Cowboyardee

Cowboyardee

Member

  • Content

    472

  • Visitors

    10,021

  • Followers

    0

  • Likes

    863

All Content by Cowboyardee

  1. Why do we do codes?

    Cowboyardee replied to scrubs0204's topic in General Nursing

    "Why bother?" doesn't cover the real objections to overuse of CPR. Lets start off with that 20% figure. Generally, that refers to the arrest to discharge survival rate for in-hospital cardiac arrests...

  2. Giving report/day shift probs

    Cowboyardee replied to scooterscamp123's topic in General Nursing

    For patient safety issues and important tasks being ignored or left undone, ask your coworkers politely to address them please before they leave. You won't make friends, but you're an RN, not a...

  3. Written up

    Cowboyardee replied to SassyRN93's topic in General Nursing

    There are many inside hospitals and working in healthcare who would prefer to treat errors this way. But in general, hospitals are more interested in limiting their liability than they are in...

  4. CVVHDF for clearing Lactic Acid

    Cowboyardee replied to MICURN5280's topic in Critical Care

    In general use of pre-filter replacement helps limit clotting in the filter. And it does help push more large particles across the filter membrane. But I'm not so sure that it helps a filter that's...

  5. Heparin - Late Rate change error

    Cowboyardee replied to NewerNurse01's topic in General Nursing

    1) As asked above, why do you have to physically go? Why is the dialysis unit drawing PTTs but not responsible for acting on them? The dialysis unit has RNs. It would be a pretty weird (and frankly,...

  6. QT correction methodology

    Cowboyardee replied to LessValuableNinja's topic in Critical Care

    1: No idea. 2: Not really. I'm open to new data. As I'll explain below, I haven't really been a party to at-work discussions or debates about the best correction formula, and the QTc is not emphasized...

  7. IV Placement Hacks

    Cowboyardee replied to Ashley Hay, BSN, RN's topic in General Nursing

    It's a problem I had to overcome as well. Remember that the point of the needle is down and the bevel is facing up - so before you advance (and after achieving a flash), it often helps to tilt the...

  8. First code

    Cowboyardee replied to MrsJt's topic in General Nursing

    See if you can find a kind and non-judgmental doctor involved in the case and ask him or her to review the code and events leading up to it with you. Failing that, maybe an experienced and...

  9. Ciwa problems

    Cowboyardee replied to Marsatron's topic in General Nursing

    You'd have to tell me more about exactly what kind of protocol your hospital is using. Most commonly where I am, we see patients on both PRN ativan given at varying doses for their CIWA score along...

  10. Blood pressure medications

    Cowboyardee replied to Joy101's topic in Patient Safety Issues

    If youre unsure whether to give a medication or dont have adequately clear parameters, ask the doctor, not the charge

  11. Syringe driver terror

    Cowboyardee replied to milly's topic in General Nursing

    For whatever it's worth, the evidence suggests that administering sedatives to patients during their end of life treatment probably actually prolongs their lives rather than shortening them. Medscape:...

  12. Don't Risk Your Job Over Social Media

    Cowboyardee replied to Nurse Beth's topic in General Nursing

    You're talking about what does happen; the previous poster was talking about what should happen. I'm well aware that employers are legally allowed to police the private lives of their employees and...

  13. Swan-Ganz Usage

    Cowboyardee replied to Cvepo's topic in Critical Care

    Do you mind going into a little more detail about the kinds of situations where you see PA catheters as justified, exactly what kinds of things you're looking for from the readings it provides, and...

  14. No rehire !!!!!!!!!!

    Cowboyardee replied to Yorker's topic in General Nursing

    What exactly constiutes a "serious" problem? If an employee was otherwise exlemplary but late to work so often and so egregiously that the hospital system no longer wanted to consider them for future...

  15. No rehire !!!!!!!!!!

    Cowboyardee replied to Yorker's topic in General Nursing

    Exactly where did you see me defending employment contracts for nurses? I only pointed out that other hospitals have more aggressive ways of enforcing retention than 'no rehire' lists to give the OP...

  16. No rehire !!!!!!!!!!

    Cowboyardee replied to Yorker's topic in General Nursing

    Training and orienting nurses costs money. New employees who leave soon after their training are a much worse investment than employees who stay and work for a good while after orientation. Hospitals,...

  17. Iv infusion confusion

    Cowboyardee replied to Joy101's topic in General Nursing

    When you're experienced, you'll find that there are many ways to skin the proverbial cat. When you're semi-experienced, you have a way that works for you and figure that most or all other ways are...

  18. "Overhire"

    Cowboyardee replied to nurseee24's topic in General Nursing

    I would not worry about the other nurses being mean to you. That's not going to happen unless 'overhire' means something much different than I think it does. Generally, that you're an 'overhire'...

  19. Research patient or see patient first?

    Cowboyardee replied to RNingBSNing's topic in General Nursing

    The general trend in nursing is toward bedside shift reports, so many nurses, experienced or not, are tending to see their patients before becoming fully acquainted with their charts. That whole...

  20. New icu nurse and feeling discouraged

    Cowboyardee replied to Audi3181's topic in Critical Care

    Id bet those knowledgeable icu coworkers with 10 years of experience didnt get all of their experience in a 4 bed icu. Here's the bad news (it is unfortunately also the truth): learning to be a...

  21. Interesting Situation (Thoughts?)

    Cowboyardee replied to asneakyseal's topic in CCU, Coronary, Cardiac

    My inclination likely would have been to diurese unless i see real signs of hypovolemia, at least after the first attempt to titrate milrinone off failed. For whatever its worth, its been a while...

  22. Metabolic Acidosis and Renal Failure

    Cowboyardee posted a topic in Critical Care

    I'm wondering if someone can help me understand better exactly what kinds of metabolic states can lead to an acidosis in a patient with renal failure. Specifically, I recently was involved in taking...

  23. Metabolic Acidosis and Renal Failure

    Cowboyardee replied to Cowboyardee's topic in Critical Care

    Thanks for responding. I was wondering if anyone has seen a blood uric acid level of 8 correspond to a pH in the 7.15-7.2 range without another acid present. It doesnt seem high enough to account for...

  24. do you think students who got kicked out of NS, were for a good reason?

    Cowboyardee replied to Skippy97's topic in General Students

    At the school I went to not many people got "kicked out." However, if you scored below a C (76%) in any class, you not only had to repeat the semester but also lost out on the financial deal that most...

  25. Religious accommodation means no Saturdays....ever?

    Cowboyardee replied to momto6msn's topic in General Nursing

    My point was that sometimes you have to threaten to quit (and mean it) in order to get what you want. Most likely, your coworker would not accept the job offered to her unless she was off Saturdays....