AlexCCRN

AlexCCRN

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All Content by AlexCCRN

  1. Narcotic Irregularities

    AlexCCRN posted a topic in Patient Safety Issues

    How do you report a pattern of narcotic medication record irregularities without making it personal. A few specific nurses consistently remove narcotics NOT ordered, presumably administered under the...

  2. Is it legal/ethical for preceptor to sabotage student?

    AlexCCRN replied to Roland's topic in Patient, Colleague Relations

    Is anyone else just sick and tired of arrogant self-appointed straw bosses who can't seem to stop themselves from screwing with new nurses? Managers could stop this sort of ADHD behavior if they...

  3. new orientee in the icu

    AlexCCRN replied to RNSUEIA's topic in MICU, SICU

    5 day orientation - unless your a seasoned ICU nurse - it's crazy and just plain bad. As for keeping up... consider a pocket sized recorder. I use my Palm PDA with digital recording to keep voice...

  4. Need some opinions

    AlexCCRN replied to RaeT,RN's topic in Ob/Gyn

    Tolerance used as a term denoting range of variability accepted - not requiring intervention ... yes, tolerance develops over time with experience - you knew this. Yet, you also know that experienced...

  5. Assessing for Pain on a M/S Floor: How Often?

    AlexCCRN replied to Town & Country's topic in General Nursing

    Assessing pain can also be accomplished without asking the patient - VS, nonverbals, trends, etc.. I've experienced that asking too often seems to train or encourage a yes or exagerated response when...

  6. funniest thing you saw a nurse do.......

    AlexCCRN replied to cre8tivRN's topic in General Nursing

    I once provided an inspirometer to a patient with a trach. I was just so happy to see her off the vent

  7. ICU - Should I stay or go?

    AlexCCRN replied to OahuRN's topic in General Nursing

    Don't go quietly. Establish yourself as a critical thinking, caring, safe RN who's willing to argue their case without emotion. I mean, whenever something ridiculous presents itself and you are...

  8. RN intubation in ED?

    AlexCCRN replied to Firemedic7's topic in Emergency

    Depends on the facility. ER nurses should be ACLS certified and therefore have rudimentary intubation skills and are expected to be able to accomplish intubations as part of the ACLS requirements....

  9. ? for CVICU Nurses!

    AlexCCRN replied to my2sons's topic in MICU, SICU

    What do we use? All drug doses are determined by patient weight. Unless you're caring for gerbils, the doses you mention are insufficient. Compensating by allowing more frequent dosing is a cop out....

  10. BIS Monitor

    AlexCCRN replied to sandman1914's topic in Certified Registered Nurse Anesthetist, CRNA

    roustan jp, valette s, aubas p, rondouin g, capdevila x. department of anesthesiology and intensive care medicine, neurological explorations laboratory, lapeyronie university hospital, 295 avenue du...

  11. BIS Monitor

    AlexCCRN replied to sandman1914's topic in Certified Registered Nurse Anesthetist, CRNA

    Not voodoo but "oh no!" is what you'll be saying if the pt is improperly anesthetized or sedated and you chose not to use the available BIS monitor. Use ALL the tools at our disposal. I've experienced...

  12. Topamax

    AlexCCRN replied to ER-RN2's topic in Pain Management

    Topiramate label use: anti-seizure and migraine prophylaxis. Investigational use in infantile spasms, neuropathic pain, cluster HA. Teratogenic & enter breast milk. Can reduce serum HCO2 up to 67%...

  13. NP w/no desire for RN?

    AlexCCRN replied to Pinoy2.0's topic in Nurse Practitioners, NP

    Pinyoy, name a responsible profession in which practical experience and measured competency isn't a prerequisite for advancement. Thankfully, reputable nursing schools rarely accept candidates for NP...

  14. Please help... (felony and nursing?)

    AlexCCRN replied to godin78's topic in General Nursing

    NO and as well, they shouldn't. Period the

  15. open visitation in icu??

    AlexCCRN replied to tennessee rn's topic in MICU, SICU

    Agree that open visits have downside. Training visitors takes up much time too. I wish we would have blocked off hours and a limitted visitors list including only a few family, friend or whoever. The...

  16. Worried...caught med error but only CNA

    AlexCCRN replied to bethin's topic in General Nursing

    Yes, the incident should have been reported as soon as you understood something was amiss. It's our moral obligation. In the future, I strongly recommend NOT tampering with or handling medications as...

  17. Boston Globe series on ICU Nursing....

    AlexCCRN replied to papawjohn's topic in MICU, SICU

    As with any discipline, just cuz you're a veteran or highly proficient DOES NOT justify being assigned a teaching role. Expert educators are needed to train experts. There's no value in the harsh...

  18. Not A Math Whiz! Which class to take?

    AlexCCRN replied to SchoolRN,BSN's topic in Pre-Nursing Students

    Finite will work just fine but if you're contemplating higher levels of involvement in say nursing research, precalc is more

  19. A patient complained about me...

    AlexCCRN replied to NurseCard's topic in General Nursing

    Skip the email. Don't act defensive either. If the manager has a problem, let her come to you unless you feel the need to report an adverse outcome or request reassignment. I see so many nurses...

  20. criminal record preclude nursing employment?

    AlexCCRN replied to sworksrider's topic in Colorado Nursing

    A new career in nursing can be life changing at the deepest level. I hope that you find what you're looking

  21. Anesthesia and the Morbidly Obese

    AlexCCRN replied to NeuroNP's topic in Certified Registered Nurse Anesthetist, CRNA

    Lipid solubility and partition coeficients come to

  22. lotsa fentanyl, no sleepy

    AlexCCRN replied to elizabells's topic in Certified Registered Nurse Anesthetist, CRNA

    Pts response to narcs is variable. Issues of tolerance and cross-tolerance may play a part. Paradoxical reactions to Versed are not uncommon. Maybe you weren't getting *all* the analgesic that was...

  23. LPN's Role in the ICU?

    AlexCCRN replied to Nurse-o-Matic's topic in MICU, SICU

    Our hospital employees LPNs but NOT in the ICU. Too many cooks in the kitchen. I find LPNs mostly distracting on the

  24. Methadone question

    AlexCCRN replied to southern_rn_brat's topic in Pain Management

    Nursing ignorance and prejudice when it comes to pain meds is discouraging. Once daily dosing - methadone has a long half-life - and analgesia efficacy makes methadone an excellent choice for RTC pain...

  25. DNR vs withdrawal of treatment

    AlexCCRN replied to acquiesce1908's topic in CCU, Coronary, Cardiac

    You have it all right. DNR does not equal WOT orders. And euphamisms that were mentioned are innapropriate of course and unethical. So, you continued to treat the patient as previously written orders...