jannrn

How does a small hospital maintain it's ratio of 1:5 during breaks? I am curious what other small hospitals do and looking for ideas that may be different from what we do. I work night shift so if we have 6 (or more) patients, then there are 2 nurses, but another RN is required to come in (state law says no meal breaks before 2 am) at 2 am to cover 2 30 minute meal breaks. If there are 11 (or more) pt then there are 3 RN's and a 4th has to come in to maintain the ratio during breaks. In a large hospital I understand that there is a charge nurse or a float nurse that covers breaks, we are not big enough for that. Any other methods to remain lawful?

Just yesterday the local paper had the front-page story about this. the hospital here is implementing a new policy that says all admissions to ICU are on a 24 hour isolation and swabbed and tested for MRSA. Anyone else do that?

We recently had a situation where the mom of 3 kids (6,9,12yr) was vacationing in Jamaica when her husband collapsed and died. She did everything, and in that country they did an autopsy (wouldn't let her go home without it being done) and he had alot of problems including ones they did not know about. He basically had a stroke, he was to be 40 this summer. The best thing you can do is get in touch with a hospice program because they often have wonderful programs for the kids, including summer camps, but mostly the regular meetings for kids (and you).

Nobody can MAKE you take a night shift job, however at the time you are looking in the area that you want to live and the specialtiy you want to work in, that may be the only shift to get your foot in the door. You may find you like it, or your sleep disorder is only if you try to sleep at night (just stretching it a little to make the point of 'you never know till you try it' and maybe you already have) But if you are willing to look around, maybe move to another area, be open to specialties you may not have thought of yourself trying, then I don't think you would have a problem finding somewhere to work as a nurse that gave you the shift hours that you can live with!

I believe it can, especially if it goes on chronically. Have you read the China Study? Interesting book. It talks alot about protein and also how not all protein sources are equal, but not specifically regarding kidney function, mostly related to general health and development of chronic 'Western' diseases.

We have been pretty low census too but when we are full it is 14 pt so we are usually 10 pt or under. I just checked to day and this last month the day shift people all had almost 40 hours of call-off time! We hope to pick up soon!

I am in California and the small hospital I work in (we don't have phlebotomy or IV services) we contract with an outside company, one that also supplies medical supplies to homes. They have RN's who are certified and experienced in placing PICC lines who will come to the hospital to place them.

Just so you know it's not just nurses who sometimes make mistakes, yesterday an MD used silvadene-soaked gause to vag pack a pt I had. Apparently the PACU nurse noticed and he came back and repacked with betadine gause. She didn't have any problems from it thankfully!

I was writing to the original poster, and not passing judgement on those who find separation from thier children easier than others.

Unless you really need the money, or to get out and do something for yourself, your kids are only little for a short time (make a timeline and see) and soon enough you can work out a little early care before school or after care, or work nights and sleep while they are in school. Good luck deciding! You sound like a very loving and attached mom (lucky kids!) because sometimes when you HAVE to work (or think you do, or don't want to give up the second car or whatever) you do have to mentally 'check out' of being attached or it hurts to much!

"The China Study is a very, very good book if you can get your hands on it." I recently read this book and couldn't put it down, fascinating info, and hard to dismiss. Research like this is being repeated over and over but it is so hard to change our culture's way of thinking about what we eat!!

To answer your specific question: no, you don't need a female nurse with you when you give a female pt personal care.

I always ask my pt if they brought their own jammies to wear and that they don't have to wear ours if they don't want to. Many do wear thier own and I think it is beneficial to be more comfortable and for the nurse to see the pt as more of an individual than a 'pt'. Of course if they are going to a procedure or have messy wounds, etc then our gowns should be worn.

wow, I have tons of respect for phlebotomy! I consider them the experts in what they do, and quite often they bail me out of a difficult 'stick'! (we don't have them, but one comes in from the lab to pick our specimens up. She's a lifesaver and has tons of info, I am always asking her questions regarding our labs! Sorry to hear of your bad experience. If they lost you guys they'd certainly be missing you!

Just to give you another side of the story, take a read at some of the birth stories on this website, and where some women see labor very differently than most in America. You'll be guaranteed to hear many a horror story, but here you can see it is not always so. http://www.unassistedchildbirth.com/ Warning: controversial...

that family member sounds manipulative and probably wanted to see if you really would cave into his demands! I can picture you saying, "well let me see, it looks like I will be busy at that time, but I could fit that phone call in at 0245, would that work for you?

The small hosp I work at will only offer 8 hr shifts. Most of the night shift, including me really want 12 hour shifts! It is really difficult working 5 nights a week. I am fortunate to be a .7 so it is 3 or 4 nights a week, but would love to increase my hours and work 12's or decrease the number of times I head to work and keep similar hours. The administration won't let us do 12's first because they can't get 100% of the staff to want 12's (and what do you think the likelihood of getting 100% of anything is?) the other reason is the law in CA that anything over 8 hr is overtime? as far as I know that is most places but I thought you could get around it by making your status 12 hour so that anything over 12 hr is overtime, not 8. also, most hosp IN CA have 12 hour shifts, are they going under financially because of all the overtime, OR maybe the hosp I work at is just making excuses for not making it work. I've given up for now. I like the place alot and don't want to change hosp over the 12's but don't think I'll do 8's forever.

I have had to do similar things. I had to get a job to buy a house so the husband knew it was important or we wouldn't get the house. When I had to orient on day shift, my husband hired a young girl to help him get kids ready and off to school (2 different schools starting at same time so the sitter took one) plus we were in temporary housing with 2 dogs and no yard, so we had to take the 2 dogs to doggie daycare! it was pretty tough for a while but now I got my night shift and the kids are in the same school with same destination and start time. things don't always go smoothly, I don't always get the sleep I need, the house is not always clean or clothes washed and put away.... sigh........but nothing is forever!! For a year I had to get up to get my son at 1130 am, so I only got a couple hours sleep! now he is in school all day, and I am loving having ALL day to sleep, what a luxury!! It never worked to have the babysitter come, they would make noise or he would want to see me.. they also did not have child care for kids that were not every day. they had to be every day or they would not take them. I could have found something but it is hard in a new town when you don't know anyone. we toughed it out and now things are better.

I also wanted to add to be careful as some people do get 'wired and jittery' from Benadryl instead of drowsy. I found that taking 2 does that to me and one 'may' work, but I have not found it very helpful at all. Melatonin doesn't seem to do much for me either. I haven't tried Ambien or other prescription methods but have thought it might be nice to have them on-hand.

It is wonderful to hear many different suggestions to give you lots of different things to try, from finding the best schedule, and other techniques. I have done night shift for most of my 15-years as a nurse (and some as a cna before that) and have found that I usually sleep only a total of 4 or 5 hours, and that is broken up into potty breaks (1 or 2). My co-workers do that too. I have not met many night shift nurses who fall asleep and sleep during the day for the whole stretch, they are either young or pregnant!! so I think I have just gotten used to it. That is my experience. I have come to think of trying to get the 'typical' stretch of sleep as one would all night is an unrealistic goal for me and will only serve as a source of anxiety I don't need in my life! I think sometimes new parents go through this too, mentally thinking that they should and could get a whole nights sleep too soon after baby comes along! Good luck finding the best way to get your needed sleep!

I don't believe this is recommended anymore. "Moist tea bags applied to the nipples are a folk remedy that recent research has shown to have an astringent effect that may promote drying and cracking, and is therefore not advised' http://www.lalecheleague.org/FAQ/heal.html

I use the pre-filled syringes. I draw up the needed amt of med with the blunt tip (metal, not plastic) type needle and squirt it in the 10 cc syringe with saline in it. sometimes I have to squirt some saline out first to make the med fit. I only do one med at a time to know which med is in the syringe, if I have alot, I'll take the supplies in the room and do them one at a time. the flush syringe I leave in the sealed package to know that it is the flush with no med. I was have been told the 20ml vials of saline have preservative in them and it is not good to give large amounts. I'd have to check the label, but that is what I was told. the pre-filled syringes I was told do not have the preservative, so it is better if you are pushing the whole amount or several at a time to use those. However, I have also wondered if administration would prefer me to draw up my own as it would be cheaper.

Our facility does us epidural tubing with a yellow stripe on it, the IV tubing is all just clear.

where I work it looks like from the hosp web site advertising a med/surg nursing job it starts out at 36.20/hr (does not include $10/hr night differential). this is central coast of california.

We can only give phenergan supp. at my hosp. it works great and lasts longer, but the first line drugs are still zofran and inapsine.