returningnurse2006 832 Views
Joined: Jul 4, '06;
Posts: 21 (14% Liked)
; Likes: 4
these are some that i know of:
tips to help take the hassle out of inpatient utilization review
understand the nuances of utilization review and utilization mangement
case management society of america
essentials of case management $$-17 hour ce distant learning course
essential connections ®-help motivate patients with chronic conditions to make challenging lifestyle changes. essential connections® offers an array of easy-to-use communications skills and patient self-care tools to motivate behavior change and improve adherence in patients with chronic conditions.
I would suggest that you try home health. Even though not recent, your experience level is most likely up to par for many of the stable, routine cases. You should find that the Director of Clinical Services will be more amenable to working with you because you are a returning RN. You could do visits or shift work. Shift work is more stable. You can work on the same case for several shifts per week or work on 2 or 3 cases each week. The big advantage is that you can look at the plan of care and speak to the supervisors beforehand to make sure you try a case that will not be overwhelming. And for the overwhelming part, you need to insist on a good orientation. As long as you get a good orientation to the case(s), you can handle anything that comes your way. Try it. Home health is a welcome respite from hospital or LTC nursing; particularly if you do shift work. The complaints about paperwork only really apply to certain positions. If you stick to patient care, you won't have the paperwork problem. Good luck.
"Please tell us your name, hometown, reason for joining the nursing program and clinical experience. Maria, let's start with you."
"Maria Sanchez, Milwaukee, WI, I joined because my mother was a nurse and I respect her so much for the job she does, and I am currently a CNA at UW Hospital on the transplant unit."
"Very nice, Tait go ahead"
"I am Tait, hometown Little Town, WI, I joined the nursing program because something in my soul told me it was the right thing to do, and I have no clinical experience outside of school. I am a waitress."
A gentle murmur.
A hawty snort.
A surprisingly approving look from an instructor.
"I have to say Ms. Tait" steeling her gaze against the class. "I have known a lot of very successful nurses who were waitresses first, it gives you a very similar look on nursing, balancing a section, being responsible, and learning how to deal with customers."
Did she say customers?
As we coast leisurely through the new millienia, life moves along beside us, changing, flowing, and dying. Like constellations born of the fiery inferno of our mothers loins we move along a genetic pathway affected by our training, habits, and lack of discipline or foresight. Each life intricately touching those around us in ways that we aren't even aware of, making a difference in the energies of others simply by passing down the street near them.
Nursing, as a profession, is a long and steady history of men and women driven to offer something more to society. To take the hand of those deemed unworthy, due to sickness and grief. To nourish those who have fallen to the unknown. To comfort those who sit beside and watch as the light of the cosmos flickers, dies and takes a massive piece of their hearts back to a higher plane. Nursing is about protection, knowledge, compassion, empathy and the ability to stand closest to the fragile line of existence than most people will let themselves admit exists. In and amongst all the expectations of nursing, there is also a special part of each person that is there to make the person feel well, protected, cared for and safe.
"Ugh is that Ms. Norris in 25 again? I swear that woman has been up to the bathroom fifty times tonight! Where is Mary, I am not going in there again, every time I do her daughter just wants to yack and yack about how to find a nursing home, how to find a caregiver, and she never wants to help clean her mother up when wets the bed."
Patients can be frustrating. They don't understand their bodies, they don't want to understand that eating well and taking their insulin will help prevent them immense pain from an amputated leg. They have families that are crying, needy, questioning and overprotective. They question the medications you have to administer, they ask one million questions about the future, even if you have answered them all, ten times. They request you wash your hands over and over because they fear being here. Yes, FEAR.
As you look at your patient load each day, what do you see. Three people who need a bath, five people who have to have insulin four times a day, two foley catheters and a ostomy in a pear tree. However, when we take the time to turn around and look from a different location, what do we see?
Four walls and a tv with a bad remote.
A plastic commode that a stranger must help you up to each time.
The open door as that person walks out leaving your exposed to the nurses station and a hundred other people you don't know.
The empty plastic cup on your nightstand without any ice in it, ice that at this point is the only, precious bit of happiness you have.
A rubber mattress with a sheet stained from the sweat of a fever two days ago.
A body that needs a "doctor's order" to be allowed to feel the refreshing flow of water cascade down it.
A different person, coming into your room, a different doctor than the one you normally see each and every day, a different person at three am to poke and prod your tender skin for blood, a different person walking in over and over judging you, questioning you, demanding of YOU.
Take a breath my patient.
Relax your heart.
Relax your mind.
As nurses we offer a unique experience. Not only are we educated in the ways of healing and technical skill, we are also afforded a very special place in our patient's heart. We have the ability to walk into a room, and have a person trust us with some of the most harrowing, painful and embarrassing situations, of possibly, their entire life. So, the question is, are we making the best experience for our patients?
Most of us believe we don't have time for customer service. We have many tasks to do, many iv's to check, many patients to reposition every two hours, many families to placate. Customer service isn't something that may even come into our daily vocabulary. However, customer service isn't something your do, it is something we are.
Imagine the person from the above scenario of worries. How much effort would it really take to make this person just a little more comfortable?
New batteries in the remote or a quick call to maintenance for a new one.
Helping consistently with the patient getting up to the commode and then giving them the dignity to leave the room and closing the door. Even if that person has dementia, it only takes one small second to shut the door and stand outside the room and listen to make sure that person is safe.
Promptly filling that cup with ice, two seconds to you, may seem like an eternity to someone with nothing else to focus on.
A quick change of bedding while that person is up, and after they have finished their natural business. How lovely the feel of crisp linen on tired skin!
A moment to help a patient sponge down the areas that can't be showered just yet, and to offer them a bit of lotion to that dry area in the middle of their back.
However, this situation isn't just about tiny changes to patient care, but also to nursing care. Customer service and patient care are not just about what we are doing for our patients, but how we take care of ourselves. Helping each other out, answering call lights when the CNA/Tech is busy toileting someone, sitting with a dementia patient when you have downtime and helping soothe their mind, and simply promoting a workplace of care and compassion. For your patients, and for each other. Yes, I fully understand there are days when you just don't have it in you, when you are overtired and feel too much is being demanded of you. However these days are most important. The days when someone else can step up, for you, and make your day a better experience.
When you notice that overwhelmed nurse, take the time to offer them a few of your precious seconds. Changing an iv bag can sometimes be a extremely productive customer service act. Not only are you silencing the wretched, repetitive beeping inside the four walls of a patient's existence, you are taking one tiny thing off a fellow nurses plate.
A tiny space that might give that nurse a few more seconds to answer one more question from a family member about post open heart surgery infection prevention.
That tiny space becomes a reinforced piece of knowledge in the mind of that family.
Who later sees a reddened area around their incision they wouldn't have otherwise noticed.
Which brings them back to the hospital mere days before a vicious osteomyelitis sets in.
Management and staff alike need to realize that nursing is more than just pushing medications and making sure a patient has had a bowel movement before going home. This is a career of compassion and care, of hospitality and service. In an age where people can pick and choose their hospital, as easily as the steak house next door, we must take the time to ensure our practice, our patient well being, and our own mental state by looking for the little things that make an experience just that much better. No, we won't make everyone happy, there will be the vegetarians, the angry couples that should have stayed home and went to bed instead of coming out for steak, the people that are late for their movie because the kitchen ran out of lettuce. However, and over all small change, can sometimes have the biggest impact.
In conclusion I offer the following challenge. Look for opportunity. To give a person a little something extra. Close the door when you leave the room. Look to the nurses around you and see if they need a little extra care as well, ask for help when you need it, push your management to deal with issues that lower patient and staff satisfaction. In the end, never forget and always enjoy the fact that you hold a place dear in each patients heart, whether they realize it or not. Without the nurses, phlebotomists, technicians, cooks, maintenance and supervisors these people would suffer, wither and die without feeling the warm touch of compassion and hope.
However, cost concerns and a worsening nursing shortage might make this an unlikely scenario.
I saw a simple demonstration for a colostomy on YouTube...thought I would share...
Get proficient on the computer as soon as you can. Then, you will be able to be a resource for the floor nurses as well. Computer charting can be quite a transition for many.
Any RN who needs CE credits to renew their license can earn them for free at this website.....
Enjoy! i just stumbled onto this link for videos that explain the human body and medical conditions...YAY! good for patho/anatomy explanations
Tell me what you guys think!
sorry if this link has been posted before*
NYT article on how a Pittsburgh hospital cut MRSA infections by swabbing all patients to test for it, using one-use BP cuffs, one stethoscope per room, encouraging hand hygiene, etc.
For the life of me, I don't understand why all hospitals don't do this. I don't think we needed a study to tell us to use disposable BP cuffs, etc. But maybe pressure from the press, and a more educated and aware public is just what is in order to pressure some hospitals who are holding out.
We also have a admit/discharge nurse on our floor. Difference is, she only takes care of the paperwork aspect. The nurse taking that pt does his/her initial assessment as with any other pt, takes care of charting this assessment, and blood work, IV starts, etc. The A/D nurse takes care of locking up belongings, documenting pt's history, allergies, etc. In other words, he/she takes care of the tidious things, while the other nurse is able to focus on getting the pt settled, orders carried out, as well as the other pts. The nurse does not have to spend over an hour simply on paper work. our A/D nurse works 8 hours, 7-3, and is able to get at least 5 admissions and 5 discharges done per day. The rest is passed on, and this is an issue we are currently working on. But for the most part, it has helped the busy day-shift greatly!
What are the expectations of Registry RN's when they come to a hospital for the first time in the med-surg setting? How do you judge a registry person as able to return?
Is it too much to expect a registry person new to particular hospital to receive various new admits... post ops and transfers...unfamiliar equipment etc?
(this seems like a stupid question) I really enjoy mentoring people, but what should my expectations be when assisting. I have witnessed people after a registry person asks a question.... for the person to answer "You should know this, you are an RN"
Any advice would be appreciated.
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