marienm, RN, CCRN

Burn, ICU

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All Content by marienm, RN, CCRN

  1. marienm, RN, CCRN

    Infusion of Meds Question

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

    I check compatibility all the time on Lexicomp. Hopefully your co-workers do too, but it doesn't hurt to double-check it at the beginning of your shift to make sure the setup the previous nurse left I...
  2. marienm, RN, CCRN

    Intervention for pt with a-fib/a-flutter who’s bradying down.

    marienm, RN, CCRN replied to Anonymous666's topic in CCU, Coronary, Cardiac

    I love reading Muno's posts and I always learn a lot! To this one I want to add, though, check a full set of electrolytes and review any known medication history. I had a memorable experience with a...
  3. marienm, RN, CCRN

    QID PRN, HELP!

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

    My hospital has standardized med times (example: BID = 09 and 21; TID = 09, 17, 21). If parameters need to be written (like Muno's example of holding a drug if a BP or HR is out of range), they are...
  4. marienm, RN, CCRN

    Anxiety Over Past Mistakes

    marienm, RN, CCRN replied to anxiousnewgrad58's topic in General Nursing

    Burn nurse here: From a practical standpoint, if you had burned his feet it would have been apparent quickly. He would have had redness or blisters or sloughing skin. It's not something that would...
  5. marienm, RN, CCRN

    Covid-19, No Beds, Ugly Stuff

    marienm, RN, CCRN replied to Ado Annie's topic in Disaster Preparation

    Yeah, this doesn't answer the OP's question directly but my small ICU would do HiFlow cannula (up to about 70L) and BiPAP. Some of these patients we could wean and they went home. The others would...
  6. marienm, RN, CCRN

    Difficult AMA situations

    marienm, RN, CCRN replied to CaliRN2019's topic in General Nursing

    Re: the patient with wounds...after addressing pain and anxiety (maybe she needs sedation?) for wound care sessions...if she still doesn't want her wounds cared for, then maybe a palliative consult is...
  7. marienm, RN, CCRN

    Got The Vaccine! Share Your Experience

    marienm, RN, CCRN replied to Nurse SMS's topic in Disaster Preparation

    Got my second Phizer dose 9 hours ago. I'm off these two nights and can rest in bed the whole time if need be. So far, though, I feel okay except being a little restless/couldn't get comfortable...
  8. marienm, RN, CCRN

    Paralytic and Sedation

    marienm, RN, CCRN replied to Tabitha871's topic in Disaster Preparation

    I've never done it that way either...but based on patients coming out of paralysis from the OR, I'd say bolus doses wear off in an hour or two. Obviously it will depend on the patient's metabolism if...
  9. marienm, RN, CCRN

    Paralytic and Sedation

    marienm, RN, CCRN replied to Tabitha871's topic in Disaster Preparation

    How are you monitoring the paralytic? I'd wait to turn down sedation until I was back to the patient's baseline Train-of-Four. We also use BIS monitoring for sedation so I would titrate down if the...
  10. marienm, RN, CCRN

    Covid 19 precautions or SARS-CoV-2 precautions?

    marienm, RN, CCRN replied to guest1143647's topic in Disaster Preparation

    My hospital labels precautions by the method of pathogen transmission, which is the part that staff really need to know. I'm not going to expect a housekeeper or dietary aide to know about different...
  11. marienm, RN, CCRN

    Got The Vaccine! Share Your Experience

    marienm, RN, CCRN replied to Nurse SMS's topic in Disaster Preparation

    I got mine 15 hours ago...my arm is sore, but comparable to a flu shot. I did take an NSAID for cramps (menses) after the shot, which I have also done a couple of times with the flu shot (when the...
  12. marienm, RN, CCRN

    Fire in the CVICU

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

    Keeping COVID ICU patients in the ED...? Obviously every institution is different, but this seems like a weird choice. However, these are weird times and hopefully your institution has an actual...
  13. marienm, RN, CCRN

    Is ICU worth the stress?

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

    I started in an ICU and am still there. But I don't think it's the "pinnacle" of nursing for a bunch of reasons. 1) Depending on the structure of your hospital (especially now during COVID), ICUs...
  14. marienm, RN, CCRN

    Advice from ICU nurses

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

    Just like every area of nursing, I think there are times to follow the rules and policies in the ICU and times to prioritize what the patient needs. Like if their BP is dropping fast and you are...
  15. marienm, RN, CCRN

    Acronym - WEOD

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

    Since I live in the northeast and I'm married to a New Englander, I have to put in a vote for cider donuts here. Preferably without sugar on them, but I'll eat them either
  16. marienm, RN, CCRN

    What the heck? (fat-shaming at work)

    marienm, RN, CCRN replied to HopefulRN4ever's topic in Home Health

    I don't know how this would fly, but I see a lot of people at work shaming themselves for food choices/lack of exercise. I make a point to say, out loud, I don't care what you eat, I am not the food...
  17. marienm, RN, CCRN

    What's it like in the VIP wing of a hospital?

    marienm, RN, CCRN posted a topic in General Nursing

    Current events have made me wonder: What's it like to work on a VIP unit? I'm not looking for celebrity/VIP gossip here, and of course no one should compromise security protocols, but has anyone done...
  18. marienm, RN, CCRN

    Devastated over Isolation Precautions Problem

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

    OP, my hospital did away with contact precautions for MRSA several years ago except in the case of draining wounds. The premise is that good overall standard precautions (hand hygeine in and out,...
  19. marienm, RN, CCRN

    What's it like in the VIP wing of a hospital?

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

    Yeah, I'm definitely not looking for any gossip about any patient. I'm appreciating the stories of how the VIP area integrates with the rest of the hospital (Or, in PA, doesn't!). I definitely hadn't...
  20. marienm, RN, CCRN

    What's it like in the VIP wing of a hospital?

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

    I think I expected a better-than 1:5 ratio, that's for sure! Maybe everyone opts for PDN
  21. marienm, RN, CCRN

    Central Lines in Burn Patients

    marienm, RN, CCRN replied to Loloberry's topic in Burn

    In brief... peripherals are changed only PRN at my hospital. They may be placed through burned skin though obviously that's not our top choice. Our normal dressing is tegaderm, no chevron taping or...
  22. marienm, RN, CCRN

    Fired from my first travel gig after 4 days

    marienm, RN, CCRN replied to Birdsofprey's topic in Travel

    I've never traveled and I'm sorry you had this experience. Most of the TNs I see are pretty diligent about covering their butts, and now you know why! *Maybe* some judicious notes would have helped...
  23. marienm, RN, CCRN

    Very Confused About Flushing IV Lines And Bolus Administration

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

    Here is another reason why you might flush manually after a bolus medication: To ensure the bolus medication is delivered at the correct rate. Example: My patient is receiving NS at 240mL/hour...
  24. marienm, RN, CCRN

    Narcotic Question

    marienm, RN, CCRN replied to Purple_Clover's topic in Geriatric, LTC

    So this is a card of patient-specific pills that was prepared in advance and then the order changed? Like Mrs. Smith's med drawer has a card of meds including her nightly 0.5mg Ativan tablets stocked...
  25. marienm, RN, CCRN

    Narcotic Question

    marienm, RN, CCRN replied to Purple_Clover's topic in Geriatric, LTC

    Where does the narcotic card come from and what is its purpose? Is it the record of narcotic wastes and removals used by staff? If so, why doesn't it match the orders? I'm not sure it is "fraud" per...