of everything: Med Surg, CVICU, CVOR, Cath Lab, and Quality and Risk Management. Currently a Clinical Coordinator on a Cardiac Telemetry unit.

Probably costs even less in Mexico. If they can charge it and you pay it then they will continue to gouge you. Not just drugs though..I still want to know why I have to pay $35.00 for ten disposable razor blades when they make them for literally pen...

The great thing about that nursing degree is it opens other opportunities if you want. If you are fed up with bedside care then use your clinical knowledge in other areas in healthcare such as quality, case management, risk management, informatics, ...

I would continue to look for other positions if you want. Keep your options open. There is nothing wrong about continuing your search while they are continuing theirs.

You need to find a new job. Life is too short to put yourself through torture every day you work. I have been there myself and left positions that became too stressful. Nothing is worth compromising your physical and mental health. I bet the momen...

I was a circulating RN in a CVOR for over two years and pulling up to 25 days a month on call. Then I went to the Cath Lab and pulled about 12 days a month and I thought I was in heaven! I now work in Quality/Risk Management for the last three years...

I think one of the issues that we need to discuss is how the physicians discuss the care of these patients with the families. There are times when the most dignified care these patients could receive is to allow nature to take it's course. I don't ...

Our hospital got called out by The Joint Commission before and accused us of "practicing medicine" (they like to use that term) when our electrolyte protocols weren't "tight" enough. They didn't like that our protocol allowed us to continue to repla...

First question I have is whether the patient is stable or not. Patients with wide complexes can be stable. If patient is unstable and complex wide then CPR then defib. The AICD may be set to trigger at higher rates then just 112 regardless of the ...

Thank you for the information. I am looking into crossing over into Quality after being in patient care for 20 years. Any advice of making this a smooth transition would be greatly appreciated.

I've been told by Intensivists that any PEEP over 5 will artificially give CVP readings on a one to one ratio. Example--PEEP of 8 will artificially raise the CVP 3 points. I've always been told to keep that in mind when accessing volume requirement...

Always have a notebook or paper available to write down notes or thoughts when they come to you. Then review them later and expand on them if you can. I ended up creating my own notebook that I still keep at my workstation and I will add to it even...

Never take the ECG machine interpretation as the final word. I have seen too many wrong explanations through the years from a machine. Trust the MD's interpretation first.

They may give you clinical scenarios that will require a knowledge of ECG interpretation or basic knowledge of pharmacology such as what drugs to use in what clinical situation or rhythm. Been a CVICU nurse for over 12 years and had an interview for ...

I worked CVICU for over 12 years and found the best 12 hour shift schedule for me was every Tue and Thur and every other weekend. That way I had a day off after every shift except my biweekly weekend shift.

I work in cardiac surgery and call report to CVICU recovery nurse 30 minutes before we go up. Anesthesia and myself transport patient to unit monitored.

I've been a nurse for over 17 years now and I don't regret for a moment my choice to enter nursing. I understand and appreciate some of the comments regarding our profession such as the long hours, disrespect, and feeling that we don't make a differ...

I work in a 12 bed CVICU in California. Our director has begun to talk about increasing our ratio to 3:1 in our unit if we have too many floor patients awaiting transfer out to med/surg. I thought Title 22 and AB 394 in California prohibited increa...

Bojar is an excellent stand alone reference. I allows remind myself what the best cardiac surgeon I have ever worked with told me once:"Never get complacent, there is no such thing as a routine open heart recovery." Every recovery is different.

It's plain insane to use Precedex as an induction drug. Etomidate and versed/fentanyl usually work much better with another paralytic if needed. Precedex can be hit and miss but we use it exclusively to wean and extubate our open hearts. We also u...

milrinone ntg nipride levophed dopamine dobutamine insulin albumin amiodarone lasix hard to keep it at just 10--off the top of my head these are the meds I use the most

Wouldn't cheat on tests for a number of reasons: The ethical side of me felt that if I wasn't prepared enough for a test and ended up getting substandard results then that was my fault and hopefully next time I can do better. My practical side alway...

Our hospital has a policy that requires the admitting physician to acknowledge and actually sign off on a list of their home meds that was obtained at admission. The pharmacy follows up on this and flags the physician if there any interactions or qu...

RN's only--I am ultimately responsible for that line-not a tech. Where I work only RN's can get blood samples from art and central lines. This makes sense to me--I have the experience to troubleshoot that line not a tech.