1:1

CCIP is moving along quickly! We've finished the cardiac modules and are now doing hemodynamics. Luckily, my nursing program was excellent about teaching this, so it isn't completely foreign to me. Also, since we did have Sim Man at school, we had a lot of opportunities to look at monitors and waveforms, etc. That being said, I've been in tele the past year and did not need to know any of this information, so there is still a learning curve. Everyday I learn more and more, yet it seems the more I learn, the more I realize there is even more stuff to know *slaps forehead*...

The past two days were a definite learning experience! Halfway through the day on Wednesday, our assignment changed from 2:1 to 1:1. The 1:1 was originally admitted to the hospital for an elective takedown colostomy, ventral hernia repair, and ileostomy insertion. He then went septic and was transfered to us and subsequently went into respiratory distress and was placed on the vent. I won't get into the details of his history too greatly, but he needs dialysis 4 times per week. He became a 1:1 assignment because we started CRRT (Continuous Renal Replacement Therapy) on him.

The last few days have been good because I'm getting "used to" titrating drips, which is not something nurses do on the floors. For example, he was on neosynephrine because of his hypotension. As the ICU nurse, we have to increase or decrease the drug to effect the patient's blood pressure and get the numbers we want to see. I love this part of ICU nursing because I feel much more autonomous! He was also on an amiodarone, propofol, and heparin gtt (drip).

As for the CRRT, it was difficult figuring out the numbers and such, but I THINK I got the hang of it...


(our machines look way more modern than this. We use NxStage)




In other "exciting" news...they started a Monthly nursing journal club at work. Each month we will get together and choose one nursing journal research article to discuss. We had the first meeting yesterday to discuss logistics of the meetings, and we went over an article from Critical Care Nurse regarding Rapid Response Teams. Here's the article:
http://ccn.aacnjournals.org/cgi/content/full/29/3/66

My ICU has had a RRT since 2004. I can't wait until I'm "competent" enough to be the one who carries the beeper and feel like a bad ass when I go up on the floor and help the nurses, haha!!


A long way to go...