Latest Comments by P B and J

P B and J, ADN 4,171 Views

Joined: Nov 30, '10; Posts: 119 (34% Liked) ; Likes: 127
RN; from US
Specialty: 3+ year(s) of experience in Nursing Supervisor

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  • 0

    We staff with our med-surg nurses (around half of them are trained), although sometimes it means our capacity isn't as high. The unit we place them on usually goes up to 20 patients. If for instance, we have 2 Adaptable Acuity patients (and no extra staff) then the unit can only take 18 patients. Otherwise, the AA patient can go to CCU if they aren't full, or we will call in a nurse if one is available, and house them on the unit.

  • 0

    We recently implemented Adaptable Acuity beds in our hospital. These are on the med-surg unit and staffed by nurses with additional training. These nurses also have a reduced patient load. Our Adaptable Acuity beds are used for patients that don't quite need CCU, but need more attention/monitoring than our tele beds.

  • 1
    xanderfan likes this.

    I am the same way, I HATE confrontation, and don't want to come across as being disagreeable. I recently accepted a decent promotion, and when HR called to "officially" offer me the position, she offered me about $0.65 in raise. I (legitimately) paused from shock... and in the silence, she said: "was that not what you were expecting?" I told her I was expecting "a bit more, more like around $xx.00." Anyway, we went back and forth, and with a few more "pregnant pauses", she finally offered about $0.30 less than I had asked for to begin with(!!!), telling me that was her absolute max for my experience without going to "way higher up".

    I learned a valuable lesson... use the pauses to your advantage (especially if you are shell-shocked, lol!), and ask for what you think you deserve!!!

  • 1
    MarisL likes this.

    I actually called a code before the pt coded...

    I was talking with a pt and they seemed to suddenly act strange, my charge nurse happened to be walking by in the hall, and I asked her to call an RRT for me (rapid response team), (I didn't know what was going on but I knew it was bad!). I turned to the pt and said "nevermind... I think he's gonna code!" and pushed the code button. The code team arrived and the pt was still sitting on the side of the bed, (with me standing by wide-eyed!) the first couple to arrive asked why I called a code blue, and within a second the pt turned grey and fell backwards in bed!

    Long story short, it was a real code, I have no idea how I knew (I was still pretty new), and he didn't make it. We called his mother to come in and she didn't seem shocked at all. Very calm and matter of fact. I asked her if she was really OK and she said "I knew it was coming, he called me tonight and told me 'bye' and that he loved me very much, but that he knew he was going to die tonight"!!

    Anyway, trust your gut. If you know something is wrong but you don't know what, ask for help! Our hospital has a rapid response team, who we can call for help, another set of eyes, and just when you know something is wrong but can't put a finger on it!!

  • 0

    A lot of what you need to know will only come with experience, and it's all dependent on what your environment is (SNF, hospital, etc)

    Without knowing the specifics...

    Help out anytime you can, be understanding and a sympathetic shoulder, try to balance the workload of your staff, delegate, prioritize, and most of all.... freely give praise when you see something good!

  • 0

    I am a new Supervisor (have been on orientation for about a week on a month long plan) at a small rural hospital (40ish IP beds). I have been a RN for just over 3.5 years, and night shift charge nurse at this same hospital for about 2.5 years. My position is technically days and nights, however most of the supervisors do not want night shift, and I actually prefer nights so that's where I'll be for the most part. Yay me!

    The learning curve is steep (NEDOC scores and such), but I am very much enjoying the challenge so far but I am looking for advice on this new position...

    What do you wish you knew when you started out?

    How do you handle difficult situations? (e.g. reprimanding former workmates/friends when they know better....)

    Did staff immediately start trying to take advantage of your lack of experience in this position? (Trying to get away with things they wouldn't even try to pull with the seasoned supervisors... every single &*^# shift so far.... grrrrr!!.....)

    Any sage advice?

  • 0

    I as well am unsure what you mean by affecting ADLs? JW's don't have dietary restrictions (unless health related or personal preference), and nothing else stands out to me other than the blood/blood products refusal.

    Can you elaborate on what exactly you're thinking/looking for?

  • 0

    I work med-surg, and sometimes our aides have 12 patients each. Depends on the night, the floor, acuity, and lots of other things. But we appreciate when the call light is used. If someone stops me in the hall to ask for something, I feel like they are standing there waiting for whatever it is, and I feel (maybe wrongly) obligated to do X right now, so I (almost always) do. Even if I'm in the middle of something.

    If a patient or family member uses the call light, whoever has a second will answer on my floor. It could be an aide, someone else's aide, me, another nurse, the charge nurse, or even the supervisor. But whoever has a second to pop in and see what's up, also usually has a second or two to do whatever it is that's needed. This is not necessarily the case for the nurse that's hurrying to give a certain med, or urgently call a doc, etc.

  • 10

    OK, I'll say it.

    Yep, you're crazy. Nosey sister-in-law not withstanding, you're 35... It's time to put your big girl panties on and grow up. Get a job, move out, support yourself, and then if you feel the yearning for further education go ahead and go for it... while continuing to support yourself on your own. Then you can tell your sister-in-law to (insert your wording of choice here).

    Besides, even if your parents continue to "support" you, I'd bet that (not-so) deep down they are anxiously awaiting having the house to themselves... Speaking as a parent, and as a sibling with brother(s) still living at home in their mid-thirties... get a job, support yourself, and MOVE OUT.

  • 1
    xholly likes this.

    Quote from xholly
    -Do you love or regret your career of nursing?
    -What was your life like before, and what's it's like now being a nurse
    -Did you have the same doubts?
    - What's your opinion of qualities that you think nurses should have, and what weaknesses do you think are a deal breaker?
    My only regret is that I didn't do it sooner. I was a stay at home mom of 4 for about 14 years before I decided to try nursing, but I was too scared. Bit the bullet and 1 year in, I am loving it, finding my place and my way, and feeling successful. I learn something new everyday, and help newer nurses find their footing as well!

    Qualities? Compassion, intelligence, be a team player, and have some confidence (nobody knows it all, if they think they do they are just going to hurt someone, but for god's sake have a backbone)!

  • 2
    sharpeimom and starwood500 like this.

    Quote from phaniea69
    1.) Collaborate w/ a pharmacist and get a recommendation from him/her that we can then suggest to the MD.
    This. In my facility asking pharmacy for a pain consult is a nursing judgment. We call pharmacy, talk to them about pain management (or lack of) and they come do a thorough assessment, including gleaning info from the chart as far as current pain meds, usage, home meds, effectiveness, etc. Pharmacy then makes suggestions directly to Doc, and follows through to assess effectiveness of the new regimen. Our pharmacists and doctors seem to get along very well, and work together. I had a patient recently that was not getting effective relief from his meds, pharmacy was consulted, and the solution (that worked fabulously!) was a BID Xanax added to the scheduled meds.

    I will also talk to the patient about what they have used in the past, and ask for this directly. "Smith in 252-1 complaining of back pain 7/10 45 minutes after X was administered. States he takes Y at home q6. Can I get an order for this? Thanks!" I almost always get what I ask for, and if not Doc will usually call and explain rationale.

  • 0

    Hello, I graduated last December as well, and have been on nights on the med-surg floor for about 6 months now. I love it If anyone tells you nights are easy, all the patients do is sleep, yada yada... tell 'em to kiss off...

    Night shift has issues all its own, at times it can be slower than days, yes, but at times it can be insane too!!

    We don't sit around listening to our patients snore, eating bon-bons, and watching video's, as I was told was all night shift nurses do last week lol.

    Try nights. You might like it, you might not. If you accept a night position, you'll likely start your orientation on days, and transition to nights after awhile.

    Then you can make your own informed decision whether night shift is for you, no one here knows you, your life situation, etc.

    Good luck!! I hope you find a position that fits you

  • 0

    By the by... no feedback is negative if you learn from it!!

  • 2
    SoldierNurse22 and poppycat like this.

    I would think this would be a good question for your PCP, the one who has prescribed your methadone... or I guess I should ask where you're getting that from?

    You should self-report, and I think you think you should, or you wouldn't be asking.

    And personally, I think time off for treatment is a GREAT reason, just as worthy as maternity leave... (whether or not it would be granted I couldn't hazard a guess...)

  • 0

    We do something similar at my hospital, only the nurses don't usually go to rounds. We report to our Clinical Leader (Charge Nurse), who then takes any outstanding issues to rounds. Sometimes the nurses do go too, mainly if the issue is complex and/or difficult to explain.

    "Rounds" here are also attended by Pharmacy, Dietary, SW, Case Management, the Hospitalists, Surgical and whoever else is anticipated to be needed.