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Most Liked Comments

  • 17

    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?"

  • 13

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

    All RNs perform comprehensive assessments.

  • 12

    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'?

  • 11

    Please don't refer to people as having borderline traits. That's like saying "the guy in bed 2 is totally schizo," or "that lady is retarded." Mental health diagnoses don't exist to help you better denigrate your patients. If the patient is needy, say that. If they're demanding, say that. You don't need to propagate the stigma of mental health to explain annoying behavior.


  • 10

    I worked as a forensic psych nurse on a max security adult male unit for 8 months as a new grad. I learned a lot in those 8 months, but I can honestly say I will never work in that setting again.

    My advice to you is: always watch your back, refrain from reading the patients crimes because even if you think you'll be fine knowing what they did, one of their stories just may hit the wrong nerve, be a team player, don't leave your coworkers stranded, don't do half ass room checks, when doing q15 checks always walk with another coworker (as in don't go down hallways alone), wear your panic alarm, listen to what your patients have to say, don't get complacent, don't carry anything sharp on you, don't disclose any personal info to or around any of the patients, wear comfortable clothes, and remember anything can become a weapon. Good luck! [emoji4]

  • 10

    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.