sarahicu

We use propofol and precedex. Propofol about 75% of the time precedex about 25% Rarely will our mds order versed or fentanyl gtt

As for unclogging coke does work. Another thing I have seen done is taking a guidewire from a mercury weighted feeding tube and inserting it into your clogged og/ng, it does break up the clogged area very well. Just be gentle don't go jabbing it in.

60cc toomey syringe. I have always pushed my meds. I don't have time to wait for gravity, unless the md orders it ; )

I have worked in icu for 2+ years, been a nurse for 4+. Before icu, I worked on a med-surg floor. Transitioning to icu wasn't an easy task, I felt like a new nurse all over again. With that being said, don't give up. I have seen many new grads come and go since working in icu and I have helped precept a few. One thing I have learned is I doubt them too soon. If it had been my decision only about 1/5 this past year would've made it, and now 4/5 are doing very well. Here are some tips: I have always, since day one got to work early, just how I am. (obviously in icu you have the opportunity to know more about your patient than on the floor.) So I get to work early (20-30 min) and look up my patient's history, recent labs, all attendings, and recent vitals/incidents. One of my pet peeves is report from new grads. Be calm and take your time but don't ramble. I understand report takes time, but we really don't care if the patient had vanilla or chocolate pudding. Let me know they are tolerating their diet or if they threw up and aspirated. Here is a decent outline. Pt name, age, code status, admission date and reason. attendings on case. medical history, allergies, significant surgeries. Start with when they were admitted and go in chronological order of what happened. It's a story, remember. Now, in report go by systems: Neuro, Cardiac, Pulmonary, GI, GU, Skin, IV, Labs, PRN meds, any recent events that are worth mentioning. Hang in there, it won't always be easy. Nursing is an emotional roller coaster at times, but it is worth it. Be nice to the more experienced nurses, we will help if we know you appreciate it and ask.

Personally if I am not in the room to monitor the bolus (i.e. with my other patient) I favor putting the bolus on the pump (999ml/hr) to ensure it does all infuse because the pressure bag will need pumped up after about 300cc infuses.