Chemically paralyzed in the ICU? What a nurse needs to know.

#heysean… my patient is chemically paralyzed on the ventilator. What do I need to know?

In the ICU we often care for some really sick patients that require chemically induced paralysis. We will purposely paralyze them with medication in order to stabilize or improve their condition. For example, research has shown that in severe ARDS chemical paralysis may improve outcomes (limited info).

The term paralyze or paralysis can be taken out of context, so keep in mind this is a response to a medication not that the medical team is intentionally causing harm (or nervous system damage).

I answer another #heysean question from the tribe.

I give you a couple of things to think about:

  • Monitoring
  • Sedation
  • GI tract
  • Skin breakdown

Monitoring:

How do you monitor a patient who is on a continuous chemical paralytic medication? You have 2 options. The TOF peripheral nerve stimulator and/or the BIS monitor.

Sedation:

The 1st rule of chemical paralysis is sedation. Sedate first, then induce paralysis. Period. No exceptions.

GI tract:

Contrary to popular belief, just because we have used a chemical paralytic medication, does not mean the GI tract is not working.

Skin Breakdown:

Be mindful of breakdown. Remember, your patient will not be able to ‘wiggle’ around when their backside or elbow have been fixed in one position for hours at a time. They can’t move voluntarily.

 

Chemical paralysis is an advanced medical therapy that requires additional education and training from ALL members of the medical team who will help manage the patient. It’s a high-risk intervention that is often used because of the severity of illness. Stay up to date so that you can continue to advocate for you patient and provide optimum care.


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The views and opinions expressed on this website, videos or posts on this channel are that of myself and not of any educational institution. In compliance with HIPAA and to ensure patient privacy, all patient identifiers in all content have been deleted and/or altered. The views expressed on this website and/or in the videos on this channel are personal opinions only, not intended as medical advice. The information I present is for general knowledge purposes only. 

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Are direct entry NP programs bad for the nursing profession?

How long should you be an RN before becoming an NP? And what about the second-degree direct entry programs?

I share my thoughts on the minimum experience needed to become an NP.

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I admit up front I’m an old-skool nurse, so I believe experience trumps everything. Care to weigh in on this topic?

 


 

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The views and opinions expressed on this website and/or in the videos on this channel are that of myself and not of any educational institution. In compliance with HIPAA and to ensure patient privacy, all patient identifiers in all content have been deleted and/or altered. The views expressed on this website and/or in the videos on this channel are personal opinions only, not intended as medical advice. The information I present is for general knowledge purposes only.

 

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Find all of my recommended products and the gear I used in my videos at www.amazon.com/shop/seanpdent

 

2 simple things to finding the perfect nursing job

Over the years I’ve had many nurses ask a repeated question:

“How do I know this is the best job for me?”

We all enter this profession bright-eyed and bushy-tailed thinking we’re going to change the world. Then we crawl through nursing school and realize it’s not all sunshine and rainbows. There are some mean and nasty nurses out there that just want to see the world burn.

I don’t know about you but that first (or next) job prospect is a doozy. We have no idea what we want, don’t want, need, don’t need. We base our decisions on past experiences (nurse & non-nurse related), suggestions from our peers and good ole’ fashion personal inquiry. There is no shortage of people (nurses and non-nurses) trying to tell you what you should or should not do and what job you should or should not take.

“Do it for the money”

“The shifts are great, no nights!”

“Get your experience”

So many times we’ve heard horror stories about the job interview that was perfect, the unit director who was so nice and the staff who were so darn cool. Then you get through orientation and once the “honeymoon period” ends… sybil happens.

Yeah, it’s as if your co-workers have multiple personalities. The place goes from a happy carnival to a page right out of a horror movie. All of a sudden those mean and nasty nurses and coworkers that you heard about are swiping the same time clock as you. WTF.

How do you avoid this? How do you know if a job will “turn” on ya? There are two things that matter.

The first thing that matters the most when interviewing for a job is the job shadow. I mean a full-shift job shadow (if possible). Follow in the nurses footsteps – literally. And do it with multiple nurses on different shifts. Walk with them everywhere you can go. Wear a pair of scrubs. Follow the nurse when their patient goes to x-ray. Follow them down to CT scan. Follow them on lunch.

Observe them interacting with other nurses, with other non-nurses, with the providers, with the supervisors. Are there students, how do they treat the students? Talk to the students privately. How do they treat others? How do neighboring nursing units treat each other? Do you notice any cliques? Is there a lot of gossiping? Remember gossip is bullying. Gossip is passive aggressive behavior disguised in self-fulfilling humor. Laughing at the expense of another person is bullying. Period.

The second thing that matters with workplace dynamics is the staff mix. The experience level and age mix. How balanced is it? Do you have both young and aged nurses (yes I’m talking about how old they actually are)? Do you have new and seasoned nurses (to the nursing profession)? Do you have new and seasoned nurses (specific to the nursing unit of interest)?
If at all possible never work for a nursing unit that has:

• All younger aged nurses
• All older aged nurses
• All new nurses to the unit
• All nurses who’ve worked an entire career there.
• All new grads
• All seasoned nurses needing to retire

Notice a pattern above? Yes, all the extremes and no balance. They don’t deal with change well. Ever. And it’s one of the worst environments to grow as a professional. This place will teach you nothing. Well, it will teach you one thing, where not to work.

Find balance. Find balance and you’ll find a place to grow, a place to learn and a place you’ll want to work.

Until next time…

 


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____________________________________________________
The views and opinions expressed on this website and/or in the videos on this channel are that of myself and not of any educational institution. In compliance with HIPAA and to ensure patient privacy, all patient identifiers in all content have been deleted and/or altered. The views expressed on this website and/or in the videos on this channel are personal opinions only, not intended as medical advice. The information I present is for general knowledge purposes only.
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What about calling NPs doctor?

Is it OK for a Nurse Practitioner (NP) to introduce themselves as doctor?

The advanced nursing degree required to practice as an NP is at a minimum a Master’s of Science in Nursing (MSN), but you can also attain you Doctorate of Nursing Practice (DNP).

Is it ok for a DNP to introduce themselves as doctor? I mean, they have earned their doctorate degree.

 

Until next time…

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📷 ▶ @seanpdent
Nurse | Blogger | Podcaster | Speaker | Author | Storyteller.
•Over 400 free nurse vlogs.
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How to display your nursing credentials?

What goes where? Which is first and what do I include? Why?

Just remember that your academic degree is always first. And you list your credentials chronologically, most recent is closest to your name.

The proper order:
-Highest earned degree (BSN, MSN, PhD, DNP, etc.)
-Licensure (RN, CRNP, CRNA, etc)
-State designations or requirements (APRN, CRNP, etc.)
-National certifications (ACNP-BC, CCRN, CEN, etc.)
-Awards and honors (…. EMT, PHRN, etc.)
-Other recognitions (BLS, ACLS, ect.)

**P.S. Can you tell this was one of my first videos…?  😂

 

 

Until next time…


Don’t forget to sign up for email updates –> HERE!
If you enjoy my work and want to support me creating new and exciting content, I’m on Patreon! With your help, I can expand and create even cooler stuff. Check me out and donate: https://www.patreon.com/seanpdent
📷 ▶ @seanpdent
Nurse | Blogger | Podcaster | Speaker | Author | Storyteller.
•Over 400 free nurse vlogs.
•YouTube Live: Fridays 8pm EST.