GeminiTwinRN 6,605 Views
Joined: Apr 25, '06;
Posts: 487 (16% Liked)
; Likes: 119
All patients being transferred out of a Unit bed (CCU, ICU, SICU, etc) are swabbed prior to leaving with an MRSA nasal swab.
You will get enough sleep and not need pills if you go to sleep and get enough hours in. If you feel like you always need something to stay awake, then you probably need to see a physician to see why.
If I have to get up at 4 or 5:00 a.m., I'm in bed no later than 7:30 pm or 8:00.
You just have to train yourself.
Sort of. I had been pulled the day before to a unit that is a paper-chart unit (I work on a computerized charting unit normally) and had the 5th patient. I had never been pulled EVER, wasn't even at my job long enough to have been pulled (but didn't know enough to say so at the time) and I was so overwhelmed. I didn't punch out until 1030 at night.
I was supposed to work the next day, on my regular unit. I guess I was so tired when I got home that I either forgot to set my 2 (!) alarms, (I always set an electric alarm and a battery operated one, just in case) or else I turned them off. I was just over 2 hours late to work. Thank God the night shift RN was kind enough to stay over for me.
I hate to see you quit a job without notice, but my gosh. It sounds like you did what you had to do!
I agree with getting a copy of the schedule ASAP when it comes out.
No I didn't I was so embarrassed that I did what happen was LPNs are not allowed to flush PICC line where I worked but I searched all over the building for a RN and had no luck well I didn't want to get behind and so I new how to flush it just as I had learned in School. Another LPN told me to just do it she does it all the time when she can't find an RN so I went to do and just about that time I heard someone walking through the door and I didn't want them to catch me doing something I wasn't suppose to be doing so I pulled the needle out quickly and it stuck into my left hand. I ran to the sink and kept making it bleed and ran it under hot water. But I didn't report it, I was afraid it would cost me my job!
I guess you're really asking 2 questions, if I'm reading this right.
Air in an NGT isn't a problem because it's just like swallowing air. The person might have a bit of bloating if it was a terrible lot of air, but I doubt it since you're probably talking about a foot of air in a feeding tube. Just think about how much air you swallow on a daily basis while eating and drinking and talking, etc.
As far as drawing back on an NJ tube, that tube is going into the jejunum and not the stomach. You don't check for residuals when the tube is placed there because there won't be any. The jejunum is part of the small intestine and comes after the stomach, therefore no need to draw back.
yes, electronic charting is done at my job. the physician's are expected to enter their orders, but if we call an md for orders, chances are it will be a whole lot faster if we just input the orders for them.
that's what i do, but that's assuming the doc is off the floor (and not all the floors in the hospital are on CPOE) and/or not in house. if the doc is standing right there, i usually ask for what i need, then say 'you'll put that in, right?' that usually does it.
Prayers being said! I hope he makes a quick and full recovery.
Good lord. Something sounds very wrong here! Not only is that pt at risk for electrolyte imbalance, but if her stool was entirely liquid, that is usually the time to stop giving the golytely! Was her liquid stool clear?
I certainly hope that she had had xrays performed to ensure that she didn't have a stricture or other obstruction before ANY golytely was given!
This could turn into a really really bad outcome. I hope you documented very well. Surely the MD's were aware. I have never given golytely simply for constipation. It has always been given by me for bowel prep for scoping.. this just smells bad all around.
Did she tell the other aide that the pt was dirty and needed to be cleaned up before she left? IMO, if she did, then she acted appropriately. Of course she could have done the BEST thing for the pt, which would have been to clean up the pt herself and then go to lunch, but the next best thing was to pass the info along and then go to break.
Like you said, everyone is entitled to their break. If we always do the next thing that needs to be done, none of us would ever go on break. I am my own worst enemy in that regard. I rarely sit down and take a lunch break because I hate the thought of my pt's needing me and knowing that my co-workers are so busy that my pt may in fact have to wait until I'm back before their needs are met. It's a darned if you do, darned if you don't situation I think.
To me, outright refusing to do something asked of her by a superior is totally different than explaining to a pt that she is off to break and therefore unable to do a task. She should explain to the pt that she is going to break but will have someone else come in and change her.
I'm so sorry for your experience. My heart goes out to you. I understand your need to blame someone/some circumstances.. but I'd instead encourage you even these many years later to obtain some grief counseling. While you didn't lose your daughter (thank God!), you did lose your vision of what could have been for your daughter's life. Her life is just as valuable as if she did not suffer from some damage, of course, but grief can be consuming.
I hope you find someone you can talk with that will offer you the support and sounding board you need. Again, I am so incredibly sorry.
I have a given scenario here where I am not able to understand whom to blame, so I would be fortunate if you give me your advice.
Nurse A is looking after a patient who is having NorAdrenaline infusion running. Before its about to finish she calls for Nurse B to check her other bag of NorAdrenaline infusion, which she is about to prepare. Nurse B appropriately checks the name of medication, expiry date, preparation and countersigns the medication. However after a short while when Nurse A is told to give Ca Gluconate as well, she confuses herself with 100ml NorAdrenaline and 100ml Ca Gluconate bag and causes drug error.
In this given scenario should Nurse B be punished as well for the drug error.
I would appreciate your advice.
If the **** hits the fan, I'd plead ignorance and leave it at that. I agree, you probably should have said no, but under the circumstances, it really seemed an inocuous thing to do, I'm sure.
I hope you can get in touch with her about the PO box thing though. Maybe there's still time to change your mind?
We have CPOE (comp. physician order entry) and I love it. Not only can the physician enter orders, but if need be we can place verbal orders on the computer much the same as the old way of writing them out as vo's.
We have just now gone completely paperless on discharge orders, too. The physician must select all previously reconciled home meds/meds ordered inpatient, place all future f/u appts in the orders, and add all activity/diet/work/etc orders by simply checking boxes. It's soooo simple, we as RN's must make sure that ALL home meds are in the computer or else all will fail. If the home meds are not reconciled, the person cannot be discharged, period. I'm sure there will be some crusty insistent MD's who will balk at these changes, but overall, it is so much better than trying to make out that handwriting that previously couldn't be trusted without clarification on a med, that went on to write illegible discharge instructions.
I'm not sure of what system our hospital is on, I'd guess it's meditech or something similar. Even all the rehab/PT/OT/Speech notes and things are computerized now.
It was a tough transition originally for me to go from paper to this, but now when I get pulled to a paper floor, it about kills me.
Oh, and to answer the OP problem of missed orders, all "new" and orders that have not been "noted" by an RN are in blue. Once noted, they turn black. If it's something written on your shift but not due til the next, we leave it blue so the next RN sees it and has to note and implement the order, ie.. labs that are due at 0500 the next morning, or a head CT c and s contrast at 0500, that sort of thing.
Orders will still get missed from time to time, it's bound to happen. Much much less than when we were paper though, I'm sure of it.
We do 12 hour chart checks in our assessments on the computer. We simply do them under "shift summary" in the focus note section. Very simple.
wow. i'm proud of you for standing up to do the right thing. i probably wouldn't have been able to stick it out as long as you have after seeing little to no response from the previous complaints but you are terrific!
maybe somehow those poor people will get the care they deserve!
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