What you wished other nurses knew

Nurses General Nursing

Published

After hearing about a nurse who cannulated an access point for someone who was in line for a AV fistula and apparently got into a bit of strife; I thought it would be an interesting thread for nurses from all different specialties to give a little advice that deals with issues that are pertinent or could even just incite annoyance that maybe other nurses may not know!

Up Vote Up Vote ×
Specializes in Hospice.

Hospice here: I wish nurses would stop being afraid to give our comfort meds appropriately.

The dose of Roxanol (short acting Morphine) ordered for my patient is not going to be the cause of their death.

You're worried about "respiratory depression"? Once again, let me put it in perspective for you; yes, the med will slow down their respirations.

However, the patient's respirations are 40 and labored. The Morphine will bring them down to 20. The little bit of Ativan we add in will help them to calm down and relax. Much easier on the patient.

I also don't think student nurses should be assigned to Hospice patients. It's unlike any kind of nursing they've already been exposed to, and frankly, they aren't ready for it at that stage of their training.

Up Vote Up Vote ×
Specializes in Critical care.
Hospice here: I wish nurses would stop being afraid to give our comfort meds appropriately.

The dose of Roxanol (short acting Morphine) ordered for my patient is not going to be the cause of their death.

You're worried about "respiratory depression"? Once again, let me put it in perspective for you; yes, the med will slow down their respirations.

However, the patient's respirations are 40 and labored. The Morphine will bring them down to 20. The little bit of Ativan we add in will help them to calm down and relax. Much easier on the patient.

I also don't think student nurses should be assigned to Hospice patients. It's unlike any kind of nursing they've already been exposed to, and frankly, they aren't ready for it at that stage of their training.

I had a hospice rotation my last semester in my nursing program and I actually loved it! Surprisingly it was one of my favorite clinicals. I could def. see myself doing it somewhere down the line. Any time we get hospice patients on my unit at the hospital I'm happy when I get them- they hold a special place in my heart.

Up Vote Up Vote ×
Specializes in SICU, trauma, neuro.

Yes, ICU nurses turn our patients -- when it is possible to do without tanking their SpO2, or causing a permanent SCI. They don't get pressure ulcers bc we're too busy eating bonbons to reposition them. Example: pt was prone for 26 hours. Turning supine caused immediate desat into the 60s -- on 100% FiO2 and 20 of PEEP. She had several pressure ulcers on her face and anterior trunk after that. :(

And yes, I have heard the question to a WOCN during the nurses' general hospital orientation: "Do ICU nurses just not turn their pts?" from a fellow former LTACH nurse who took direct admits from ICUs. (The WOCN cleared that up quickly.)

Up Vote Up Vote ×

From me: if someone is acting strangely please do a thorough assessment and don't just assume it is dementia, nearly three nurses almost missed a TIA for four hours because of this.

Up Vote Up Vote ×
Specializes in Reproductive & Public Health.

CNM and LDRP RN here- I get that non-OB folk are nervous around pregnant/laboring patients. Never hesitate to consult us about a pregnant patient. Just please don't tell the patient who is 24 weeks pregnant, in your ED with a UTI, that she needs to go see her OB to get treatment. Please give her any and all narcotics necessary. Oh, and PLEASE, please do not deny a breastfeeding patient needed treatment because you are worried about the baby being exposed to meds via breastmilk, or tell her to pump and dump "just to be safe." Don't counsel her against antidepressants due to nebulous concerns for her newborn, or tell her she needs to stop breastfeeding before she can get on meds. You can look these things up, you can consult with peds or OB, and most of the time you will find that the treatment you want to give is safe, or find an alternative that *is* safe. If you have a postpartum patient on med/surg, support her if she wants to pump. Allow her access to her newborn unless there is a medical contraindication- unit policies against children should not apply to breastfeeding babies.

Oh, and to all the pre-hospital providers- don't cut the cord. Leave it be. Nothing bad will happen. I have noticed this bizarre focus on OMG WE NEED TO CUT THE CORD, leading to babies coming in with shoelaces and floss tied around their stump. And if a patient calls an ambulance because of a cord prolapse at home, please do not present her to my unit, calmly SITTING IN A WHEELCHAIR (thank science, baby and mom were fine). If you do that, I will call the ambulance director and you will have to sit through a lot of staff re-education.

Oh! And to all the dentists and dental hygienists- you absolutely can and should do any needed dental work on pregnant patients. I will dutifully fill out the form you send me, giving permission for narcotics and instructions on which antibiotics are the best choice, but really- untreated dental infections can cause major pregnancy complications, and there is no reason you can't have standard procedures for pregnant patients, and only consult when needed. Making your patient reschedule her dental work because you don't have the damn form from me is creating unnecessary barriers to care, with potentially negative consequences for her and her baby.

Up Vote Up Vote ×
+ Add a Comment