LovingLife123, RN 5,653 Views
Joined: Dec 20, '16;
Posts: 716 (75% Liked)
; Likes: 2,825
Sorry, but does anyone else think this is a dumb policy? Patients who aren't ordered for anythign IV need 2 IVs just in case?
Also, since the patient refused further sticks and the MD agreed that 1 IV was fine, you didn't leave anything for the next shift. If I was a patient on your unit and on no IV meds, I'd refuse 2 IVs too.
The only reason in my mind to need a masters is to be an NP, get into upper management, or informatics. I had a job before graduation with my ASN. I only got my BSN because I personally wanted to. My job did not require it.
She needs to sell her home, plain and simple. She then uses that money for AL and once that is depleted, she gets Medicaid. Don't get Medicare and Medicaid confused. Medicare is not for long term care.
It can't understand the logic of this policy. Two IV's...that according to most policies and standards have to be changed every 72 hours...so less sites available every time they are changed, so they go bad, leak, so have to be changed again. All for "possible" emergencies? Even in ACLS is has never been hinted at that two IV's is recommended.
I am assuming you mean two peripheral IV's.
A critically ill patient needs a triple lumen central line, or VAP, or PICC, right from the get go. And maybe one peripheral IV
A moderately ill patient needs one IV. Maybe two IF both sites are being used, needed for multiple infusions or incompatible IV solutions or such.
But a routine blanket policy that every patient have two IV's irregardless of their condition doesn't make sense to me.
Do many of your Foley patients need UA's? Is q12h Foley care actually being done?
By "measuring" I meant putting the leads in the correct spot related to the anatomical reference points we use for lead placement. I did not mean getting out a measuring tape but there is a reason the leads are placed where they are. It takes no more time to place them correctly than it does to slap them on somewhere sorta near where they are actually supposed to be which I have seen done repeatedly.
You'll want to go to work to recover once you have a few small children at home.
I almost always put the leg leads on the abdomen. Especially on men. Their legs are very hairy and the leads don't stick well.
I have never once measured to put leads on. Usually, if I'm getting a 12 lead, I need it now and don't have time to piddle around with that stuff. I never have issues with reading.
Lol. I'm still confused by the PCA. All of ours are a lockout if 10 minutes. So, to me, the fact someone could push it every 6 minutes and get a delivery is crazy. Most of ours are morphine but we also do dilaudid. And I think it's .2 q10 with a 4mg/4 hour lockout.
I've had numerous jaw dropping moments. Some within the past week. I won't mention for fear of being recognized on here.
Your RTs don't do it?
I don't give medical advice to friends. I may tell my mom a thing or two if she calls and asks me a question. I did chew her out when I found out she had a TIA about a year ago and she didn't seek treatment right away.
As far as the meds, I wouldn't give a kid meds without asking the parents. But your teacher was stretching it a little. When my husband has a headache and I give him excedrin migraine, I'm not prescribing. I'm not a nurse at home. I'm a wife.
I'm not on duty 24/7. Now, giving my patient in the hospital excedrin migraine without an order is prescribing. But me at home giving my family an ibuprofen is not.
I used to have nursing school instructors like that. Loved to scare us with not true stuff. When I found out the truth, I lost all respect for those instructors not just as a teacher, but as a professional nurse.
Eh, I had a doc get crappy with me for calling him over an ABG the other day. My pt had scheduled ABGs. If it was a normal one I would not have called, but my pt was getting acidic and needed a change in vent settings. I had to listen to why this was so stupid. I was like, well it's ordered so I did it. The results were way different from 6 hours ago. I need you to treat it.
Honestly, I think physicians think we like making extra work for ourselves. I know I don't. But I'm a patient advocate. If you don't like it, take it up with your fellow colleagues is my opinion. I doing what's safest for my pt.
I would like to check WNL on all my boxes and not do labs or tests and not have to assess my pt extra and leave on time every shift. That's what I would love. Stable, normal patients. Unfortunately they are in the icu because they are abnormal and sick.
Most places with a decent trauma center have a designated trauma icu.
I like getting the surgical icu patients sometimes. My favorite are the open belly patients.
Trauma patients are usually pretty straight forward. Just a fun fact. 85% of trauma patients are falls. Usually the elderly who break a few ribs. Trauma is not all gun shot wounds and car wrecks.
I would explain that I can clock out right on time every shift, but do not expect my charting to be perfect or all of my tasks done.
It irritates me that every week we are given another duty and are told it doesn't take much time. Well, no, this one extra charting item or extra line change doesn't take a lot of time in and of itself. But adding a new thing every week adds up over time. Getting a brand new admit 30 minutes before shift change, expecting to transfer at shift change plus all of the other crap adds up. It adds up to an extra hour each shift.
Sometimes, you just have to advocate and do what you need to do for the patient. I've had to on several occasions. Sometimes I was right and the patient crashed, and others I've been wrong. I'm glad when I'm wrong. But 80% of the time if I feel something is going bad, it usually is.
I'm not there to pacify a doctor. I'm there to advocate for the health and safety of my patient. Sometimes, that means stepping on some toes.
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