samrn32

I fell I must vent on this subject. I am feeling very anti-establishment this week. Our hospital has fallen into the service mode, as I have seen from this board many others have also. We have started the scripting, Hey I'm not in preschool I do not need to be told what to say to people. I've heard the scripts purchased from a marketing firm, I've seen the surveys also purchased from same marketing firm, We say certain statements to patients repeatedly , supposed to be everytime we enter room, "is there anything else i can do for you, i have time now" , "i am closing this door because i am concerned about your privacy" "I am concerned about your pain control do you need anything for pain?", Then the survey asks , "did you feel staff had time for you, concerns for your privacy, concerned about your pain?" Well the whole idea is to be in a certain percentile on the survey results, so after we have spent the entire hospital stay brainwashing our patients we are supposed to get better survey results. I really love the 10 foot 5 foot rule when meeting someone in hall at ten feet make eye contact and smile at 5 foot greet this person. PERSONALLY, if I am a patient just take care of me , be nice, treat me as an individual, don't talk to me like I'm stupid, and please be more concerned with making sure I live than all that other crap. All that crap won't matter much to me if my nurse is busy taking someone to their destination they were unable to follow the signs and find, or taking another stupid phone message for the 15th time for the same irritating family , no it wont matter much to me if I I'm not well cared for. sorry about the b***** ing and moaning and I realize I digress from the thread but I just had to say it

I think they have all gone stupid . Why spend millions of dollars on a new facility and then do something like this.

I was curious as to how some of the other ICU'S are set up. We used to be a 9 bed ICU with all private rooms, We are now a 10 bed ICU . 4 private rooms and 3 semi-privates. This is a brand new building , brand new ICU. I just feel this was really poor planning. I can forsee many problems with this, not that it will change , but what do you all think of this?

It has been over a yr. since I have given this drug. So just from memory we monitored heart rate continuous and bp every 15 minutes. In our experience it can really affect blood pressure We now give this drug to a group of chf patients in our heart failure clinic, but I don't work there so my memory is a little poor. We do give 1st doses sometimes to inpatients who will be going to outpatient clinic or to a member of the clinic who has been admitted for some reason, but all those have been on my days off. If I get a chance I'll talk to our arnp who does the clinic and get back to you but I don't work this week , so it may be awhile.

When our ob is closed there is a nurse on call and one who stays in house. The in house nurse floats and does tasks , usually does not take patients. The nurses from other floors do float to ob but only postpartum and nursery. We have floated to clean delivery rooms after delivery. There is only 1 ob nurse that I've worked with who seems to have a problem floating and functioning on the other floors but I've heard she has the same trouble on her own floor . It isn't a matter of skills she just has one of those attitudes.

we have a small hospital and a small emergency room. people generally stay in er about 3 hours before being admitted. the nurses in er are pretty good about getting iv's in before admit and the first doses of a/b . it would be nice to get more advanced warning of admits to out unit (ccu) when we are full. it does take time to empty bed, clean room , transport patient complete their charting when possible otherwise we have to go to the floor later and complete charting. there are of course many times they aren't aware of our census and they don't know if they will be a ccu admit until the last minute. i think the biggest problem we had was a 56 yr. old female with a pot. level of 8.2 who had been vomiting and having copious loose stools thru her ileostomy for 2 days with poor oral intake . we were told by er that they had gotten everything going except the tx for the hyperkalemia. she arrived with a 22 gauge saline lock in her foot. but mind you when we reviewed the orders and subsequently called the on call md urgently there were no orders for tx of hyperkalemia or dehydration. all of our cp admits and ccu admits are always accompained by monitor and nurse or paramedic. our er has a chest pain protocol and stroke protocol in place and in use and all suspected cva's go to ct as soon as iv access established.