marienm, RN, CCRN

Burn, ICU

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All Content by marienm, RN, CCRN

  1. marienm, RN, CCRN

    Epic Charting

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

    In our version of EPIC, if you admimistered the med I could come back and edit your administration, but it would be obvious in the MAR (ie: now the administration would be charted under my name). If...
  2. marienm, RN, CCRN

    NG Tubes

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

    I think the biggest question with NG tubes would be: what are you supposed to do if it comes out? Do you have in-house Xray & radiology to verify placement of a new one? Or would you have to...
  3. marienm, RN, CCRN

    ED treatment for severe burn victim

    marienm, RN, CCRN replied to jcast2213's topic in Burn

    The American Burn Association currently recommends the modified Brooke formula instead of the Parkland formula. (2mL x kg x TBSA). Urine output goals are 30-50 mL/hour or 0.5mL/kg/hr except in rhabdo...
  4. marienm, RN, CCRN

    Pre-Employment Physical Attire

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

    I don't think I had to lift 50#, although I had to sign a form acknowledging the physical requirements of the job. The physical, though, was a complete head to toe minus a breast exam/pelvic exam....
  5. marienm, RN, CCRN

    I want to become a nurse but my husband says I will be always sick and unhappy

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

    I work in a unit where deadly infections sometimes occur (like resistant pseudomonas) and I still get sick less than I did when I worked with healthy college students in an academic support job. At...
  6. marienm, RN, CCRN

    Gloves required for ALL oral meds.

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

    Re: why would I handle the pills? Because some of them are hard to get out of the package (our pharmacy puts single tablets in these annoyingly sticky blister packs). Also, chances are I'm giving them...
  7. marienm, RN, CCRN

    Pyxis undocumented waste

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

    Not quite the same issue, but I was called into my manager's office based on the discovery (during a chart audit of a now-discharged patient who had been hospitalized for 2 months) that I had pulled...
  8. marienm, RN, CCRN

    Gloves required for ALL oral meds.

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

    NIOSH is issuing new guidelines regarding handling a disposal of hazardous drugs, so lots of institutions are changing their policies. The gown sounds like overkill for non-hazardous drugs, but I've...
  9. marienm, RN, CCRN

    ?Afib in declining 85 year old

    marienm, RN, CCRN replied to NutmeggeRN's topic in Cardiac

    An elderly relative in my family was encouraged to get a pacemaker at age 92. She was in fair to poor health. I was strongly against it, doubting she would even leave the hospital. She did leave,...
  10. marienm, RN, CCRN

    ED treatment for severe burn victim

    marienm, RN, CCRN replied to jcast2213's topic in Burn

    Let me point you in the direction of "burn resuscitation," which is the general term for the first 24-48 hours of care for a serious burn. It focuses mostly on fluids...we do not actually just pump...
  11. marienm, RN, CCRN

    New RN needing prioritization advice

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

    Probably any disposable item! IV tubing, IV sites, tube feeds, pressure ulcer dressings, chest tube dressings, drain site dressings, ostomy pouches, IV and/or central line dressings (if your IV team...
  12. marienm, RN, CCRN

    New RN needing prioritization advice

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

    I hear you that getting a list of stuff you forgot first thing is demoralizing. Charitably, I'll assume that your charge nurse is trying to help you, either by letting you know so you can fix your...
  13. marienm, RN, CCRN

    Why are nurses the only profession that cannot accept gifts?

    marienm, RN, CCRN replied to RockinNurse2018's topic in General Nursing

    I don't think we're the only profession, but in my workplace I'm a government employee so we are not allowed to accept gifts that have monetary value. I think it's for all the reasons others have...
  14. marienm, RN, CCRN

    old. starting new. self-conscious

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

    I started as a new grad in an ICU at 35. The unit was divided at the time...several nurses were older than I was, and the rest were young to mid 20's in their first careers. I had worked for a...
  15. marienm, RN, CCRN

    Workplace Sayings

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

    I work in a burn ICU that also takes other ICU & step-down (mostly surgery/trauma) patients. Some patients come in after doing something...ill-advised. You know, stuff everyone does all the time!...
  16. marienm, RN, CCRN

    Best choice for emergent desaturation in COPD

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

    Do you have the option of a rapid response team? In my hospital, that calls a respiratory therapist in addition to a hospitalist and the RT can initiate CPAP or BiPAP if it seems warranted, in...
  17. marienm, RN, CCRN

    are the signs of hyper/hypokalemia the same if the cause is a transcellular shift?

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

    Yeah, I guess I overstated that. But at initial presentation, serum K+ is often normal to high normal and then will decrease (to below normal) if K+ isn't supplemented during treatment with insulin...
  18. marienm, RN, CCRN

    are the signs of hyper/hypokalemia the same if the cause is a transcellular shift?

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

    There are exceptions to every rule, but generally a patient in untreated DKA will be HYPERkalemic at first because they are acidotic. The patient will present with all the s&s-abdominal pain,...
  19. marienm, RN, CCRN

    ER to MS transfers

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

    An alternative view of the problem your facility is having could be that the ED doc should only order stat tx (EKG, boluses, cultures before antibiotics, intubation, pain control, and imaging...just...
  20. marienm, RN, CCRN

    Tips for older new student?

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

    One thing I would add to what others have posted: If you don't have good computer and typing skills, take a class to brush them up. You will probably need to write a lot, find and save references a...
  21. marienm, RN, CCRN

    OR to Burn Unit? Please advise

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

    There's a lot here! Will you like the burn unit? I don't know! Why did your friend think you wouldn't? (Not that your friend is right, of course, but if she has the inside scoop on serious...
  22. marienm, RN, CCRN

    Picture of wound?

    marienm, RN, CCRN replied to Glycerine82's topic in General Nursing

    I appreciate what the nurse was trying to do, but I'll add this thought to why I'd never take a picture on my personal phone: most phones attach all kinds of data to every picture. Time, date, GPS...
  23. marienm, RN, CCRN

    Adaptic vs Vaseline Gauze

    marienm, RN, CCRN replied to NurseAsh0912's topic in Wound, Ostomy, Continence

    I agree they are not the same product...one look at them will prove that. However, whether they're interchangeable depends on the wound. I work in burns and we use Adaptic to keep the absorbent gauze...
  24. marienm, RN, CCRN

    How to get the best experience out of the ICU?

    marienm, RN, CCRN replied to thehyruler's topic in MICU, SICU

    As a student, I'd suggest you use the ICU time to refine your assessment skills...you're going to hear lung sounds you haven't heard before, see +4 edema, hear and see different cardiac rhythms, etc....
  25. marienm, RN, CCRN

    CCRN as a requirement?

    marienm, RN, CCRN replied to Steph41's topic in Critical Care

    I did mine because I wanted my manager to quit asking about it. My hospital paid for it (and offers some training) but other than a clinical ladder rung (worth about $200 annually, IF you apply for...