[pink dolphin]

one thing I don't understand is, why do so many nurses leave thye leave the clip (not sure of the proper name for it) open after they flush patient's heplock, it's not that difficult of a concept, and yet I see it quite a bit.

[pink dolphin]

Originally Posted by crazystudent

I am not a med-surg nurse (hopefully will be soon). Just thought I'd add my opinion.

Transferring patients with urine collection bag on the BED!!! Even worse, leaving it sitting there. I have seen CNA's, EMT's, and Nurses do this. It seems so basic to know better, yet it happens all the time.

definately. I know that I am clumsy enough, so when I am in aroom with a pt that i need to get out of bed, I take 30 sec to assess the situation. OK, where is there tubing, what are they attatched to, cords are where, am I am going to trip over anything and do I need another person to help me with ivac, etc.

[earle58]

how do you guys address constipation?
given the amt of narcs most of these pts are on, do you give anything to prevent it?
or ask pt if they have gone?

leslie

[litbitblack]

Monitoring vs. We had a pt with 214/82 bp and a new nurse who didn't do anything about it. Focusing on task instead of the whole picture. Not asking for help when they obviously need it. Keeping thier nn with them so I can't chart anything that I have had to do with their pts. I have a new nurse 6months out that still stays until 9pm just to finish stuff up.

[Ginny516]

As a new grad nurse who hasn't yet started a job, I find it really interesting to read all these posts. I feel like by reading what everyone writes, maybe there will be a lesser chance of making mistakes when I start. Keep 'em coming!!

[Fiona59]

Originally Posted by earle58

how do you guys address constipation?
given the amt of narcs most of these pts are on, do you give anything to prevent it?
or ask pt if they have gone?

leslie

We give Colace if they are on any narcotics, and oh yup, we ask every shift change "have you had a bowel movement".

No BM in three days gets you a DDF. Or if discharged before then we have it on the discharge instruction sheet "no bowel movement within three days contact your doctor"

[earle58]

Originally Posted by Fiona59

We give Colace if they are on any narcotics, and oh yup, we ask every shift change "have you had a bowel movement".

No BM in three days gets you a DDF. Or if discharged before then we have it on the discharge instruction sheet "no bowel movement within three days contact your doctor"

thanks for your reply, fiona.
i'm finding that in general, hospitals do very little in addressing these very real complications.
impaction, obstipation, ileus/obstxn are very real problems.
i receive so many pts to my hospice facility, from the hospital, that are screaming for relief.
sluggish to absent bowel sounds, distention, even vomiting and pt c/o not having bm for a week.
you just wouldn't believe how much stool i have removed.
i mean...
you.just.wouldn't.believe.it.

so for all you new nurses, when your pt is receiving opioid analgesia and has remained relatively immobile, please, get them colace bid or even senna bid.
until you've been through it, it's painful and dangerous to just let it slide.

leslie

[Fiona59]

Earle58, I so know what you are talking about. Many of our patients have been on heavy duty opiods and let's just say the results can be large. Distention and vomiting on my unit will pretty much get you an NG within four hours.

Some units and some nurses are better at asking than others. Hell, at my age, I have no problem asking but some of the newer grads figure the patient will tell them if they need assistance.

[RN28MD]

You guys make a great point. At the place I use to work most of the post op pts got colace BID and senna BID together. Some pts even complained that these two didn't help and we had Lactulose PRN. I never understood that pain of constipation even when I thoght what it was untill I had a baby. OMG! THe pain! Never again I let anyone go through this pain ever again.

Great chats keep it coming

[aphi~gn]

I totally agree that nursing students are not as well prepared as they should be for the simple cares. But I don't think that we can completly blame the nursing students either. They don't teach you the simple things.. . .aside from making a bed and giving a bed bath and positioning the client. I was never instructed on how to take accurate I&Os (in particular the IV bags. . I didn't know for the longest time that their was a way to see how much was infused thru an IV or how to clear the IV). . over time I figured it out but I think that the simple things obviously aren't covered in class because apparently there are more important things to learn and when there is one clinical instructer for 8-10 students and students are just starting out it is really hard. . .and some are too scared to ask because it seems like a dumb question to say "how do you do I&O's?" and some nurses are not easy on new students and can be very intimidating. Hopefully, nurses will become better when they have a brand new nurse at explaining the simplest of things if they see a new nurse that needs help.