marienm, RN, CCRN

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 the tube straight back. I generally try to drive it...

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 of D50 plus IV insulin" is our typical treatment fo...

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 supplies & trying for new access. That's my ratio...

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 case, you chose to skip a step of med administration ...

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, do it. If not, pick up more CNA shifts or some oth...

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 jury of your peers to decide whether you violated t...

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 you're thinking you'd be angry at her, humiliated, una...

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 amount anyway. I'm not advocating for padding your ti...

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 on the back end: they take yesterday's CBC and use...

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 too.

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 like "mL per hour" or "gtt per minute." Students t...

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 12 inches 1 foot ----------- ...

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 assessment q shift * focused assessment with change...

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 the math here: how much volume (in mL/hour) is the ...

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, but I'm thinking of you and every day as a new grad ...

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 colonoscopies...we prep the patient, push meds, & moni...

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 probably "stable-ly sick" and ICU patients aren't. Mr. ...

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 on the patient during transport/scan, theoreticall...

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 discouraged by those classes because you probably were...

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 months before you need to renew. It would be easy ...

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 be friends with her. If you interact with her in p...

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 dignity and autonomy, engagement (even if you're ...

"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 judgment, and it strains our relationship if we h...

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 stable but needed a bunch of incompatible meds so someo...

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 you're the only one, it sounds like you're missing a...