ICU RN

MSN, CNL, #CCRN. ICU nurse for 2 decades. Historical perspective-not old, just seasoned. Lover of learning. Wife & mom of 4 #nursetwitter #medtwitter

[ICU RN @ICURN_]

Urologist has to come in for procedure. MD text me on charge phone “be there in about an hour.
I replied: “Drive safe. Urine my thoughts.”
No response.

I’ve never met this MD before. I’m either going to get a write up or make a new friend tonight.

[ICU RN @ICURN_]

I miss when everyone on the vent was sedated on prop and fent IVP.

Now it’s a sprinkle of dex, a dash of ketamine, touch of fent, +\- a tincture or prop.

We really do the most for no reasons sometimes.

[ICU RN @ICURN_]

@Thrash_Michaels @Q2turnQueen If you don’t mind, share your Rationale

Asking because we haven’t gotten a lot of comments from those voting MD

[ICU RN @ICURN_]

MD places order for foley. Indication is “per family request to promote rest”

RN refuses to place foley per nursing policy that doesn’t list that as an I indication for foley.

MD tells RN that order supersedes nursing policy. RN disagrees.

Who’s side are you on?
#MedTwitter

[ICU RN @ICURN_]

@narkosdoc Not sure I can give more details on MDs perspective. I know that MD was asked to place foley by family to promote rest/so patient didn’t have to get up overnight and doc agreed to do so pt could rest better

[ICU RN @ICURN_]

@RachaelEWoods I just mean they have very patient centered evidence based nursing policy which creates a great culture.
I don’t work at the hospital. It If you mean alternatives for the foley, the policy is modeled after AHRQ https://t.co/9Ghd2gumx5

[ICU RN @ICURN_]

@narkosdoc It depends on who you ask. The nurse doesn’t want to place the foley because it puts the patient at risk for hospital acquired problems and isn’t indicated based on best evidence/best practice. Doc wants to oblige family request.

[ICU RN @ICURN_]

@KickenALSAss Sorry I should clarify, the patient is not comfort measures/comfort care.

[ICU RN @ICURN_]

@RachaelEWoods I have been on many units like that, wanted every foley and restraint wr could get

The Culture of nursing practice at this hospital is very founded in evidence based practice and patient safety. Not as much focused on what makes life easier for the nurses. It’s quite impressive

[ICU RN @ICURN_]

@ThinkingCC @phlegmfighter But that doesn’t change the value of their service when they are done? Doctors openly talk about the need to reform med education, so do it. The number of years spent and giving up your 20s isn’t an argument for your current value.

[ICU RN @ICURN_]

@PostOpPrincess Hoping it makes it to both nurse and med Twitter for both sides input

[ICU RN @ICURN_]

@RNSuperHero Maybe it was a rude way of asking who the proxy is or if there is one?

[ICU RN @ICURN_]

@Q2turnQueen Idk if this applies to you or not but I admire nurses who are self aware enough to know that they should not be an NP. Not all nurses are capable of being good NPs.

[ICU RN @ICURN_]

@thelakesshow Powerful, Kate. I am so sorry for your loss.

[ICU RN @ICURN_]

@sharpcheddar I’ll allow it

[ICU RN @ICURN_]

Anyone who is over 50 in healthcare in grandfathered in on saying TPA instead of TNKase if desired. We know the drug isn’t TPA anymore.

[ICU RN @ICURN_]

@neurornx Love when there isn’t a huge gap between the wedding and reception.

[ICU RN @ICURN_]

@HalstedMD I think there’s a 99.9% chance you write these posts yourself to be able to screenshot them. Are you okay?

[ICU RN @ICURN_]

@DGlaucomflecken @Cigna These insurance companies suck, O hope that’s something we call know and agree on by but But how do we actually burn them down…

[ICU RN @ICURN_]

@PostOpPrincess I genuinely checked the NG for placement on every patient every 4 hours for like 3 years when I was fresh out.

[ICU RN @ICURN_]

@TheNPwithT1D No. It’s factual.