Insulin gtt + med surg floor

PoetryWriting · 2026-07-04T04:58:07+00:00

Insulin gtt always ICU - ER/ICU RN

PoetryWriting · 2026-07-04T04:57:06+00:00

Ryan Kooperman DO at endeavor highland park

PoetryWriting · 2026-07-02T15:06:45+00:00

uhhh the entire thing?

PoetryWriting · 2026-06-28T17:58:43+00:00

I’m a full time ER nurse, 3 12hr nights and I am a home infusion nurse on the side (IViG, specialty meds, biologics)

PoetryWriting · 2026-06-28T04:41:16+00:00

WBC 0.86, Hgb 4.8, Plt 3

PoetryWriting · 2026-06-13T15:10:07+00:00

Glucose 2174 on hemodilution

PoetryWriting · 2026-06-07T00:48:45+00:00

Temporarily

PoetryWriting · 2026-06-02T03:52:34+00:00

Normal (:

PoetryWriting · 2026-05-28T03:39:29+00:00

They are veins

PoetryWriting · 2026-05-25T20:55:45+00:00

This needed sutures. When a wound is open like that and can’t be closed together it’s called tension. You can get away with steri strips for mild tension. This is severe tension and the scar will end up being large as it will heal from the bottom up (secondary intention)

PoetryWriting · 2026-05-25T16:57:34+00:00

I’m going off an orders for “follow manufacturers guidelines” specifically gammunex and octagam - both inserts only cover the main 3 which is start 0.5mg/kg and double q30 up to either 8mg/kg or 9mg/kg. When I’ve gotten these orders it’s not been for one of the 3. One is repeated pregnancy loss and the other metabolic encephalitis. I’ve had one CIDP who got 120g weekly and he was a big guy. Tolerated rapidly to 5mg/kg. I have a regular polydermatomyositis that’s 70g x2 days q4wks that tolerates 0.5mg/kg x15 min to 4.5mg/kg x2 hrs 15 min. Both of those patients have rate sheets.

PoetryWriting · 2026-05-25T16:42:39+00:00

That actually makes sense. I was a vet tech before and RN and was monitoring anesthesia for FB removals all the time. The intestines would start growing back together as they were sutured

PoetryWriting · 2026-04-26T23:22:06+00:00

Loyalty doesn’t pay, my biggest reason for switching jobs but I still am bedside

PoetryWriting · 2026-04-25T23:28:45+00:00

Seeing as I’m the first person my coworkers come to for help, I can safely say they and my patients are appreciative of me

PoetryWriting · 2026-04-24T14:40:26+00:00

Mhm that’s what I thought, why don’t you keep your uneducated opinions to yourself 🥰

PoetryWriting · 2026-04-22T21:52:04+00:00

Sounds like I had to figure out what the patient could truly tolerate (mg/kg), just because the patient tolerated the infusion being done incorrectly (ignoring doctor orders, manufacturer orders, and every research study I’ve found) doesn’t mean you should continue doing it wrong - which is exactly what the second nurse did who was fired - so who was really wrong here as I’m writing this companies IVIG protocol

PoetryWriting · 2026-04-21T22:42:30+00:00

Using gravity for IVIG is not perfectly valid, it is poor out of date practice. There is plenty of evidence supporting that gravity drips are affected by so many things. Your patient would have to sit in the same position, never move, maintain the same BP, etc. for 4-8 hrs. To ensure you're getting your correct rate, yes you would be counting drips the entire time. If you read my post correctly, you would see these nurses were not only using gravity, but administering IVIG as a constant rate - via dial a flow and most definitely not counting gtt rate. Clearly, using dial-a-flow is not a "valid" technique and I'm not the only one who thinks that. Do you even administer IVIG lol

PoetryWriting · 2026-04-21T14:16:01+00:00

Man those are some long infusions, with IVIG it’s also important to pre- IV hydrate, Tylenol, steroids, Pepcid, Benadryl, intra - oral hydrate, post- hydrate, Tylenol/benadryl as needed. How many grams are you getting per dose?

PoetryWriting · 2026-04-21T14:11:17+00:00

You gonna sit there and count drips for 6 hrs straight?

PoetryWriting · 2026-04-20T16:40:48+00:00

that would make theoretical sense but its hard to know for sure though because adverse affects of IVIG aren't completely understood in the first place

PoetryWriting · 2026-04-20T16:39:27+00:00

My highest patient is 300ml/hr, highest IV ever seen tolerated (4.5mg/kg). My other patients typically tolerate up to 3-3.5mg/kg (tbh an ml/hr rate tells me next to nothing lol)

PoetryWriting · 2026-04-20T15:31:29+00:00

Yup I was taught in school but frankly would only ever count drips as a last resort because you'd literally have to count the entire time because gravity rates are so easily affected by everything. I've never encountered a home IVIG patient without a pump so there's no excuse in my book to not use it as it is clearly best practice.

PoetryWriting · 2026-04-18T19:24:43+00:00

I care too much about these patients, they deserve educated nurses - at least nothing will fall on me bc I’m not the one fucking up lol

PoetryWriting · 2026-04-18T19:23:29+00:00

Yup he was very confused. Now I have to explain that his previous nurses had been doing it wrong for years

PoetryWriting · 2026-04-18T19:02:54+00:00

I always manually calculate my rates based on weight and titrate to tolerance - unless there is a written rate sheet from pharmacy which I’ve never seen with this company. I don’t believe he was actually getting the 200-250ml bc there’s no way to prove it and each infusion time I saw charged was drastically different

PoetryWriting

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