CharmedJ7

CharmedJ7

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About CharmedJ7

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  1. Steps of a wet to dry dressing

    It's frustrating. Wet-to-dry dressings at best will do little real harm to otherwise clean and normal post-op wound. It's totally inappropriate for more complicated high-risk wounds. Non-healing wounds deserve a wound consult. Wet-to-dry orders a...
  2. Am I the only one annoyed by these PCA orders?

    That's strange. Most of the patients on my floor are on PCA and the docs don't write a 4-hr lockout at all. We calculate it as a back-up to what we put in, ie, Dilaudid 0.2/0.2/10, 4-hr lockout is 5.6mg. The vast majority of patients do not zonk t...
  3. bariatric nursing a good job?

    We get a fair amount of bariatric patients on my floor. Generally I find them to be reasonably pleasant - a little wary maybe, I see a lot more super positive family members then patients themselves. What I will say though is that I see a LOT of re...
  4. Chemo exposure...when to worry

    It really depends on the chemo agent in question. I work in oncology and the general rule is that for 48 hrs after someone received chemo they are considered to be on "chemo precautions." Exactly what that means is somewhat debatable, but gloves ar...
  5. Standard Hospital Scrubs National Standard?

    We just moved over to uniforms. We tried the ID band thing, but they still flip around a lot which is maybe why they decided they weren't working (I suppose this is a solvable problem though if they just make them double-sided). The funny thing tho...
  6. This definitely seems like a policy and/or order thing. Pre-OR, the order set has a space for docs to specify which meds, if any, they want given prior to OR. All other PO meds are held, IV usually given. If I'm unsure I'll talk to the team. For...
  7. Question re: patient handoff/shift change

    As others have said, it really depends. I received report on a pt, didn't like the sound of it, went it with the off-going night nurse and we ended up having to rapid response here and send to ICU. The night nurse stayed the entire time, as was app...
  8. Nurse-Resident Communications

    I find in general new nurses have a far easier time talking to residents than attendings on my floor, partly because they're who we have the most contact with. And for the most part, the residents are receptive and easy to work with. I think a lot ...
  9. Heparin SubQ administration?

    I don't know what the purpose of going slow is. Most of my patients prefer it as fast as possible. I've never had any issues.
  10. Patient Positioning Frustrations

    Thanks for all the responses, I appreciate it! Getting the bed lower for pulling is an interesting thought, I usually bring it up high so I'm not bending down, but potentially it is better lower. As for the too fast/rough thing, usually that compla...
  11. Patient Positioning Frustrations

    Not the pt, one of the residents (docs) I'm friends with. I love the PTs and they're great when they're there, but they can't be there all the time and they often put the pt in the chair and then we have to get them back to bed. I like trapezes too...
  12. I'm going to try to avoid this being a rant, but my apologies if I fail. I find patient positioning and mobilization to be the worst part of my job. We have lift equipment, and I will say it is helpful with getting patients out of bed more safely, ...
  13. diluting IV push meds

    I dilute narcotics because it's pretty hard/impossible to push 0.5ml slowly. I dilute benadryl because it's irritating to the vein. I dilute ativan sometimes for the same reason as narcotics, plus it's kind of thick. Mostly I dilute, usually in 10...
  14. Percocet PRN

    Pharmacologically it is safe to give 1 then the second at 3 hrs vs 2 together. The only risk I see potentially is if at 6 hrs from the first you give another 2 more than the patient has 3 in their system for a time. It's a little scary that anyone...
  15. improving staff responsiveness

    I actually think this is a great idea. When one of our techs is injured they are designated to "light duty" that means only VS and BS but they did it for all the patients. I actually thought it was a good system because when all the techs are resp...