nservice

I'm confused. Are you guys saying you don't want to use critical thinking skills to try and come to an answer? Critical thinking is so very important as a nurse and a hard skill to master. I deal with orientees almost daily and use this same appro...

As an educator, I can't stand the story tellers either. I welcome questions / comments, but it's simply not necessary to have a story about every topic I cover. I always announce before each class that I've reserved the room for an extra 30 minutes...

I think the majority of med errors happen because someone failed to follow policy and procedure. Sure, you didn't follow P&P because you were busy, over-worked, sleepy, stressed...etc. But the bottom line is, someone took a short-cut and made a...

It is probably in your hospital P&P to fill out an incident report for medications missed and notify the MD. I would fill out an incident report describing exactly what happened. The day shift nurse is at fault. Medications should only be char...

I've only had one person attempt to bully me. I was a traveler at the time and had been at this facility for a few months. This nurse was in charge and always gave me the sickest patients...usualy DNR's circling the drain. I was on a first name ba...

I'm sorry your daughter is having to go through this...you too. The whole area probably had deep tissue damage that you just couldn't see until everything opened up. The good news is now that it's open, it can be treated. Make sure you ask for hom...

WOW!! I'm sorry your friend is having a hard time. Yes nursing school and clinical are learning experiences, but some things have to be common sense. If a student is lacking in at least common sense, they have to be failed for the safety of the pat...

Speaking of defibing babies... I got a request from the newborn nursery a few weeks ago requesting an inservice on how to work the defibrilator. It seems they had to cardiovert and had quite a time figuring things out. Since my own child will be de...

I would also take that order to mean 1000ml should be infused over 125 cc/hr. If it were continuous, it would have just said NS @ 125 cc/hr. Maybe it is a regional thing. Better be careful with travelers, because they are going to read the order as...

I use the CURE approach when teaching time management / prioritization. C = Critical U = Urgent R = Routine E = Extras Of course the key is to constantly re-evaluate. Often times, new graduates are very task oriented and their stress level rises whe...

The thing about menial tasks is, they do require tons of critical thinking. You're not just cleaning poop. This patient has been hospitalized. Do they have diarrhea. Did they contract C - diff in the hospital. Are they constipated? Could they be...

OK, so I'm the only wierdo. I don't play with people's hair, but I'd let (almost) anyone play with mine. I love it! If I could only get them to rub my feet!!

This is a great learning experience! It's also a great opportunity for patient teaching. Many diabetics do not understand sick day management for their diabetes. If they are sick and not eating, they hold their diabetic meds. The stress/illness c...

What a hard position to be in. My instinct is to hold fluids and give lasix. Patient probably needed pressors instead of more fluid. Could the increased intrathoraxic pressure be causing the low b/p or was the sepsis causing the low b/p. It's har...

I thought the purpose of the una boot was to decrease edema in order for the wounds to heal. If it is wrapped on two separate portions of the leg, the edema will be trapped between the wrapped areas. I have used dressings directly to the wound site...

I don't think this doc is just a jerk. I think he has some big mental health issues that will only get worse.

Ouch! On the bright side, I am very pregnant (almost 8 months). When people touch my stomach and ask when the baby is due, I act offended and tell them I'm not pregnant. The horrified look on their face is priceless. Then I just die laughing. Ok...

Once when my daughter was a year old, we were flying to see my mom. It takes 12 hours with flights and wait times. On the last leg of our trip, I was on edge and about to lose it. I was literally on the verge of child abuse. I'll never forget the...

When I was in my last semester (10 years ago) I was precepting in CCU. We couldn't find a pedal pulse on one of the patients. The nurse from Cath lab was asked to bring a doppler to try and find a pulse. I was watching and since he couldn't find a...

When I worked home health, all of the RN's were chemo certified and we did hang chemo in the home. We did lots of IV's. Most of the time the caregiver was taught to hang the IV's and the RN would only have to come weekly for PICC line maintenance. ...

Why in the world would any hospital think that 4 weeks is enough orientation? You need time to adjust and 4 weeks is not enough. In my experience, Nurses who are returning to acute care usually need longer orientation. Especially those who have be...

In my opinion many of the JCAHO directives are very useful to patient care. The problem is that most of the directives / deficits are "Physician problems". Since administration couldn't possibly make the physicians accountable, they try to make the...

Our hospital will soon be moving the hall patients up to the floor halls in order to decongest the ER. This is supposed to be in emergencies only. My guess is that it will be the norm.

I can only imagine how disappointed you feel. I'm sorry this happened. If you are looking for classes to fill a semester, I would suggest a pharmacy class. You can never learn too much about that. Another class I wish I had taken is Spanish. It'...

Man, this is a great thread. I just thought I knew all about this subject. Thanks CoreO!