Lev <3, BSN, RN 53,965 Views
Joined: Jun 3, '11;
Posts: 2,900 (53% Liked)
; Likes: 5,365
No, you need a pen, in order to write notes on the sacred parchment (AKA paper towels).
Their legislation looks great on paper. Problem is... many states who have acuity based legislation are still struggling with unsafe ratios and working on getting ratios because of it. For example... Ohio, they have the ANA state legislation, ICU nurses are reporting getting 3/4 critical (multiple critical drips, ventilated, and unstable patients. I have seen the same testimonies in Illinois (who also has ANA legislation). The legislation has no real teeth to hold hospitals accountable. It is legislation that caters to hospital administration with an attempt to make nurses feel involved in the process. The verbiage appears as though the bedside nurses will ACTUALLY have a voice which in reality is often over ridden by management. We need a set limit to the amount of patients a nurse is forced to take. Ratio legislation is great because we can have the set limit and still adjust down in patient assignment for acuity.
The one has mandated ratio's the other DOES NOT, and furthermore, it doesn't give the actual bedside nurse performing the care a say. We need mandated ratios!
ANA is worthless
My friend said "Hey ER nurse!", then proceeded to show me a darkened spot on the tip of one of her toes. It's been going on for years actually.
I dutifully examined the toe, then proclaimed "That's not an emergency.". Case closed.
This is why I stopped discussing any personal topics with patients and families.
My birthplace, my accent, where is my family, who is my husband, how many kids - I am sorry, sir/ma'am, I DO NOT WANT to speak about it. Change the subject. No excuses like "but I am just curious". Repeat as needed. If they want another nurse after that, better for me.
And I just wouldn't work in a place which puts someone' nosiness and something worse above it's own employees' safety and comfort.
To be frank, I deal with patient's only for a short amount of time (ER nurse). If someone is verbally abusive/screaming/yelling/acting inappropriate we will place them in a room, on the monitor, and shut the door partially. We deliver care and follow through on the MD orders, but if the patient refuses then we stop and again shut the door partially and continue to monitor the patient. If they are unable to control their actions due to medical diagnosis we will medicate them with haldol, geodon, ativan, or benadryl. We will place spit masks on the patient's that are biting/spitting, place pt's in restraints if they are physically aggressive. During all of this we do not engage/speak/attempt to placate the patient if it only furthers the behavior.
If the patient is alert and oriented, I will tell them to stop. I do not make demands, I will simply say: "That is unacceptable, you need to stop. There are children/other patient's nearby who are sick and this is not fair to them." I will then deliver the ordered care without verbally engaging with the patient. If the patient continues to be verbally inappropriate, I have had the MDs discharge them from the ER and have security escort them out. Legally we have an obligation to ensure they aren't dying/treat obvious life and limb situations but we do not have to put up with harassment.
If the patient is sick enough that they need to stay, I will continue to provide care but will not go to the bedside unless security is present/at least one other nurse is present to protect myself from being both physically assaulted and/or to prevent the patient from saying I did something inappropriate/did not medicate at ordered/etc.
It is odd that nursing staff is not allowed to set limits at all, though. I have to put up with difficult patients like everyone else, but I will let them know when they step out of line ...and that I'll be back in "ten minutes" to check on them so we can try again.
Orientation would be 2 months with a preceptor on one of the units and then one month on my own on the same unit. After that month on my own I move on to the next ICU and do the same process until I complete all four. It would be about a year before I am fully oriented on all of them.
Not harsh.. speaking the truth.
Ruby Vee, I totally agree happiness is a choice. So is sustained misery
I am a nurse on a cardiovascular stepdown unit and I have been there for about 2.5 years. I am very involved on the unit and have tried to come up with other things to help me be more satisfied with my job. I am a charge nurse, active on unit committees and involved in new nurse education. I'm feeling stuck because I don't know if there is anything that will make me happier and more challenged.
I've never really had an interest in going to the ICU. I just don't see myself caring for 1-2 patients at a time, even when they are much sicker. I think it would still end up being boring after a little while.
Basically if anyone can help, I feel like I've stagnated and I don't know what to do. I don't want to be one of those people who switches to a new job every two years, but this may be what I have to do for myself to be happy with work.
I am likely starting school in the fall for my FNP, but I am thinking that maybe I should go for the ACNP route, just to prevent myself from becoming bored as quickly.
If any of this makes any sense, and if anyone has any ideas for improvement, please let me know. I just applied to an ED job, and while I think I would like that, I don't know if it's the right solution.
I hate it that nursing professionals are using the term "mini stroke" for TIA. A TIA is not actually a stroke, mini or otherwise. I think this term is very confusing to patients and great care should be used when explaining to patient or family what a TIA actually is (as well as what it actually is not).
Agree with others that just passing on information like that was not the wisest thing. I would have gotten a lot more clarification from the outgoing nurse (why did she believe the patient had a TIA, what is the patient's DNR status, was family called with onset of symptoms, what kind of follow up was done, etc.).
What a fun read! Thank you. Please do share more.
I wonder which "Nursing Interventions" we use in 2018 will get chuckles from nurses (and nursing students) in 101 years...
Nux vomica is still used a lot on CAM, especially in aurvedic medicine. As the name says, it causes vomit which is supposed to "purge the body" of whatever thought to cause the disease. I'd seen liver failure caused by it once.
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