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I work in a busy Level I Trauma Center that treats approx 125,000 patients per year. There are many challenges, but most days I love what I do and wouldn't trade it for anything.

Loo17's Latest Activity

  1. Loo17

    Are %100 online BLS certifications legit?

    I have gotten mine through pro cpr, I believe that AHA's website actually directed me to them as a good online option. Its employer specific, my employer doesn't care where I get re-certified, others do. Best to check before spending the money.
  2. You don't need to worry about the titrate to solve the problem based on the information you provided. An actual titration order (or facility policy) would have a goal BP or MAP, you would titrate (increase) the drip every 5 minutes until that BP/MAP is achieved.
  3. Loo17

    IV Medication Setup

    You follow the policies at your facility and the doctors order. The meds are already mixed in fluids, if you dilute them more depends on the order. You cant just piggyback with extra fluids without an order.
  4. Loo17

    Any suggestions on shoes???

    Its important to buy the right size with danskos. They are supposed to be loose unlike most shoes. If your heel is right up against the back they are probably too small.
  5. Loo17

    Do you clean bedpans or throw them out?

    Wish we could do this. Employer told us doing that costs the hospital too much money because biohazard waste is very expensive to dispose of.
  6. Loo17

    Medication test Kindred

    I took the test at a different kindred so I am not sure if it is the same but we went over the information during classroom orientation prior to taking the test.
  7. Loo17


    I didn't think traffic violations were criminal
  8. Loo17

    Do you clean bedpans or throw them out?

    Where I work, bodily fluids (including stool). Can not be thrown in the regular trash. The stool needs to be placed in the toilet or if it is watery, in a biohazard bag.
  9. Every place I have worked has had a policy regarding calling out on a holiday. Where I work now has a policy stating if you call out the last scheduled day before, day of, or day after a holiday that you lose your holiday pay (which is 8 hours of bonus pay that you receive regardless if you work or not). There is also a policy that states if you call out on a weekend without a doctors note that you are required to work the following weekend if needed. This goes for all hospital staff.
  10. Loo17

    When to piggyback This

    Where I work the initial Zosyn dose is over 30 min with all over doses being delivered over 4 hours Q8H. The ID docs say that this improves patient outcomes and reduces length of stay by keeping levels constant.
  11. Loo17

    Ultrasound Guided IVs

    I found the article below to be quite useful. Ultrasound-guided peripheral I.V. access: Guidelines for practice - American Nurse Today
  12. Dobyour patients get set up with a visiting nurse? As a previous visiting nurse I find this is a crucial part of the puzzle and can be a great opportunity to reinforce hospital teaching in their home and follow them for a short time to make sure they understand and provide further teaching. Medicare will pay for this in most cases of new diagnosis.
  13. Loo17

    Do you carry around your stethoscope?

    As I said, I always have my stethoscope available and use it when applicable. I am simply saying for the most part one could get by without. Most of the docs I work with are great, the best nurses and doctors can miss something time to time. We are all human.
  14. Loo17

    Do you carry around your stethoscope?

    I am not saying I agree with the OP but nowhere did they ever say they would chart what they didn't do. Charting in the emergency department is different than on units. You could easily get by not charting or listening to lung sounds if you wanted to. Like I said, I prefer to do the task and chart it but it is not something a nurse would get fired or disciplined for not doing on a patient if it was charted by respiratory therapy or one of the many providers.
  15. Loo17

    Do you carry around your stethoscope?

    I do carry mine and use it however...in the ED where I work I think a nurse could easily get by without one. A patient comes in SOB, the med student, resident, and sometimes attending physician listens. A patient gets a neb, those are administered and charted on by RT. ET tube placed, the med student and docs are again listening. Plus the patients are all getting CXR's. They want to order fluids on a CHF'er the doc does a bedside ultrasound to make sure they can handle the fluid and of course everyone listens. I am sure if I didn't use my stethoscope on a patient there would be 5 other people who did but I like to be in the loop.
  16. Loo17

    Vancomycin rate question

    Infusing Vanco too fast is dangerous clinically, not just because it is a vesicant. Micromedex (our pharm reference) recommends infusing no faster that 10mg/min. Infusing faster can potentially lead to hypotension and red man syndrome. Also with higher doses you need to monitor for ototoxicity. At my facility we infuse >1gm at 90min and 1-2gm at 2 hrs. As far as the pump, the vanco should be running as the primary through the pump. You should not y site Vanco below the pump, doing so the vaco could dump in. If you y site above the pump it would be delivered at whatever rate the primary is running. So if you had the NS set to 100ml/hr the Vanco would be going in at that rate. Better to use two pumps in my opinion or set vanco as the primary and the fluids as the secondary to infuse after the antibiotic completes. I have never seen a dose of Vanco 3 grams ordered. Only 1gram, 1.5 or 2. Are you sure that is your Vanco dose? Seems higher than any of the recommendations for treatment of anything unless you are dealing with very obese patients.