What are your critical care write-ups like?

[Mrs07RN09]

I'm in my senior rotation of critical care and am just curious as to how write ups are before clinical for other programs. When we have clinical on Wed. and Thurs. in an ICU, we go to the hospital on Tues. afternoon to get our assignement and read the chart. That night we have to type up the patho, at least 3 pages and the meds. For the meds we have to list the action, side effects, class, why the pt. is on that med, lab results, and how to monitor effectiveness. This takes forever since a lot of us get up to 17 meds!

The next night, we have to write a page on what diet they're on and why, list all of the nursing actions we did the previous day and why, come up with 5 top priority problems and why, and one for the family of the pt. and...why of course. The following day labs are due. We have to look up all abnormal lab values and the ABGs and list why..again. We are so exhausted by the time we come to clinical that we can't function at 6:30 in the morning! We have 4 instructors and 1 of those is "in charge". She's retiring this year and the other instructors have told us that next year they are changing things a lot and not requiring all of this prep-work. So I was just curious if any other programs out there require this too!

[fiveofpeep]

20+ pages was normal for us

[jackson145]

I'm so jealous! We don't get a critical care rotation. The hospital we do clinicals at doesn't want students to be in the way in the CCU.

[redtshirt]

if only i was made do that i might learn some important things! Sounds excessive though. The hard taskmaster is leaving tho

[NurseLoveJoy88, ASN, RN]

We have to do a paragraph or so on the eitiology, pathophys, and clinical manifistations. Then, we have to list nursing diagnois, and a nursing action and all nursing actions must be implemented using the five aspects of care. Than, ofcourse we list our short-term and long-term goals. My careplans are about 10 pages or longer.

[werlp]

I go to a hospital diploma program so we are right across the street from the hospital. I am in critical care too.We also have to preassess and have 3 days per week in ICU/CCU. For day 1 due is the patho, a problem list sorted by systems, a careplan a written patho and meds (Action, dose, S/E, labs and anythin else important to know). Then for the next three days we do everything the nurse does except IV meds are under supervision. We chart at the hospital and then have a 20 page packet of papers we fill out (basically everything we charted but we have to write it again). And lab correlations-why they are high/low and some other random miscellaneous busy work. So it sounds pretty similar.

[vastudent09]

i just finished my critical care rotation. for all our other clinicals we did similiar paperwork to what u describes- 5 nursing diagnosis with interventions and rationale. meds, labs, patho, pmh, ect. about 5 hours of paperwork. but for cc all we had was what our school called a care map. a middle box with pt primary problem(reason in the icu) then connecting boxes such as cardiac, gi/gu, resp. ect, then explain how they all interconnect and why that effects the paitent. we had to be knowledgabl;e about meds but did not have to write them down.

ex: heres one of my boxes... i like this way better than all that other tedious paperowrk.

cardiovascular: volume deficit, hemorrhagic shock, exsanguinating bleed or: ebl 7000cc, severe inflammation

original hypotension, 70's/40's, stable on levophed-9.4 cc, 5.0 mcg, nsr, abp 119/55, levo titrated between 3-10 mcg keep map>65

9/15 h/h: 6.7 & 20.8 9/16 h/h 10.0/31.1, mag 1.8-received 1 g replacement, k 3.1-received 50 meq, plt count 168,

vs: 99% spo2, rate 15, hr 77, bp 119/55 negative troponin 9/15

poor cap refill, cold extremities, and weak pulses

tx: 4 units prbc prior to or, 10 units prbcs, 4 ffp in or- massive transfusion protocol started. prn ns bolus for map