marienm, RN, CCRN

Burn, ICU

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All Content by marienm, RN, CCRN

  1. marienm, RN, CCRN

    Bolus 25mL/hr

    marienm, RN, CCRN replied to Leah8183's topic in General Nursing

    JEE93: Short answer--connecting a faster fluid to the Y-side of a slower med will not slow the delivery of the faster fluid. After the pump, the only thing that slows the fluid down is the IV itself...
  2. marienm, RN, CCRN

    Patient-Police Statements

    marienm, RN, CCRN replied to cliniquenurse's topic in Emergency

    I did ask/tell a detective that he couldn't interview a patient at 0300. The patient had been injured while committing a crime (this was known), no one else was injured, pt not a flight risk due to...
  3. marienm, RN, CCRN

    Bolus 25mL/hr

    marienm, RN, CCRN replied to Leah8183's topic in General Nursing

    Not to muddy the waters but I will point out that if a bolus is running via gravity (with or without a pressure bag), Y-siting anything critical into it isn't a great idea because the critical drip...
  4. marienm, RN, CCRN

    Feeling terrible about a mistake I made in clinical

    marienm, RN, CCRN replied to CatieK's topic in PICU, Pediatric

    OP, I'm sure you feel like you want the earth to swallow you whole. But the way to move on from this is to 1) learn from it and 2) actually move on. These are also ways you can demonstrate to your...
  5. marienm, RN, CCRN

    Over $300k in student loans - help.

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

    I'm no expert, OP, but it's worth seeing if any of these loans can be consolidated. I was able to consolidate my private loans (already had a bachelor's degree so I didn't qualify for much federal aid...
  6. marienm, RN, CCRN

    HELP be a nurse or another career opportunity?

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

    I agree with all the cautions posted here but I'll also point out that I know a lot of nurses who have some type of side-gig going on...nurses who work in hospitals but also do home infusions, nurses...
  7. marienm, RN, CCRN

    Graduated in March, Cannot Find a Job

    marienm, RN, CCRN replied to cfelt23's topic in General Nursing

    Central NY is hiring new grads into hospital positions. One heads-up: the way my employer words the ad, it asks for 1 year of experience but stipulates that RNs with less than one year may be hired...
  8. marienm, RN, CCRN

    Is it responsible of me to try to become a nurse?

    marienm, RN, CCRN replied to SaltyFish513's topic in General Students

    I haven't been where you are, OP, but I do work with some nurses who have mental health diagnoses and are succeeding in their careers. One thing I would add to the advice above about having an active...
  9. marienm, RN, CCRN

    Question regarding warmer fluid

    marienm, RN, CCRN replied to marymetzzzzz's topic in Emergency

    Pixie, if by heat injury you mean "burn," these patients get cold fast due to evaporative loss, even if it was a hot day. We definitely use warm fluids in the Burn ICU in addition to keeping the...
  10. marienm, RN, CCRN

    Full time jobs hard to find ?

    marienm, RN, CCRN replied to Anotherdegree4me's topic in General Nursing

    If jobs are scarce in your area, are you willing to move? Are you willing to work any shift? Would you be willing to work in a hospital/at a clinic/at a procedural center/at a school/at a SNF with 40...
  11. marienm, RN, CCRN

    Need help with syringe test question?

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

    If I'm overexplaining, OP, forgive me. But injected medications are usually ordered in WEIGHT (milligrams (mg), grams (g), micrograms (mcg)). But they are diluted and delivered in VOLUME (milliliters...
  12. marienm, RN, CCRN

    Sand bed-turn or not?

    marienm, RN, CCRN replied to mmccool719's topic in Wound, Ostomy, Continence

    We've occasionally used these beds for burns. My memory is that we did at least weight-shift the patient every 2 hours. We also had to have some amount of sheet/absorbent pad under the patient because...
  13. marienm, RN, CCRN

    Med passes and technical skills- I'm asking for advice not just to gripe

    marienm, RN, CCRN replied to 2ndchance85's topic in Long Term Acute Care

    I work in-hospital ICU but something I've noticed that nurses who come from the floor tend to include in their reports (and ask when getting report) is how a patient takes their...
  14. marienm, RN, CCRN

    Blood administration

    marienm, RN, CCRN replied to Serotonin2's topic in General Nursing

    My hospital specifies that the tubing may be primed with blood or saline. Personally, I prime with saline first to get the air out and then with blood, since I have to stay with the patient for 15...
  15. marienm, RN, CCRN

    Low census and COVID-19?

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

    Us too: elective surgeries cancelled, huge push for telemedicine wherever possible so we're taking fewer transfers, lots of beds open and waiting... Staff who get called off can use accrued time or...
  16. marienm, RN, CCRN

    Setting up Manifold using 3 way stop cocks

    marienm, RN, CCRN replied to Walle2014's topic in PICU, Pediatric

    I don't know what your preceptor showed you, but I typically prime each stopcock with a NS flush syringe...attach syringe, prime the "straight" portion (with the lever OFF to the side port) then prime...
  17. marienm, RN, CCRN

    Vent: "I should warn you, I'm a tough stick..."

    marienm, RN, CCRN replied to Anna Flaxis's topic in Emergency

    I, also, think that your doctor needs to review their assessment of the problem! In an inpatient setting, I advocate for patients to get PICC lines all the time; they might wind up being discharged...
  18. marienm, RN, CCRN

    Well, At Least They Tell You Up Front

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

    I live in the area and new grads in the hospitals here start around $24/hour right now. There are 3 major hospitals so each has different benefits, but if this comany expects any prior experience with...
  19. marienm, RN, CCRN

    Bad CPR techniques- do you say something?

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

    We rotate compressors every time we do a pulse check. (Teaching hospital...shortage of bodies is not usually a problem.) We use the Zoll with feedback, and our code nurse team managers track all the...
  20. marienm, RN, CCRN

    Acute Kidney Injury

    marienm, RN, CCRN replied to Future Nurse In Training's topic in General Nursing

    Did the AKI diagnosis come from the patient's problem list in the electronic medical record? At my hospital, every current problem as well as chronic but relevant conditions are listed there. It can...
  21. marienm, RN, CCRN

    Midlines and Nephrology Sign off

    marienm, RN, CCRN replied to cslagle1989's topic in Medical-Surgical

    If it's that urgent, the primary medical team (MD, PA, APRN) places a CVC. If it can wait until daytime, the interventional radiologist can place a PICC. I think the choice at my institution not to...
  22. marienm, RN, CCRN

    Midlines and Nephrology Sign off

    marienm, RN, CCRN replied to cslagle1989's topic in Medical-Surgical

    The PICC nurses at my hospital place midlines as well. I've always been told they don't want to risk damaging the vessels on a patient who might, in the future, need a hemodialysis fistula placed in...
  23. marienm, RN, CCRN

    Night Shifters - Hobbies?

    marienm, RN, CCRN replied to yesrun's topic in Health, Stress Management

    Might not be your cup of tea, but I like doing something quiet with my hands...I'm currently working on a big embroidery project. It's not too taxing mentally but it keeps me more focused/awake than...
  24. marienm, RN, CCRN

    PICC Lines And Air Bubble

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

    OP, the likelihood that you would even have a syringe with more than, say, 1mL of air inside is pretty small. The pre- filled saline flushes at my hospital have about 1mL and I either squirt it out...
  25. marienm, RN, CCRN

    Code Blue: Just Trying Figure Out What Happened?

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

    This case is going to be on your mind for a while, sorry. The discussion about patho here has been good! The one idea I'll add is that it sounds to me like the ED provider may have been out of their...