LCRN

At my facility we document the following routienly: full assessment Q4 hr lung sounds Q2 hr vitals Q1 hr I/O Q1 hr hemodynamics Q4 hr (also w/ every change in vasoactive meds) This is all subject to change depending on the patient and the circumstanc...

Hey- Were you running all these meds via a central line or swan? I know you said you had no cvp...Was it via a PICC or peripherals?Do you use neosynephrine at your place? I would probably used that first due to the preference at my hospital. Seems to...

Hello- At my place we run Dopamine mcg/kg/min...Our max is 20 mcg/kg/min. We usually titrate up and add another agent for blood pressure support at around 15 mcg (of course every patient is individualized), other vasoactive meds we commonly use are.....

As an ICU RN I'd love an OB RN to come down with their patients however it's not realistic with staffing. When we get patient's on mag infusions we check reflexes Q1 and mag levels Q4 usually. We do this while we are addressing their other issues at ...

peripheral vascular disease, aneurysms, thrombosis, some autoimmune diseases cause decreased perfusion to periphery... I'm sure the list goes on but their a couple off the top of my head

The difference in the hospitals that I have worked at is basically as the above poster had stated...when patient's no longer meet ICU criteria but may require closer monitoring. In my ICU our patient-nurse ratio is 2:1, on our step down unit it is u...

Hello- at my facility the for patient's who are hyponatremic our goal to correct is 12 (mg/dl) in a 24 hour period due to the severe complications of correcting too fast as were mentioned by other posters. We usually never infuse 3%saline for more th...

The policy at my hospital is that all narcotic continuous infusions are to be run on PCA's however all of our benzo's and paralytics are just on regular pumps... \ LCRN

Hello- Routinely we have a ratio of 1 RN: 2 patients for most of our assignments. Post-op OH are 1:1 the 1st 8 hours and then unless they are considered unstable (requiring 3 or more pressors/dilators) or have open chest with IABP another patient is ...

We have a "skin care protocol" and if a patient is having loose, incontinent stool and is at risk for skin break down or already has skin breakdown we use appliances--> let me explain. 1. Recal Pouches do work if applied correctly...at our place w...

I make 90k with working around 40-44 hr/wk including my double (at my facility you make 1.5 pay for doubles) with under 10 years experience. I work primarily days but I do pick up nights. I live in CT and some of the senior experienced RN's that are ...

In any situations that I wear a mask which for myself are few and far between if ever a patient insulted I usually let them know it's for their own protection when I'm cleaning them if they have any areas of break down so that I do not get any of my ...

I don't know what you're going through and can't imagine it but I'm assuming that there's no way that you can safely take care of an assignment that large...let alone do assessments on a 1/4 of them!!! You need to find a different position that respe...

In my unit--> We have one Charge unit without an assignment and one resource unit without an assignment this is because as ICU RN's we are responsibile for multipile tasks throughout the hospital--> MET team, Code team, bronch team, conscious s...

I work in a 2 unit ICU-->medical side with 16 beds and a surgical side with 14 beds. So all RN's have to be cross trained for both units. Each of our pods have 2 beds. When you're seated at your pod you have both of your patient's in view by the w...

I had a PICC line when I had to receive Vanco for osteomyelitis for 6 weeks. My homecare RN also had a lot of difficulty drawing blood from my picc. I routinely flushed with additional saline and hep saline. I ended up having to always hold my arm ab...

Anzemet if the patient has IV access or Marinol PO has been a solution for intractable N/V with the other suggestions that posters have suggested

Synvisc will not STOP your knee from developing effusions necessarily. The etiology of the effusions needs to be determined. I had synvisc injections in 2001 --> the intra-articular injections regardless of the practictioner's skill level do cause...

I think we need to know more about the specific situation. If the above poster is calling respiratory depression resp=7 after morphine administration before narcan is given an oxygen saturation maybe should be checked. If the pulse ox is fine with de...

I work in a split unit medical and surgical ICU--> we have to be cross trained to work in both units and a level I trauma center that can entail any type of patient any day. I love my job, I feel I am blessed to hold people's hands as they pass, t...

I agree with the above poster...at my facility we have to types of DNR--> one is a comfort and one we provide supportive care to such as vasopressors/treatment of cardiac aarythmias/blood products. If a patient is a DNR comfort and is receiving mo...

I guess it really depends on what dept. you want to work in. Being that St. Vincent's has just opened a brand new state of the art 30 bed ICU...if that's what you are looking for I would reccommend that. I cannot comment on St. Raph's because I do no...

I'm at a loss about the pacer beside mode could've been changed or augmented by being interrogated. About the senior RN referring to being refractory to the meds...to be on 1mg/min of amio for more than the usual 6-8 hours (then you're to reduce the ...

I can only comment on St. Vincent's...I love it. There is very much a family feeling in that hospital. What type of position are you looking for ICU? ER? med/surg? Although Bridgeport is not the greatest area it's easily accessible from I95 and Route...

Also you need to think about patient's co-morbities that could've caused a "false" high cvp such as any right sided heartfailure or issues with valves. In some patients you have to use the trend of the cvp to measure volume status rather than necessa...