Pearls of Wisdom

[seanpdent, ADN, BSN, MSN, APRN, NP]

I'm looking for suggestions.

I would like to know what you have learned over the years as a nurse that they DID NOT teach you in nursing school that has helped you out at the bedside.

What tips & tricks have you learned by accident, or have learned the 'hard-way' that has made your life easier when working at the bedside?

For instance, no one actually showed me, but I learned through my own difficulties that administering ProSource through and NG/OG or Duotube flushes MUCH easier when mixed with H2O prior to flushing it through the tube. Otherwise it will take you forever and a day to flush.

Any and all suggestion would greatly be appreciated.

Thanks.

[owhite9878]

cover your own ass. document, document, document! did i say cover your own ass and document, document, document! did i say do walking rounds while the nurse you are relieving is still on the unit. did i say always pull the covers back on your pt when doing walking rounds. did i say always take the chart with you when you give meds and please check their name band and ask them their name and always ask the pt if they have allergies before u give any meds. get everybody's name!

make the respiratory therapist your best friend[ i love our respiratory team]:bowingpur call them 1st if the pt is crashing then call the doc, he might call u back next year. :bowingpur

[owhite9878]

cover your own ass. document, document, document! did i say cover your own ass and document, document, document! did i say do walking rounds while the nurse you are relieving is still on the unit. did i say always pull the covers back on your pt when doing walking rounds. did i say always take the chart with you when you give meds and please check their name band and ask them their name and always ask the pt if they have allergies before u give any meds. get everybody's name!

make the respiratory therapist your best friend[ i love our respiratory team]:bowingpur call them 1st if the pt is crashing then call the doc, he might call u back next year. :bowingpur

[if, if's and but's were nuts we'd all have a merry christmas.]

[anurseuk]

I have learnt so much over the past year; too much write down probably and more than I even realise.

I feel that I barely learnt anything during my training looking back!!

heres a few...

Document as you go along instead of trying to catch up at the end of your shift.

Take your breaks when offered them; you don't know whats going to happen later on and may not be able to fit it in.

Make up your infusions so you have at least one spare on your trolley (in critical care only really) and with inotropes hav a spare one sitting in a pump already attached to the patient; incase the pump fails and ready there for when you'll need to double pump.

Know whats going on with the patient next to and around you; and tell the other staff nurses key facts about your patient; also keep the clinical suport workers up to date.

well I guess some of those if not all are common knowledge. hope it helps some way xx

[ghillbert, MSN, NP]

Make up your infusions so you have at least one spare on your trolley (in critical care only really) and with inotropes hav a spare one sitting in a pump already attached to the patient; incase the pump fails and ready there for when you'll need to double pump.

I'll agree with having spare infusions around, but I can't say I have ever had spare inotrope infusions attached to the patient and sitting in a pump "just in case" another pump fails!! What about when you have multiple inotrope/pressor infusions... spares of each?

The main thing I learned (the hard way) is to TRUST your instincts. If something ever feels wrong, don't do it. Double and triple check. So many times I've caught something which didn't seem right and thought "thank GOD I didn't give it/do it etc..."

[anurseuk]

I'll agree with having spare infusions around, but I can't say I have ever had spare inotrope infusions attached to the patient and sitting in a pump "just in case" another pump fails!! What about when you have multiple inotrope/pressor infusions... spares of each?

The main thing I learned (the hard way) is to TRUST your instincts. If something ever feels wrong, don't do it. Double and triple check. So many times I've caught something which didn't seem right and thought "thank GOD I didn't give it/do it etc..."

Thats actually part of our inotrope policy now... it's quite scary when you have a problem with on of your pumps and the patient is inotrope dependant.