sevo87

If the patient somehow has a bad outcome that could have been prevented by knowing an h&h (transfusion etc) and you go to court, it will be you sitting in the hot seat and not the lab tech. Just my .02, get the blood and don't put it on the backburner

The term mixed is what is throwing you off, the blood is all oxygen poor. The svo2 value tells you how much oxygen the body tissues are extracting, basically it tells you how much you hAve left over if you will. It is not a 'mixture' of oxygenated and deoxygenated blood.

Theoretically yes it would, the vent is blowing off her c02 which will make her more alkalotic, the kidneys if they are working properly will decrease bicarb production to compensate for this. That is assuming her kidneys are working properly and that the vent is blowing off enough c02 to not only fix the acidosis but to shift her the other way to alkalosis.

The vent is acting as a temporary fix for the acidosis. The underlying problem is what needs to be fixed, a lot of intensivists don't like to give the patient exogenous bicarbonate because it really skews what is wrong. The problem could be something as simple as dehydration, or it could be something much more complex like renal failure. The short answer is they are blowing off c02 as a temporary fix.

Worked in a 24 bed SICU recovering hearts. Was usually charge, usually had three patients, if I didn't have three patients it was because I was admitting a heart. I felt like I'd rather have the three patients knowing I could take care of them instead of throwing a new grad to the wolves and endangering the patient. Obviously this wasn't the best arrangement but what can you do when they staff a 24 bed unit with 8 nurses

1st step BSN 2nd step AT LEAST 1 year of good ICU experience 3rd step get as many applicable certifications you can (CCRN etc) You will be able to get a masters until 2025 when they will require a doctorate.

Not trying to be a ****, I'm just sick of everyone and their brother thinking it's easy to get into anesthesia school and succeed.... Especially prefacing it with the fact that they've already flunked nursing school once. This person is a great candidate for AA school, they would fit it great with the AA's I know.

Took me 5 years between graduating with my BSN and starting CRNA school, and some days I feel like I jumped the gun. Chances are, if you can't cut it in a ADN program... you most likely will struggle mightily in anesthesia school. But best of luck :)

You seem to just want to do the minimum and get accepted to 'any' crna school in the country.... Understand this, not all anesthesia schools are created equal, not by a long shot. And trying to get in with 5 months experience is ridiculous, you would be doing the patients a serious disservice. You know ABSOLUTELY nothing after 5-6 months in a high acuity ICU. If you really want to become a CRNA then you need to take everyone's advice and focus on what's in front of you. If you do end up graduating and can find an ICU job right away try to learn as much as you can. You have to be OK being JUST an ICU nurse because not everyone that gets into anesthesia school ends up finishing... Just my .02

What is ATI?

Get yourself a care plan book at a bookstore, they have all you'll need

I am certainly not advocating googling anything if you don't know what to do. They need to spend some time reading about these drugs, learning what situation each should be used for, appropriate dosing guidelines, how to titrate, etc. However there is really no substitute for real world experience. I certainty don't think they should be given patients on multiple drips if they aren't conformable taking care of those patients. But at the same time, unless they work in an extremely small ER, after a year you should've had some exposure to these types of patients and should start becoming comfortable caring for them. Just my .02.

I didn't specifically say anything about protocols there because I don't have to run to the book every time I start a drip. I understand that a new nurse may have to. Like I said, I've never worked in a hospital that didn't have such protocols, therefore I assumed it was understood. If not, my bad.

Unless the ordering physician is an intensivist working in a purely intensive care environment it has been my experience that they have NO CLUE what to 1. Start the drip at 2. Titrate by or 3. What the max should be. They will look at the same drug book a new nurse does to find this information. If the doc tells you to start a Norepi drip what do you think he wants it for?? A systolic of 170? As has been mentioned previously every er or unit I've ever worked in has a drip book that gives you standard concentrations, typical starting parameters, max doses and so on. Certain drugs have different maxes from facility to facility. I'm reasonably sure that every hospital has protocols for this. I don't get why, after having an order for something, some nurses want to be micromanaged by the MD. Why not just have him come in the room and push the buttons on the pump for you?

I agree with most of what you guys have said. You are right that I should have prefaced my statement with "as an experienced nurse", I'm not implying that a new grad should or would know what to start the drip at. However, unless I read it wrong didn't they state that they have a 5-6 month orientation??? I have never heard of this, and if it is indeed the case I would've expected their preceptor to teach them this, among many other things. So I guess it's more of a failure on the part of their preceptor. Also, I am well aware of what my scope of practice includes and does not include... thats why I went back to school. :)