marienm, RN, CCRN

Burn, ICU
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marienm, RN, CCRN has 9 years experience and specializes in Burn, ICU.

Second-career RN working nights in the Burn ICU.

marienm, RN, CCRN's Latest Activity

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  1. marienm, RN, CCRN

    "Discrepancies" In Epic Documentation

    Are other co-workers having the same problem? If so, it could be a systemic issue like others have mentioned, but it would be very strange if it only applied to specific controlled substances. If you're the only one, it sounds like you're missing a...
  2. marienm, RN, CCRN

    Heparin Flush

    To your original (but several month old) question about peripheral IVs, my hospital hasn't used heparin in them in at least a decade. We also don't use them for CVCs. And now, with the current shortages, we've stopped using them for PICCs as well (...
  3. marienm, RN, CCRN

    Interpret This Order For Me Please

    At my hospital I would call the pharmacy with this question, since (as others note) the 1000mL is probably the dispensed unit. So if you're not familiar with how MAR orders are written at this facility (or if this one is wildly different from all ot...
  4. marienm, RN, CCRN

    Buttocks Skin Graft Protection Strategies???

    Agree with both of you. Apart from a diverting colostomy, the most helpful thing we've used is metamucil TID. You want that stuff to come out like formed jello! Our normal bowel regimen is colace/senna/miralax/lactulose which usually do get things...
  5. marienm, RN, CCRN

    How to keep anxiety in check

    This is going to sound mean, but it sounds like your hospital isn't prepared to have an ICU? They're leaving you out there with no support in situations you don't know how to manage. That's not fair to you or to your patients. I don't think this s...
  6. marienm, RN, CCRN

    IV gtts and arterial line

    It will not get contaminated (they're in totally different vessels, even if they happen to enter the body at similar locations such as a femoral CVC and A-line on the same side of the groin). Pausing your pressors that are running through your CVC t...
  7. I know this is an old thread but someone was sweet enough to like my post and so I came back...and I have another trick to suggest! Use the corner of one packet to slit open the back of other packets. I specifically do this with our gabapentin caps...
  8. marienm, RN, CCRN

    Burn Codes in shower and Defibrillation

    Our hospital has said that it is safe to defibrillate on our shower table. The table is padded but like yours has metal railings. Our plan is the same as yours--dry off the chest to apply pads. For burned skin, though, we'd need to use paddles and...
  9. marienm, RN, CCRN

    Fully running IV Piggyback meds?

    We use Alaris pumps too. Occasionally I've had a problem where I've screwed the secondary set onto the primary line and backprimed it (so it seems patent), but it must not be fully threaded because the secondary med will only partly infuse. If I wa...
  10. marienm, RN, CCRN

    Re: Weight based critical drips

    My hospital uses whatever weight the provider chooses (admission weight or current weight). We don't typically update these orders daily...our official policy says it should be changed if the patient has a 10% or more change in their weight. We used...
  11. Tricia is probably right but if continence/preparedness is actually the concern, could she use a Purewick? Or if she is able to ambulate, up to the commode every 2-3 hours while awake. We have patients who we don't allow to use bedpans because they ...
  12. marienm, RN, CCRN

    New RN Age

    I started in an ICU at 34. There are days I feel my age (so much back pain!) but honestly I move faster than some of my younger co-workers! (I've always been a fast walker...maybe not as fast as NurseSpeedy though!). I work 12-hour night shifts and a...
  13. marienm, RN, CCRN

    Foley placement in COPD exacerbation pt

    If you have the equipment...a hoyer or ceiling lift that allows you to lift the pt in a semi-seated position? If you arrange the sling correctly, I think you can separate the legs (vs drawing them together in standard transfer-to-a-chair configuratio...
  14. marienm, RN, CCRN

    Vocera! Can you talk to...?

    Ours are connected to our call lights/bed alarms on some units (old building, different systems in different wings). We don't have to "accept" the alarm, though; if you're logged into that unit your Vocera receives it automatically. They're also con...
  15. marienm, RN, CCRN

    Vocera! Can you talk to...?

    We have Secure Chat in our EMR but we don't use it the same way as the Vocera. Vocera tends to be for immediate stuff, like new patients being assigned by the bed admin, RRT coverage, and "can someone help me boost bed 8?." We use Chat for non-urgent...