Sonjailana 4,868 Views
Joined: Oct 13, '08;
Posts: 180 (53% Liked)
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We work with a skeleton crew at night. For the love of Heaven, if a patient is ordered a laxative at 0900, stop waiting until 1745-1800 to give it. Nine times out of ten, the NURSE will be responsible for cleaning the mess on night shift because, for some reason, it's ok if the CNA/PCT doesn't answer his or her phone. But it's a matter of national security if the nurse doesn't answer his or hers.
This reminds me of a joke about pen's Here we go...
Planning to cash her paycheck, a nurse walks into a bank. She reaches into her pocket to pull out a pen to sign her check.
Instead of a pen, she finds she has pulled out a rectal thermometer from the pocket. She looks at the rectal thermometer in complete shock. "Oh no!" she states in disbelief. "Some ***hole has my pen!"
HaHaHa there you go so the next time you go searching for a pen think of this... Anthony
One day many years ago in a very busy ICU the husband and boyfriend of a critical patient showed up at he same much to each others suprise. As they proceeded to fist fight and hit each other with furniture I took the CO2 fire extinguisher and sprayed them both.........as they looked at me in shock I informed them that I was far too busy to deal with their crap....as they both tried to plead their case......I informed them....."Frankly I don't care if you go outside and kill each other....as long as it is across the street and I don't have to fill out the paperwork!" They looked at each other and walked out talking to each other about how crazy that nurse was........
Statistically, in the US 25% of the female population has been the victim of some form of sexual assault before age 18. Males are also the victims of sexual assault.
With that in mind, there might be some valid reasons why some patients are hesitant to have someone of a specific gender perform personal care. It is about the patient, not the nurse. Hospitalization is often a stressful time for people. They are already vulnerable. There is no need for them to relive some past trauma or feel re-victimized.
This may not be the case with every gender preference, but please realize that sexual assault is much more common than most of us recognize.
Well, our unit did just that. We redesigned how we did staffing, got rid of team nursing (where an RN was responsible for 6-8 patients with the help of an aide), initiated primary nursing, limited the RN to pt ratio to 4:1 during the day and 5:1 during the noc. Our nurse manager was on board with this, went to bat for us, increased our staffing budget, and fought for the budget increase with the VPs, CEO and the board. We argued that we would increase staff and patient satisfaction and increase pt safety. We've been doing this for 6 months now; our fall rate has been cut in half, our low turn over rate remains the same (despite the fact that our hospital pays RNs less than area hospitals--so in other words, we aren't looking for greener grass), and our medication error rate has dropped 25%. Our code rate, low to begin with, is nearly zero (though our rapid response rate has remained the same). We've also cut our overtime by 75%; nurses aren't staying over to chart, because they can get their work done during the shift. All of this is unofficial thus far; we're waiting until our next full quarter to start really compiling evidence that we can correlate these improvements directly to our staffing.
I just wanted to throw out there that there ARE hospitals that do these things. All of this was initiated from our unit based council. Our main push was that the hospital paid a lot of money to have speakers and educational programs regarding "relationship based care" and "shared governance". Basically, when the board and VP of nursing initially shot down our budget increase, our nurse manager responded "So this relationship based care and shared governance is all just meaningless lip service? You paid tens of thousands of dollars to have a speaker come and tell my nurses about shared governance, but then you don't actually want to implement it? You directed us to improve pt safety and satisfaction on our units. THIS is what my nurses have decided to do to improve care on the floor." It worked.
Edited to add: This is a med/surg floor in a 120 bed hospital.
Do the public a favor and do not place yourself in a position where you cannot give patients the care and services they desire separate from your own feelings and beliefs. Women do not need yet another healthcare provider refusing to give or refer them to emergency contraception so they possibly end up having to have an abortion as a result of a decision that was forced on them because of your personal beliefs.
This is about meeting the patient's needs, not yours. If you can't do the job 100% with whatever the patient wants done then please let the job go to someone who can do it.
If you want to practice certain belief systems, then IMHO there are places in nursing where it's just not appropriate for you to work.
They are saying the demand will increase as the baby boomer nurses retire again and the baby boomer population begins to use the health care system more. Do you believe this?
Gonna have to go with the "Customer Service" trend, made more intolerable by people with corporate-business backgrounds thinking they are here to save the nursing world by applying their customer service training background to the clueless dweebs who've only been working as a nurse for 45 years. Sorry, the same principles do not apply to both nursing and that phone-bank in Sri Lanka.
I have used the chapstick trick and occasionally do smell something that makes me just stop inhaling - LOL. I just wanted to reiterate though that it really won't be a big deal once you get into patient care. I work at a small LTC facility specializing in termally ill patients. We currently have one gentleman who has a disorder that makes him produce a LOT of secretions. He has also lost much of his muscle control.
When I started volunteering (before I worker there), I hated helping with breakfast after he came to the facility because spit made me SO queesy. I once even had to give him a quick "oh, I have to go check on another patient" and excuse myself because I was about to lose it. I was so totally ashamed to admit it, but it grossed me out.
Now I'm working as a CNA at the same facility. This morning this same man took my hand with his (which was covered in secretions and chocolate drink), slowly brought it to his mouth, and gave it a kiss. After thinking that it was so sweet, I couldn't help but think that I would've thought that was really gross just a little while ago.
I like that idea, but I think I might find considerable resistance from OT/Speech.
Many of my resident WILL drink thickened tap water if it is cold. Maybe I can get a couple of pitchers delivered with nourishments and offer them freely.
I'm also going to ask my DON if she'll let me track all UTIs in the facility by resident and see if there's a correlation between incontinence, dysphagia diets, and UTIs. I'd also be interested into seeing how much urinary retention we have among some of the more debilitated residents.
If there is a link with the thickened liquids and UTIs I may have some ammunition.
Thanks, Sonja. You've been really helpful. So has everyone else. I appreciate the inpout.
We have a lady on our floor right now that we are trying to discharge. She has some dementia and she is OK as long as her husband is not there. But when her husband is there, who also has dementia, they just get each other going. But he really worries about her and he just tries to to everything for her. So the other night after he went home he called back up to the unit to talk to her but he was asleep. So he starts telling me that he is trying to do the laundry but he can't figure out how to use the washing machine. So I sit there on the phone with him for about 15 minutes talking him through how to do the laundry, how to do the settings on the machine, how much soap to use etc. And I would bet that he screwed it up, even though I was talking him through it. This of course is part of the customer service that we now offer.
Several years ago , myself and fellow nurse were "trying" to insert a NGT into a gentleman' s stomach and we were asking him to "swallow" the water that we were attempting to give him to ease the tube down. The patient was slightly confused at times , but was doing his best to help. After several attempts and saying ,SWALLOW over and over, he grabbed her hand and said "it's a bird". I of course was laughing hysterically.
Having watched bird flu evolve over the past several years in Asia, it is interesting that North Americans pay little attention to health issues in far away foreign lands. But there are now 40 confirmed A/H1N1 swine flu cases in the USA. High schools in Texas have been closed down as has St. Francis Preparatory School in Queens in NY because 28 students have been infected.
Perhaps when it is your children or grand children, spouse, siblings, other relatives, or friends and neighbors that are infected and need professional health care, you might be more inclined to follow the news.
Hospital Nurse Staffing
How about a trap door with a slide to the parking lot for those family members who INSIST on force feeding their dying loved ones. All the while the patient is coughing up the aspirated food and I am swabbing the oatmeal out of their mouths the rest of the shift.
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