veegeern

Pain or sedation resulting in shallow breathing or slowed respiration rate? I've seen it with other procedures.

:yeahthat: Most of ours have multiple tablets, and many take them 1 at a time. A couple of our nurses will crush meds for these to save time, but I really hate to do this if the patient can swallow. :smackingf

Thanks to all who have already responded. I see that there a those who have either always been held to the 1 hour standard, or have gone to the 1 hour standard. As an entire floor, it is a challenge to give our medications within the 2 hour time frame, so I guess I'm also looking for ways that we can do things differently and comply with a 1 hour med pass. Any suggestions/strategies for speeding up a med pass? This is a busy (who isn't busy ) M/S floor. Right now it seems like I do a lot of my patient teaching r/t medications as I'm giving them. I usually have at least 1 patient/caregiver that states she didn't know xyz about that medication, and many times she's been on the med for years. Do you find it's better to give out the "quicker" ones first, and then move on to the more time consuming patients? Quicker being the patients that can swallow easily or don't have IV push meds that take several minutes. How are you handling dressing changes that have medications recorded on the EMAR or MAR and are due at the same time as your other meds? Have you found anything that works to minimize interruptions during a med pass?

An e-mail went out today from the Pharmacy head stating that a (hospital) corporate wide change went into effect today. Until today, a medication could be given up to 1 hour before or as much as 1 hour after the scheduled time without it being considered early or late. A 0900 medication could be given as early as 0800, or as late as 0959. Starting today, that 1 hour window was narrowed to 30 minutes. A 0900 medication could be given as early as 0830 or as late as 0929. Now, take it for granted that as nurses we all want to give a 0900 dose at 0900. This just got me to wondering...What kind of policies are out there? For how many patients are those nurses providing care? How many/what kinds of meds and accuities? Do the policies work? Anyone care to comment?

I have seen this with gravity flow, especially with INTs in the upper arm or when a patient is gettiing out of bed. Have only seen this happen with a pump when the MD ordered a rate of 20 ml/h, and then it only was partially up the tube.

My husband had a "different" odor to his breath before his thyroid cancer was diagnosed and treated. Don't know if it was the cancer or the impaired metabolism that gave off the odor. My grandfather had prostate ca. with mets to the bone. He had a very sickly sweet body odor that couldn't be washed from the bedding even long after he had died.

I took a quick count of nurses who also happen to be male in my rather small, rural, southern facility. I counted 13 without even trying. If any of them are gay, then their wives and children are in for a big surprise sometime later in life. :icon_roll And their sexual orientation sure isn't any of MY business. But I digress... My point was actually that I can't see someone calling any of them a "murse." These guys are "good ol' country boys." One's a rancher, one's a biker, one's a body builder, all but 2 hunt, and they all fish. Then there's the photographer and the computer programmer. They are sons, husbands, fathers, and grandfathers. Oh and by the way, they happen to be pretty darn good nurses, too. It's a shame that the society that we live in needs to place labels on people so that we can't see beyond sexual orientation, gender, skin color, ...

Funny how we never see things like this in the national news. As opposed to nurses that kill their patients...

Definitely oral care. Changing any tubing including feeding tubing runs a close 2nd. Usually gets done by certain nurses consistently, and not done by others consistently. Our assessment screen flags IV sites that are over 72 hours old (computerized charting). If you had to wait until after shift to finish charting, then this doesn't help, of course.

To the OP: I am so sorry that you found yourself in this situation. You say that you lost your cool, but I say that you kept it. You did what you had to do to protect yourself and to make the pt let go of you. End of story. You did not beat, torture, mutilate...out of anger. You did the right thing. Talk to a lawyer to find out how to put it in the right legal perspective. Seek counseling to deal with your feelings. Don't continue to be a victim. I was raised in martial arts. Dad, 2 uncles and 2 aunts are instructors. I was taught real world techniques and well as traditional arts for competition. I was also given a value system for using what I knew in the real world...defend others, defend self, and defend country. I also took self defense classes in college for my physical edu. hours. That said...if I'm being assaulted, I'm not going to be thinking about my license. AND if I am successful and have my health when it's over, they can have my license if they want it...after a fight of course.

as a new grad, i did both of these!:trout: i was in a hurry and failed to note that i had incorrectly connected the tubing to the cannister. fortunately, our wall suction has a one way valve, so the secretions didn't make it into the system. i now double and triple check my tubing. we used to have glass bottles for lipids. i was spiking the bottle, and my grip slipped. the spike broke off into the rubber stopper, and i had to call the pharmacy for a new bottle of lipids. the pharmacist had a good laugh and then told me that i was the first one he'd heard of doing this.

KVO fluids makes sense. Just had never heard of flushing with 50 ml saline. I have chosen to use 10 ml for certain abx and after phenergan. Thanks to everyone who replied!!

I'm in Georgia. Hep flush is only used for central lines in our facility. Saline flush only for peripheral IVs.

Our facility protocol is to flush IV sites q 8 hrs with 3 ml NS if the site is not being used. We also flush with 3 ml NS before and after IV med admin. Had a patient receiving multiple IV antibiotics. The patient's site was being moved about every 24-48 hours r/t infiltration and/or pain at the site. The night nurse passed on in report that a Nurse Anesthetist (spelling?) suggested periodically flushing the site with 50 ml NS to preserve the site. Does anyone know if there is any evidence for this practice? Thanks!

I personally can't imagine coming back into nursing after that many years, and I'm basing my opinion on the volume of new information that I've had to assimilate since I became a nurse almost 3 years ago. After 30 years, I think it would be like starting all over from the beginning. How would you even know what you didn't know?:chair: