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Most Liked Comments

  • 21

    I hadn't even finished your post without having thought : STAFFING!!!

    Why is it so obvious to us, but not them?!? Maybe selective 'elephant blindness'?

  • 19

    Trying to use a logical, rational explanation won't work for those who are already acting illogical or irrational. They don't care that you "can't", no matter what the reason. They don't want to hear that someone else is more important to them because they don't believe that.

    "I'm listening to you and I want to help. What can I do to help you?"

    Generally that question forces the person to pause and think about what they need. When they respond, you can go into more detail but avoid making excuses ("the doctor is not available" will be perceived as an excuse). Maybe the demand isn't practical at the time. Let's use the demand for pain medication when no order is available:

    "I hear that you need more pain medicine. I want to get your pain under control. In order to access the medication, I have to get an order from the doctor. I am going to go try to get that order right now but it may take me a few minutes. Is there anything else I can do to help while you wait, like bring you an ice pack or help you get repositioned?"

  • 19

    Is there a reason why you think nurses do not fall under the umbrella of "clinicians"?

    All RNs perform comprehensive assessments.

  • 16

    Quote from Lemon Bars
    Ah, so JBudd you are saying that a head to toe assessment of each patient by their nurse is common at the start of every nursing shift? I never observed this as a nurse aide - I suppose I was too busy rushing around gathering vital signs and toileting patients.

    And klone you are saying you do a detailed healthy history when a new patient enters prenatal care. I see.

    Assessments by hospital nurses are ongoing and not necessarily at the beginning of the shift. As was stated hospital floor nurses will focus on what they need to. I work ortho and I'll focus on the extremity but also listen to the lungs and belly for complications. I won't drag out a penlight and check their pupils if they are alert and oriented. Also if they are a walkie-talkie, I'm not going to make them turn over to check their sacrum. Throughout the day we're observing our patients, assessing vitals, etc. I'm sure the nurses in the hospital you worked at did this sort of thing.

    Also, when a patient is admitted we take a history, or in my case the patients that are admitted to the pre-op unit have this done, but I review their history.

    We're prescribers of nursing treatments, but not medications. We are smart enough to recognize when a patient needs a medication, say like a diuretic, or a procedure like an EKG when they are complaining of chest pain, but we operate under the direction of a doctor/NP/PA that can prescribe what we recommend. It's a collaborative thing.

    All that said, the assessments and physicals you learn to do in your BSN program aren't always the reality for the practicing RN...but you need to know how to do it all in order to focus. You need to be able to get out that otoscope and check out a complaint your patient might have, you need to know those heart sounds, lung sounds, how to do a good neuro assessment on someone with mental status changes during your shift, etc.

    Good luck.

  • 15

    Being a great nurse and a great employee can be diametrically opposed.

  • 15

    I think you are not clear on what you are asking. It's about FOCUS. We ALL perform thorough assessments, but they may vary by SPECIALTY. We focus on varying systems based on our specialties and what is the focus. And it's not a one-time thing. We are continually assessing and re-assessing our patients throughout their stay, or in my case their treatment, in dialysis.