RNexplorer

At times, I feel worried about my ability to perform adequately in this profession. Patient was admitted from the cath lab. I was confused with the access site description. There was a single lumen central line at the access site, and I had never ...

I know this is an old thread, but I'd just like to comment. I understand wanting to always follow the doctor's orders, but there are certain situations in which there isn't time to wait for a new order. Susie2310, sometimes you have no choice but t...

What's rude is nurses who make fun of patient's bodies. It is cruel and distasteful. I don't want to hear you criticize someone for the size of their genitals, the shape of their nipples, or anything of this sort. I would never want a loved one to...

Regarding interpersonal skills during a code situation, what are your thoughts/opinions on this issue? - What interpersonal skills do you think help or hinder a code? - Do you think respecting your colleagues is important? Why? - Do you think your un...

No, this is not an essay question. I was just curious what people's thoughts are on this.

I wish I could handle difficult people by being more assertive rather than emotional. Sometimes I just have to shut my mouth because I feel tears welling up inside and don't want other people to see that. But then I get trampled on by bullies/peopl...

Thanks for this information. Do you know of any really good resources on CVADs?.. There are so many types and I'm often confused about them... Yes, I assessed the site and checked for blood return. I also tried to get more information from the phys...

Thanks for your response. It has really helped me put things in perspective and create something positive out of the situation. I will definitely find the answer and add it to my knowledge base. Also, I am looking forward to trying your technique ...

HeySis, thanks for the encouragement. The problem is I'm not a new grad. I've been working for 3 years as an RN. I don't have this problem on every shift, but it happens once in awhile... There's no excuses for it. I should have asked the cath la...

For the following basic question, elite reviews and Barron's are giving different answers: What vent settings would be important to have for a patient with asthma? - Elite reviews: "a longer inspiratory time" or an "inverse I:E ratio" to keep the alv...

I'm just wondering why one of the contraindications for PICC line insertion is renal failure? Lots of ESRD patients have access devices... so I'm confused why a PICC line is contraindicated? Please excuse my ignorance. I'm a new nurse, just wanti...

When your patient is on a heparin drip, and aPTT comes back at say 45 and you need to give a bolus... Do you think it's reasonable to bolus at a Y site closest to the patient? Or do you disconnect and bolus directly into the vein? After bolusing at...

I tried to do a search on this topic but was not able to find an answer, so I decided to post the question myself... I'm starting a new position in a MICU with a 3 month orientation. I'm just wondering what I should expect for my first buddy shift...

Thanks for the heads up!! I will try to enjoy the learning process and realize that things will be easier when I start out on my own.

Thanks for your advice mbrookeRN. My experience in the ICU is minimal - less than 6 months, and I received very little orientation at my most recent position. I will definitely use my preceptor and try to benefit from her knowledge and experienc...

I have a question about the intubation I saw today... Is it normal for neuromuscular blockers to be ordered before the sedative....??? I had drawn up etomidate and rocuronium... And I kept thinking to myself, he's probably going to ask for the eto...

In shift change at the start of my shift, I was told that the patient refused to wear the BiPAP because it was really uncomfortable... I'm not sure why he was okay with the non-rebreather.... I really think this patient's pulse oximetry must have ...

The patient was not actually hypoxic... his pO2 levels were actually elevated. And I'm not too sure exactly how the patient would respond to the BiPAP... But I think it could lower the CO2 even more as others have already mentioned. Given that his ...

In response to Mully: If the patient is having lots of shortness of breath due to pulmonary edema (common in CHF), he/she may be tachypneic... Tachypnea, in turn, will cause too much CO2 to be expired, leading to respiratory alkalosis.. However, i...

That's a good point and made me wonder at the time... It all seemed so weird to me. Sorry, I can't remember the exact numbers. However, I do recall a normal pH, on the upper end of normal (7.41 to 7.45; therefore FULLY compensated). pCO2 was on t...

Team work is really important to me, and I can see that it is essential to ICU success. I wish I could be a better team player, but I'm finding it really hard to keep on top of some of my assignments. I typically skip eating all together or have a l...

I agree with you about all of this... I feel awful that I did what I did. I guess I need to have more confidence in my own knowledge and intuition. I don't know why I followed the charge nurse's instruction... maybe because she's the one with over ...

Thanks for everyone's comments. I'm new to the ICU, and I discussed this with the charge nurse BEFORE even setting foot in the patient's room. I told her the medications I would expect to give first. However, she gave me direct orders: "you must f...

Nurse to patient ratio is usually 1:2. We have 1 CNA for the floor -- approx. 14 beds.