Ditto for our Perioperative and Surgical Services. Those that do direct care
for kids pre and post op complete ENPC as well.



Alisa Shackelford, RN MBA MA CCRN

Manager Saint Francis  Inpatient  / Outpatient Pre & Postoperative Services



  Roper Saint Francis Health

Charleston,SC



[Non-text portions of this message have been removed]

Absolutely
Sent from my Verizon Wireless BlackBerry

-----Original Message-----
From: "bmadden_21797" <bmadden_21797@...>

Date: Fri, 29 May 2009 00:58:03
To: <NIHMBL@yahoogroups.com>
Subject: [NIHMBL] ACLS- mandatory competency  for ICU and/or IMC RNS


Please let me know if ACLS is a mandatory competency for all of your ICU and/or
IMC RNs.

Ann Marie Madden,RN,MS,CCRN, NEA-BC
Senior Nursing Director Critical Care/Neurosciences
Washington DC




[Non-text portions of this message have been removed]

ACLS is mandatory,  new comers have 1 year to complete.  This is true
for ICU's, telemetry, PACU & ED at our hospital.  Areas that take care
of kids require PALS.

Bonnie Blankenship RN,MSN,CCRN
304-624-2939
blankenshipb@...

RN can give with physician order----pt could be on Tele unit or in the ICU.  If
given on Tele unit the RN gives while the LPN is on the phone with the another
RN who is watching the Tele monitor; crash cart is in the room.  If given in the
ICU we have the bedside monitor and 2 RNs present with crash cart at bedside.

Diane Lietz, RN, BSN
ICCU Nurse Manager
Jacksonville, IL
diane.lietz@...

Please let me know if ACLS is a mandatory competency for all of your ICU and/or
IMC RNs.

Ann Marie Madden,RN,MS,CCRN, NEA-BC
Senior Nursing Director Critical Care/Neurosciences
Washington DC

Same here. Physician present, crash cart in room.
Missy

Does it include any management or educators? Thanks.

Jill Hunter RN, BSN
Director of Critical Care Services
Knox Community Hospital

A physician must be at the bedside with crash cart in room.


Jason

|  Office:  314.251.7911  |  Cell:  314.306.4401  |  Fax:  314.251.7918  |
|  Email:  jasonlynch@... or Jason.Lynch@...  |
|  Website:  www.jasonmlynch.com  |

 I was on vacation and I missed all the information during my vacation. Will you
be able to fax the INULIN PROTOCOL PLEASE!
My fax # 718-883-6128  Attention to Aleyamma Eapen.Thanks

When calculating our HPPD - Our current HPPD is 11.89. ADC is running around 15
- 16.

We include:
	 * Unit Assistants
	 * Ward Clerks
	 * Charge Nurses
	 * All Nursing staff
	 * PTO (ELD)
Hope this helps. It's alway tricky and we typically go by what Magnet Requires.
 
Todd M. Grivetti MSN, RN, CCRN, CNML 
RN Clinical Nurse Manager
Poudre Valley Hospital
Ft. Collins, CO. 80524
970-45-8325 (Office)
970-495-7621 (Fax)
tmg4@...




[Non-text portions of this message have been removed]

We are a 25 bed CVICU unit that admits Trauma patients when the 12 bed NTICU is
full--which they have been for several days.  What creative ways do other areas
have to flex up for admits--especially Trauma admits to avoid diverting patients
because we are full or are not staffed for all beds?

We are technically staffed for 20 beds, but when with 1:1 patients in the mix,
our staffing gets spread thin.  We do a lot of calling staff to come in extra. 
We can get staff to come in extra up to a point--but with the holiday it is
harder to get extra staff.

Between our units we do a lot of triaging and take lateral transfers depending
on the type of patient needing to be admitted to a unit.  Head trauma  are
always admitted to the NTICU.

We require a resident or other physician to respond to codes with the RN & RT. 
Outside of the ICU setting the RN must have a physician order to administer
meds, inside the ICU they are covered by standing orders for ACLS protocols.

Bonnie Blankenship RN,MSN,CCRN
304-624-2939
blankenshipb@...

Pts with a temporary transvenous pacemaker are either in critical care
or a true stepdown with lower pt to nurse ratio according to every
seminar I have gone to.

Not without a physician order and the ED doc on standby

-----Original Message-----
From: NIHMBL@yahoogroups.com [mailto:NIHMBL@yahoogroups.com] On Behalf
Of ramseycen@...
Sent: Wednesday, May 20, 2009 7:20 AM
To: NIHMBL@yahoogroups.com
Subject: [NIHMBL] Adenosine at bedside



Hi everyone.? Can you tell me if?the critical care nurses who respond to
rapid response calls in your organization?permitted to push Adenosine at
the bedside without physician presence?? If so, under what conditions
are they permitted to do so?

Thank you

SRamsey :-)

[Non-text portions of this message have been removed]

Yes of course.  It is ACLS protocol for stable SVT.  The Nurses follow all of
the protocols until a physician arrives and assumes responsibility.

Ours come to the ICU.

--- On Wed, 5/13/09, darlaphardy <darlaphardy@...> wrote:


From: darlaphardy <darlaphardy@...>
Subject: [NIHMBL] temporary transvenous pacemaker
To: NIHMBL@yahoogroups.com
Date: Wednesday, May 13, 2009, 10:22 AM








Hello All,

What unit do you sent your patients to if they have a temporary transvenous
pacemaker? I have been discussing this issue with my CNO as he thinks that this
patient could be cared for by either a med/surg or tele nurse with minimal
orientation? We are a small rural community hospital with lower acuity and only
do this occasionally? Anyone have a policy for these patients they are willing
to share?

Darla Hardy, RN, MSN, PCCN
Nursing Director
Level 2 - PCU



















[Non-text portions of this message have been removed]

We do the same as you but we don't have a RRT team but we do respond to codes
and our charge nurse does take a team.  We do not hire new grads (they have to
have 6 months on the floor at least)  Once they are in here, it depends on their
assessment and leader skills but usually 6-12 months before they are in charge
(usually the 6).

Hi everyone.? Can you tell me if?the critical care nurses who respond to rapid
response calls in your organization?permitted to push Adenosine at the bedside
without physician presence?? If so, under what conditions are they permitted to
do so?

Thank you


SRamsey :-)


[Non-text portions of this message have been removed]

SRamsey :-)


-----Original Message-----
From: ramseycen@...
To: NIHMBL@yahoogroups.com
Sent: Wed, 20 May 2009 8:19 am
Subject: Adenosine at bedside


Hi everyone.? Can you tell me if?the critical care nurses who respond to rapid
response calls in your organization?permitted to push Adenosine at the bedside
without physician presence?? If so, under what conditions are they permitted to
do so?

Thank you


SRamsey :-)


Dell Inspiron 15 Laptop: Now in 6 vibrant colors! Shop Dell's full line of
laptops.



[Non-text portions of this message have been removed]

Darla,
Thank you so much for responding to my email. We also do staff
interviews and it has worked well. I have nurses on nightshift that only
have 1 yr of nursing experience and it is all in ICU. We have taken some
new grads on nights and have "grown our own". It has worked well except
now I have a nightshift where I have some experienced nurses with only a
few months of ICU experience and then the newer nurses with 1-2 yrs
experience. We have a 7 bed general med/surg ICU that is very busy most
of the time and until recently I have always had experienced nurses to
utilize in the charge role. Thank you for sharing your charge nurse
requirements.
Missy

Jill,
I manage a 26 bed PCU.  We care for medical and surgical stepdown type patients.
Our ratios are 4-5:1 on days and 6-7:1 on nights.  I don't utilize monitor
techs. We have one Nurse Aid on days to assist with am care and transporting. We
are 12 hour shifts and require an assessment every shift and as needed for
condition change. We administer several drips such as LD Dopamine, Amiodarone,
Cardizem, NTG, Integrilin, Natrecor and other IVP drugs.  Hope this helps.
Karen

The ICU does assist with transvenous pacer care and takes these patients
post-op CABG, valve, etc. Our physicians also place the transvenous pacers
if necessary. In addition, our Telemetry unit does take transvenous pacers
also. Usually, the patient has an underlying rhythm and is waiting for
permanent pacer placement. (Underlying rhythms of asystole routinely stay in
ICU until permanent pacer). The Telemetry staff are trained on the use of
the pacer after initial experience on the floor. The education is tiered in
phases and tracked. They also only assign a limited number of patients to
the nurse caring for these extra pieces of equipment, i.e. 3 patients to one
nurse versus 4-5.

Hope this helps!

Raumi Kudrna, RN, BSN, CCRN
ICU Clinical Coordinator
Extension: 4780
E-mail: rkudrna@...



[Non-text portions of this message have been removed]

Hi, The charge nurse for our 18 bed MSICU also responds to codes and RRT's. We
do not give an assignemnt to our CN. If worse comes to worst during the shift,
the CN will take a pt, but is is rare. We like our CN's to have at least 2 years
of exp. K




[Non-text portions of this message have been removed]

Missy,

It's funny you should ask as about a month ago I hired a new part-time evening
shift charge nurse.  I have charge nurses Mon-Thur. from 6:30am to 11pm.  My day
shift charge is full time and my evening shift was split with 2 RN's both
part-time.  One was not performing well and chose to step down to a staff role
so the position was open since January and was filled in April.  The process I
have followed for just over a year includes the candidate completing an initial
interview with myself and the educator.  The next step involves a 2 hour job
shadow followed by a panel interview with staff members.  The responses are
calculated and the staff rank the candidates in order if there are more than one
for any position.  The educator and myself review the responses and offer the
position.  I go with the majority vote for positions as I feel if the staff
picked the person then the transition is more likely to be successful.  I have
included staff in
  the interview process for over a year now and they absolutely love it.  For the
recent charge nurse it was no different, except there were 2 internal candidates
and an external candidate; the external candidate was chosen and offered the
position and is doing very well.  The job description required at least 3 years
experience as a nurse, preferrably PCU experience with some charge experience. 
The successful candidate has 15 years experience with telemetry and
ICU with approx. 10 years experience with charge situations.  She is wonderful,
has fit it well with all staff (even the 2 who weren't chosen) and is the
experience level I was looking for during the evening shift with
minimal resources available.

Our ratios for day shift are 5 or 6 patients to 1 RN and for night shift it is 7
to 1.  We schedule the same amount of techs as nurses (for example for 32
patients on day shift there are 6 nurses and 6 techs), however, one of those
techs are the monitor watcher.  I have put in for a new program this year for a
monitor tech position up and above the usual staffing and if approved we will
have "care pairs" of one nurse and tech with a team of patients.  I am waiting
to see if it was approved.

Darla

I'd like to know where the article was about RRT's placing PICC lines.
We have our IV team and some ICU nurses starting them (after extensive
training), and it was not easy getting administration & IV therapy to
allow this ICU nurses to get the training.

Bonnie Blankenship RN,MSN,CCRN
304-624-2939
blankenshipb@...

I just read an interesting article describing a hospital that has the RRTs
placing PICC lines.  Do any of you use RRTs to place PICC lines?  If so, what
steps did you take to start the program?
Thanks.

How many support staff---CNAs, techs and/or clerk staffs?

Diane Lietz, RN, BSN
ICCU Nurse Manager
Jacksonville, IL
diane.lietz@...

Transvenous pacers are placed by the physician in our ICCU.  The patient stays
for monitoring until they no longer need the pacer or they get a permanent one. 
We don't have a policy about transfering out to the general floor but we
could/and do send patient's to our Medical/Telemtry unit with a temp. pacer (a
rare occasion).  Usually the pacer was placed due to bradycardia as a result of
medication overdose (otherwise they get a permanent pacer).  It is turned
off/not really needed but the physician wants to keep it one more day just to be
sure.  The pt is monitored via tele and the pacer turned back on only in rare
instances.  We are also a small (licensed 99 beds), rural hopsital and sometimes
our ICU is closed---however, we always have an experienced ICU nurse in house at
all times who acts as a Resource for such things.  Do you hold anual
skill/competency days?  Our ICU staff are required to competency for temp pacer
insertion/care on a
  yearly basis---maybe something like that for your med/surg staff could help???

Diane Lietz, RN, BSN
ICCU Nurse Manager
Jacksonville, IL
diane.lietz@...

Darla,
What about your Charge Nurses. What criteria do you use to choose a
Charge Nurse? Years of PCU experience? Years as an RN?
Also do use use techs or support staff with those ratios?
Thanks, Missy

ICU Manager
Schneck Medical Center

We are a 200 bed regional medical center and we keep those in the ICU.




________________________________
From: darlaphardy <darlaphardy@...>
To: NIHMBL@yahoogroups.com
Sent: Wednesday, May 13, 2009 10:22:49 AM
Subject: [NIHMBL] temporary transvenous pacemaker





Hello All,

What unit do you sent your patients to if they have a temporary transvenous
pacemaker? I have been discussing this issue with my CNO as he thinks that this
patient could be cared for by either a med/surg or tele nurse with minimal
orientation? We are a small rural community hospital with lower acuity and only
do this occasionally? Anyone have a policy for these patients they are willing
to share?

Darla Hardy, RN, MSN, PCCN
Nursing Director
Level 2 - PCU







[Non-text portions of this message have been removed]