Content That BittyBabyGrower Likes

Content That BittyBabyGrower Likes

BittyBabyGrower 7,317 Views

Joined Feb 9, '04 - from 'Somewhere in the midwest'. BittyBabyGrower is a Nurse of course!. He has '30+' year(s) of experience and specializes in 'NICU, PICU, educator'. Posts: 1,789 (18% Liked) Likes: 942

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  • Jun 27

    I'm going to reiterate, don't refuse the admission on the theory that it's somehow not right. What's not right is that the children shouldn't have a mom who's sick, and no one to turn to. ER should (amongst their million other duties), notify CPS as soon as it becomes clear mom's being admitted and there isn't a responsible adult to pick up the kids. Mom also needs to understand that we are going to turning the kids over pretty soon so it's in her best interest to find someone (if she's capable).

    But keeping the family in the ER does no good. And as someone else mentioned, may be additionally traumatic to the kids.

    And once more let me know how frequently y'all have luck getting your social workers to respond in the middle of the night. Even good ones.

  • Jun 27

    Quote from NurseGirl525
    But why call CPS? What did the mother do wrong? She didn't have anyone to take her kids and was obviously seriously ill. If she had to be on fall and seizure precautions was it better to send her out in a car? If you are thinking legality issues, that's honestly a big time legality issue. Can you see my point?
    CPS isn't just for neglect. It's an emergent social worker that has greater resources than a hospital worker to locate kin and can assist in getting family to the child or child to family and secure temporary guardianship for non-immediate family until the parent recovers. It's not to file a complaint against the ill parent. It's to secure emergent social work services and safe placement.

  • Jun 27

    Quote from RainMom
    Huh? You can have preeclampsia AFTER baby is delivered?
    Actually, I read recently (though I can't remember where, so I don't have a citation) that most deaths from pre-eclampsia/eclampsia occur after delivery because that's the time when she's not being monitored as carefully, or may be at home, and preoccupied with care of her baby. In other words, the patients who have pre-eclampsia prior to delivery are more likely to have it caught in time.

  • Jun 27

    Show of hands here, who has called their hospital social worker after MN? I have (or witnessed it). Real lucky if they answer half the time. And we are not a sketchy facility. I'm not sure they have the job threats for not answering when on call that nurses and doctors do. And I love me some social workers. Don't get me wrong. But good luck getting them to help in the middle of the night!

  • Jun 27

    You need to discuss this with your private physician and the school as to whether an alternative dosing schedule is appropriate and acceptable.

    Many schools will allow a student to move forward with the first two shots a month apart if the third is scheduled. But this is program dependent as well as your current health status

  • Jun 27

    Following parameters will always include nursing judgment. Consider the baseline patient vitals when holding anything. Heart rate of 62 and giving a beta blocker is not a concern, unless the patient has OTHER issues.
    As long as you notify promptly when you decide not to give a prescribed medication, you will ( and the patient will )be okay.
    Too bad if the provider is "bothered" ..better safe than sorry.

    Carry on.. good job.

  • Jun 27

    Having been a trauma nurse in more than one Trauma Center, (Both level 1 and Level II) having a specialized trauma nurse can make a difference in your trauma care. How well it would work in non-trauma ED's would really depend on the ED itself.

    Trauma has become a sub-specialty unto itself. It mixes skills from the OR, Prehospital, Critical Care and even Rehab. With the constant addition of new skills and procedures (REBOA for one) having nurses who are a bit more focused is good for patient care. They can develop a relationship with the Trauma Surgeons than can help with the workflow.

    If your trauma team is integrated with the regular ED the Trauma Nurse makes a great Critical Care Resource Nurse. Help run codes in the departments, assist with procedural sedation, etc. Of course, if you're one of those rare people who have the pleasure of working in a dedicated trauma unit, then you practice and train.

    An education/training program is a mandatory requirement, along with continuing education. SIM training for skills that you might not use regularly, or to practice new skills.

    Like any program or process, it can be done wrong. Seeing a nurse just sitting there waiting for trauma and not doing anything to help the rest of the department when they are getting creamed can set up some bad vibes.

  • Jun 26

    This is an interesting thread! At my large level one trauma center we allow children 14yo and older to be a pt's support person. We also allow newborns to stay with mothers who are readmitted due preeclampsia on the high risk OB floor. (Preeclampsia can be diagnosed up to six weeks post partum). There must be a support person to care for the infant due to the fact they are not considered a pt. When working in our OB/GYN triage we have often been forced to deal with young children coming in with our female patients. If they are going to be admitted, then social service is called for emergency foster care. Often when we start this process, the patient is then able to call out of state family who can pick up in the AM. If a child gets hurt, or lost while the mother is a patient, it ultimately is the organizations responsibility. This is why states have emergency foster care.

  • Jun 24

    The place I used to work for and utilizes EPIC has an awesome care plan part. All JCHAO core goals are there premade even the education materials are all linked and I only have to click a few buttons and its done! I don't ask the patient goals. They don't know what they need only what they want! HA!

  • Jun 23

    I currently use EPIC but there is no such thing as a patient/family goal. We have templates with specific problems, which automatically pops up your goal and intervention. Example: Select template for GI bleeding, it assigns a goal and lists the assessments and interventions (which you can either select or leave blank depending on what you actually did for the patient).

    Also, I spend as little time as possible on care plans. I treat it like flare from Office Space. "If you want me to wear 37 pieces of flair, make the minimum 37 pieces of flair." Office Space Joanna Flair - YouTube<a href="https://www.youtube.com/watch?v=KJtrLKGZZFg" target="_blank" rel="nofollow">

  • Jun 23

    At the end of a long shift I just LOVE having to do the dots and POCs for the careplans- I get to chart again everything I've done (said no one ever). That "select all" box and "F7" become your best friend.

    Our careplans are all templates and it's kind of a crap shoot at times finding one that fits. Pain, infection, COPD, and heart failure are the biggest ones we use on my unit.

  • Jun 23

    In addition, 85 percent of U.S.-educated test takers pass NCLEX on the first attempt. Therefore, if a student nurse or GN fails NCLEX, he/she falls into the small minority of people who are unsuccessful on the first try.

    In other words, the facility doesn't need to wait around for a student nurse or GN to keep retaking NCLEX until (s)he passes because the majority of applicants are able to pass the first time around. Time waits for nobody.

  • Jun 22

    We are a locked down unit using the HUGS security system. We monitor and screen all visitors. We drill once a year.

  • Jun 22

    Several are also toxic in small quantities especially with preemies already fighting for their life.

    The wife of a family member was insistent on using oils and home remedies and almost caused permanent damage to her infant son. He was born with a congenital issue and suddenly was getting worse. The worse he got the more "oils" she tried. Thank goodness her mother in law spoke up when she went to the pediatrician with them. The physician said that's exactly why I want to know anything that you are giving the baby other than breast milk or commercial formula. Even too much water can cause harm.

    Peppermint and tea tree oil can actually cause a chemical burn on sensitive skin. They had to recall the infamous B&BW twisted peppermint line a few years back as people were getting burns & skin reactions from the high peppermint oil concentration in the lotions.

    Concentrated oils can be accidentally inhaled burning fragile lung tissue (thinking of diffusers & sprays) and the pure oils can cause respiratory issues and headaches.

    The small of pure lavender actually gives me such a headache it induces nausea. I had a coworker that swore by it and couldn't place the scent. I was even sent home. The physician saw her with the oil and knew the possible effect for those sensitive. The place was scent free after that.

  • Jun 22

    What does your policy say about scents? Also, keep in mind that some of the essential oils can damage plastic. If you had it on your hands (no matter how well you may wash them) it may come off on IV tubing etc and cause problems. These babies are sick enough without adding anything else.


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