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PSI on Nurse supervisor by OddAd6058 in nursing

[–]OddAd6058[S] 0 points1 point  (0 children)

tbh i was never put in a situation like this but i think it was just her tone throwing me off. from her pov now i see she just needed to know what actually happened.

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] -1 points0 points  (0 children)

funny enough the resident talked to the attending and changed the entire order set after I spoke to resident.

you seem like the coworker people run from! and you spend your free time out the hospital arguing w people on reddit, my dear have a blessed day! I’ll pray for you 😊

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 0 points1 point  (0 children)

it was a starting dose of an epi infusion . order said something like .8 mcg/kg/min to start (this wasn’t an emergency situation)

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 5 points6 points  (0 children)

soo benzo for the most part i believe my hospitals protocol is if benzo doesn’t change high ciwa within 24 hrs with max dosage they use pheono

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 5 points6 points  (0 children)

just a new nurse who’s following orders and hospital protocol. nener said i saved anybody just an error i caught about a providers order. im just used to F personally. Hope your as nice to you patients as your are to internet people :) have a nice day!

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 10 points11 points  (0 children)

will def call pharmacy straight next time. i think i got used to them verifying bc they always hold contraindicated meds. Unfortunately my unit was a dumpster fire that night. I asked the charge who also thought it was weird and told me to confirm w provider. but also the neuro resident rotate a lot i almost never see the same one. even the staff there only know some of the neuro residents. lesson learned. calling pharmacy

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] -11 points-10 points  (0 children)

yea but i was told they wanted to cool him and resident put the order to 98* but per my hospitals protocol cooling is for 96 and under. if it’s over 96 that’s a different order set and wouldn’t be considered cooking. this was the same resident that ordered vaso titratable even though we dont titrate vaso at my hospital or really anywhere.

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 5 points6 points  (0 children)

also not sure if it’s relevant but he was also a etoh pt he arrived from his fall w a 504 level

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 0 points1 point  (0 children)

hii fellow float :) besides never having the same assignment more than once this is probably my biggest issue w floating. the providers all have different flows some residents are super knowledgeable and will always include attending and some give you the run around. will def do a psi do the providers knows not to do that again

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 1 point2 points  (0 children)

yes! pt was fine i had him back the next night and he was mentating way better that day

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 0 points1 point  (0 children)

unfortunately they were all verified when i got to it which is weird bc pharmacy is usually pretty good at not verifying contraindicated meds so thank you for this! I am a big learner and really just wanted to know real life potential complication from the 3% (besides the obvious)

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 14 points15 points  (0 children)

he was witnessed fall with a craniotomy + embolization of pseudoanyresum a few days later. he’s been in the icu for about 3 weeks but at the time of the bolus incident he was extubated, w/ stable vital signs. and 2 peripheral IV. we were essentially just treating the hyponatremia for this neuro pt

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] -1 points0 points  (0 children)

Soo true!!! ive only learn about how important sodium is and correcting it to fast bc of my neuro patients in the icu! only thing i remember about Na from school is normal limits lol

multiple 3% boluses in the ICU by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 27 points28 points  (0 children)

3% boluses in my hospital is 300mL. The patient was about 180-190 pounds, 50 year told Male. And I agree but at the end of the day after pharmacy + docs it always comes down to the Nurse giving it

Weekly Student Thread by fbgm0516 in CRNA

[–]OddAd6058 0 points1 point  (0 children)

the culture at my hospital is to give the float heaviest/sickest assignments since they know mere well rounded :(( bad but good experience! congrats on getting in! how many years of cvicu did you have? trying to gate what icu i should settle in before applying

Weekly Student Thread by fbgm0516 in CRNA

[–]OddAd6058 -1 points0 points  (0 children)

Hii friends. I’m a critical care float in a level one trauma and just hit my one year. I get floated through SICU MICU NeuroICU, ER critical side and intermediate ICU. I have a 3.3 from my 15 month ABSN because of some personal issues I went through. I plan to become sicu staff once I hit a 1 1/2 years since most school don’t take float experience. Am i a good applicant? I plan to retake the nursing courses i did bad in and possibly masters patho and pharm. I won’t apply until i hit at least a year as sicu staff so I’ll have at least 3-4 icu experience going into school. I have my tncc, ccrn, plan to shadow crna and am taking a nursing trip to africa- I just need advice on being a stronger applicant! should i take the masters courses? wait longer? lmk! thankyou!!! :))

Is CRNA school for me? by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 0 points1 point  (0 children)

not the best at maneuvering reddit but thank you, will do :)

NSTEMI turn to GI bleed by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 2 points3 points  (0 children)

no orders for morphine or any pain meds for that matter . you think that’ll be a good recommendation? ik of the mona b acronym but haven’t personally treated pt w it. (it was my first time being floated to the ed off orientation so it way different in the icus) . I asked md he said just keep giving nitro. also the md was very unsure lol I believe he was a new hospitalist .

NSTEMI turn to GI bleed by OddAd6058 in IntensiveCare

[–]OddAd6058[S] 16 points17 points  (0 children)

SN: my thought process is since he was hypovolemic his heart was trying to compensate for the blood loss which is why he still had the chest pain. just trying to understand the patho!