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brownbook

brownbook

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  1. brownbook

    Tips for same day surgery

    Same day surgery...."we" don't even have our own Nursing Specialties section . I know this has been answered by me many times....but I am not good at finding old posts either. Maybe look under OR..or PACU...or Ambulatory Care/Clinic...but none of those are only for same day surgery. Some same day surgeries can be connected to acute care hospitals, or they can be independent stand alone clinics. There are differences in working either one. A patient for same day surgery has to be, is, very healthy. They are assessed and cleared by their primary care physician, they are assessed by the surgeon, they may, or always, receive a pre-op phone call from the anesthesiologist and the pre-op nurse to review their health, medications, etc. The pre op nurse mainly checks the paper work, takes vitals, wittiness the consent, puts in an IV. It is not the time or place for a head to toe assessment, not even listen to lungs, heart, etc., UNLESS, they present with c/o chest pain or trouble breathing, are asthmatic, etc. (then they may be sent to the ER?) Of course there can be more assessing done. I'm just keeping it simple. The OR is run like an assembly line. Ideally the patients are moved in and out by the clock. The surgeon loses money, wastes their time, if they are ready for the patient and the pre-op staff does not have the patient ready. Plus making the following case start late! Even in PACU, a fresh out of OR sedated patient is moved quickly. These days anesthesia is so "light" and short acting, patients are wheeled out of OR sitting up joking with the anesthesiologist and nurse. I've worked out patient surgery clinics where I've been"threatened" with an incident report if a stable patient was kept over 2 hours. So of course you assess them, but a quick one, then start their snacks, start their pain pills, go over post op instructions with their ride home, and out the door.
  2. brownbook

    ICU Nursing

    This, plus outpatient surgery clinics. It's better than cake , I think of it as Disneyland. We're closed weekends, nights and holidays. My only warning is if the surgery clinic is part of an acute care hospital you may have to take call for PACU.
  3. Study: Dietary Supplements Do Nothing for Health By Serena Gordon (HealthDay Reporter) Here's the link to the entire article. I've been hearing, from bona fied medical scientific research, since at least 2005, that multivitamins and supplements are not needed unless you're a vegan or pregnant, or diagnosed by a medical doctor as deficient. Which is very rare. If you are basically healthy adult you do not need them. Being tired, not adjusting to night shift or day shift, is no reason to take them. Sure see your primary physician if you're constantly tired. But unless a specific diagnosis is made multivitamins and supplements won't help! In fact they give many people the false impression that scrimping on a DAILY variety of fruits, vegetables and unprocessed foods, because they are soooo busy, work night shift, don't have time for healthy eating, is okay! Just my vent. I'm tired of reading on All nurses recommendations for vitamins and supplements.
  4. brownbook

    Reporting coworkers

    I hate it when old threads pop-up. I've responded to a few and feel like a fool.... thanks Allnuerses . I do enough stupid things during the day.
  5. brownbook

    5 must-know tips for new RN

    It takes a while to find what works for you, but get a routine down and except for a patient coding or bleeding profusely try to stick to your routine. The 100's of interruptions are what cause mistakes. For example, first make rounds on all your patients, unless you find a critical problem, don't stop to fix it, make a note of it and finish your rounds.
  6. brownbook

    Mini Rant

    Welcome to the great BSN ADN debate, this educational difference has been the norm for over 40 years. In "most" situations a bedside nurse in an acute care hospital has the same job and pay whether ADN or BSN. For over 30 years there has been a debate that all RN's should be BSN. Some hospitals only hire BSN nurses. Some hospitals "grandfather" their long time ADN nurses into their position even if they're only ADN.
  7. brownbook

    Single mother working 12 hours night shift

    Good to be proactive. If when, the babysitting arrangements fall apart it's a mess! No great ideas here.
  8. brownbook

    Mini Rant

    If you do what you love you'll never work a day comes to mind. Adding if you do what you love the money isn't that important. Anyhow I think nurses make good money.... which has never been my goal in life. Poor but happy beats rich but miserable every time. I grew up in a very comfortably rich family....but a miserable family in many ways. Money can't buy happiness.
  9. brownbook

    Short term strategies for lifting a child.

    I love YouTube. I'm sure there are many nursing videos on transferring patients in various settings.
  10. brownbook

    Mini Rant

    With your experience I'd hire you in a heartbeat. Your hands on 4 years experience trumps a new grad whether ADN or BSN.
  11. brownbook

    Question about Code Beds

    I was a house supervisor. Never heard of a code bed. Never heard of saving an empty bed in ICU for just in case there was a code. If ICU got admits that stretched staff beyond the 2:1 ratio I'd pull staff from another unit or get a stable patient transferred out of ICU or call in ICU staff at home to come into work early, I'd even take over the care of a stable ICU patient myself to free up the nurse to take the more critical new admit.
  12. brownbook

    RNs giving patient lab results.

    So you wouldn't tell a patient who's been IDDM for many years their Ac 1 level? How about a patient with a low H & H, the doctor has discussed all the treatments and options, told the patient they'd get 3 units of RBC's and have the H & H rechecked. You'd just hang a 4th unit and not tell the patient what the H & H was?
  13. brownbook

    RNs giving patient lab results.

    Your reply is makes sense, but is confusing at the same time . Maybe you or your "boss" should discuss, review, the policies with that doctor, maybe he is confused also. The "old system" was a little over the top. You couldn't tell parents their child's arm was broken!
  14. brownbook

    RNs giving patient lab results.

    I'm very confused. The patient is discharged home and calls you at work, at the hospital, for lab results from when he was septic in the ICU?
  15. brownbook

    Holding HS Meds

    Great, that explains a lot. Your protocol is to notify the RN, (and document that you did). Did you notify the RN about holding the trazadone and seroquel? I can completely understand why you held them, but it's still up to the doctor to decide if it's appropriate to hold them. I doubt that missing one dose of either meds is a problem. But almost all psychiatric mood altering meds, even when prescribed for sleep, cannot be stopped abruptly.
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