dekatn

I hope I'm not sounding too stupid, I just wish the people that come up with this crap had to follow their own rules for just one week and see how they would do it in the real world and not in some stupid office behind a desk w/o a million interuptions and trying to take care of multiple pt and tasks at the same time. Sorry for the vent, but this is very frustrating to me. But, we do team nursing, one nurse does po meds, one nurse does iv meds for all the pt, that's books with all the mars and meds listed that a pt gets. space is very limited on the pages and documenting this stuff has just become overwhelming. It is up to the med nurse to document the pain and meds given and then the results. Am I making any sense or do I sound like a blubbering idiot, lol. I just got off a 12 hr shift and we had to attend a meeting on this before we left this am. Can you tell I'm stretched to the limit. Feel like a rubber band, lol. Thanks to you all for your input, I think I just needed to vent and think this thing through some more!!! Nursing, gotta love it!!

Darn, I wish we had computerized charting, I think it would make things a lot easier. We are just trying to come up with a simple yet efficient way to keep up with the med, the rating and the follow up. It would be easier if we could have everything on one page in the mar, maybe have the med listed at the top, then underneath have a place for date, time and to rate initial pain, check med given, and 3min later have follow up rating all in one place and only have to chart it one time. Something that we could use for the duration of hosp. stay.

I need some help, as everybody knows pain is the big thing now. How do some of you document and keep tabs on the level of pain your pt. is experiencing, pain med given, and then go back and document follow up pain relief. Do you have a certain form, mar or whatever to help keep up with all this? We are trying to come up with a workable and user friendly solution to document level of pain, med given, follow up pain and all the other stuff that is required now days with out taking so much time to go to different pages to document everything. If anybody has a good form or solution that you use at your hospital, any input or advice would be appreciated.

What is a phlebomsity?

Oh no, I've been found out!!!!

Since I work nights I have to disagree, I don't consider myself or my coworkers weak in any shape form or fashion. I think if you work nights, especially at a small hospital like I am in, you have to be on top of things, because you don't have the backup that days has. We have to be prepared for anything and are each others backup, until somebody can be called in if needed. We have to have excellent assessment skills and know our pt. baselines in order to detect changes that might require calling the doc at ungodly hours of the night. We are responsible for our pt. for 12, sometimes VERY long hours w/o the benefit of extra help that you may have on days. If we need something ASAP we have to call somebody in, which in many cases depending on the service, can be up to an hour. So, no, I don't think night shift nurses are weaker, I'm not saying we are better, I'm just saying, we have to have all our poop in a pile before calling a doc in the middle of the night and getting treated like an idiot. Some docs may think we are weaker because we refuse to do their job for them while they get a good nights sleep.

Sounds like you are in a nursing home, try not to stress, just do things by the book. You can put all the pt pills in one cup, if it is the right time for them. Liquids go in separate cups. If it is a tube feed, you have to push meds separate and flush between each one. The DON or adm is usually the one to pick which pt. the state follows or it always was in my nh. Make sure the pt is in their room and not in the hallway when you give the meds. Check the ID. Check pulse when giving dig. If I think of anything else I will let you know.

I left LTC after about 4 yrs., applied at a local hospital and got hired on the spot, that was 3 yrs ago, I haven't looked back. My worst night at the hospital is still like a vacation after working LTC. That's just my experience. I never say never, but I hope I never have to go back to work at a nursing home. Just from reading the posts and some of the pts. we get at the hospital, things aren't getting any better in LTC. I don't blame the staff, it's the politics that is involved that makes everything so unbearable. Keep looking, there is something out there for you. And God bless all LTC nurses and aides, there is a special place in heaven for all of you that are able to hang in there for all those underserved pts. that really need you.

I am so sorry for your loss, my thoughts and prayers will be with you during this difficult time.

Hey all, I need some input. I had triple bypass in 1999, just found out I am again facing another cabg. I have worked practically all of my life and have done pretty good since my last surgery, my upper body strength isn't as good as it was, but my question is: have any of you gone back to work and been able to function o.k. after having a second cabg? I love what I do, med surg 12h shifts 7a to 7p, but it can be very taxing at times. I'm worried that I won't be able to go back to work afterwards. I still need about 10 more yrs to retire and hate to give it up. I know that the ultimate decision is mine and my doctor, but if any of you have been through this I would appreciate some feed back. Thanks

I love the Gold Bond ultimate healing with aloe, can use it during the shift, non greasy. Has vitamin A,C and E in it.

I am so sorry for what you are going through. Your mom will always be with you in your heart, just know that she would be sooooo proud of you.

This is just about the biggest waste of time and money I have ever seen. If you told the person about the medication why in the world didn't they just go ahead and record it and send it in with the test. Good grief. Life has really gotten difficult to manuever. I used to administer drug tests to potential employees, if they were taking anything that would make the test positive, we would copy it and send the copy in with the test.

Sounds to me like you are a valued employee and they are trying to keep you. Knowing you have management background they may have felt you would have been an asset in that position. JMHO. Of course, it would be an asset for them, but there may have been more perks with the position, but, then again, probably more headaches also. Too, it really blows their minds when someone on nights is offered a day position and turns it down, it's hard for some to beleive that some of us really do prefer nights to days.

In my opinion, if the pt. c/o chest pain, elevated BP and had appt. with cardio, the cardio should have seen this pt., enzymes along with ekg should have been stat to r/o. I would definitely discuss this with my director. What happened with the pt.? If you decided that it was possible MI, do you call 911 or are you located in a hospital? Just curious. It just seems odd since the pt. already had the appt. with cardio.

Ivanabee, We had a husband and wife that was the same way, the husband suffered a major MI and she a major OD. Thankfully, both survived and like you, we haven't seen them back.

I work in small hospital too, we have our frequent flyers. Like the above poster, most of ours are chest pain, they know we can't refuse a chest pain and they are given the "good stuff", at least until they rule out. I know there is always that ONE chance that they are going to have something really serious going on, but it's almost like the little boy that cried wolf, you see these people the week before the checks come out EVERY MONTH. Don't get me wrong, we treat them the same as everybody else, I would never mistreat a pt. on purpose and truth be known, it just isn't worth risking my job and license. The M.D. are the ones that write the orders not me. It's just really frustrating, when you have been a nurse for many years your gut can tell you things that a test never will!!!!

When I worked psych these meds were widely used for psychosis and were effective for the most part. You could tell when a pt was non compliant with use. As for the nursing home pt., it was my experience that these meds were prescribed a lot of the time for pt. that weren't clinically psychotic. These people had dementias, a lot of them, in my opinion, acted out due to losing their autonomy, they had no families or friends left. They are put on a schedule according to the nursing home and bathed, fed etc. according to somebody elses' rules, not their own. When they try to resist they are considered "behavior problems" thus the meds are started. There is the chance that giving them these types of meds for the wrong reasons will cause dangerous SE and I am totally against it. I feel a pt. must have a hx of schizophrenia or some type of psychotic disorder in order for these meds to be prescribed. Just because a pt. demonstrates behavior problems isn't reason enough to be prescibed anitpsychotic medications. But, what do I know, "I'm just a nurse".

Congratulations!!!!!!!!!

Best of luck to you and keep us posted. I would bet this doc is still employed. I worked with a nurse one time that told a family they should sue the doc, she was out of a job within the week.

Hi and welcome to all nurses. West Tennesse here, I work in hospital.

West Tennessee. Welcome to the site.

Agree with Duckman, I work 3 off 4. Works for me. This is a neat thread, it's interesting to hear how others deal with the noc shift. We all have things that work for us. I basically just reverse from what I would normally do if working days.

I too worked in a NH for many yrs., then switched and went to a hospital. I love working in the hospital, but you would be surprised at the times you will use the same skills you learned in the NH. A large number of our pt are geriatric and some of the same skills have come in really handy. Since you are in school, personally, I would take the less stressful route for now.

Good luck!!!!!