marienm, RN, CCRN

Burn, ICU

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About marienm, RN, CCRN

marienm, RN, CCRN has 11 years experience and specializes in Burn, ICU.


Second-career RN working nights in the Burn ICU.

Latest Activity

  1. marienm, RN, CCRN

    NICU new grad NG tube insertion

    I am NOT a NICU nurse but I am sorry that you haven't gotten any replies :( The thing I noticed you mentioned was that you angle the tube downward...in adults, I usually have the best luck pushing the tube straight back. I generally try to drive it...
  2. marienm, RN, CCRN

    Insulin Before Dextrose or Vice Versa?

    My facility does all the things you mentioned too, plus: kayexalate, get an EKG, possibly start emergent dialysis. It's all depending on the patient, the etiology, and their K+ level. But "1/2 amp of D50 plus IV insulin" is our typical treatment fo...
  3. marienm, RN, CCRN

    Insulin Before Dextrose or Vice Versa?

    I push the dextrose first just in case I lose the IV. If I gave the insulin first but then lost the IV, the patient's blood sugar would be decreasing fairly rapidly while I fumbled around getting supplies & trying for new access. That's my ratio...
  4. marienm, RN, CCRN

    Fluid Med Error

    The lunch break thing is important but it's also a bit of a red herring here OP. The fact will be that you will ALWAYS have multiple demands on your time and multiple things to prioritize. In this case, you chose to skip a step of med administration ...
  5. marienm, RN, CCRN

    Is Phlebotomy necessary to pursue nursing?

    I know nurses who bartended through nursing school because it paid well and was mostly evening work. Also, they're good at casual conversations! If phlebotomy pays you enough and offers useful hours, do it. If not, pick up more CNA shifts or some oth...
  6. marienm, RN, CCRN

    Peer Review

    Do you know what the purpose of the peer review is? To me, that sounds like something that might be part of your annual evaluation (shouldn't be something where you'd need a lawyer) and not, like, a jury of your peers to decide whether you violated t...
  7. marienm, RN, CCRN

    What to do if I like someone at work?

    Scenario: You run into her and say "I'd love to get coffee/check out the mini golf place/see xyz band together, would you like that?" She says "no, thank you." How would that make you feel? If you're thinking you'd be angry at her, humiliated, una...
  8. marienm, RN, CCRN

    Clinical Hours Liar??

    If your program has already okayed it, take them at their word! We are assigned educational modules and training classes at work that don't always take the full time but we get paid for the full amount anyway. I'm not advocating for padding your ti...
  9. marienm, RN, CCRN

    Type and Screen

    We have a two-tube, two-collection-time process but often we can add a t&s onto a lavender (CBC) tube (our normal t&s tubes are pink) so I think sometimes the blood bank just does this for us on the back end: they take yesterday's CBC and use...
  10. marienm, RN, CCRN

    Dosages help!!

    Yes, exactly. I did not make this rule and I don't disagree with you, but if the OP wants to pass their exam it sounds like they are required to use DA. That's what my school required too.
  11. marienm, RN, CCRN

    Dosages help!!

    3 tablets is correct and is the answer I showed. The point I was making about "2 units" is that the answer requires calculating "tablets per dose", where tablets and doses are both units, just like "mL per hour" or "gtt per minute." Students t...
  12. marienm, RN, CCRN

    Dosages help!!

    You can do this! The biggest thing to remember with dimensional analysis is that each "fraction" is equal to 1 (or equal to itself), which means you can flip it over if needed. You can write 12 inches 1 foot ----------- ...
  13. marienm, RN, CCRN

    How is life in the ICU? I am in a LTACH

    Charting: everything we do at my facility needs to be charted. How difficult this is depends on the EMR and the complexity of the patient, but at minimum for an ICU patient I chart: *full assessment q shift * focused assessment with change...
  14. marienm, RN, CCRN

    Starting Quad Strength Drip

    So, the patient is getting 15mcg/minute and 1) this is too much fluid and 2) the BP is still not where they want it, right? Since it sounds like you are a student, I'm going to expect you to do the math here: how much volume (in mL/hour) is the ...
  15. marienm, RN, CCRN

    My New Position Makes Me Want To Drink

    You might find more replies about the nursing aspects of your new job on the 1st year nursing pages, but I'm assuming you posted this in the recovery page on purpose! I haven't been where you are, but I'm thinking of you and every day as a new grad ...