Cowboyardee

Cowboyardee

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All Content by Cowboyardee

  1. How to be on an ICU Nurse's good side?

    Cowboyardee replied to Nkukiller's topic in MICU, SICU

    It helps to know why the ICU nurse is getting annoyed. Off hand, I can think of several different scenarios: - ICU nurse is annoyed because they're busy and you're interrupting. solution: don't do...

  2. Very Frustrated!

    Cowboyardee replied to cretin's topic in General Nursing

    Losing a few hours of incentive pay sounds like a fair price to pay for the information that your boss is a crook and will not deal fairly with you. Look for another employer. Even if your boss...

  3. Scared to have a convo with my nurse manager ?

    Cowboyardee replied to JLB1215's topic in General Nursing

    Say she allows you to interview for the cath lab position. If you didn't get that job, would you be looking to stay in the ICU? If so, under what circumstances? How to go about this conversation...

  4. PCU Nurse Feels "Second Rate"

    Cowboyardee replied to PacoUSA's topic in General Nursing

    If you're willing to move, there are always ICU jobs open somewhere. If you're not willing to move, consider (politely) pestering some of the local ICUs. I just oriented a nurse to our ICU who applied...

  5. My CI is doing things that are unsafe

    Cowboyardee replied to bootsandcats's topic in Patient Safety Issues

    If you are in a situation where someone's life or limb is in real danger because of a practice you are witnessing, you are obligated to speak up. Then and there. If you are in a situation where...

  6. Distractions & interruptions: ICU vs. other units?

    Cowboyardee replied to Lemon Bars's topic in Critical Care

    Point: It may be unwise of me to disclose this information here, but I also have non-hyperactive ADD, and I personally have found that the ICU environment is the environment most well-suited to my...

  7. Nurses Call the Governor of Tennessee

    Cowboyardee replied to Nurse Beth's topic in General Nursing

    A drunk driver is doing no public service in the first place by drinking. A drunk driver has no reason to cut corners in order to perform life saving interventions on others in a timely manner. A...

  8. What is your unit's provider staffing like overnight?

    Cowboyardee replied to CCU BSN RN's topic in Critical Care

    We have 1 intensivist and 1 PA, covering about 45 beds at night. This would probably be adequate if we had mostly experienced nurses on who knew what orders they needed when they call, but too many of...

  9. BBB VS vtach?

    Cowboyardee replied to mizunderstood219's topic in Critical Care

    Lifeinthefastlane has a decent online tutorial on this. Take a look please. Unfortunately, it's not always a simple or easy dstinction to make. First, I suggest being able to recognize bbb morphology....

  10. Did this patient overreact?!

    Cowboyardee replied to Apatientnow's topic in General Nursing

    The nurse in question should not have exposed the patient over her objections or without explaining the situation to her beforehand. Of course, I have no way of knowing of that's what he did. Using...

  11. New Grads in the ICU

    Cowboyardee replied to Mr. Murse's topic in Critical Care

    This topic is something of a minefield. On the one hand, I firmly believe that nursing skill level is a major factor in patient outcomes and the effective day-to-day operations of any ICU. On the...

  12. Nurse Gives Lethal Dose of Vecuronium Instead of Versed

    Cowboyardee replied to Nurse Beth's topic in General Nursing

    What strikes me most about this situation: - On the one hand you have a role whose job appears to be to swoop in and fix problems and keep the ball rolling with minimal instructions or backstory, and...

  13. Should I leave the ICU? New grad

    Cowboyardee replied to tianova's topic in Critical Care

    I don't know you, and I don't know what's best for your life, how much stress you can take, etc. I do know that the first few months after orientation for a new grad are often the most stressful time...

  14. Are all PCUs Critical Care?

    Cowboyardee replied to Dianna11's topic in CCU, Coronary, Cardiac

    In common parlance, the terms 'critical care' and 'intensive care' are more often than not understood to mean the same thing - associated with ICU/SICU/CCU/etc level of care. I haven't worked on the...

  15. Page MD off work?

    Cowboyardee replied to Lapreea's topic in General Nursing

    Assuming both you and the physician are involved in the patient's care and that you're paging the doctor about issues in the ongoing management of the patient (rather than, say, gossiping about the...

  16. Nights vs. Days

    Cowboyardee replied to nurseontheway's topic in Medical-Surgical

    In most places, the average night shift is less hectic than the average day shift. There are some exceptions - notably, units that go to a substantially lower nurse to patient ratio on nights, and...

  17. Difficult conversations in the ICU

    Cowboyardee replied to Ddestiny's topic in Critical Care

    As a nurse, I feel as though giving a medical prognosis is beyond the scope of my practice, even when I know perfectly well how bad a patient's prognosis is. (I do occasionally cite statistics about...

  18. Incompetent to Make Decisions

    Cowboyardee replied to SisterofMary's topic in General Nursing

    The process of declaring a person incompetent to make their own healthcare decisions as well as the rights of a patient deemed incompetent depends mostly on the laws in the state in which you live....

  19. I don't feel like a real nurse

    Cowboyardee replied to joansmith1's topic in General Nursing

    In general, I feel like american culture tends to over-value holding the most impressive sounding job or position or resume you could have and under-values being good at what you do. In other words, a...

  20. CRRT

    Cowboyardee replied to Emily ICU's topic in Critical Care

    It would be good to know whether the pressure drop was also elevated and what type of settings you were using. An elevated TMP can be a sign of either clotting (small blood clots forming in your...

  21. Iv antibiotic running as primary?

    Cowboyardee replied to SquatsNScrubs's topic in General Nursing

    Two points: 1 - Typically, most of the leftover, unfinished medication in any given infusion is in the drip chamber rather than in the more distal tubing. In effect, this means that you can hang an...

  22. Case Study: Sick And Tired, Seeing Things? You Might Have Anemia

    Cowboyardee replied to SafetyNurse1968's topic in Critical Care

    Thank you for posting and updating. It was a pretty interesting case, and anyway I always enjoy open ended medical case studies like this. I am curious though how the hallucinations can be reliably...

  23. New Nurse, morality question.

    Cowboyardee replied to car48's topic in Patient Safety Issues

    Strongly disagree. The OP knows nothing yet of the workflow on the unit they're shadowing. They know nothing of the character of the nurses involved or the kinds of priorities they have to juggle....

  24. Am I overthinking this? Am I a bad nurse?

    Cowboyardee replied to tigermuse16's topic in General Nursing

    I usually tell new icu orientees that it takes about a year and a half to 2 years to feel comfortable and competent in the setting, and longer still to feel like you're good at the job. The ones who...

  25. Is this discrimination?

    Cowboyardee replied to eacue10's topic in General Nursing

    Would not getting a raise upon asking be evidence of discrimination that you could use in a lawsuit? - Im no lawyer, but I doubt it. Should you ask for a raise? - possibly. Depends on whether you...