Help, advice needed!!!!!

[hreddevil29]

I have been a nurse for 7yrs and this is the first time I've heard this. I just started a new job on a childrens behavioral health unit, after working many other areas. Today was my first orientation day on the floor, it was me, the nurse precepting me, and the charge nurse. One of the kids fell and twisted his ankle, it was swollen, so I put an ice pack on it and elevated his leg, pretty basic, huh? The next thing I know, the charge nurse runs over, yanks the ice of the kids leg, and says " first rule here-you can't use ice without a doctors order" What the heck? I have never gotten an order for ice BEFORE applying it, I thought that was just a basic nursing judgement. Am I wrong? To make matters even worse, the charge nurse says, why didn't you just apply bare ice to the skin, it isn't effective unless you do. Ok, I know for a fact you aren't supposed to put bare ice on skin for any length of time, and when I challenged him on it, he stated " I was an ER nurse, and thats how you are supposed to do it". He acted like I was an idiot,who doesn't have a functional brain in my head, I wanted to choke him. anyway sorry to ramble on and on, but just needed to vent. I should have dumped the ice on his head.:angryfire :angryfire :angryfire

[Stephanie in FL]

I was taught in nursing school that you need an MD order for ice (or heat).

Stephanie in FL

[galenight, BSN, RN]

An order for ice for basic first aid?!? That's preposterous. I can see needing an order for prolonged cold or heat therapy, but not for this type of situation. Puhlease... and that charge nurse was obviously not an ER nurse for long and maybe it was "back in the day", because unless you feel like risking frostbite, or you just want to make the patient uncomfortable, or you like melting ice all over your unit then you don't use bare ice on skin. Geeshh!

[lovinghands]

Ack...this was your charge nurse on the first day? Oh my! Sounds like he enjoys powertripping to me. CYA until you find a more supportive work environment. I am so sorry your new job started so rocky. Best wishes to you.

[MajorDomo]

Most state boards of nursing allow for nursing interventions to be done that any 'reasonable and prudent' nurse would do, such as icing a sprain. It has been my experience that mental health nurses are excellent in their fields, but get rather rusty on caring for physical ailments that other nurses deal with every shift. As for the ER comment, either he was a reeeeaaaallllyyyy bad ER nurse or got washed out. Us ER nurses know that you amputate sprains (yes, its a joke) not put ice directly on the skin.

MajorDomo

[Bipley]

I have been a nurse for 7yrs and this is the first time I've heard this. I just started a new job on a childrens behavioral health unit, after working many other areas. Today was my first orientation day on the floor, it was me, the nurse precepting me, and the charge nurse. One of the kids fell and twisted his ankle, it was swollen, so I put an ice pack on it and elevated his leg, pretty basic, huh? The next thing I know, the charge nurse runs over, yanks the ice of the kids leg, and says " first rule here-you can't use ice without a doctors order" What the heck? I have never gotten an order for ice BEFORE applying it, I thought that was just a basic nursing judgement. Am I wrong? To make matters even worse, the charge nurse says, why didn't you just apply bare ice to the skin, it isn't effective unless you do. Ok, I know for a fact you aren't supposed to put bare ice on skin for any length of time, and when I challenged him on it, he stated " I was an ER nurse, and thats how you are supposed to do it". He acted like I was an idiot,who doesn't have a functional brain in my head, I wanted to choke him. anyway sorry to ramble on and on, but just needed to vent. I should have dumped the ice on his head.:angryfire :angryfire :angryfire

You are being P'd by an idiot. I was in mental health for quite some time. You did the right thing.

And it is only effective applying ice to bare skin? Is he a total idiot? Is he actually a nurse?? Yikes.

I have to say, if you are an ER nurse by trade, are you sure you want to be in psych nursing? I've done both and I am NOT saying one is better than the other. It's just that technical skills are vastly different. What is technical for one is in verrrry different areas vs. what is technical for the other. You will be shocked at what you learn in Psych. Yet a psych nurse would be shocked at what s/he learns from ER nursing.