I am an Lead LVN in a facility and I am the one who has to train all new nurses. RN and LVN alike. I have a new grad RN and we have some disagreements on a few things. I could definitely be wrong so I wanted to clarify.
For J-tube I had informed her that we do not check placement, aspirate, or put air in the j-tube. She said she checks placement by putting air.
For bradycardia, would a pacemaker be beneficial? She has informed me that they are only for people who's hearts stop beating.
I try my best to help anyone new and let them know to ask me any questions if they are unsure, and help them do things accordingly to protocol if I see it is being done incorrectly, sometimes I feel that because I am an LVN they refuse to listen to what I have to say. I have been with this company for over 5 years as a lead.
I understand in the medical field, we are constantly learning new things or new ways of doing things. I just want to be sure I'm training the nurses correctly, if I am incorrect I would want to make sure things are being done the right way. Thanks in advance for any advice.
pt is nonverbal with profound intellectual disability and has gone to see a cardiologist who stated to "ignore slow pulses" what he actually wrote in his progress notes. Has had episodes of HR in the 30's, lethargy, and not easily aroused from being asleep when hr is low. Cause is unknown. I just wanted to know if there was more that I can do to advocate for the pt. EKG was normal
A lot of individuals have a low HR when then sleep. Does he also have episodes of this when he is awake--i.e., go suddenly from awake and alert to unresponsive with a low pulse? Report it to the physician, but in the end, it is going to be a cardiologist's call as to whether or not this individual needs/gets a pacer.
psu_213, BSN, RN
3,878 Posts
A lot of individuals have a low HR when then sleep. Does he also have episodes of this when he is awake--i.e., go suddenly from awake and alert to unresponsive with a low pulse? Report it to the physician, but in the end, it is going to be a cardiologist's call as to whether or not this individual needs/gets a pacer.