Cheat Sheets and other weird policies - page 2
by JDD1017 7,290 Views | 25 Comments
I just transferred from the ER to the NICU about 3 months ago and just got off orientation. I was shocked to learn how many different policies and procedures there are, and in an effort to remember them all and have them at my... Read More
- 1Feb 20, '13 by JDD1017Quote from catlover314That is exactly what I want! I think if it is a unit approved cheat sheet that is routinely updated they might be more accepting of it. I think I'm going to present this idea to my manager and see what she thinks. I am glad I got some feedback from everyone. Thanks!Our unit created a pocket sized guide for all nurses for quick reference for a wide variety of need to know info. Each page has a blank side with space for personal notes. Our educator and 3 staff nurses collated the most common things people of all experience levels needed to look up and that's what they put in the 'book'. Every staff member and all NNPs and our floats have a copy and we will update it every year so the info stays current. Meets people's need for info but keeps the info consistent with guidelines of practice. I think the committee did a great job and so far the feedback is very positive.
- 0Feb 20, '13 by mortebeing proactive!Quote from JDD1017That is exactly what I want! I think if it is a unit approved cheat sheet that is routinely updated they might be more accepting of it. I think I'm going to present this idea to my manager and see what she thinks. I am glad I got some feedback from everyone. Thanks!
- 1Feb 21, '13 by M/B-RNI say just write them down and keep it in your purse. Sometimes just writing out information helps it stick better. I write down all kinds of things for myself even if I don't need to reference it for a long time, it's there when I need a refresher. Also, when they change policies they alert us to read the new one, so I update info as needed.
Congrats on the new job.Last edit by sirI on Feb 22, '13
- 7Feb 21, '13 by WildflowerRNPIVs are NOT done under sterile conditions.
When is the last time you donned a mask, sterile gloves and draped the patient to start an IV?
The Infusion Nursing Standards of Practice to which nurses are held in the US regarding invasive line placement, only midline, arterial, central, and PICCs are required to be placed using sterile technique.Last edit by sirI on Feb 22, '13 : Reason: edited by moderator
- 2Feb 21, '13 by Esme12 Senior ModeratorI have always been terrified of the NICU and spent my time in the ED and critical care units....the youngest I prefer is about anything full term that has been in the world about a month. I kneel at the feet of NICU nurses (and OB if truth be told).
As a long time experienced nurse......I agree that the NO Cheat Sheet rule, while possibly being of good intention, micromanagement in the worst way. I see the wanting to be sure consistency and accuracy is key.....to forbid people their own method of learned safety seems mighty control-freakish. 100% IV starts on a neonate? Good luck with that. Sterile PIV sites? I can see why on neonates......but I ahve not done that on any other patient.
I have NO expereince with NICU....Bortaz does.....I'd listen to him.
Good Luck in your new home!Last edit by sirI on Feb 22, '13
- 1Feb 21, '13 by iluvivtNo one can tell you you cannot make your own personal cheat sheets just do not post them in the unit or share them. I bet that is what they do not want to happen. You need to do what works for you based upon what kind of learner you are and what you know works for you.
As far as the IV team doing all the IVs you cannot do much about that if the policy states that is what they want!
That MD stating that nurses need to have 100 percent success on IV starts it nuts!. Everyone knows I am the go to IV nurse for peripherals and even my teammates send me on calls when they cannot get it BUT I am not at 100 percent on first sticks,I probably am at 90 to 100 percent but that is after 26 years on the IV team. I may go for days and days without doing second attempts and then bang have an awful day when a lot of patients get stuck more than once. I am certain that MD is nowhere near my 90-100 percent. A few years back I actually calculated our attempts on all team members and found out we had a 92 percent success rate with the first stick. I would be shocked if we were that high now since all we get now are the very difficult sticks for the most part.
The neonate population have so few suitable peripheral veins for cannulation that one must be prudent about the number of sticks. They could just allow one stick and then if you all cannot get it you can call the IV team. That seems fair.
- 0Feb 22, '13 by PediLove2147I am not a NICU nurse but I wanted to chime in. I have a binder that has a page of important information/numbers that I need and the print out of policies that I use often. I don't use it as often anymore since I have experience but it was a god send my first few months. I would very upset if management told me I could not use it, come to think of it I don't think my manager has ever seen it. I would make one and hide it in my pocket!
We have an IV team at my facility but all nurses are IV trained, we are supposed to try twice and then call. They get very angry if you call before trying. I am terrible at IVs though and sometimes don't feel like sticking a patient just to stick them. It's like they are trying to get rid of their own position! 100% success rate is not a realistic goal. You will have no one left. Some people are just unstickable!