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wooh 28,343 Views

Joined Feb 12, '04 - from 'GA, US'. wooh is a RN & Critter Mama. Posts: 4,988 (74% Liked) Likes: 20,670

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  • 5:09 pm

    Everyone that wants to close visitation, will YOU leave your family member alone in the hospital?

    The answer isn't blanket rules forbidding visitation during whatever hours. It's allowing staff to kick out disruptive visitors. And management standing behind them when they do.

  • Sep 23

    Quote from Esme12
    One day I heard a newer nurse happily chatting away in a room in the ICU and I heard her say....

    "Oh..... I just kill everything I touch".
    Quote from nursel56
    That reminds me of the time one of our family practice docs told a group of us "I'm not too good with living things."

    Apparently she was referring to a houseplant, but still ---- the hilarity of that statement completely escaped her!
    I've done that too. Talking with a patient's mom about houseplants. My mom can grow anything. My neighbor could go grow anything. And I can kill anything!! (Always a reassuring thing to hear from your child's nurse!)

    Quote from canesdukegirl
    So here I am, on the other side of the OR bed helping the anesthesia care provider transfer my pt to the OR bed from the stretcher. My pt was quite sedated from the 2mg of Versed that was given in pre-op and seemed to be confused as to how to scoot himself over to the OR bed. So I patted the OR bed and said, "Bend up your knees and scoot your (another word for a donkey) on over here toward me." Umm....that kinda slipped out!
    You developed a rapport with your patient, what more could a manager want?
    Long ago when I was a CNA, the nurse had gathered up reinforcements because we had to get a cath UA on one of our more ornery old ladies. And she was a big woman too, not so much obese as just big frame, strong lady. This woman had a mouth on her, saltiest language that to this day I have ever heard from a woman, and few men have matched her either. So we're about to start, and everyone is ready for a fight. Lady starts asking, "What are y'all trying to do?" So I take a chance and just say, "Show us your [the word that sometimes comes before "cat"]!" She says, "Oh, y'all want to see my *****? Well here!" and she spreads her legs and we're done in about 2 minutes without any trauma. The nurse says to me, "I can't believe you said that!" And all I could say was, "Well it worked!"

  • Sep 23

    Quote from teeniebert
    D5 1/2NS. Stickiest shower of my life.
    Better than lipids!

  • Sep 19

    Quote from AmberHawkins
    I once had a pt that was admitted for tampering with her stoma to make it bleed and hurt so she could get pain meds (dilaudid, of course). ... Apparently she met a gentlemen out there smoking, ... she gave him a blow job.
    At least it was just a blow job. And not stomal penetrating sex.

  • Sep 16

    Not around THAT long, but did work in a nursing home where we had to rinse the poo out of linens before they could go in the linen bag. That was a fun time after getting everyone up the morning after beef stew nights.

  • Sep 15

    Interesting thoughts, but I'm going to agree with the poster that said that wouldn't be the sole explanation for complaints from 15-1900. Perhaps: staffing cut at 1500 (after all, it's not daytime anymore) and still all the hustle bustle of days? Doctors coming in after offices close and creating lots of orders to be done at the same time dinner trays hit the floor. Patients and visitors getting cranky at the end of the day because they're tired. I think boiling it down to "Type A" and "Type B" nurses is sometimes just another chance to blame staff for what is more of a system type problem.

  • Sep 8

    Quote from Esme12
    The ADHD tendencies of the ED nurse finds the ICU while difficult and interesting...suffocating by tending to the same patients everyday.
    Hehe! I often whine that I should just go work ICU since my floor gets patients that would be in ICU at our sister hospital (and I've got a 5 to 1 ratio where their floors have a 4 to 1.) But I absolutely HATE only having 2 patients. I don't care how much work they are, how interesting they are, how critical they are. BORING. I actually like running from room to room AND TO ROOM TO ROOM TO ROOM.

  • Sep 5

    Quote from Do-over
    Back to the topic at hand - if you all could only see the place we go for a beer in the mornings after work... between us and the guys from the plants it isn't usually pretty. But, we've all been working hard and just want to have a drink and shoot some pool.
    You have bars open in the morning. THAT is so awesome! We have to sneak our own liquor into the Waffle House. And at the Waffle House, my scrubs are about the cleanest thing in there!

  • Sep 5

    I've been at work all day, knowing what rooms I need to wear gowns in to avoid the germs. You've been to Wal-Mart. Who knows who had the buggy before you. Who pawed the banana you're picking up. Who sneezed while looking at underwear. Who was just released from the hospital with a still oozing wound and picked up some gum on their way home.

    If my scrubs keep you and your Wal-Mart worn FOMITE clothes sitting further away from me, all the better for me.

  • Sep 3

    So many new grads start off on a Med-Surg floor. Either they want to, they think they should, someone else thinks they should, or it's the only job in town. Being a Med-Surg nurse at heart, and having great mentors in school and after graduation, I've become pretty good at Med-Surg, because I stick to a few basic rules. This series will be aimed at helping the new grad in Med-Surg (adult or pediatrics). I hope some it will prove useful to others as well, as some of the things I've learned have been from ED and ICU nurses. But I'm aiming at the "baby nurses" entering the big bad world of hospital floor nursing.

    The two most important things a nurse in Med-Surg has to learn are PRIORITIZATION and ORGANIZATION. Nobody can organize like a Med-Surg nurse. Unfortunately, for the new grad, this is one of the hardest skills to develop. Being inexperienced, it's understandably difficult to look at the million tasks for the shift and say to yourself, "What do I do first? What can wait?"

    An important point to remember is you can't organize without prioritizing, and you can't prioritize without organizing. You can have a beautiful sheet of paper with checklist after checklist that's brilliantly organized, but you'll barely have time to do everything you MUST do, much less time to do everything you want to do. So you'll have to prioritize. And you can know what's most important for each of your patients, but fitting it all into a 12 hour shift won't happen if you don't stay organized.

    For Part 1 of this series, I'm going to share a few general ideas about that core concept of Prioritize and Organize.

    First, you need to start the day figuring out what is most important for each patient. When you come in and get your patient information and get report, there will likely be a whirlwind of diagnoses and treatments and drugs. For each patient, step back from the trees to look at the forest. The trees are all the comorbidities and drugs and social issues. Step back and look at the forest, "Why is the patient in the hospital TODAY?" And with that thought in mind, look into the future and imagine the best outcome and imagine the worst outcome.

    For example, you have an easy post-operative appendectomy. Best outcome? Pain is controlled on PO meds, they're eating and drinking without nausea, and they go home. What's the worst outcome? If you said, "Death!" then I'll give you bonus points, but let's think of the likely bad scenarios. For post-op patients, I always imagine post op ileus and some pneumonia.

    So next is to think through, "What's the most important thing I can do today to increase the chances of that good outcome?" And then, "What's the most important thing I can do today to decrease the chances of a bad outcome?"

    So for this post-op patient, I'm thinking, "Good pain/nausea control." And then I'm thinking, "Get their bootie out of bed and ambulate!" What has this done for me? Instead of a swirl of things to do and think about, I've now found what I need to focus on for that patient.

    But wooh! None of my patients are a simple post-op! In this day and age of outpatient surgery, rarely will you have the easy post-op patient. But you'll still apply the same concepts. If my post-op appendectomy patient is 84 and has a history of COPD, I'm going to account for her lungs not working as well, and I'm going to focus even more on making sure they don't end up with pneumonia from inactivity caused atelectasis. The secret is to look at the big picture of the patient. Step back from the trees to see the forest.

    It will take some practice at first, but soon it will become second nature. Next time we'll look at what we do once we've located the forests amongst the trees.

  • Sep 1

    Doing peds, I would really appreciate if patients' parents/parents' significant others/people that parents just met in the lobby/etc. could find a form of stress relief other than having sex in patient rooms. And if they're going to do it, could they please stop hitting call lights while doing so. Especially the emergency lights that a staff member MUST GO IN THE ROOM TO TURN OFF.
    I really don't care who you have sex with. But I don't go to the bank/store/wherever and have sex in your workplace, please stop having sex in mine.

  • Sep 1

    Quote from AmberHawkins
    I once had a pt that was admitted for tampering with her stoma to make it bleed and hurt so she could get pain meds (dilaudid, of course). ... Apparently she met a gentlemen out there smoking, ... she gave him a blow job.
    At least it was just a blow job. And not stomal penetrating sex.

  • Sep 1

    Quote from PMFB-RN
    Who even thinks of that?
    There's a peg for every hole....

  • Aug 28

    Quote from francoml
    I just wish I had the same opportunities to have those wage increases on my floor. ... When I made the comment about just passing meds I was just coming off a shift on medsurg when that was all that I did. ... I have had over 150 hours of critical care class only to make $22/hr !
    First, want to make med/surg pay at your hospital? Transfer.
    Only passed meds? Probably because they gave the inexperienced float nurse a cushy assignment.
    And if you were paid while you were sitting in all those classes? What are you bitter about. You got paid for training that will make you marketable, and got to sit on your ass in class making $22/hr while your fellow nurses were busting their butts on the floor to earn only $3/hr more.

    Quit whining. You could have it worse. You could be one of the many nurses who graduated when you did and are unemployed. Or could be the patient that you're making all those "life altering" decisions on. (Silly me, on the floor, my decisions are all just what I'm going to eat for lunch or when I'm going to take a pee break.)

  • Aug 27

    Quote from TazziRN
    I've also had people who I know speak English refuse to and insist on a Spanish interpreter.
    Just because they speak English doesn't mean they're fluent in medical English, and doesn't mean that they are comfortable counting on their English skills in a stressful situation. When I'm scared and stressed, my English skills get limited, and it's my first language! If it was my second language, I'd hate to think that I might say something wrong inadvertently that could make a huge difference in my or my family member's care. I'd much rather they insist on a Spanish interpreter than give me information that's wrong because they used the wrong words.

    I want to learn Spanish. I'm trying. I speak enough that I've had new coworkers think I'm fluent. (Amazing how overhearing "My name is wooh, I'll be your nurse for the day, everything ok? Questions? I speak a little Spanish, so you speak English?" with decent pronunciation will fool people!) I can do ok on rounds with settled patients, but when I ask if they have questions, I'll get the LL or interpreter. But for admits and discharges, I want to make absolutely sure everything is understood on both sides, so I always get the LL out on those, and preferably the interpreter (I really feel face to face is so much better.)

    It would be great if they learned English before they came to the hospital. But I get lots of scared moms, and when your at home with the kids all day, you get limited practice. It's HARD to learn another language. Lack of practice is the big thing holding me back. I learn new phrases, but by the time it comes to use them, it's already floated out of my brain. These are folks that just want a better life for themselves and their kids. Yeah, there's a few rude ones, but by far, my Hispanic patients always tend to be so wonderful. They want to learn, they're grateful for the care. They're not the ones on the call light complaining that their waffles for breakfast weren't freshly prepared from scratch instead of frozen. Learning spanish is the least I can do for people that actually appreciate my care!