Please Start!

[Pepper The Cat]

Ok. A spin off from the Please Stop thread.

Please start: label the IV lines! I hate coming on and not knowing how long that IV line has been hanging.

Please start coming in on time! I am tired of staying late because you can't get your act together!

please start learning the computer system! We've been sunning this system for years, you have received the exact same training as everyone else, please figure out how to enter your own freaking orders cause I am tired of doing it for you!

Uhhh, your pharmacy doesn't round and put the 0900 meds in the patient boxes?

I'm in the ED but we end up with a fair number of boarders and no, pharmacy will only send doses that are requested by the nurse (beyond what's already stocked in our Pyxises)

[sistrmoon, BSN, RN]

I'm in the ED but we end up with a fair number of boarders and no pharmacy will only send doses that are requested by the nurse (beyond what's already stocked in our Pyxises)[/quote']

Oh okay, ED is a whole different ball game. I was trying to imagine the chaos that would be a floor without routine stocking of 0900 meds!

[meanmaryjean, DNP, RN]

Please, if your patient is in isolation and you KNOW we don't have housekeeping at night, EMPTY the d@mned trash and linen hamper which are both overflowing! Throw a few yellow gowns in the isolation cart. And put the picked over, hours old dinner tray remnants in the dirty utility room.

[meanmaryjean, DNP, RN]

Oh- and hold those isolation visitors accountable for washing their hands and wearing the required gowns/ gloves/masks.

[icuRNmaggie, BSN, RN]

Please start:

passing the dinner trays, collecting them and recording what was consumed on the I&O.

[annie.rn]

Please start following the K+, Mg, and Phos protocols properly. First off, give the dang replacement. Secondly, order the appropriate follow up labs at the appropriate times.

I second the blown I.V. sentiment. That happens all the time and usually when the pt. has an I.V. abx. due.

Start zeroing out the I.V. pumps when you do your 1400 I&O's. I can't stand trying to do my 2200 I&O's and find the pump says something like 1842 cc infused when the I.V. has been running at 75cc/hr. I CAN put 75cc x 8 hrs. = 600 cc but that won't account for the time I know the pt. was unhooked to take a shower, do P.T., go to X-ray, etc.,etc.)

Start giving your pts. a "hat" or a urinal and tell them they need to pee in it and not dump it until it has been recorded. If the pt. wants to dump it, give them a piece of paper and pencil and have them write down the amount first (after you've shown them how to read the amount). If they are NPO, on IVF and have an NG tube, you need to record their output.

Start checking to see if the pt. has a Vanc. trough due before you hang it. Also, pass on when the next one is due. I hate going to hang a dose of Vanc. and finding out that the trough ordered 3 doses ago was never done.

[icuRNmaggie, BSN, RN]

Please start following the K+, Mg, and Phos protocols properly. First off, give the dang replacement. Secondly, order the appropriate follow up labs at the appropriate times.

I second the blown I.V. sentiment. That happens all the time and usually when the pt. has an I.V. abx. due.

Start zeroing out the I.V. pumps when you do your 1400 I&O's. I can't stand trying to do my 2200 I&O's and find the pump says something like 1842 cc infused when the I.V. has been running at 75cc/hr. I CAN put 75cc x 8 hrs. = 600 cc but that won't account for the time I know the pt. was unhooked to take a shower, do P.T., go to X-ray, etc.,etc.)

Start giving your pts. a "hat" or a urinal and tell them they need to pee in it and not dump it until it has been recorded. If the pt. wants to dump it, give them a piece of paper and pencil and have them write down the amount first (after you've shown them how to read the amount). If they are NPO, on IVF and have an NG tube, you need to record their output.

Start checking to see if the pt. has a Vanc. trough due before you hang it. Also, pass on when the next one is due. I hate going to hang a dose of Vanc. and finding out that the trough ordered 3 doses ago was never done.

I second all of the above. Especially clearing the pumps.

[NightOwl0624]

I know there are a lot of day shift/night shift pet peeves, here is my biggest one:

Day shift, PLEASE document your I's and O's! I know that my patient on a regular diet that has continuous IV fluids running had SOME input during the day - when it is left blank, it just drives me crazy. I can't chart what I didn't see/do.

The poor doctors never get accurate counts, and I wonder if they take the time to see that half of the day wasn't even charted.

Oh okay, ED is a whole different ball game. I was trying to imagine the chaos that would be a floor without routine stocking of 0900 meds!

But that same chaos applies to the individual nurse who has to hit up three machines and a tube station to gather up the bucketfull of AM meds... if they're not requested ahead of time, you're late on your med pass.

[ËŔNurse~dujour]

Music in my heart,

I will start ordering the 0900 meds. I work nights in a busy ER with loads and loads of boarders sometimes and a pyxis full of nothing but emergency meds. You know, I had never thought about doing it and had never been asked. I can't wait to surprise my day nurses with this =)

[sistrmoon, BSN, RN]

But that same chaos applies to the individual nurse who has to hit up three machines and a tube station to gather up the bucketfull of AM meds... if they're not requested ahead of time you're late on your med pass.[/quote']

Yeah that doesn't seem like a very efficient system. If the patient is checked into the ED, why can't pharmacy send the 0900 meds there? Our hospital sends all meds to the ED(emergency and IV antibiotics first of course) and then the routine. If they aren't given in the ED they are transported with the patient to the floor.

[Lev, MSN, RN, NP]

Please stop ignoring elevated blood sugars and blood pressure (and then ambo transport comes and won't take the patient)