marienm, RN, CCRN

Burn, ICU

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All Content by marienm, RN, CCRN

  1. marienm, RN, CCRN

    "Discrepancies" In Epic Documentation

    marienm, RN, CCRN replied to Faithx14's topic in General Nursing

    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...
  2. marienm, RN, CCRN

    Heparin Flush

    marienm, RN, CCRN replied to Kelly_the_Great's topic in Infusion, Intravenous

    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...
  3. marienm, RN, CCRN

    Interpret This Order For Me Please

    marienm, RN, CCRN replied to guest1143647's topic in General Nursing

    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...
  4. marienm, RN, CCRN

    Buttocks Skin Graft Protection Strategies???

    marienm, RN, CCRN replied to Kel.R's topic in Burn

    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...
  5. marienm, RN, CCRN

    How to keep anxiety in check

    marienm, RN, CCRN replied to Lynden74's topic in Critical Care

    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...
  6. marienm, RN, CCRN

    IV gtts and arterial line

    marienm, RN, CCRN replied to Kate96's topic in Critical Care

    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...
  7. marienm, RN, CCRN

    How do I peel pill packets without meds flying everywhere!

    marienm, RN, CCRN replied to hs4zu's topic in Nursing Student Assistance

    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...
  8. marienm, RN, CCRN

    Burn Codes in shower and Defibrillation

    marienm, RN, CCRN replied to Caroline Keith's topic in Burn

    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...
  9. marienm, RN, CCRN

    Fully running IV Piggyback meds?

    marienm, RN, CCRN replied to HelloThere247's topic in Patient Medications

    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...
  10. marienm, RN, CCRN

    Re: Weight based critical drips

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

    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...
  11. marienm, RN, CCRN

    My patient is going to get a pressure ulcer and there's little we can do to stop it. How do you handle situations like this?

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

    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...
  12. marienm, RN, CCRN

    New RN Age

    marienm, RN, CCRN replied to Kooper48's topic in General Nursing

    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...
  13. marienm, RN, CCRN

    Foley placement in COPD exacerbation pt

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

    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...
  14. marienm, RN, CCRN

    Vocera! Can you talk to...?

    marienm, RN, CCRN replied to LibraNurse27's topic in General Nursing

    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...
  15. marienm, RN, CCRN

    Vocera! Can you talk to...?

    marienm, RN, CCRN replied to LibraNurse27's topic in General Nursing

    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...
  16. marienm, RN, CCRN

    Vocera! Can you talk to...?

    marienm, RN, CCRN replied to LibraNurse27's topic in General Nursing

    When the voice recognition works, I like it. I also like being able to assign yourself to different user groups on the fly...so if you float, you can join the new unit's group. (This probably depends...
  17. marienm, RN, CCRN

    ADN vs BSN salary

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

    That's a myth, though magnet hospitals need to have a plan in place to increase the number of BSNs held by their nurses (so some hospitals could choose to only hire BSNs as a part of that plan.)...
  18. marienm, RN, CCRN

    ADN vs BSN salary

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

    New York requires a BSN within 10 years of finishing an ADN program (only passed a few years ago so enforcement hasn't been an issue yet!). I got my ADN before the law but figured I should get the...
  19. marienm, RN, CCRN

    Biology or Chemistry

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

    Biology will probably include the functions of the cell and the Kreb's cycle, so it might help prepare you for
  20. marienm, RN, CCRN

    BIS monitoring and sedation titration

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

    Finally got a chance to look...our default orders are for a RASS score (filled in by the provider). They could choose to remove these instructions and replace them with instructions for a BIS score,...
  21. marienm, RN, CCRN

    BIS monitoring and sedation titration

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

    Mmm, I think they don't. I know our paralytics have titration instructions based on the TOF...but our default for the sedatives is RASS and I don't think we get it changed when we paralyze someone....
  22. marienm, RN, CCRN

    BIS monitoring and sedation titration

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

    Our target BIS is usually 40-60, where 100 is fully awake and 0 is completely unresponsive. You need to monitor signal quality as well as the score (our EMR has a place to chart both). I would...
  23. marienm, RN, CCRN

    Should I quit nursing school?

    marienm, RN, CCRN replied to girl.in.blue's topic in Online Distance Learning

    Many schools are allowing students to take time off without penalty right now...can you take a semester off to think about things (and maybe when you come back, in-person classes will have restarted...
  24. marienm, RN, CCRN

    Sick all the time first year at the hospital

    marienm, RN, CCRN replied to Lovethenurse2b25's topic in General Nursing

    I started as a night shift nurse having left a career working a support staff at a local university. I get less sick, less frequently in the hospital than I ever did working with mostly-healthy...
  25. marienm, RN, CCRN

    I’ve working in the ICU for 6 months and I feel miserable

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

    Not all ICUs are like that, especially not every night. I will point out that undoubtedly some of this is harder because you are new and things do get easier with practice. Your skills (like blood...