JaredCNA

For my own reference information, can you find this policy online for me? I'm totally not comfortable with doing it, as I said earlier. But if need be, and it is acceptable in the eyes of both the BON and the facility, then I guess I would have to do it?

Pagandeva, I understand what you are saying. I was confused because I know that the nurse who delegates a task or asks a CNA to assist with a task is held ultimately responsible for the outcome and accepts responsibility since we are, in a sense, acting under their license. There's a gray area, and I will probably be better off asking the BON if it is okay, then checking facility policy. I am not very comfortable with doing it, even if it is allowed, because I do not know anything about discrepancies or how to resolve them, or even if they are resolved properly against the system count. However, if it is allowed by the BON and my facility, I also don't feel comfortable refusing a task that is delegated to me.

It has always been my understanding that narc counts are done by two RN's or an RN and an LVN in the hospital setting. Of course, this may be only my understanding because I've never seen it done differently. At 0400 the charge nurse told me to help her count the Omnicell. She's been a nurse for 29 years and worked at this particular hospital for the past 17, so I assumed she was aware of policies and what-not. However, she asked me because the other nurses were busy with admits, so when one of them showed up at the desk, she told me nevermind and had one of them do it. Does the policy on narc counts vary from facility-to-facility, or is there an organization or policy (Nurse Practice Act or state BON, for example)? If it is a facility policy, then I can find it. But I'm not comfortable counting with a nurse if there are state policies against or if it is a violation of the nurse practice act.

I used a tape recorder as well. It really helped out.

In my profile, there is a link to my blog. I have some other RT bloggers listed on the right-hand side of my page. If you read their blogs you can learn a lot about RT.

Last night I moved a very combative (and very confused) pt up in bed. He apparently thought we jerked him up in bed really hard, and he got in my face and told me that next time he would shake a salt shaker in my face if I wasn't more gentle. :uhoh21: :chuckle

I'm assuming this was directed toward me, because the two posts above your post don't talk about grades. I'm not sure what you are trying to say, so I'll just leave it alone. If I feel compelled to talk about my grades on the internet, I'll do so. It's not like it violates TOS or anything.

No, no one saw him go in there. He didn't have a friend working on the floor. It's still confusing to me. The only thing I could think is that someone was trying to start an IV on him and left the supplies in there when they couldn't get it. They probably called ER or the supervisor to start it and they never came. I don't know.

Oh, I'm reluctant to share this one, but... Never prostitute yourself out to homeless folks, and definitely don't let them stick their member in your colostomy. No matter how I try to forget that one...

Exactly. Like the patient we had S/P Shoulder Hemiarthoplasty, getting 3mg Dilaudid (I wanna say q2h), with an On-Q Pump, who I found shooting up in the bathroom... We searched his room and he had about four of our IV start kits, and three 20g IV caths in his suitcase...from our clean utility room. Somehow he figured out the code to get into our supply room. It's very sad.

Never let your s/o place a cucumber in your rectum during sex. I kid you not. We once got a post-op cucumber removal surgery at 3am. A 44-year-old male whose wife said she "did it to him all the time with no problems."

All I have left to do is the final exam, which is this Monday. It's 100 questions (worth a point each) and all I need is an 86 to get an "A". Oh, the suspense...

Also, here are some additional certifications for respiratory therapists: Neonatal/Pediatric Specialist (NPS). Certified in Asthma Education (AE-C) Polysomnography Certified (RPSGT) Respiratory Care Case Management (CCM); Not exclusive to RTs Registered Pulmonary Function Technologist (RPFT) Cardiac Pulmonary Function Technologist (CPFT) Certified Tobacco Cessation Treatment Specialist (CTCTS); Not exclusive to RTs

What does "RN, APR" mean? Is this homologous (sorry, I've got A&P on my brain :chuckle) with "APRN" or "APRN-BC"? Does anyone know if there are any additional certifications for CNA's?

I wonder how this scope compares to the Littmann Cardio III or Master Cardiology. Does anyone know?

I'm highly considering this stethoscope from ADC. It's the double-sided cardiology stethoscope. It actually seems like the specifications listed are better than the Littmann Cardio III. Are you familiar with this scope?

Unfortunately, I can't say that this will change any time soon. The (elderly) patients will usually request you to move them up in bed, etc. because they are accustomed to the male being the one who should do the physical labor. Your co-workers will ask you just because. I don't mind it, really.

Thanks everyone for all the replies. I've only been working in the nursing profession for about 2 years now, so I'm not used to seeing this sort of thing. Of course, I work orthopedics and most of the patients are on high doses of narcs which would interact with the EtOH, so that is probably why. Last night, I was floated to the cardiac floor and they had a med/surg patient in with FUO, and in fact, he had an order for "Pt's beer of choice, 12 oz can TID PRN, to be supplied by family for s/sx of DT's." I was pulling all of the expired meds out of the med room fridge and I noticed a six-pack of Sam Adams with the patient's label on it. It was the strangest thing. Like I said, I didn't really mean to call this an "ethical issue." That is my mistake. I agree that it is a good thing because I've seen a pt or two die from DT's and others who already seemed like they were dead as they lay there. It is a horrible thing. I think docs should order it more often.

Thanks. I was looking at the Littmann Cardio III vs Master Cardiology mainly d/t price and because as a student RT I'm sure I won't need a master cardiology. By the way, does anyone know of a cheaper alternative cardiology scope that works just as good as the Littmann? I was looking at the DRG stethoscopes because the acoustics are made by Bose and their basic model is like $69 if I remember correctly.

I probably shouldn't have tagged this an "Ethical Issue." I'm not a nurse, but I know that if I was one, and the doctor ordered ETOH to prevent DT's, I'd be required to carry out the order based on the nurse practice act.

Our nurses still write out verbal orders. They have to put V.O. (nurse's name and credentials)/ (doctor giving order)/ VORB (nurse's name and credentials.) Example: VO John Doe, RN/ Dr Smith/ VORB John Doe RN. The addition of VORB is just to indicate the verbal order is read back to the physician. It is the same with telephone orders, except it is TO instead of VO.

I totally agree with the above poster. DT's are a horrible thing. However, if a patient has a history of ETOH abuse and is used to drinking say, 24 beers a day, won't 1 beer at HS, or before meals just make them crave more and become more anxious?

I hate when a patient sees the outline of my pack and asks me if they can bum one off of me. I'd never allow it, although I don't know that we have a policy against it. Well...I take that back. I don't mind giving one cigarette to a psych patient that I know is a smoker. It helps them calm down sometimes. I've never went downstairs with a patient who wants to smoke. Our policy is that if a patient wants to smoke, they should be physically able to take themselves downstairs. Out of curiosity though, would you smoke in front of a patient you took downstairs to smoke? I don't think I would for some reason.

Crocs are my shoe of choice. The ones with holes in them are better because they allow your feet to "breathe" but most facilities don't let their staff wear them d/t infection control issues such as if a needle was to fall through the hole in your shoe or something. If I wear tennis shoes, then any type of jogging or cross-training shoe works. I love ADIDAS and New Balance, they seem to be most comfortable. Nikes always make my feet hurt.

I'd like to say thanks to the OP for the kind words. They are much appreciated. We get a lot of new nurses, fresh out of school, that think they can't learn a damn thing from their CNA's. Trust me, most of them learn really quick though. :-D