bryson.holbrook

Often times the patient and their families have different expectations. I love taking care of my patients but don't always enjoy pandering to their loved ones. The issue I am specifically talking about this time is a patients daughter wants our staff to write in a log every time we come in the room documenting every thing we did, medications administered, turns, JP drains checked and emptied. My patient doesn't want us to do any of these things. My concern is that because this is not a standard of practice that a nurse or CNA doesn't log things a few times and I am now having a conversation about why we didn't check on her mom for 4-6 hours. This is just one example of when my patients and their families have different expectations and needs. It is really hard to make a balance and keep everyone happy including our nurses and CNAs. How do you find balance? What hard patient/family difference in plan of care have you struggled with?

Our current hospital policy is to use wash cloths and chlorhexidine for bed baths. Some of the big hospitals in Utah are using a product that has wipes specified for certain areas of the body. I have been fighting incorporating this product. I think that if the sheets don't get wet then you haven't properly cleaned your patient. How do you give bed baths? Any support for using these wipes? I think this is an attempt to sell us something with the benefit of people being lazy and giving subpar bed baths.

My hospitals hypotension protocol uses Levophed (norepinephrine). I have read some articles that state that Levophed is more potent but Dopamine increases cardiac output. Dopamine has potential to have detrimental effects on pituitary hormones. The hospital I work at is a small hospital, Promise Hospital SLC. I was curious if any of the hospitals that you guys work at use Dopamine instead with your hypotension protocols. What if you only have peripheral access? Is Dopamine or Levophed better if you don't have a central line?