Renee_RN

I have administered Regitine into a Dopamine infiltrate on several occasions. I use aseptic technique and do not change the needle. Renee

In our facility, we frequently give Amiodarone peripherally. I have not seen an increase in phlebitis as compared to other running IV medications. Also, we do not have a special filter to use. Renee

We are actually in the process of using the Arctic Sun machine for intentional post-resuscitation hypothermia. This is what we are supposted to do. We have policy in place that defines criteria for usage (adult, v-fib witnessed arrest, 5-15 min emergency response team, 60 min or less until return of spontaneous circulation, coma post-resuscitation), cooling procedure, rewarming procedure, equipment and monitoring. We have strict documentation guidelines as well. We cool to 33 degrees C within 6 hrs of event. All patients are intubated, sedated (propofol, versed), a-line, good iv access, paralytics on board for shivering. We use BIS monitoring with a goal of 40 for monitoring sedation, bladder catheter with thermistor, train of four, and the cooling device. We draw BMP's q8h including Mg levels, with ABG's, lactate, and CBC as ordered, Q1hour BGM, outputs. Fluid boluses for diuresis. K and Mg boluses for deficiencies.We have to chart the temp of the patient via two methods (oral and bladder probe) and the water temerature hourly as well. After 24 hours, we begin the rewarming process. This is over 6-8 hrs (slow). Once the patient is 35 deg C, we turn off the paralytic. Sedation is off when temp is 37 and the paralytic has worn off. We are also watching the K levels during this time for major increases. Hope this helps. Renee

Can you use the same reference letters for all applications? I think it would be very difficult having a person fill our five letters of recommendation. Renee

I will be finished with my BSN in March. I am currently an RN with two years ICU experience. Should I begin the application process this year or should I wait until I am officially finished with my BSN? What are your thoughts? Renee

I graduated from the program two years ago and it has served me well. There is the same BS paperwork and projects in all programs. I know several LPN's who did the bridge and were fine. Actually, you have the advantage of being a practicing nurse during the program. It will be fine. Renee

I know there are nurse managers out there that do not agree with this post however I have to agree. As a staff nurse, I can name six shifts in the last two weeks where I have been forced to take more patients than our established safe ratios in the ICU. I have been told by the nursing supervisor on several occasions to "flex up" , "suck it up", or "punt" in regards to unsafe ratios. I have spoke with my operations coordinator about this but the nothing changes. She is a good person but this is coming from higher up, the ones so far removed form the bedside they would have no idea how to practice as a bedside nurse. Cut to the "bare bones", we're over budget. How is this safe for the patients? They're the reason we have a budget. They pay our salary!!!!! Renee

In our facility, nurses are responsible for set up, maintaining, and trouble shooting. CRRT patients are 1:1 and there is someone on call to answer questions if we run into problems. Renee

My earlier transcripts are included in the 3.5 GPA from my ADN program...it was all the same university. I just am embarrassed about the fact I dropped a lot of classes and changed majors multiple times. I pulled it together in the end. Renee

I am having pre-application anxiety. I have an ADN, almost finished with my BSN. However, at the college I attended for my ADN program, I changed majors four times, dropped classes, and stopped and started school multiple times. It took me about 4 years to get my crap together and start my ADN program. I did graduate with a 3.5 GPA from this university and got almost all A's in my nursing program. I currently have a 3.8 in my BSN program. I am afraid when I send in my transcripts, colleges will be scared away by my first transcripts. Do I have a chance? I am afraid to get my hopes up. I have met all other requirements. Renee

A friend of the family died of a massive MI at 29 years old. He had no health problems except a strong family history. Due to weather conditions, he was transported critical care ground versus lifeflight where he coded in the ambulance. By the time he made it to the facility, he was brain dead. Renee

Wow! He is an extremely lucky person. I have never seen a troponin that high (I have heard of massive MI pts with these numbers). Is the extremely high troponin due to a massive, global ischemic event secondary to the acute blood loss (anemia, lack of adequate oxygenation to the entire heart) affecting so many of the cardiac muscle cells at one time? Maybe the event was reversed fast enough before a permanent infarction of muscle occurred. Thanks for sharing! Renee

Hey Mike, Can you explain a little more about dynamic platform and the impact it has made on your son? Also, can you elaborate on your experience with relocation? My son was diagnosed early (1 year 10 months old) and I have been working with him for a little over two years with PT, OT, speech therapy, early intervention, socialization in the classroom setting, and some behavior modification principles. I am now in the process of moving in order to save money to apply to CRNA school next year. I am worried about my son regressing and am feeling quite guilty about moving when I have found something that works. He was completely nonverbal with just utterances and crying until he was almost 3 1/2 years old. Now at four years old, he is learning early imaginative play, acknowledging others, trying to socialize with other children, and speaking in short sentences (although garbled). I would love to hear more about your experiences. Thanks for posting. Renee

Thank you for your advice. I have spoke to all schools and have been encourages to apply however I know that a community ICU would heart my chances. Also, the GRE scores meet the criteria to get in all schools. Actually the minimum for 4 out of 5 schools were 400/400/3. The last school was 500/500/3.5. I will retake it if I do not get an interview. I am not proud of my scores but I am being honest about them.

I have worked in a Community ICU for approximately 1.5 years. We take care of medical, surgical, and coronary ICU patients. I am very comfortable with vasoactive medications, ventilators, A-lines, CVP monitoring,etc, and have limited exposure to swans and CRRT. We also are first responders to any codes in the building. The only thing I have not been exposed to is IABP. I have one year left to complete an online RN to BSN program. My dilemma is I live approximately 1.5 hrs away to large teaching hospitals. I tried the commute and only lasted three months because they required rotating shifts and my health insurance did not cover anyone within 50 miles. I want to apply to CRNA school after obtaining my BSN next year. What are my chances with community ICU (3 years at that point) versus a larger teaching hospital? Should I try the commute again? What else can I do to be more competitive? I plan on applying to 4-5 schools all within 2hr radius. *I am ACLS, BLS certified and am taking the CCRN this fall Also I have already taken the GRE 550/540/3.5 My accumulative GPA- ASN- 3.5 BSN-3.8