marienm, RN, CCRN

Burn, ICU

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All Content by marienm, RN, CCRN

  1. marienm, RN, CCRN

    Hypochlorous wound cleansers

    marienm, RN, CCRN posted a topic in Burn

    Is anyone using these in their Burn ICU? (One brand name is Vashe, but there are others, I think.) How do you use it? How often do you use it? What did you use before hypochlorous? Are you seeing...
  2. marienm, RN, CCRN

    NICU new grad NG tube insertion

    marienm, RN, CCRN replied to New_gradNICU's topic in NICU, Neonatal

    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...
  3. marienm, RN, CCRN

    Insulin Before Dextrose or Vice Versa?

    marienm, RN, CCRN replied to vmrose93's topic in General Nursing

    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...
  4. marienm, RN, CCRN

    Insulin Before Dextrose or Vice Versa?

    marienm, RN, CCRN replied to vmrose93's topic in General Nursing

    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...
  5. marienm, RN, CCRN

    Fluid Med Error

    marienm, RN, CCRN replied to Newgradtrauma's topic in General Nursing

    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...
  6. marienm, RN, CCRN

    Is Phlebotomy necessary to pursue nursing?

    marienm, RN, CCRN replied to Tt_'s topic in Pre-Nursing Students

    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,...
  7. marienm, RN, CCRN

    Peer Review

    marienm, RN, CCRN replied to Queen Tiye's topic in Nursing Career

    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...
  8. marienm, RN, CCRN

    What to do if I like someone at work?

    marienm, RN, CCRN replied to Convoy2022_TrumpSupporter's topic in General Nursing

    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...
  9. marienm, RN, CCRN

    Clinical Hours Liar??

    marienm, RN, CCRN replied to Kylie Standfest's topic in General Nursing

    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...
  10. marienm, RN, CCRN

    Type and Screen

    marienm, RN, CCRN replied to ShipleyRN's topic in General Nursing

    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...
  11. marienm, RN, CCRN

    Dosages help!!

    marienm, RN, CCRN replied to bluedreamerstu's topic in General Students

    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
  12. marienm, RN, CCRN

    Dosages help!!

    marienm, RN, CCRN replied to bluedreamerstu's topic in General Students

    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...
  13. marienm, RN, CCRN

    Dosages help!!

    marienm, RN, CCRN replied to bluedreamerstu's topic in General Students

    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...
  14. marienm, RN, CCRN

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

    marienm, RN, CCRN replied to Beautiful_Beginnings's topic in General Nursing

    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...
  15. marienm, RN, CCRN

    Starting Quad Strength Drip

    marienm, RN, CCRN replied to JustCuriousMe's topic in Critical Care

    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...
  16. marienm, RN, CCRN

    My New Position Makes Me Want To Drink

    marienm, RN, CCRN replied to BeckyRN's topic in Nurses Recovery

    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,...
  17. marienm, RN, CCRN

    Nurse at LTACH, need help if it's different than the ICU

    marienm, RN, CCRN replied to Beautiful_Beginnings's topic in General Nursing

    Fair point @JBMmom there can be a lot of variation in facilities! Our residents do not place NG/NJ/OG tubes in the ICU, but I should make clear that our nurses don't actually intubate or do...
  18. marienm, RN, CCRN

    Nurse at LTACH, need help if it's different than the ICU

    marienm, RN, CCRN replied to Beautiful_Beginnings's topic in General Nursing

    Yeah, this sounds awful. Those are all the tasks I do in the ICU with a 1:2 or 1:3 ratio. The main difference (I think) between what you're describing and an ICU is that the LTACH patients are...
  19. marienm, RN, CCRN

    Do you burp IV bag prior to putting pressure on it?

    marienm, RN, CCRN replied to Nurse Beth's topic in Career Advice Column

    I get all the air out of A-line tubing by flipping the bag over, applying pressure, and priming the tubing. Air normally rises to the top of the bag, so a hanging bag is fine but if you rest the bag...
  20. marienm, RN, CCRN

    Passed the NCLEX, but I feel like I need to go back to nursing school.

    marienm, RN, CCRN replied to Ame_0818's topic in First Year After Licensure

    Honestly, taking ACLS and PALS before doing any patient care was probably a mistake. You need to have some actual patient experience to correlate with the material in these classes. SO, don't be...
  21. marienm, RN, CCRN

    RN license expired but did not know and was working for 1 year as NP in NY

    marienm, RN, CCRN replied to dannipoint's topic in General Nursing

    In NY, licenses are renewed every 3 years and expire at the end of the month before your birth month. They send you ONE paper letter in the mail with a PIN code for renewal, and they send it several...
  22. marienm, RN, CCRN

    Why do the younger generations have less empathy? And how can we stop them from going into nursing?

    marienm, RN, CCRN replied to RitzyCinnamonRoll's topic in General Nursing

    So, based on a sample size of 1, you're declaring 2 generations of people to be a lost cause? That's a look that doesn't look good on you. You don't have to like that student, agree with her, or...
  23. marienm, RN, CCRN

    Is it possible to be a decent nurse if I'm a sociopath or have antisocial personality disorder?

    marienm, RN, CCRN replied to uniteddemclub's topic in General Nursing

    Things I expect of a nurse working with patients: technical skills and continuing growth of skills, politeness (even if the patient isn't), critical thinking, patience & de-escalation, respect for...
  24. marienm, RN, CCRN

    Nothing Left To Give At Home

    marienm, RN, CCRN replied to Weebnurse's topic in General Nursing

    "I can be your spouse or your nurse, but I can't be both. There's a reason we don't take care of family members or friends when they're in the hospital- we're too close to the situation, it clouds our...
  25. marienm, RN, CCRN

    How many I.V.'s

    marienm, RN, CCRN replied to summertx's topic in Critical Care

    I recently took care of a vented septic patient who had 12 channels running plus CRRT. Patient had a quad-lumen CVC, an A-line, and a VasCath (and then the next day the patient was actually more...