candicane

I had a pt that said she was allergic to an antibiotic, (I don't remember which one) when I asked her reaction to it, she told me she gets a yeast infection when she takes it!

Most of our peds rooms are connected to a monitor at the peds station and in our icu for increased monitoring. A few are not and we have to use a portable sat machine to monitor that is not easy to hear. I always tell parents that if it is going off and we do not come in to turn the call light on because we may not hear it.

I'm on another forum for moms, somebody posted a thread called "What they DO NOT tell you about labor and delivery that you wish they would have" After reading several comments (some about nazi nurses..) I have to wonder from a nurses point of view what you wish your patients knew before coming in (not just L/D but everywhere) My number one is: Yes you just had surgery, yes you will have pain, no you cannot lay in bed until it goes away you need to get up and move. anyone else?

Last week I had to call the dr twice on the same pt, first time bp's 240/110 and c/o headache. Dr says "I'm not really worried about that" what?! so I used my nursing judgement and gave his BP meds early!! Brought it down. Later that night (2230) the pt calls that he feels funny and wanted us to check his blood sugar, ok 41, call the dr and the order was "just give him some orange juice and recheck him in 30 minutes" thats it??? why didn't I think of that :smackingf (and I wrote it as an order) anyway I ended up giving the pt some oj, grahm crackers, some milk and documented everything, this pt was not his he was the on call that night and does as little as he can. I'm sure his primary physican hit the roof when he saw what was ordered. He's lucky I didn't see him in the parking lot after work :angryfire.

I feel the same, it always upsets me when we get a kid in with resp distress, known asthma and the parents come in reeking of cigarette smoke and can't fiqure out why their child can't breathe (huge pet peeve!!) Also this thread reminds me of the pt I think 12 came in with spontanous pneumothorax, chest tube put in in ER, dr did consious sedation because of age, as the pt starts becoming more alert says to mom "did it hurt, cause I thought it would hurt, but I think maybe it was a dream and it didn't really hurt" mom replies "oh yes honey it hurt really bad" and just kept egging it on. We had a heck of a time with the pt, turns out couldn't tolerate half the meds we tried for pain and everytime we would try something new mom would start asking are you ok honey, are you breathing ok, is your throat closing up (nothing caused any resp problems, all reactions were vomiting or hives) I know mom was worried and scared but I think the kid would have done better if mom would have calmed down (dr offered us prn ativan for mom!!) Maybe we need rule for parents if your child is sick... 1. If you bring your child for medical attention, do not freak out when we try to give it to them!

In the peds unit that I work, we weigh it and chart it under urine/stool or mixed diaper so the docs know it was both.

Where I work the RN is partnered with either a LPN or CNA and on evening shift we usually have about 6 patients per team, of course sometimes 7 or 8 depending on the amount of admissions and who the charge nurse is, (one will not put anyone over 7 and will take admissions herself)

I just read this article and thought it was great, what do you think? http://www.desmoinesregister.com/apps/pbcs.dll/article?AID=/20060516/LIFE02/605160389&SearchID=73244932162411

My husband was the only one in the delivery room, (the hospital only allows 2 anyway). Most of the rest of the family waited it out in the waiting room. My mother-in-law couldn't be there because she had to go to BINGO that night (she is a bingoaholic!) Giving birth is not a spectator sport, only people that make you feel comfortable should be there.

The facility I work at just changed how we do care plans due to being cited for each pt only having one care plan for the primary diagnosis. Now they are all on a computerized flow chart, you go down to whatever your nursing diagnosis is and click on it then you can put your goal, if you are the one starting that plan or whatever interventions you have done. Not only that there is supposed to be a nursing diagnosis for every problem the pt has, even if that is a chronic problem that has nothing to do with their admission. For example a pt having joint replacement surgery would have: Acute Pain, Risk for infection, Impaired physical mobility, knowledge defecit, impaired tissue perfusion (DVT), if they have O2 and a cath, inneffective breathing patterns, or inneffective airway clearance and urinary elimination impaired. This is just for the surgery if they have a hx of anything else add all those too. Then once a day a careplan summary is to be written to let the rest of the shifts know what has been happening and what needs to be done. Of course most of this stuff is in our regular flowchart so we do a lot of doublecharting. If you chart something on the flowchart like a pain assessment you have to go into the careplan chart and put see flowchart: pain. As you can imagine this new system is very time consuming because we are supposed to look into their health history for anything that might need a care plan.

I am also a new grad, June this year. I worked in the same hospital I am at now as an LPN for 2 years, so making the transition has been a little easier,(note easier not easy!!) as I am already familar with the staff and the routine. I also have a great group of co-workers that are always ready to lend a hand or answer a question when I have one, (which is frequently). But there are the incredibly overwhelming shifts, but you have to realize you are not supernurse, take a deep breath and just do the best that you can, and do not be afraid to ask for help when you need it. Good luck to you!

In the hospital that I work at, one of the questions in the intial interview is what do you prefer to be called, so right away you know how to address them, then this information gets passed on to the next shift.

At the facilty I work at we have taped reports, but they have just instituted a policy that only RN's go to report which takes 30-45min then they have to find time to give report to the LPN they are working with. The idea is that the LPN can go ahead and start checking vitals and things to save time, but when its busy half the shift is over before you actually get report. The other problem is that pts expect their nurses to know something about them so there is a lot of "I don't know I will have to go find out" when a pt asks a question.