Spatialized

Cardiac Telemetry/PCU, SNF

Member

All Content by Spatialized

  1. Spatialized

    Night Shift?!?!

    Spatialized replied to pitbullkcm's topic in First Year After Licensure

    I've been working nights since I started as a nurse and really wouldn't change. That said it can really play havoc with "life". I was lucky enough to get the schedule I really love, 3 days on, 2 off,...
  2. Spatialized

    3rd Degree Block with Junctional Escape

    Spatialized posted a topic in CCU, Coronary, Cardiac

    The other night our tele tech and I were discussing a patient's rhythm and neither of us could figure out the best way to label it and whether or not our interpretation was even correct....
  3. Spatialized

    3rd Degree Block with Junctional Escape

    Spatialized replied to Spatialized's topic in CCU, Coronary, Cardiac

    Yep, QRS was less than .20s. One tracing we had was from lead II the other was the V lead on a 5-lead telemetry system. No 12-lead was done. We weren't worried, the patient was hemodynamically...
  4. Spatialized

    Worried about too much accountability.......

    Spatialized replied to kstockdaleRN's topic in Cardiac

    Yipes! That's more than unsafe, that's downright dangerous! And this is even worse. We run our Lido drips on our step-own floor, with a 3:1 ratio - and the nurses don't have to run to another...
  5. Spatialized

    Some hard questions about entering nursing

    Spatialized replied to Anotherguy's topic in Men in Nursing

    I'll throw my in too.. 1. What are some of the worse things you have face on the job? poop, vomit, blood, mucus, screaming family members, screaming docs, screaming patients, inadequate/incompetent...
  6. Spatialized

    Question about Cardizem Drip...

    Spatialized replied to al7139's topic in Cardiac

    Theoretically, yes. Remember, everyone's chemistry is different and their reaction to meds will be that way as well. We've had several patients that I remember who were on cardizem drips that either...
  7. Spatialized

    how many patients for a new grad on the first day on the floor?

    Spatialized replied to Surgical_RN08's topic in First Year After Licensure

    It depends on so many factors. First, what kind of floor? How acute? What's atypical load? Second, the preceptee/new grad. Are they a "go-getter", or a little more timid? Did they work...
  8. Spatialized

    Inappropriate ICU transfers

    Spatialized replied to BlueEyedRN's topic in MICU, SICU

    Speaking of inappropriate ICU transfers... Awhile ago we had a post-op surgical patient hanging out on our PCU floor. We take post-op hearts on day 2 frequently so dealing with new onset rapid afib...
  9. Spatialized

    Need help! New RN to telemetry floor

    Spatialized replied to massou's topic in Cardiac

    You're asking a pretty broad couple of questions. Like mentioned above, what part of assessments do you need help with? Is the finer points? The overall feel? As for questions, most new grads have...
  10. Spatialized

    V-fib after Asystole

    Spatialized replied to Shell5's topic in CCU, Coronary, Cardiac

    ...in best "Waterboy" accent, "they need some high-quality ee-leck-tri-city!" It doesn't really matter when you get V-fib, it's always a shockable rhythm, the heart needs a good 200 joule jolt to...
  11. Spatialized

    When pulling sheaths after a cath...

    Spatialized replied to qt2168's topic in CCU, Coronary, Cardiac

    Interesting. Ours simply said the distribution of weight was too uneven and not a direct enough application of weight to the site. I have occasionally used them post-pull (like 3 hours+ in the even...
  12. Spatialized

    When pulling sheaths after a cath...

    Spatialized replied to qt2168's topic in CCU, Coronary, Cardiac

    I almost forgot, take a double with you! We have to have an ACLS trained nurse with us when we pull sheaths (granted, we're all ACLS trained...) to have an extra set of hands if things go south....
  13. Spatialized

    When pulling sheaths after a cath...

    Spatialized replied to qt2168's topic in CCU, Coronary, Cardiac

    It really depends on your hospital policy. We use assist devices, like a C-Clamp and the Femostop for the initial pull. If that's in your facilities policy, use them. Past that, it's all up to the...
  14. Spatialized

    I was slapped by a doctor!

    Spatialized replied to cluelessRN81's topic in General Nursing

    Sorry, latecomer but... Complain? No. File charges? You better believe it. He'd be on his way to the Big House. The thing that makes me even more upset is that he hit a woman! There are...
  15. Spatialized

    Labeling IV lines

    Spatialized replied to moonshadeau's topic in MICU, SICU

    I'm not a critical care nurse (PCU/Step-down) but if I have multiple lines running I too label lines and pumps. It's not policy or protocol, but to me it just makes sense and that's only with 2,...
  16. Spatialized

    Portland and New Grads

    Spatialized replied to bridgfor428's topic in Oregon Nursing

    I went to school in AZ and tried to get a job in PDX as well, I was moving no matter what, but I wanted to have a job lined up ahead of time. That plan didn't work out so well. But I learned a great...
  17. Spatialized

    Argatroban, PT/PTT, and PICC

    Spatialized replied to 1TachyRN's topic in General Nursing

    If I remember correctly, you can turn off the drip for 10 minutes or so, flush well and draw your labs. Even if you have dual (or multi) lumen PICC, I would still do the same - hold, flush, draw. We...
  18. Spatialized

    Ablation for SVT

    Spatialized replied to daisybaby's topic in Cardiac

    :yeahthat: Also, hope they pull the sheaths before you leave the lab, other wise you'll be on your back far longer that 4-6 hours.
  19. Spatialized

    IV cannula size/ overtesting

    Spatialized replied to rjrule's topic in CCU, Coronary, Cardiac

    Our OHS patients are recommended to have 16g or even 14g IVs pre-op. To me that's a little overkill, although I do understand the rationale behind it. There's nothing wrong though with an 18g in a...
  20. Spatialized

    Pericardiocentesis/Pericardial window-whats the diff?

    Spatialized replied to Atrial Kick's topic in CCU, Coronary, Cardiac

    With a pericardial window, they can also leave the pericardium open, i.e. not stitch it back up again to prevent tamponade from recurring. The idea is the same, to relieve the pressure causing the...
  21. Spatialized

    ? about coding the post Open Heart pt???

    Spatialized replied to rickard's topic in CCU, Coronary, Cardiac

    i call "limited/advanced interventions" gravity codes. just push in the drugs and a good flush and hold that arm up in the air (hence gravity) and pray the drugs actually make it into circulation....
  22. Spatialized

    tele nurses

    Spatialized replied to debg's topic in General Nursing

    Cardiac tele, 3-4 days, 3-4 at night. 1 aide for up to 23 patients on nights and 3 split 46 beds on days. Unit secretary 9-9 and tele techs 24-7. Used to 5:1 on nights with same CNA ratio. Can't...
  23. Spatialized

    ecg pauses

    Spatialized replied to vwb1's topic in Cardiac

    Actually, I'd call it ventricular standstill, or even asystole. 8 seconds is a little long just to be considered a "pause". But you could call it a pause. I always measure R to R. When you have...
  24. Spatialized

    Training for Charge Nurse

    Spatialized replied to Tuddy's topic in Cardiac

    First, I think you're not giving yourself enough credit. They asked you to do this, not the other way around. Granted, there may be a touch of the "we need someone to fill the role" in their asking...
  25. Spatialized

    HELP-New Grad to Tele- Day or Night?

    Spatialized replied to BwayDani's topic in Cardiac

    Days you have to juggle patients coming and going, tests, procedures, docs, family, admits, discharges, management and the plethora of the interdisciplinary team. You can learn a lot. You can also...