Joycean

Our Telemetry unit has a 4:1 ratio. Patient on Cardizem must be monitored continuously and transported with an ACLS certified RN. We take Insulin drips that require no more that every 2 hour blood sugar checks.

You have great insight into what needs to be done to make a good team. Anyone in a supervisor role should have both managerial and leadership skills. I believe the leadership is more important, esp. in a Magnet envirenment. Having the frontline caregivers active in what happens in the processes and protocols involved in pateint care makes a happier, more productive team. People skills are the most difficult to learn and not everyone can do it. Along with communication is collaboration. This combination will make any team tops. I have been an Assistant Director for almost a year and the unit I took over never had involvement in what went on in the unit, much less the hospital. As a staff nurse on a sister unit in the same service I saw thought this was because there was no incentive. The fact is the opportunity was not there. I have seen a tremendous change over the past year with Shared Leadership that is hospital wide. What you need to do is research shared governance and shared leasership. This is part of being a Magnet hospital. If you voice your concerns in a factual manner, with supportive data, administration will be more apt to listen. Something else to look for is a program called First Touch which has to do with patient satisfaction. The initaition of this program was developed and initiated by bedside nurses. It is a way to get involvement and get the ears and eyes of administration. Good luck!

I took a position as Tele AD in January and it sounds like the duties are very similar. We do staffing, scheduling (self scheduling by staff is in progress), hiring, mentoring, discipline and evaluations. Patient rounding and conflict resolution (we do have help from our Service Excellence Dept.) with patients, families and physicians. On occation we staff the units. Then there's compliance monitoring, some staff education. We are expected to be the clinical experts for the service, so we attend all training reqiured by the staff. I don't think I will go on...it's my day off!

We are not a teaching hospital. There are 3 Tele units totaling 88 beds. The ratio is 4:1 24/7. We have 3 nursing assistants on days (12 hr shifts) and 2 on nights, monitor tech 24/7 and health unit sectretary from 7:00AM to 11PM on each unit. No vent patients and we do pull sheaths as well as med gtts.

Isn't that the worst. No dignity in dying with that situation. I hate to have a DNR dying patient on the monitor! That's almost as bad as a CCU patient with a monitor at bedside and the family focus is on the monitor. YUK

We take lido, heparin, insulin (stable with bg q2 hrs), pronestyl, amiodarone, corlopam, natracor, bicarb, cardiazem, dopamine, dobutamine, integrilin, reopro, vassopressin, no nitro...yet. I may have missed some. We do have some patients with elevated cardiac enzymes, usually trending down. venous & arterial sheaths (short term). Post-op carotid endaterectomy, post CCU cardiac surgery, No hemodynamic monitoring. And of course Med/Surg overflow, if we have beds.:roll

Wow, I haven't worn my cap in years! I wore it, along with a classmate the first shift after receiving our licence. After that we would wear them every year for Nurses Day. They are difficult to work in, just not used to something high on top of my head. I need to do a presentation and interview for a Compass Award next month and plan to wear it as part of the presentation. I have always wanted a cape...anyone know where I can find one?

I ran a poll on this subject a few months back and 65% of the responding nurses do double checks on insulin. Our hospital policy states double check orders and dosing when drawing up any type of insulin when dose is 20 units or greater. This is evidenced based by research done by our pharmacy dept.

I stopped watching The View long ago because of unflattering comments made about another group of people. Specifically, Christians, and not in a joking manner. I feel they tend to generalize instead of dealing with individuals. I only wish I could have seen this episode so I could respond. It has taken lots of years to develop the profession of nursing to the level it is now. It takes very little negative publicity to loose the respect of the public.

I worked with a doc that was sooooo bad...he couldn't read it either when asked to clarify! He would just cross it out. He started typing out his orders. Then he bought a computer program that typed in his hand writing. LOL