Friday, October 21th 2011
Chat w/ 5a Manager, Pauline Stillman and NP, Allyson Edmundson
October 21th 2011

Freddie was having difficulties with d-sating and I was helping him with suctioning and o2 as I had always done since being taught how to in the Neuro Unit.  After telling Freddie’s nurse what the situation was and what I had done so they could keep up with the event and changes.  She called the 5A manager, Pauline and she brought the NP, Ally to have a chat with me about not messing with vent.  After explaining that I had been helping with Freddie’s vent for quite some time, they asked that I just not adjust the vent o2 settings due to their policies with RT on that floor.  I said that’s fine but it would mean that the nurses and RT would have to be called a lot more.

What I learned was the difference in 5A was that the nurses are not allowed to change o2 settings on the vent.  Where as in the other ICU units the nurses could as needed and then report to RT what changes had been made.  I was allowed to do that for the nurses when I was with Freddie, because Freddie had so much problems that the nurses would have to nearly spend all their time working Freddie as he d-sated and the o2 had to be raised to compensate.  Then have to come back and try to wean back down.  When I was there, they could work with the other patients and I could handle Freddie and then I just reported to them of the events and changes.  It worked really well for all, including Freddie, because I was able to spend 100% of the time with Freddie and was able to wean him much more in less time.

I brought up about the changes that had been made from PICU with feeding and catheter.  They felt like it wasn’t a big deal.  I told them that PICU had led me believe that it was better for Freddie that he not have a catheter due to the risk of infection and that it had been explained to me that having timed bolus feeds as oppose to continuous was much better for Freddie’s digestive system.  The manager, Pauline said that her nurses were limited on their time and normally run continuous.  NP, Allyson said that there wasn’t any difference doing it this way as compared to the other.

So there it is already, things are going to be a little different in 5A.

Chat with 5A Manager and NP
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