domsmom

1. As I coordinate care for my patients, I involve whatever discipline is needed to meet my patient's needs. The wound care nurse, social worker, ostomy nurse, pharmacist, dietician, physical therapists, doctors, speech therapist and respiratory therapist are team members I engage regularly. 2. I share the problem and either suggest how they can assist me or ask for advice on how to prevent complications. 3. How do you see care applied within your particular nursing practice situation? 4. Describe the roles of different nurses (e.g., clinical nurse specialist, nurse executive, bedside nurse) in promoting safe and quality outcomes of care for diverse populations. The CNS is an expert and thus knows the best care practice and promotes evidence based practice.The CNS acts as an educator, writes policies and translates research findings to bedside practice, which is taught to the staff nurse. The nrse executive reinforces what is stated by the CNS by also writing policies and enforcing the policy. 5. Nurse-sensitive indicators are monitored thru chart review, walking rounds, secret shoppers and interviews with patients. 6. Nurses facilitate patient-entered care through nursing bedside rounds, interdisciplinary rounds, Schwartz rounds and regular family meetings. 7. I cared for a paranoid schizophrenic with lung ca during the last 4 weeks of life. We held biweekly meetings with his family and all disciplines collaborated to promote his dignityand keep him comfortable and safe. 8. Interdisciplinary bedside rounding has decreased call light use, improved collaboration and decreased length of stay. 12. APNs are NPs and CNS who are master's prepared nurses. A CNS is a clinical expert for a specific patient population,answers consults and is a clinical expert and in my facility, runs a clinic. The APN instructs the staff nurse and the CNL on best care protocol for a clinical problem. Depending on the state inwhich they practice, the APN has prescritive powers. The CNL is a master's prepared nurse who focus is care coordination, patient safety and quality of care. The CNL will teach staff nurses and patients on best practice protocol for a clinical problem or seek the expert who teach the staff. The CNL collaborates with the social worker to guide the patient/family as they transition to the next level of care while coaching staff nurses to implement evidence based practice and improve quality of care. The CNL also works with the nurse manager to develop competencies for the microsystem and develop policies that promote patient safey and quality of care.

I attended Union County College and enjoyed my experience. There are classes during day, evening and weekend.

Usually patients come from PACU. Recently one of patients on the surgical floor suffered a heart attack during the immediate postop period. How often do you assess patients/do vital signs during the first 24 hours post op? We are considering changing unit policy.

I am a CNL at a VA facility and many CNLs are employed throughout the U.S. I do not advocate trying to find a job as a CNL without staff nursing experience. The CNL is an advanced generalist at the bedside. The role improves quality of care and patient safety by promoting evienced-based practice and staff nurses use us as clinical receptors. It's difficult to improve nursing care and act as a clinical resource without a substantial amount of nursing experience.

I was recently transferred to an acute surgical unit that cares for post surgical patients that has no unit protocol. What is the standard of care during the first 24-48 hours post op? Is it appropriate for a LPN to care for the post op patient during the first 8 hours?

You will encounter a lot of wounds in a rehab facility. I would be more interested in opportunity for advancement and professional growth.

This sounds like a case for the ethics committee. If there's no written DNR order or an advance directive, the client would be a full code. The doctor should listen to his client and write the DNR order.