Spatialized

My unit is in the process of starting an observation unit. It will be detached from the ED, under our Internal Medicine service, catering to CP r/o MI, COPD, CHF, Cellulitis, Syncope and Pneumonia observation status patients. Obs is based around CM...

It's like a nursing nightmare. Not the kind where you end up in front of the school body naked, but close. There's a patient in rapid atrial fib who keeps climbing out of bed in room 23. A new admit just came up from the cath lab and is cooling their...

When we have someone who needs bicarb, they get another line. Easy to get around incompatibilities that may happen that way. Yes, it is inconvenient for the patient (and the staff who has to start the IV) but it seems to be the best work around. O...

Our image too often is formed based on the twisted stereotypes portrayed in the popular media. Sexy nurses, pillow fluffers and doctor's handmaidens is the image shown to the world and they all believe it (well, not all of them, but a good majority ...

The odds of developing a hematoma 3 days out is fairly slim, but if by chance the MD accidentally created a pseudo-aneurysm during the procedure it could manifest itself later like that. Usually a hematoma is a firm/hard lump, sometimes ecchymotic, ...

There are days I still don't feel like I have it together and December will be 3 years for me. If you really think about it, 6 months is not that long at all on an active cardiac floor. There's a very wide scope of information that you have to unde...

I just smile and say, "Nope, I love poop too much!" Then in all seriousness I relate how that I wouldn't even be done with residency until my forties and would like to raise a family and lead a semblance of a normal life. Beside, my last name does...

Whatever y'all. Nearly everyone in PDX is a transplant of some sort or another. Sure, some have been here longer than others, but what does is matter? How long you have been somewhere makes no difference when it comes to the caliber of the nurse. ...

'Tis the season for low census, that's for sure. We're getting canceled (or at least placed on stand-by) at least once a pay period at Good Sam. And as for hiring? Nothing. Nada. Zip. We had a student do her senior practicum with us and she's g...

My night shift co-workers rock, plain and simple. Not such a big fan of the day shift, but I don't hate 'em by any means. It's sad when it is perceived as "odd" or "strange" to like ones co-workers. Says something about our profession eh? Tom

Yep, you've got it. Practice until you see strips in your dreams (uh, I wouldn't know anything about that...). Ask questions of more experienced nurses, bug the tele tech (if you have one) and if you hear that someone is doing something funky, chec...

It is possible, but it isn't pleasant. Sleep is a foreign thing when you do so. I did it because I had to, working 2 jobs, combined full-time through the end of school having worked 1 job full time the first year. It sucked, weekends were non-exis...

:yeahthat: Pretty much what Dianah said. We don't use sandbags as studies have shown that the weight distribution is too large for adequate control of a bleeder. If you get a bleeder, direct pressure just above the site (remember you anatomy...) f...

Typically ST depression is indicative of myocardial injury, the myocardium is not getting enough oxygen due to blocked arteries, vasospasm, poor cardiac output and on and on. Yes, it's not a good thing, usually. Although you can have pseudo depress...

Hiring freeze it is. My floor usually hires a handful of new grads, usually due to turnover and people moving on, but there is none of that this year. Same thing goes for all the floors at Good Sam. The ICU there is not even doing their usual inte...

Thanks for sharing this. It's been a rough couple of weeks at work and am in danger of becoming slightly more burned out (already...?), but your story rejuvenated my faith in nursing...the true personal aspect that tends to get lost at times in the ...

Yep, push away, you're really only going to help. I responded to a code on a post-op day 4 CABG and ended up doing compressions. They went to the Unit and came back. I was helping a nurse with their bath and he said, "Be careful around here -point...

I second the others thoughts above, don't beat yourself up, we've all been there before. One of the first codes I responded to I walked (well, ran) in with the code cart and went completely blank. I "woke up" as a second nurse pushed past me into t...

When I started on a 43 bed unit, we got abbreviated report on ll the occupied beds, the idea being you're able to help out easier and by aware of who might be in line to crump. We no longer do that, and the unit has been split in half. When I am in...

Many of our docs write parameters to ensure the meds get given, not held. When you have a CHFer on the "cocktail" (ACEI, B-blockers, lasix, et. al.) many times they need the meds, even when it seems like their pressure will not support it. If it is ...

Just because you're a bedside RN, doesn't mean it's all changing beds, cleaning poop, rubbing backs and whispering comforting words into the ears of LOLs. Sure, when necessary I'll do that, but also I'll be interpreting their rhythm, trying to figur...

You just have to find your niche, like someone stated above. Don't go into the experience with pre-conceived notions of where you want to work - you may be surprised where you end up. I thought for sure I was going into the ED (emergency department...

You've got it right, take the number of QRSs in 6 seconds and multiply by 10. Because the rate is irregular you're not going to get an exact rate. That is unless you print a minute of strip and count, which is a little silly. The better way for c...

Actually, blood cx prior to ABX is a core measure for pneumonia. It is not required, but it goes into audits for our friends at the Joint Commission and reported on the hospital compare website. So it's neither a standard of care or a regulatory th...

If someone develops a STEMI while on the floor, we can call in the cath lab team who are on-call 24-7. We've had a couple of times where the patient comes through the ER with mild symptoms and they are being admitted for observation, then start to e...