Tag Archives: clinicals

Dealing with difficult docs using SBAR

SBAR

Before I start an “us” vs. “them” war, let me start off by saying that I cannot imagine the pressure that physicians are under these days. They go for long stretches with no days off, work very long hours, have tremendous responsibility and, basically, have a job that I would never ever ever want. So, with that said, it is understandable that you will, at times, deal with a difficult or demanding physician. These tips about SBAR and effective communication should help!

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Managing intracranial pressure (ICP)

ICP

Taking care of patients with neurological injury means managing their intracranial pressure, or as it’s commonly called, ICP. And when we say neurological injury, keep in mind that we’re not just talking about people getting bonked on the head with a 2 x 4. We’re talking about space-occupying lesions, hydrocephalus, intracranial hemorrhage, subdural/epidural hematoma, even severe hyponatremia…basically anything that’s a key player in (drum roll please….) the Monro-Kellie doctrine.

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Surviving Night Shift

Night Shift

If you’re like me, your 4th semester preceptorship is on night shift and you have no idea how you are going to survive. Even if you snagged a fabulous day shift precept spot, chances are you’ll be a night shift nurse as a new-grad anyway….and knowing how to survive could mean the difference between loving your job and absolutely dreading it. With these tips, you’ll be rocking night shift like a pro!

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Taking care of patients in renal failure

renal failure

Ah, the kidneys…who doesn’t love ‘em? These two little bean-shaped organs will come into play with just about every single patient you deal with. In some cases it will be a chronic and devastating case of renal failure, (such as those patients requiring dialysis), but in most cases it will be moderate and more subtle. In all cases, renal function will tell you volumes about the patient’s fluid balance, electrolytes, blood pressure, infection and perfusion. Keeping an eye on renal function is a basic skill you’ll use every day as a beside RN…so let’s get to it!

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A puzzle for you.

For some reason I get super excited about IV compatibility problems, and I had a good one recently. Let’s assume this is your patient…she is on 8 continuous infusions and has IV piggyback meds to give at regular intervals.

The continuous infusions are: Epinephrine, Fentanyl, Insulin, Levophed, Nimbex, Sodium Bicarbonate, Vasopressin and Versed.

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