I just got my licence this year and I am starting a home health job. The person has a trach, g-tube, and is on a vent. at night. I will be watching this person through the night...
What exactly do I chart??? Unless there are complications or meds, what else should I be looking for and charting hourly if the person is just resting peacefully?
Apr 19, '11
I didn't forget that I had this open. (Family issues
I was planning on looking at the old charting but there is only one problem: I will be the first nurse that they have so I have nothing to look over.
As far as charting q1 or q2, they really didn't give me an answer when I asked that question. The director just said to chart when I give meds or if anything happened, how they tolerated the meds and of course head-to-toe... that sort of thing. Lucky for me they gave me a sample charting sheet and gave me verbal instructions to use the sample as guide. The sample has charting q2 hours, when nothing else is going on.
Last edit by CalinurseDiana on Apr 19, '11
: Reason: added info