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Joined: Sep 21, '09;
Posts: 13 (23% Liked)
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12 year(s) of experience
Call the nursing supervisor to expidite the transfer to ICU so this patient can be under the care of an intensivist and not a new ER physician.
Thank heavens the dude who shot his huevos off while sticking a Glock 9 mm down the front of his britches rendered himself incapable of reproducing, because the world is already LOADED with stupid.
I'm starting to here about vented pts being ambulated with the RN, PT, and RT. Do any of you practive this at you hospital? There's videos on Youtube, which is pretty wild. The pt has a walker with the vent on a rolling table.
ICU isn't my area, but that sounds like it's about a 3 person job!
I've found that it helps to make a schedule every day. I list the time on one side of the page
And then across the top of the page, I list my pt. names.
M. Jones R. Smith G. Williams...
Then for every hour of my shift, I list what I need to do for each pt. That way, you'll know that at 0900, you have meds for three paients due. Then when it' done, you can check the task off. I've found that taking the extra 5-10 minutes at the beginning of the shift to do this, makes my whole day flow a lot smoother.
Funny you should say that because I do ask myself when I'm tempted to cut a corner. The answer though is, yes, I still cut corners.
Just one example: At my workplace, we are required to chart two head-to-toes per shift. I do a full hands-on assessment at the beginning of shift, but the second one? Well, if I can't figure out if anything has changed in six hours when I've been in that room at a minimum of three times, my assessment skills and powers of observation suck.
OK blood starting to curdle....I feel a vent coming.
Let's try something novel, the truth. I have worked on 2 continents nursing for the last couple of decades and I assure you every nurse has cut corners somewhere. Promoting this myth of perfection serves no one. It is not only dishonest to paint the picture of the nurse who is perfect every time it is quite frankly a disservice to the profession. It is attitudes like this that make nurses not fess up when they err when the climate portrays and expects perfection.
Just look at the poor new nurses. What are we thinking. Not perfect...there's the door. God I would be petrified to be a new nurse in this climate. Zero tolerance. Its just brutal. No one and I mean no one can tell me they do it right everyday.
So let me start the ball rolling. Forget to wash my hands, yes. Made medication errors yes. Told the pt, yes. Felt the wrath for making that mistake,yes. Next error I got the Dr. to write an order that covered me and I am not ashamed of it. Do I reflect,yes. If it is a stupid rule like the script hospitals have us say, no. I work under my own honor. I do the best that I can. I treat people how I wish to be treated.
It sets me on fire that a climate has been created not to tell the truth. If I don't do my work I am honest. If I didn't do a dressinsg I admit it. If I don't want to do the next admission I say it. I say what's the truth "I am tired , or I'm feeling lazy, or I'm just too grumpy today "I don't care whose looking because what you see is what you get, a real person. Instead of all this perfection let's try trust. Work on establishing trust that the pt knows you are giving everything you have got.That we begin trusting each other. That management create an environment where trust is valued over making things look good. Lets give the care rather than writing stacks of paper on what we are meant to do. I do not believe that people are doing head to toe assessment because I have seen enough on pts to tell you they weren't looked at . Furthermore nurses on med surg have looked at me ga ga at even the thought of doing it. Your really lucky if the nurse is listening to pt lungs when they are admitted for CHF. Don't take my word ask your pt. Again,lets try some honesty. It is done in units but not on the floors. If anyone tells me "oh no,not me" .Then you are the exception
We would have less law suits and paperwork if we actually valued forming a trusting relationships with pts. Why, because we miss the most basic thing we don't take the time to listen. People who feel heard ,validated forgive us the mistake of not washing our hands or forgetting an alcohol prep. Why, because they feel cared for.I simply can't take this holier than thou attitude. I absolutely think that when we harm pt,correct it, even sue but trying to make people perfect is just denying our basic humanness We are flawed. So lets just start focusing more on making an environment where people feel safe to tell the truth, room to learn, safe to be yourself without a camera hanging over you. Lets start with the basics give the best care you can. Forgive yourself when you don't and try for bettter tomorrow.
Interesting survey. Let's see how I do:
Do you cut corners in your daily nursing practice? Or do you do everything according to the ‘book’.
I am the very embodiment of perfection in everything I do. OK, is this a serious question?
Do you police yourself in your everyday care of a patient, what do I mean by police yourself? I mean always follow the correct procedures no matter how busy you are, and when tempted to deviate never vary because you know it is wrong and that errors do often occur.
I police myself, whatever that means according to your strangely framed question.
When you are in a patient room alone, by this I mean no other staff member watching you or a patient who is oblivious. Do you behave as though you were being scrutinized?
Yes. (Finally a question I understand.)
Do you manage that patient care the right way, because it is the correct way.
My way is always the correct way, silly. (See my first response.)
Do you manage your hygiene, the correct procedure for changing IV fluids, remaining clean/sterile when changing dressings?
Um...Yes. Yes. Yes. I think you need to do a "fill in the circle" type thing because it is hard to tell when you are done asking a question.
Do you always wear gloves, do you change your gloves between procedures, do you wash your hands.
Let's see...No. Yes. Yes. (You don't always have to wear gloves).
Or do you occasionally forget to wash hands, not follow guidelines for procedures. Cut corners because you think nobody is looking, even though you know it is wrong but do it anyway?
No. No. No. (I think someone is doing some projecting here.....)
Do you reflect on your care after every shift? Reflection is old fashioned now, but after every event I do reflect on how I managed that situation, and if I could have done it better.
No. Jeez how in hades do you reflect on every event?
Often a corner is cut, nothing bad occurs so the next time you give yourself permission to do it again because you tried it once and it was OK. Soon the corner cutting becomes a habit and you no longer remember that you are cutting corners because it is part of your daily practice.
Your honor, is there a question here?
The reason I ask you, is because there are professional health care staff who do cut corners on a regular basis.
Name names, senator.
We do see frequent mistakes made because we don’t take our time.
You got a worm in your pocket?
Medications mistakes being common
So many are made, but I wonder how many are actually happening and caught, and how many are never caught?
478 are actually happening and caught. 15 are never caught.
How many of you will go into a room, ask the patient her name, check her name band and then ask what she is allergic to? Every time you give that same patient her medication.
Whoever does that will eventually get slapped in the face by everyone around him or her.
Do you tell the patient what medications she is receiving? Do you discuss the side effects or check if the patient actually understands what meds she is receiving and why?
Sometimes, and always with medications new to the patient.
Do you watch every patient take the meds you gave them? Or do you give them the pot and walk away?
Don't bogart that pot, Tonto. Around here we share the pot.
Remember when you sign the MAR you are saying the 5 R’s are correct, but you are also saying you saw the patient take the meds you gave her?
Do I remember this? I suppose I remember this.
How many times have you been into a room and seen a pot of medication sitting on the side!
Pot doesn't last long in the open around my patients.
Do you always do a head to toe check, or do you skip some parts of it?
I often do focused assessments when proper, and I never skip the proper parts of the correct assessments at the perfect times.
You know that these things I mention occur on a daily basis and often go unchecked until a major disaster occurs.
You know you wanna leave me, but I refuse to let you go.
Often causing patients an injury, we have an obligation to provide each patient with high quality care always.
I don't often cause patients an injury, but when I do, it's Dos Equis.
Ask yourself when you are tempted to cut a corner, would you approve or condone this if it was your relative or meaningful other?
Myself is annoyed with me and refusing to answer.
When a mistake happens, it is often something that could have been avoided but it is something which will live with you for a very long time.
Sounds like you've been talking to my exes.
I am not your judge, I am not your conscience and I am only playing devil advocate.
Please please please do not cut corners because in the long run you may have cost somebody a lot more time, than you spared.
WHY DIDN'T YOU JUST SAY THAT TO BEGIN WITH??? SHEESH!
LMAO!!! Thanks for the laugh!
The questions are crazy but the intention of the questioner is good I suppose. I'd say there are 3 types of nurses, the first one cuts corners to save pts' lives and her/himself, the 2nd one cuts corners to update their statuses of FB, and the 3rd one cuts corners to cut corners.
The imperious tone in the red text is hilarious. They should've just said, "you will kiss our ring (or our royal patootie) and in return we will pay you ****.
Our hospital just implemented a new policy where upon a pt's DC the RN has to strip the linens, suction canister liners, and...something else, I forget.
If I have time, I'll do it as a courtesy, but with 6 pts, it's not always a possibility.
Man. Now I want hot pockets. And I don't have any. Sad.
My former hospital decided to treat NG and G-tubes as sterile lines briefly and instructed people to scrub the ports with alcohol for 15 seconds prior to accessing them, use only sterile H20, use a new sterile syringe every time, throw away the rest of the bottle of sterile H20 (they were 60 mL bottles and we'd be using like 10 mL to flush these tubes in these kids) after using it once, etc. Almost no one complied with it and then they realized that the evidence didn't support any of it and spent as much time and energy rescinding the policy as they did creating it. Now they get mad when people use sterile H20 for anyone other than oncology or transplant patients because of the "budget".
Our management had plans to fire everybody in dietary and have the nurses make all the food in little kitchens on the unit. I told my NM, "I hope everybody likes hotpockets and juice". Thankfully this was never implemented.
Having no seating for charting sounds crazy. I sit maybe 1 hour while Im charting if Im lucky, and my feet are grateful for it. Id probably quit if they took that away. Did they lose a lot of nursing staff?
Are they going to take the desks out of the CNO and CEO offices?
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