I know it's been discussed a million times but I really don't understand why nurses who are on a vent/trach/gt case can't do:
Vent circuit change
Know how to respond to alarms
Change trach ties
How to give a bolus feed
Check availability of a med
Read a MAR
I've been doing this for 5 yrs now and have seen some crazy things. If you don't know, don't ask, pretend you know - you putting the client at risk as well as your license. While I know the response will be the agency just wants warm bodies...I get that and agree to a certain extent. We as nurses need to take responsibility!!! At the end of the day it's our license and the agency isn't going to protect you if something goes wrong.
You need to advocate for yourself. Example: I've been doing peds for a long time...trach/vent/gt...agency asked if I would cover at a camp-no orientation. NO was my answer. While I know I have the ability I've never worked in that environment or with that population. I would ask for orientation but based on my schedule there's no time based on the needs. Do I need to the money? YES...but the possible outcomes don't out weigh the benefits.
Just my opinion cause I'm tired of hearing/reading the excuses 'it wasn't done cause I don't know how to do it. I didn't ask for help. I'll just do what I do know and ignore what it says in the MAR. The agency put me here.' Take responsibility for yourself!
I don't like the communication book and unless it's really important don't write in it. The agency should have guidelines to its use but they don't.
The longer you stay in PDN the more you learn what battles to fight ie: nurses doing things incorrectly, the communication book, etc.. Unfortunately not much is done by the agency so I keep my head down and do my job to the best of my ability.
We have a communication book, me and the other night nurse started it because she and I were the only ones for 8 months. We didn't have a report off. I refuse to put my signature at the end of my quick note. I heard that if you sign your name to it, it becomes a legal document. If I am wrong, please correct me.
When I saw that other nurses on a case continued to use the communication book as a preadolescent back and forth after the nursing supervisor addressed the fact that it is a professional legal document, I stopped using that book altogether.
When I saw that other nurses on a case continued to use the communication book as a preadolescent back and forth after the nursing supervisor addressed the fact that it is a professional legal document, I stopped using that book altogether.
Somebody needs to tell my agency that.
We have those communication books from 5 years ago still sitting in the home.
When filled, the communication book is returned to the agency to be kept with the rest of the permanent record and a new book is started in the home. For those who think these books are for "cutesy" or "nasty" remarks, the communication book is hauled out by the attorneys for the depositions at lawsuit time.
I always found those communication books annoying. I wrote my notes once and writing them over in that #%€€ book drove me crazy. There was no need for them, and some of the nurses I encountered wrote books, whole pages! No need for them on a case with one shift a day. I finally just quit writing in them. And as a PP said, some used them for nasty grams to others. My agency forbid us to use them eventually, thank goodness.
JustNursn
93 Posts
I don't like the communication book and unless it's really important don't write in it. The agency should have guidelines to its use but they don't.
The longer you stay in PDN the more you learn what battles to fight ie: nurses doing things incorrectly, the communication book, etc.. Unfortunately not much is done by the agency so I keep my head down and do my job to the best of my ability.