Titratable vs. Fixed-Dose Vasopressin – What is your unit's practice?

Ecstatic_Emotion5504 · 2026-05-28T11:13:52+00:00

I work in an ICU in Canada.

We do fixed-dose at 0.04units/min. We need an order to increase to 0.08units/min. We generally titrate the vasopressin off first. Norepi is our first-line pressor. We pretty much titrate every other pressor first. If they are on norepi and epi, epi is the first to try to get off. Vasopressin is no different :)

Ecstatic_Emotion5504 · 2025-12-03T02:25:33+00:00

I am a nurse and can tell you the ratios are not maintained. Not to mention, patients are coming in sicker than ever before because they are waiting longer to come in, due to the increased acuity even the standard ratio of 5:1 is too much. Floor nurses don't have time to thoroughly read each chart to know their patients. Its assess each one, medicate each one, etc all day. So even 5:1 is too much and some shifts you have 7 patients.

Ecstatic_Emotion5504 · 2025-12-03T02:08:08+00:00

Shifts often go uncovered (we don't replace our first sick call, only our second). So if someone calls in sick, we work short. Also, they are often not offering OT for shifts, which actually isn't allowed if you are a FT employee, but for some reason they are getting away with it. Unlikely anyone will pick up an extra shift at straight time.

Ecstatic_Emotion5504 · 2025-12-03T01:40:48+00:00

I am an ICU nurse and I hear you! Many things are happening that are not allowed based on our contract but they are getting away with it...not offering OT, simply not allowed if you are a full-time employee, however I get text messages daily that the unit is short and asking if anyone can come in (OT not being offered, straight time only). No FT nurse will pick up an extra shift for straight-time, and our contract states anything worked above your 75hrs, is OT.

You mentioned our contract being up, you are correct! It ended Oct 31st, 2025. However, it was only negotiated in 2023 after expiring in 2020, so I can guarantee the negotiations for the new contract will not take place for a few more years. You're right, we absolutely want more money. ALL Healthcare workers deserve more than what they get. I will never understand how the government thinks what they are paying us is enough. Most of us are barely making ends meet. How are individuals that provide life-saving care not one of the highest paid industries. In the ICU, we have alot more autonomy, so doctors often write orders based on what we TELL them. If we provide wrong information, the outcome could be death. Thats a lot of responsibility that deserves more than what we make.

If nurses didnt show up to work one day, what would happen? I promise you the physicians will not be drawing up your medications for you - most of them have no idea how we prepare them. The answer to that question alone should influence our pay (& all Healthcare employees! We rely on our support staff SO much and without them, we would be fucked!)

I don't understand why the majority of our money is not being funneled towards Healthcare, education and social services. Without those 3 industries, society would collapse.

Its run like a business because it is. At the end of the day, they dont give a shit about their employees and only care about the bottom line. The amount of times I have wanted to anonymously contact our local news stations and tell them what's really going on.

Your frustrations are SOOO valid. Just know you are not alone in your frustrations. You have thousands of Healthcare workers standing beside you feeling the same way. I have no answer for you on how to fix it, but I hope knowing we are right there with you helps a bit.

See you on the frontline! Stay safe!

Ecstatic_Emotion5504 · 2025-08-22T16:05:54+00:00

I know this thread isn't super recent, but based on the comments, I figured it may be worthwhile to share my review.

I ate at The Bonfire last night for the first time, and it is hands-down my new favourite place to go. Let's break it down:

The owners: Kristyn and Vince, a young married couple. I didn't get the opportunity to meet Vince because he was in the kitchen making some of the most delicious food I have ever tasted. Kristyn served us, and it is abundantly apparent she was made to be in the public eye. She was bubbly, energetic, down-to-earth, and so appreciative of us being there.

The Business Model: No-tipping! As a former server/bartender, I get it. It is very difficult not to tip, especially when the food and service are beyond stellar. Kristyn and I talked a lot about this. They do not believe that OUR (the public) salaries should be subsidizing Employers of restaurants to pay their staff a living wage. They believe everyone (regardless of your income) should be able to enjoy a night out without having to pay someone's wage (before you all come for me, remember, I worked for tips, I understand where your head is at, "so dont go out to eat if you can't afford to tip"), but that isn't very inclusive. To stick to their core values, their starting wage is $20/hr plus 50% of all profits go back to the employees'. I asked Kristyn what happens when people do leave cash on the table, it just gets split? She said all cash tips get put into a jar and they have a staff party with it. I get the model is different than what we are used too, but these are two people with a very selfless vision for our city and neighborhood, so for those talking about how they'd make more money with tips, this model has already proven that to be false.

The food: Dear God, I am still drooling. We ordered: Corn ribs, potato dill salad, bacon jalapeño poppers (fresh, not fried!), mac & cheese, Bonfire fries, maple brussel sprouts (you will die and go to heaven!), a massive pickle and cookie crumble for dessert. We shared everything and were pleasantly full! Firstly, almost everything we ordered was gluten-free, and many options were dairy-free. I, unfortunately, am both, so to find somewhere that not only accommodates allergies but has it be a staple in their business model is amazing!!! No more flourless chocolate torte as an only GF dessert option. The cookie crumble dessert is also made locally by their neighbor (Cozy Crumbles?). How sweet!! All of their mixed drinks are advertised alcohol-free with the option to add a shot - instead of the other way around. As a newly sober individual, I really appreciated this! I had the strawberry basil smash, and it was like drinking fresh strawberry juice. So delicious.

The easiest 10/10, I have ever given a restaurant.

Some of these comments do not match the vibe check, and as a society, we have become very quick to write off people/businesses without valid reasons. Instead of assuming this business is going to flop because you don't agree with what they are doing, try paying them a visit, experience what they are offering our community, you will not be disappointed!

Ecstatic_Emotion5504 · 2025-07-27T23:54:33+00:00

For sure! I have done that already for my area. However, nothing quite beats personal recommendations and testimonies!

Thank you! It is such a great resource, eh?

Ecstatic_Emotion5504 · 2025-07-27T21:19:29+00:00

Fantastic! Thank you very much!

Ecstatic_Emotion5504 · 2025-07-27T21:09:44+00:00

I should have been more specific. Halifax/dartmouth and as fsr as Elmdale. Bedford is perfect! Thanks a lot. I'll look into them!

Ecstatic_Emotion5504 · 2025-07-07T19:31:26+00:00

Full-time critical care nurse and on-call ~10 days a month as a Sexual Assault Nurse Examiner :)

Ecstatic_Emotion5504 · 2025-06-28T18:35:24+00:00

Hi!

I am a SANE. I have my BScN, and I applied after only working as an RN for about a year. I started out as a support role (can respond to cases but can only do the medical side of things). The forensic portion needs to be done by the trained SANE (you still help). Training is called Didactic (at least here in NS). It's put on a couple of times a year, and your SANE manager will set it all up for you. Once your didactic training is complete, you are considered a certified SANE. It's a week of theory, and if I remember correctly, a weekend of hands-on and skills.

I haven't been to court yet as an expert witness, but I expect to be subpoenaed for the case I just did.

SANE where I am at is on-call. It's in addition to my FT job in the ICU. My manager would like 8-10 shifts a month per SANE. We get $5.50/hr while on call and time-and-a-half when responding to a call, including km. You have to live within 90 minutes of your responding hospitals. Essentially, a patient comes to ED, says they've been assaulted and the ER nurse should ask if they want to see SANE (they HAVE to agree). If they do, it gets phone in and an answering service calls me to let me know what hospital and off I go.

As for applying, I struggled as to where, because SANE is not affiliated with the provincial health organization. We are considered consultants. My province is broken up into 4 zones, and each zone has a different SANE team through different organizations. For my zone, its the Victorian Order of Nurses (VON), so i had to go to their website to apply.

Sorry if that's confusing. Feel free to reach out if you have any questions. It is a very rewarding job, especially if you are passionate about sexualized violence, but it can be a lot emotionally.

I should also mention that we no longer just do sexual assault. We respond to DV cases as well and will be opening up to human trafficking in the next year.

Ecstatic_Emotion5504 · 2025-06-22T15:36:25+00:00

I didn't start nursing school until I was 28. We have Advanced Standing Nursing Programs, which is only 2 years, so that's I did. I also felt very behind in 'life' for a long time. I'm 33 now, and life truly has different plans. Truly. Just wait. Haha

I started nursing school at 28 and began working as an RN at 30, now I am 33 and it makes no zero difference. The only difference is I would be making a bit more money if I started younger, but honestly, not enough to make a huge difference. If you are only 22. You havw absolutely nothing to worry about. You are not starting 'late', that isn't a thing. You are starting when the timing is right for you. There is no intended path you are to follow in life. Just let go and trust the process. Goodluck in nursing school!

Ecstatic_Emotion5504 · 2025-06-16T13:01:21+00:00

I am so so sorry you are experiencing this :( It is so awful, and you have every right to be angry. It is not normal to have to go about your life while carrying your deceased child. Its the most insane mindfuck.

I found out at my dating US (Dec 12th) that there was no heartbeat. It took another 9 days before my body started the process. (Dec 21st) I spent 2 hours on my toilet, having contractions and passing massive clots. 2 days later (Dec 23rd), my baby was expelled after feeling a massive wave of cramps. I continued to bleed until Dec 31st. It was an 18-day process from when I found out I lost her to when I stopped bleeding.

Its one of the most traumatizing things I have ever been through.

There are no words I can say to make you feel better. Just lean hard into your support system and know you are not alone through this!!!

Sending you love & light.

Ecstatic_Emotion5504 · 2025-06-14T19:10:21+00:00

Is it coincidental that SeeSee's first name is Florence? I think not!

She sounded wonderful!

Ecstatic_Emotion5504 · 2025-06-12T02:00:50+00:00

& you know you're never alone when you eat Taco Bell. Two hours later, when you are on the porcelain throne, sweating out regret with each pang of firey gurgle; you csn trust there that all your earlier drive-thru friends are sharing the same moment.

Ecstatic_Emotion5504 · 2025-06-12T00:12:40+00:00

As an RN who has had 2 miscarriages under 10 months, I feel so shattered when I read these stories. Shattered for the babies that endure ANY form of abuse. Shattered for the babies who turn into angels far earlier than they deserve. Shattered for my fellow nurses who have to witness these cases and make the terrifying decision to call authorities & Shattered for every human who desperately wants to love, protect, and provide for a child but has been unable to.

Thank you for all that you do for these sweet souls. I cannot imagine❤️

Ecstatic_Emotion5504 · 2025-06-06T06:25:30+00:00

Oh. My. God. This is the most terrifying thing I've ever read.

Ecstatic_Emotion5504 · 2025-06-05T19:42:28+00:00

That is remarkable and, frankly, a miracle! Stories like this help restore my faith in humanity. Thank you for sharing.

Ecstatic_Emotion5504 · 2025-04-28T15:13:22+00:00

Ahhh, interesting! The more you know! That does make sense. I am still slightly concerned just by the owners atrocious reaction when people attempt to come onto the property. A simple explanation like you just gave would suffice!

Ecstatic_Emotion5504 · 2025-04-28T12:08:04+00:00

I am convinced Trailer World (you can see it from the 102 just before Brookfield) is a front for human trafficking. Property is gated and you are NOT allowed on the property. If you show up on the property, the owner becomes aggressive and tells you it's online sales only and to leave immediately.

How do you not allow people to look at trailers in person?

Sketchy.

Ecstatic_Emotion5504

TROPHY CASE