kdbsmom

Hello, I have a concern with an unwritten practice that is done on my floor and I am trying to change it. I would like to hear what others might think. We do something that is called courtesy assessments-which means the off going night shift nurse will have all patients who are going for a procedure assessed with vital signs, bathed, prepped, etc. I do not have a problem doing any of this. I completely support it because I know how hectic 0645-0800 is. My concern is where this assessment is to be documented. I refuse to document my assessment and vital signs on the part of the flowsheet that is designated for the day shift, because of this many on my floor are frustrated with me. I tell each of them that 1. it is not safe to document on a shift I am not working, 2. I don't think it is legal, 3. I am not doing this assessment so that you do not have to do one for your shift, I am doing it so that if the patient is called for their procedure before 0800 you don't have to rush around to get everything done, and 4. I discussed it with my manager and she said I am right to do what I am doing. Yet, I still have nurses getting upset and telling me that I am wrong. I am told that my assessment won't count for their shift, I am told that if I would document it on their shift then they won't have to do an assessment until afternoon, and a few other reasons that I can't remember at this time. What they expect us to do is go in and cross out their 0800 blocks and write the time we do the assessment, like 0530 or 0615. This has been done for years now. It all started so that first case procedures would be ready as soon as they are called to go down. It was started as a kind act so that the day nurses wouldn't be coming straight out of report and being hit with patients leaving the floor unassessed. Then it turned into an expected thing and now everyone just assumes it is policy, it isn't. If your flowsheet was designed in 11p-7a, 7a-3p, & 3p-11p sections with four 2 hour blocks per shift for each body system from 2400-2300, where would you chart an 0530-0630 assessment 11p-7a and the 0600 blocks or 7a-3p and the 0800 blocks? Well, maybe I am making a bigger deal about this than it really is, but we chart by exception, so I like for my blocks to be available. I don't think you can over assess any patient and I make it habit to always assess all my patients at the start of my shift and then I do a second assessment for my next flowsheet since I work nights. I don't always assess every patient before I go off duty, but I always check on every one and do what I feel is necessary. Thank you in advance for your opinions. If you reply, please send to the board, my email is messed up. Time for this night nurse to get to bed. Good morning!

Hello Butterfly80, I just graduated from a community college in the Raleigh area in December. If you are talking about the one I am thinking of, it is quite competitive. I would like to clarify what you mean by pre-req's. Do you really mean pre-req's, as in courses that are not part of the curriculum credits for graduation (like Chemistry or Algebra)? Or do you mean the non-nursing courses that are required for graduation (A&P I&II, Nutrition, Micro, Patho, Eng, Psy, and a Hum)? If you have not taken the non-nursing courses that are in my second question, then acceptance will be less likely. But if you have completed all of those and your Hobet thing (I did not have to do this, this is a newer thing) you have a good shot. It is very frustrating, especially since now, they make you reapply once a year and I don't understand how they determine the point system. I can't give much info though because the process I went through was different. They completely changed it in the past couple of years. Good luck!

DonaldJ Breastfeeding is a natural process that is shared between a mother, child, and that immediate family. Someone on the outside really can't make a judgement about it being right or wrong for that family. For someone to tell a mother who knows she is doing the right thing for her child that it is wrong because personally they think that there is something wrong with it when they have never experienced it or done in depth research on it will just cause unnecessary tension in the relationship. Breastfeeding is a very hot topic and really should not be debated amoungst friends. You don't have to agree with it. The WHO actually recommends breastfeeding for a minimum of 2 years and then for as long as mutually desired. The AAP has been behind on these recommendations, but the fact that they say a year minimum and then for as long as mutually desired means they have figured out the benefits. It is hard for the AAP to say longer because of Americans distorted view of breastfeeding. In America breasts are a sexual organ, but in most other parts of the world (and not just third world) it is seen as a source of nourishment and comfort for babies and young children. And babies can actually exclusively breastfeed for the first year of life without any other supplements. When solids/nonbreastmilk items are introduced it is purely for experiencing new tastes, smells, and textures. It really isn't meant for being the main source of nourishment. In the second year of life, solids start to be the main nourishment and breastmilk is considered to be a boost. And for those who choose to nurse their child until 5 or 6, studies have demonstrated that the natural age of weaning for humans is anywhere from 2-7 years of age. Also, many babies who "wean" before a year are usually going through phase (I foget what they call it). Often this phase is mistaken as the baby self-weaning, but it really isn't. For you and your friend, stop talking about this topic. She is a mother who believes (and I am sure she has research to make up her belief) she is doing the right thing for her child, it isn't harmful to the child. The only harm that is coming is a disagreement between you and her that might end your friendship. If this was a patient of yours whose beliefs wouldn't allow for certain procedures how would you handle it. I hope you wouldn't keep telling them they were wrong and constantly try to change their mind and submit to something that would ultimately challenge who they are. Just for the record, if something truely harmful were occuring, like abuse of some sort (which extended breastfeeding is not, you can NOT make a child nurse against their will) I would say contact the appropriate people and let them handle it. In no way do I agree with abuse as a personal choice. Well, I know many will disagree with my post, but these are my 2 cents. I am not an IBCLC or part of LLL or anything like that, but I do strongly believe in the right of women and children. I have done a lot of research on this particular area. Thank you and take care, KDB

:balloons: CONGRATULATIONS!!:balloons: I am so happy for you! Yet, jealous at the same time! Did you test at the Greenville center? KDB

you are not alone in the wait. we had our pinning on dec. 9. the bon received my paperwork on nov. 9 and pearson vue received my registration on nov. 25. everything on my end that i am aware of was completed. there was an error with the verification forms that the school sent for all of us in my class, so all of that was sent back to the school. they corrected it and sent it back in. everyone who completed their stuff has received their att and has scheduled an exam date or already took it. except for me. my school overlooked my form so my processing has been delayed again. i am so upset. i was one of the first to have everything completed in my class and because of someone elses error i am in limbo. i spoke to the bon at the beginning of the week and they said they had everything and the next declaring day would be friday (late), well here it is saturday and the site still does not have me declared eligible, and i have no email from pearson vue. i am sorry you are going through this, i know how it feels. i was so ready to test earlier this month, now i can't concentrate on anything. people who were able to schedule their exams said that the center in our area is booked until mid-february or later now. so, you have to wait to test or see if there is something at another center. i hate going to unknown places, stresses me out so bad, but i will have to do that. sorry to be so long. sorry to complain. i am just getting so sick from the wait and racking my brain as to what can be so wrong with my stuff that i have not received anything yet, when my classmates received theirs on jan 11. i hope you hear something soon and i am so sorry that you have to wait. take care, kdb:crying2: