ICURNBSN

Here is an excellent video showing you the patho of sepsis. You are on the right track and this explains the details. As for sedation of a vented patient, it can vary. Most of the time the patients are sedated for comfort or to increase effectiveness of mechanical ventilation. However there are some reasons not to sedate. If the pt. can't tolerate it-sedation lowers blood pressure, if you are already struggling to maintain BP then you don't want to add something that will lower it. If the patient is neurologically not responding they will often discontinue sedation so they can be sure they are able to get an accurate Neuro assessment. If they are planning to extubate a patient, they will turn down/off sedation to ensure that they can protect their airway after the tube is out. Because of Evidence-based practice, there has been a move toward less sedation. Some research says we should be walking our vented patients! Sedation can have negative side effects such as increased delirium in ICU patients so the idea is if we dont sedate them as much, risk is decreased. I am sure there are other reasons but these are the ones I have seen the most.

I'm a new hard and jumped right into the ICU. I think this is the best way. You just jump in and learn as you go. I've seen nurses who have experience now and started in the ICU and some who came from the floor. The new ones who started on the floor are behind the ones who jumped right in.

Were you working before? If you have not worked and gone to school at the same time, it will be an adjustment. A BIG adjustment, it is really hard balance family, school, home and work BUT it is completely doable. I worked full time as a tech in the ICU and completed byte hardest program in my area. The experience you gain is amazing! And you get to seebid it would be for you once you graduate or if you would prefer something different. How many hours will you be working? And are you ok with telling them no when they call for the second time this week asking you to pick up a twelve hour shift? Congratulations! You will learn sooooo much!

In nursing school, we were required to go to a board of nursing meeting where they deal with these things. I found that in most situations the board was more understanding if the nurse showed that he or she showed that they were taking steps to fix what they did. Many of the people who got probation over suspension of their license went to meetings, met with a counselor, and stated why they were wrong . The ones that said but it was just one little mistake and didn't show that they were working to make sure it didn't happen again seemed to be more likely to get more punishment.

Very true! In the hospital I used to work at, if you knew you were going to be in a patient's room a while, you could go to that patients monitor and pull up your other patient's monitor as a mini screen. It would flash too if it was alarming. I miss those monitors! Also, each one was portable and so you didn't have to unplug your patient to help them to the bathroom or to go down for a procedure, you just unhooked the monitor from the wall and away you went. Now we have to unplug patients from the monitor to help the to the bathroom and either stay with them or pray nothing happens to your seemingly stable patient ?

Thanks for the advice! Last night was my last shift on orientation! I can't wait but am scared to death!

Thank you, I am good at asking questions. I think that's why I'm nervous to be on my own because I don't have my own personal experienced nurse to ask anything to. I am prepared to put in the effort and the time to become great at what I do! Thanks for the reply :-)

I am a new nurse in a CICU. I am off orientation next week and I feel I am doing well. My preceptor got my orientation shortened because of how well I am doing. However, I am still so nervous. My question is for those of you who started as a new grad in the ICU. When did you start feeling comfortable? When did you stop getting the feeling that "you don't know what you don't know"? I am starting to feel comfortable with the unit, the policies and procedures, the meds and the charting but still nervous to be on my own! I study outside of work and look up things at work as I go and as things come up. I ask questions of my preceptors about policies and etc. But I feel like as I start to make more independent nursing decisions I am told "well I would've done it this way" or "you should've done this" and I understand that they want to help guide me but what happens when I don't have someone right there to guide me? I know I still can ask questions of my coworkers but I'm not going to be able to ask about every move I make because they will be busy with their patients...

Most other higher level professions require Baccalaureate degrees. Nursing has held out because of the "nursing shortage" and the need to create nurses in a shorter amount of time. BSN is the way nursing needs to go for the future nurses coming in to the field. I understand that there are EXCELLENT Diploma degree nurses and Associate degree nurses however, nursing needs to catch up in this regard.

I was a new grad in Indiana and started around $19/hour this year in the ICU...

I work in CCU and we get them quite often. Mostly for pt. waiting for heart transplants.

The questions will get easier with time. For now, I suggest prioritizing. Start with ABCs and follow Maslows the rest of the way. Always think of it as if you could do only one thing and walk out of the room. Also, try to determine exactly what the question is asking. Does it require you to gather more information before you can do something for the pt.? Or is there something you can do first? Rarely do you choose "call the physician" because most likely there is something you can do as the nurse first. Hope this helps, good luck!

I believe I have seen this as a nursing care plan at my facility. If your instructor says it's fine, then use it! I would suggest Altered Elimination r/t abdominal wound AEB need for bowel diversion via ileiostomy.

Thank you, thank you, thank you!! I found this and tweaked it a little to my unit. I have been using it this week and it really helps! It prompted me to ask some really good questions during report! This is for EMSnut45

Gotcha, thanks :-)