frankie,RN 7,232 Views
Joined: Oct 9, '11;
Posts: 399 (31% Liked)
; Likes: 342
After having worked in several LTC facilities over the course of six years, I have encountered a handful of nurses who do not call the physician with glucometer readings that exceed 400mg/dL as a time saving measure.
They'll document the blood glucose as 399mg/dL, 380mg/dL, or some other number that falls just below the 400mg/dL radar, and they'll administer sliding scale insulin as if the result fell between 351 to 400mg/dL.
I am so happy nurses are voting for Obama it shows they are smart.
President Obama!!! 2008 & 2012
ROMNEY/RYAN FOR 2012!
I remember the President's remark very specifically. The tone of the statement was what caught my attention. Mr. Obama put a strong emphasis on the work nurse; as in, "he could not [even] get a job as a [mere] NURSE! We have to change that!" Words in brackets are my additions to convey the tone of the President's comment. I believe that is what Mr. Obama was trying to convey. If you prefer, read the statement without the inserted words. What do you think? I must say, it rankled this old nurse.
Obamacare is going to effect nurses with ADNs and diplomas by banning them from working in hospital settings. Those who have an ADN or diploma will be grandfathered into the system. But I don't know if that will kick them out if they try to change jobs or not. This is going to encourage those with ADNs and diplomas to go back and achieve higher education. I personally think it is a good idea because you need the critical thinking skills to achieve the best possible outcomes for patients. But some of the best nurses I know only have an ADN. We will see what happens. Hope this helps.
Too busy to explain? How much longer to say "it's like a nurse's aide" rather than "same thing as a nurse" ? Too busy? Didn't want to take time to explain! Puh leeeze!!!
This is now my new favorite thread.
We have a place to chart narratives everywhere I've worked. "Patient updated on plan of care, given meal tray, ate pills off floor at own insistence. Family at bedside."
The patient can complain that the nurse made her lick the doorknob or some equally silly thing. Should the nurse document in order to prevent every potential complaint? The answer is no. That is not the purpose of the patient care record.
The mouth is not a common site for MRSA infection, due to the mouth's own defenses. Sure, it's possible but not highly likely. If the person did develop a MRSA infection in her mouth at some later date, there is no way to know whether it was caused by taking those pills or drinking from a contaminated faucet, or touching her friend's oozing pustule and then sticking her finger in her mouth, or any other cause. The cause would not change the course of treatment anyway.
If the patient starts behaving erratically, then it would be worth documenting. But an alert and oriented person choosing to take pills that have been dropped on the floor is not really "crazy". People drop pills on the floor all the time at home and still take them. That doesn't make them mentally ill.
You're free to document whatever you like, but I don't think it was necessary in this case.
Why would you document it? How is it pertinent to the patient's nursing diagnosis, plan of care, or response to treatment?
I suppose if the patient was admitted for a spinal cord injury and was suddenly able to get out of bed and retrieve dropped pills off the floor, it would be significant. If the patient had been obtunded all day and was suddenly alert enough to climb out of bed and pick some pills up off the floor, then it would be significant.
If there was no significant change in the patient's status, why would this be pertinent information to document in the medical record?
LOL! I like this one.
How many hours of sleep do you get? Do you have certain rules that household members must follow?
Any time management tips for sleep deprived nurses?
Click Like if you enjoyed it.
Please share this with friends and post your comments below!
Want more nursing cartoons?
To OP -Not to disagree with you but a lot of other specialty nurses would argue with you. However, I will concede a tie with med/surg and LTC. They are both overwhelmed specialties needing the generalist insight and time mgt skills that the nurses need to possess.
And just FYI - what I DID in MS eons ago, is now the level of acuity that I see in LTC today. HONEST
So kudos to MS and LTC.
Advertise With Us