Latest Likes For Anna Flaxis

Latest Likes For Anna Flaxis

Anna Flaxis, ASN 19,524 Views

Joined Oct 15, '10. Posts: 2,787 (67% Liked) Likes: 8,070

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  • 1:02 pm

    All4NursingRN, what do you hope to accomplish?

    His behavior was definitely rude, but did it impact patient care in any way?

    What do you think a union rep or HR might do about a co-worker butting in on a conversation that had nothing to do with patient care?

    You could try to talk to the physician in question, but I'm not certain how constructive that would be.

    I would suggest letting it go. The best time to deal with things like this is in the moment, and the moment has passed.

    I must say it sounds like he has the world's crappiest schedule. That doesn't excuse him acting like a horse's behind, but taking call every day for a month? I. Just. Can't. Even.

  • 9:18 am

    Quote from Cola89
    Once in awhile this ER doc calls the nurses monkeys. Being as I'm new, I haven't heard it for my self yet. The subject just came up when I was telling another nurse that this doc had just explained to another doc on behalf of our new ER Physician Assistant that 'PA school is like nursing school, but for smarter people.'

    How would you interact with someone who such an apparent disdain for nurses and other health care personnel?
    So you haven't actually heard this doc referring to nurses as monkeys?

    The PA school comment certainly sounds inappropriate, but if you weren't involved in the conversation, I say MYOB.

    How I would interact with someone like you describe would be to keep my interactions professional and appropriately respectful and centered around patient care.

    Since you are a newbie, don't go into this expecting this doctor to treat you badly based on hearsay/gossip. Go in expecting to be treated in a professional manner, and behave accordingly.

    If and only if this physician treats you in an unprofessional and derogatory manner, address it in the moment and let him or her know you will not tolerate it. If it continues, then file an incident report on his or her disruptive behavior.

  • May 4

    All4NursingRN, what do you hope to accomplish?

    His behavior was definitely rude, but did it impact patient care in any way?

    What do you think a union rep or HR might do about a co-worker butting in on a conversation that had nothing to do with patient care?

    You could try to talk to the physician in question, but I'm not certain how constructive that would be.

    I would suggest letting it go. The best time to deal with things like this is in the moment, and the moment has passed.

    I must say it sounds like he has the world's crappiest schedule. That doesn't excuse him acting like a horse's behind, but taking call every day for a month? I. Just. Can't. Even.

  • May 4

    All4NursingRN, what do you hope to accomplish?

    His behavior was definitely rude, but did it impact patient care in any way?

    What do you think a union rep or HR might do about a co-worker butting in on a conversation that had nothing to do with patient care?

    You could try to talk to the physician in question, but I'm not certain how constructive that would be.

    I would suggest letting it go. The best time to deal with things like this is in the moment, and the moment has passed.

    I must say it sounds like he has the world's crappiest schedule. That doesn't excuse him acting like a horse's behind, but taking call every day for a month? I. Just. Can't. Even.

  • May 4

    All4NursingRN, what do you hope to accomplish?

    His behavior was definitely rude, but did it impact patient care in any way?

    What do you think a union rep or HR might do about a co-worker butting in on a conversation that had nothing to do with patient care?

    You could try to talk to the physician in question, but I'm not certain how constructive that would be.

    I would suggest letting it go. The best time to deal with things like this is in the moment, and the moment has passed.

    I must say it sounds like he has the world's crappiest schedule. That doesn't excuse him acting like a horse's behind, but taking call every day for a month? I. Just. Can't. Even.

  • May 4

    Quote from Cola89
    Once in awhile this ER doc calls the nurses monkeys. Being as I'm new, I haven't heard it for my self yet. The subject just came up when I was telling another nurse that this doc had just explained to another doc on behalf of our new ER Physician Assistant that 'PA school is like nursing school, but for smarter people.'

    How would you interact with someone who such an apparent disdain for nurses and other health care personnel?
    So you haven't actually heard this doc referring to nurses as monkeys?

    The PA school comment certainly sounds inappropriate, but if you weren't involved in the conversation, I say MYOB.

    How I would interact with someone like you describe would be to keep my interactions professional and appropriately respectful and centered around patient care.

    Since you are a newbie, don't go into this expecting this doctor to treat you badly based on hearsay/gossip. Go in expecting to be treated in a professional manner, and behave accordingly.

    If and only if this physician treats you in an unprofessional and derogatory manner, address it in the moment and let him or her know you will not tolerate it. If it continues, then file an incident report on his or her disruptive behavior.

  • May 3

    We do this quite often, as we are a small hospital and specialties are frequently unavailable. How we handle it depends. For instance, if it's an interfacility transport, we handle it like an EMTALA transfer except they go POV. If the specialist wants the person to come to their clinic, or meet them at the ED of the other facility, then we discharge them. We only ask them to sign AMA if the physician does not agree with their wish to go POV. If the physician thinks it is safe to go POV, then we do not ask them to sign AMA.

  • May 3

    Quote from Cola89
    Once in awhile this ER doc calls the nurses monkeys. Being as I'm new, I haven't heard it for my self yet. The subject just came up when I was telling another nurse that this doc had just explained to another doc on behalf of our new ER Physician Assistant that 'PA school is like nursing school, but for smarter people.'

    How would you interact with someone who such an apparent disdain for nurses and other health care personnel?
    So you haven't actually heard this doc referring to nurses as monkeys?

    The PA school comment certainly sounds inappropriate, but if you weren't involved in the conversation, I say MYOB.

    How I would interact with someone like you describe would be to keep my interactions professional and appropriately respectful and centered around patient care.

    Since you are a newbie, don't go into this expecting this doctor to treat you badly based on hearsay/gossip. Go in expecting to be treated in a professional manner, and behave accordingly.

    If and only if this physician treats you in an unprofessional and derogatory manner, address it in the moment and let him or her know you will not tolerate it. If it continues, then file an incident report on his or her disruptive behavior.

  • May 3

    Quote from Cola89
    Once in awhile this ER doc calls the nurses monkeys. Being as I'm new, I haven't heard it for my self yet. The subject just came up when I was telling another nurse that this doc had just explained to another doc on behalf of our new ER Physician Assistant that 'PA school is like nursing school, but for smarter people.'

    How would you interact with someone who such an apparent disdain for nurses and other health care personnel?
    So you haven't actually heard this doc referring to nurses as monkeys?

    The PA school comment certainly sounds inappropriate, but if you weren't involved in the conversation, I say MYOB.

    How I would interact with someone like you describe would be to keep my interactions professional and appropriately respectful and centered around patient care.

    Since you are a newbie, don't go into this expecting this doctor to treat you badly based on hearsay/gossip. Go in expecting to be treated in a professional manner, and behave accordingly.

    If and only if this physician treats you in an unprofessional and derogatory manner, address it in the moment and let him or her know you will not tolerate it. If it continues, then file an incident report on his or her disruptive behavior.

  • May 3

    Quote from Cola89
    Once in awhile this ER doc calls the nurses monkeys. Being as I'm new, I haven't heard it for my self yet. The subject just came up when I was telling another nurse that this doc had just explained to another doc on behalf of our new ER Physician Assistant that 'PA school is like nursing school, but for smarter people.'

    How would you interact with someone who such an apparent disdain for nurses and other health care personnel?
    So you haven't actually heard this doc referring to nurses as monkeys?

    The PA school comment certainly sounds inappropriate, but if you weren't involved in the conversation, I say MYOB.

    How I would interact with someone like you describe would be to keep my interactions professional and appropriately respectful and centered around patient care.

    Since you are a newbie, don't go into this expecting this doctor to treat you badly based on hearsay/gossip. Go in expecting to be treated in a professional manner, and behave accordingly.

    If and only if this physician treats you in an unprofessional and derogatory manner, address it in the moment and let him or her know you will not tolerate it. If it continues, then file an incident report on his or her disruptive behavior.

  • May 3

    I was just curious how others handled this type of situation.
    I am rarely caught by surprise when an otherwise sweet LOL suddenly turns into a raving lunatic. I actually kind of expect it.

    Some potential causes are UTI, constipation, hypoglycemia, sundowners syndrome, a pulmonary embolus, worsening illness, or even just being afraid and feeling helpless. A change in mental status should trigger inquiry into what could be causing it.

    UTI would be one of the more common causes, and constipation can be a contributing factor to UTI due to compression of the urethra by bowel contents, leading to incomplete bladder emptying and thus, urinary stasis. So maybe, your LOL's complaint about being constipated might not be too far off the mark. One of the more common symptoms of UTI in the elderly is altered mentation/delirium.

    Also consider the reason this person was admitted-for pneumonia. Her change in mentation could be related to a worsening of her condition.

    Another consideration is that often, elderly folks with milder forms of dementia compensate well at home in their normal, predictable environment, but once they are in an unfamiliar environment with different routines, the altered mentation is more noticeable. Family members may tell you that "Grandma has all her marbles" or is "as sharp as a tack", but that's in the home environment where she is able to compensate. The hospital environment interferes with this ability to compensate, and so you will see behavioral changes that would go otherwise unnoticed.

    So, to answer your question, how I handle this type of situation is first, I do what I need to do in order to keep the patient safe. Make sure the room is free of clutter, the patient is wearing nonskid slippers, and offer to toilet her. I will offer warm blankets, another pillow, PO fluids or a snack. I will offer a distraction, such as TV, or ask her about her life- her children, pets, where she grew up, etc etc. Once the patient is calmed down and safe, I will take a complete set of vitals, including a temperature; if diabetic, check a CBG; and I will then notify the physician of this change in condition. The physician may want to order a UA, or a repeat chest xray, as her change in mentation may be related to worsening pneumonia.

    I would then document the patient's behavior, the actions I took to ensure her safety, my assessment data, that I notified the physician, and whether any new orders were received.

  • May 1

    I was just curious how others handled this type of situation.
    I am rarely caught by surprise when an otherwise sweet LOL suddenly turns into a raving lunatic. I actually kind of expect it.

    Some potential causes are UTI, constipation, hypoglycemia, sundowners syndrome, a pulmonary embolus, worsening illness, or even just being afraid and feeling helpless. A change in mental status should trigger inquiry into what could be causing it.

    UTI would be one of the more common causes, and constipation can be a contributing factor to UTI due to compression of the urethra by bowel contents, leading to incomplete bladder emptying and thus, urinary stasis. So maybe, your LOL's complaint about being constipated might not be too far off the mark. One of the more common symptoms of UTI in the elderly is altered mentation/delirium.

    Also consider the reason this person was admitted-for pneumonia. Her change in mentation could be related to a worsening of her condition.

    Another consideration is that often, elderly folks with milder forms of dementia compensate well at home in their normal, predictable environment, but once they are in an unfamiliar environment with different routines, the altered mentation is more noticeable. Family members may tell you that "Grandma has all her marbles" or is "as sharp as a tack", but that's in the home environment where she is able to compensate. The hospital environment interferes with this ability to compensate, and so you will see behavioral changes that would go otherwise unnoticed.

    So, to answer your question, how I handle this type of situation is first, I do what I need to do in order to keep the patient safe. Make sure the room is free of clutter, the patient is wearing nonskid slippers, and offer to toilet her. I will offer warm blankets, another pillow, PO fluids or a snack. I will offer a distraction, such as TV, or ask her about her life- her children, pets, where she grew up, etc etc. Once the patient is calmed down and safe, I will take a complete set of vitals, including a temperature; if diabetic, check a CBG; and I will then notify the physician of this change in condition. The physician may want to order a UA, or a repeat chest xray, as her change in mentation may be related to worsening pneumonia.

    I would then document the patient's behavior, the actions I took to ensure her safety, my assessment data, that I notified the physician, and whether any new orders were received.

  • May 1

    I was just curious how others handled this type of situation.
    I am rarely caught by surprise when an otherwise sweet LOL suddenly turns into a raving lunatic. I actually kind of expect it.

    Some potential causes are UTI, constipation, hypoglycemia, sundowners syndrome, a pulmonary embolus, worsening illness, or even just being afraid and feeling helpless. A change in mental status should trigger inquiry into what could be causing it.

    UTI would be one of the more common causes, and constipation can be a contributing factor to UTI due to compression of the urethra by bowel contents, leading to incomplete bladder emptying and thus, urinary stasis. So maybe, your LOL's complaint about being constipated might not be too far off the mark. One of the more common symptoms of UTI in the elderly is altered mentation/delirium.

    Also consider the reason this person was admitted-for pneumonia. Her change in mentation could be related to a worsening of her condition.

    Another consideration is that often, elderly folks with milder forms of dementia compensate well at home in their normal, predictable environment, but once they are in an unfamiliar environment with different routines, the altered mentation is more noticeable. Family members may tell you that "Grandma has all her marbles" or is "as sharp as a tack", but that's in the home environment where she is able to compensate. The hospital environment interferes with this ability to compensate, and so you will see behavioral changes that would go otherwise unnoticed.

    So, to answer your question, how I handle this type of situation is first, I do what I need to do in order to keep the patient safe. Make sure the room is free of clutter, the patient is wearing nonskid slippers, and offer to toilet her. I will offer warm blankets, another pillow, PO fluids or a snack. I will offer a distraction, such as TV, or ask her about her life- her children, pets, where she grew up, etc etc. Once the patient is calmed down and safe, I will take a complete set of vitals, including a temperature; if diabetic, check a CBG; and I will then notify the physician of this change in condition. The physician may want to order a UA, or a repeat chest xray, as her change in mentation may be related to worsening pneumonia.

    I would then document the patient's behavior, the actions I took to ensure her safety, my assessment data, that I notified the physician, and whether any new orders were received.

  • Apr 30

    I helped start our unit practice council. Processes, since they relate to nursing practice, are very much within the scope of a unit based council. Is there a specific process you'd like to start with? I suggest attending the next unit based council meeting and getting it on the agenda.

  • Apr 30

    I was just curious how others handled this type of situation.
    I am rarely caught by surprise when an otherwise sweet LOL suddenly turns into a raving lunatic. I actually kind of expect it.

    Some potential causes are UTI, constipation, hypoglycemia, sundowners syndrome, a pulmonary embolus, worsening illness, or even just being afraid and feeling helpless. A change in mental status should trigger inquiry into what could be causing it.

    UTI would be one of the more common causes, and constipation can be a contributing factor to UTI due to compression of the urethra by bowel contents, leading to incomplete bladder emptying and thus, urinary stasis. So maybe, your LOL's complaint about being constipated might not be too far off the mark. One of the more common symptoms of UTI in the elderly is altered mentation/delirium.

    Also consider the reason this person was admitted-for pneumonia. Her change in mentation could be related to a worsening of her condition.

    Another consideration is that often, elderly folks with milder forms of dementia compensate well at home in their normal, predictable environment, but once they are in an unfamiliar environment with different routines, the altered mentation is more noticeable. Family members may tell you that "Grandma has all her marbles" or is "as sharp as a tack", but that's in the home environment where she is able to compensate. The hospital environment interferes with this ability to compensate, and so you will see behavioral changes that would go otherwise unnoticed.

    So, to answer your question, how I handle this type of situation is first, I do what I need to do in order to keep the patient safe. Make sure the room is free of clutter, the patient is wearing nonskid slippers, and offer to toilet her. I will offer warm blankets, another pillow, PO fluids or a snack. I will offer a distraction, such as TV, or ask her about her life- her children, pets, where she grew up, etc etc. Once the patient is calmed down and safe, I will take a complete set of vitals, including a temperature; if diabetic, check a CBG; and I will then notify the physician of this change in condition. The physician may want to order a UA, or a repeat chest xray, as her change in mentation may be related to worsening pneumonia.

    I would then document the patient's behavior, the actions I took to ensure her safety, my assessment data, that I notified the physician, and whether any new orders were received.


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