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

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The secret to passing the NCLEX: Mental Aerobics

We hire a lot of new graduate nurses where I currently work. I actually help with the orientation and transition process of new grads transforming from Student Nurse (SN)to Graduate Nurse (GN), to the auspicious Registered Nurse (RN).

The biggest question on all GN’s minds is taking the NCLEX-RN.

“What’s the best way to study?”

“How did you study?”

“I don’t want to fail! I only want to take it once.”

Of course, we all want the above. The NCLEX-RN exam is simply a pressure cooker. It doesn’t really measure your knowledge or your total knowledge of nursing basics. What it measures is how you react under pressure. Do you crack, or do you rise to the occasion? Because the reality is, that’s exactly what an RN does every day.

“It doesn’t measure our knowledge?”~ It does, but not like you think. It wants to know how sound your nursing judgment is, and how developed are your critical thinking skills. Nothing more.

You’ll find that some of the most intelligent nurses you attended classes with will have difficulty passing their boards, due to this very simple fact. It doesn’t matter how much knowledge you have consumed, if you can’t apply the given lessons to everyday nursing responsibilities, it will only do one thing. Get a patient hurt. A good nurse has sound judgment and good critical thinking skills, not a know it all.

So here is the key to passing the NCLEX-RN: Mental Aerobics.

We have all heard and done our homework when it comes to the specifics of the exam. We all know that you will be asked a minimum of 75 questions and a maximum of 260-ish. It all depends on how well you answer your questions. Answer them correctly and you’ll have fewer questions.

So. 75 questions MINIMUM.

There is the key. You need to guarantee your mind will be sharp all the way up to that 75th question (or more). Because if not, you will be sitting in front of that computer to answer the 260!

Practice questions. Practice questions. Practice questions. Do them. And when you’re done doing them. Do some more.

You have to start small and work your way up. You’d be surprised at how fast your mind will wander and lose focus after just 20 questions. And remember… you have no idea if you’ve answered them correctly. So your anxiety is building with each additional question.

Practice daily. Start with 20. Once you can efficiently answer 20, move to 30. Then 40, 50, 60, etc. You get the idea. My suggestion is to be able to sit in front of that computer screen for 100 questions before you become mentally fatigued. That way you’ve factored in fatigue and anxiety. (Trust me, the pressure cooker is a quaint description of the exam environment)

Oh and one last thing. Do nothing 2 days before the exam. You’ll do nothing but drive yourself crazy if you study up to the night before. Give yourself the mental break to refresh and revitalize.

Best of luck!

Blog reheated: I originally wrote this post August 22, 2008


What are some tips for difficult IV starts?

There is no 100% guaranteed method to successful IV starts, but I share some things that might get you close to that.

This was a YouTube Live broadcast, so pull up a chair.

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You know how much I love coffee.
________________________________________
Check out all my other videos on my YouTube channel. Almost 500 free videos http://bit.ly/seanpdenttv
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**Have a question? http://bit.ly/askheysean
________________________________________
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.
*may contain affiliate links*
Find all of my recommended products and the gear I used in my videos at www.amazon.com/shop/seanpdent

Every nurse feels overwhelmed

Do you feel overwhelmed? (Will it ever go away?)

Nobody said being a nurse would be easy.

There isn’t a nurse out there that hasn’t felt overwhelmed at some point in their career. I have felt it multiple times! This feeling is so common, it’s almost a requirement. Do you pedal back… or do you lean in?

Welcome to nursing.

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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
____________________________________________________
**Follow me on Instagram: @seanpdent
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**Let’s continue the conversation: http://bitly.com/thenursetribe
**Have a question? http://bit.ly/askheysean
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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.

 

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

What do you think about the NY state BSN mandate?

In mid-December 2017 New York Governor Andrew Cuomo signed into law a requirement that nurses earn a BSN within 10 years of initial licensure. A decision that affects all nurses throughout the nation.

I offer my answer.

[Warning, this was a YouTube live broadcast. The video is almost an hour long, so have a seat.]

Other topics discussed in this live broadcast:

• When should nursing students apply for their first job

• NCLEX study tips

• Residency programs

 

Here are some links of interest:

https://www.nurse.com/blog/2017/12/20/new-york-governor-signs-bsn-in-10-into-law-for-nurses/

http://donnacardillo.com/higher-education-for-nurses/

http://www.adirondackdailyenterprise.com/news/local-news/2017/12/new-york-raises-bar-for-nursing-students/

https://www.beckershospitalreview.com/human-capital-and-risk/new-york-state-passes-bsn-in-10-nursing-education-legislation.html

The IOM Future of Nursing Report:

http://nationalacademies.org/hmd/reports/2010/the-future-of-nursing-leading-change-advancing-health.aspx

 

 

 


 

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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
____________________________________________________
**Follow me on Instagram: @seanpdent
**Facebook Live: http://bit.ly/2hd3M8X
**Let’s continue the conversation: http://bitly.com/thenursetribe
**Have a question? http://bit.ly/askheysean
**Buy me a coffee? http://bit.ly/seanscoffee
____________________________________________________

 

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.

 

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