MDMBSNRN

MDMBSNRN

Trauma ICU, Neuro ICU, Surgical ICU, ED

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All Content by MDMBSNRN

  1. Could I have done anything else?

    MDMBSNRN posted a topic in Critical Care

    I was working in ICU the other night (technically as a float nurse, although I was given a patient assignment), and was receiving a patient from the ED. He was in his late 70s (78, I believe), and...

  2. restraint/seclusion order question

    MDMBSNRN replied to sassyann85's topic in Psychiatric

    That's how it is done at my hospital. If the patient is in restraints, I have always been told that the door must remain open. For some reason, seclusion generally isn't ordered at my facility. It...

  3. combining PRNS

    MDMBSNRN replied to sassyann85's topic in Psychiatric

    Standing orders for agitation in my department are 20 mg Geodon and 2 mg Ativan given together (either IM or PO). If this fails, we generally move on to the B52 (50 mg Benadryl, 2 mg Ativan, and 5 mg...

  4. restraint/seclusion order question

    MDMBSNRN replied to sassyann85's topic in Psychiatric

    Our restraint room was also the seclusion room. This was convenient for us, as restrained patients could be segregated from the general population, and other patients did not have to witness that....

  5. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    Here.I.Stand, you are exactly right in what you have said, and I totally agree. The incident I mentioned earlier in the comments about how my primary manager took issue with the way I handled a...

  6. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    I called and checked on the patient today once I got to work, and settled things in the department. Turns out he did, in fact, have an NSTEMI while in the unit the night I admitted him. He still has...

  7. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    Here.I.Stand, thank you! That's exactly how I feel sometimes. As if I went to school, got my education, and am now being stripped of half the rights and privileges of the degree I pursued. We...

  8. Describe a typical day

    MDMBSNRN replied to ellieheart's topic in Psychiatric

    Windsurfer, people certainly do have misconceptions about psych. The attitude does tend to be one of, "oh, I would love to have your job. You just sit around, talk to the patients, watch them, and...

  9. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    superT, I agree that if you don't know when to call, you should't be working in the ICU setting. The ED tends to do basically whatever they want, and I feel that I have way more autonomy when working...

  10. ICU RN Report- How does your unit do it?

    MDMBSNRN replied to seamel's topic in Critical Care

    Our ICU report is given by the charge nurse to all incoming nurses, and I don't really like this. At shift change, the charge nurse takes all the nurses into the break room, and gives full report on...

  11. Describe a typical day

    MDMBSNRN replied to ellieheart's topic in Psychiatric

    Windsurfer, I agree that working inpatient psych wasn't as hard on my back. Working ED/crisis psych is a totally different story. I perform full medical, as well as psych treatment, and often have...

  12. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    Lev, this patient was a full

  13. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    Calivianya, I once had 9 patients on the telemetry/oncology unit. One received 12 units of blood over the course of the shift, one had a BP of 240/120, one was a CVA in progress, one was a metastatic...

  14. rhythm questions!

    MDMBSNRN replied to nursingq123's topic in Cardiac

    If a patient goes into any rhythm, and still has a pulse, stay calm and assess the patient first. Check their general appearance, level of consciousness, vital signs, pulse strength, etc. If they...

  15. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    JeanOfAllTraits, thank you for your kind words! ICU is my goal, and it's what I will be interviewing for (at another hospital) very soon. I agree with you about policies being bent and not...

  16. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    Lev, I specifically asked to draw a lactate, as I was worried about lactic acidosis secondary to shock (septic or possibly cardiogenic). Once again, no one saw any clinical indication for this, and...

  17. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    I once had a near disastrous situation after holding medications and refusing physician orders. I had a patient with CHF, renal failure, hypotension, hypoxia, anemia, and other issues. She was an...

  18. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    MunoRN, good point about the troponins, and the time it takes from cardiac injury to elevation. I had heard an elevated troponin blamed on demand ischemia before, but I have never seen it so acutely...

  19. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    I interview at Centennial Medical Center in Nashville, TN in a few weeks for an ICU position. I'm praying hard that I get the job there, as this hospital is getting worse by the

  20. Er burn out? Stressed out?

    MDMBSNRN replied to ERnurse71's topic in Emergency

    I know exactly what you mean by that. I did some time in a trauma center, and I always loved having the patient who was in the process of bleeding out from their multiple gunshot wounds beside the...

  21. What was the MOST ridiculous thing a patient came to the ER for?

    MDMBSNRN replied to JUSTYSMOM's topic in Emergency

    My favorite from the other week was "someone broke into my house and stole my entire bottle of Percocet. They didn't take anything else. I need a new prescription for Percocet tonight. I'm in...

  22. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    That form in the eMAR sounds like a great idea. I wish that we had that. We resort to writing a nursing note that we called the doctor, and whether we received new orders. I think that the form in...

  23. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    Calivianya, first and foremost thank you for your great information and wonderful reply! There is a policy for critical labs, and that first huge jump in troponin occurred while the patient was still...

  24. Could I have done anything else?

    MDMBSNRN replied to MDMBSNRN's topic in Critical Care

    I just remembered one detail after reading your reply. The admitting doctor had been made aware of the increased troponin by the ED (the jump from 0.14 to over 2), and she stated that she felt it was...

  25. What was the MOST ridiculous thing a patient came to the ER for?

    MDMBSNRN replied to JUSTYSMOM's topic in Emergency

    Last week, I saw "I have a splinter," "my back has been hurting for three months," (that patient came in at 0300), "I am hungry, need help finding a job, and am tired of being homeless," and, "my...