cpnegrad07

This is what we use: http://books.google.com/books?id=AoqqhULQaukC&pg=PA158&lpg=PA158&dq=medicus+patient+acuity&source=bl&ots=ZGWMdBpVoN&sig=MRgFgCWe890P92q59Xsh-KbnO4o&hl=en&ei=PUKwTdqUEciutwfessCKDA&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCAQ6AEwAA#v=onepage&q=medicus%20patient%20acuity&f=false I think it would work every day if 1. the correct data is entered, which means having every staff member know what the various categories mean, and 2. all the correct staffing positions are filled (ie. RN for RN, LPN for LPN, etc) We get short-staffed when someone calls off sick and their position is either not filled or filled at a lower level.

Nope. We know what they are (just took a test on that) and can get to a number if i have to, but the only input we are asked for is bowel/bladder. The other disciplines do their area of expertise. Some of the staff (PT/OT/RT) use numbers when describing, some use the words. I think this was discussed in 2010 here; you might want to search.

It is well-known and accepted that new grads don't know how to be nurses--that we are expected to train you. (now, i think that is what school's should do, but what do i know?) So, don't get overly-wrought about not knowing a lot and having a lot of basic questions. As a trainer, i would worry if you didn't have basic questions. But i am not a trainer; i was new a little over 3 years ago and am still learning. I carry a small notebook in my pocket to jot on, anything from the new unit phone numbers, door codes, employee names, to questions i want to ask or look up later. Learn what stuff you need in your pockets and get it before the shift to save yourself time later. Carry a clipboard because you will find a lot of info that you need to keep with you. Finally, IT WILL GET BETTER, but there will be bad times ahead. Know that and don't think you are the only one.

we threatened to start this about 8 months ago and a compromise was reached (informally). we now do shift change report at the chart box, which i like a lot more than the nurse-lounge report . we have the chart (usually), the kardex, and the actual pt a few steps away. I find this helps jog the memory when needed and is a step closer to actually being with the pt/family. having said that, i do not look forward to full-on bedside report. i have too much real information about real problems that i don't want to tiptoe around in front of the pt/family. and the amt of time needed to include pt/family will be impossible with the current 30 min limit (that is about 5 min per pt). i'm sure that after the pt/family go thru this 6 times, they will tune us out and it would be faster, but the first week of every pt/family's admission will be an impossibly long report.

We have the pt's nurse-for-the-day do the RN part because she is more likely to know something about the pt than the mgr (tho the nurse may have the pt for the first time that day! But she has a 3-day report already filled out from the day before giving her some info). We meet in a board room with MD, social, PT, OT, psych, RN, pt and fam (every other meeting, and without them as an interval meeting). On the downside, we schedule 20 minutes and hold to it, so it can be rushed, esp for the first meeting when the civilians are trying to catch up with the process and the lingo). And we have a speaker phone for any fam who can't make it. We try to speak to the pt, not about the pt. I wish we would all use common language to describe the FIM status, but we don't. I wish we had more time, but we don't--of course, i (as a nurse) am not in charge of that, like everything else.

Glad i don't have to do that along with all the other stuff. We send them for a venous doppler: end of story. I do measure their calves to get the right size TEDs, and i have never seen anyone else do that.

Sometimes God turns on the SitcomNurse channel. Its like Comedy Central for Her. Sorry, i don't have the answers you want; i just want to say i Love your tag, or whatever you call it.

remember to use the lifting tools they have, like the seralift and the maxilift--real back and patient savers. they take a little more time to set up but are worth it. amen.. baths and bowel programs. this is when we do ours. we have (mostly) great people who are happy to help if i ask. but i found the medsurg floor to have the same.(generally). i think the families are easier, because you get to know them and they, you. that is one thing i definitely like about rehab--getting to know and visit with the pt and family and to be able to help them navigate this thing. we all need to rant; what would nursing be without it? well, it could be better, for one, but don't get me started.

I'm not ignoring you; i'm waiting to see what other people write. Since they haven't, here is what we do: I'm an RN and we follow the program prescribed by the doctors. Usually it is PVR after each void and cath if >125 or so. This goes on for a week or more and, when the pt seems to be emptying each time, the PVR just gets ignored. In other cases, the order is straight cath (IC) every 4 or 6 hours. Or it might be 'freq. toileting', which means every 2 hours. What i want to know is what problem are you having with the therapists not buying in? Also, i would like to see us have meetings or gatherings with the OT/PT/RT people to get their perspective and education. We never have and i really don't know where they are coming from on these and other issues. But there is definitely a divide between us, kind of a 'necessary evil' attitude both ways.

Ditto, Commuter. Everything you said about Med-Surg. It is bad enuf working there; imagine being the patient?! I remind myself of that whenever something bad happens on Rehab. Our unit ain't perfect, but it is lot better than Med-Surg.

Thanks for the update!!

" that's great for continuity of care " ---good point.

I would say it would not be an "easy" pick up, but i'm sure one could do it within a few months if someone helps you. ( after all, i did :)). Your 'med-surg' and 'home health' should come in handy--'short stay': not so much. And, of course, you will have to overcome the outsider-in-charge charge, which is true. Good luck. Why did you take it?

I never applied as an extern, but i applied at that hospital 2 or 3 times and never heard from them--i even tried to part-time there from their sister hospital (st francis) where i was already employed--never heard from them. These places cry about needing nurses and then do this??!! doesn't make sense. My suggestion is keep at their door. I didn't do that; maybe that is what it takes. Or know someone.

CAMC has an active and energetic extern program. I didn't know much about it and applied in Feb or March. I got in in May, along with 100 other nursing students and new grads just after they graduated. Paid $9/hr and i did nurses' aide work. HOWEVER, they really value you because they know you will be looking for a job when you graduate, hopefully a job on the unit that you extern on. So they treat you well, show you and teach you a lot. Call them up and ask for the details. You may be able to get in now. Basically, you choose a unit (like Renal, Ortho, ED---whatever you think you are interested in. You interview with your top 5 choices and the manager chooses among the applicants. But there is a very good chance that you will get on somewhere, even if not at your first choice.