Kimburly

I work in SC; a hire and FIRE at will state. Unfortunately a mass revolt will not do us any good in a non-unionized environment. So I do my best to fit in the majority of the script when admitting a new patient; meanwhile they are usually looking around for the tv remote, talking to their family or asking when they'll get to eat. One of my *favorite* parts of the survey we often "fail" is did your nurse provide you with reasons to call your doctor upon discharge? I do not know how we get negative responses on this when part of our pre-printed discharge includes reasons to call doctor after discharge and I have never seen a nurse not review this on discharge. Ugh, don't get me started. But I do like the town crier idea! (Especially since I am originally from Massachusetts!)

So thanks to Studor, who I am sure is making buttloads of money off their "great ideas" we are expected to AIDET and hourly round to scripts. Now we were already introducing ourselves to our patients and families and checking on them hourly, but that wasn't enough to make them score all 9s and 10s on our surveys to such questions as "When you called for help did you get help AS SOON AS YOU WANTED IT" talk about a set up for failure, of course not, they want help before they even ask for it! So now I have to say Hello my name is __________ and I will be your nurse for the next 12 hours. I have been a nurse for ___years and I have been in this department for ______years, so I have seen over 100 or 1000 or 10 patients with your diagnosis. I am also a certified whatever nurse. I or one of my colleagues will be ROUNDING on you hourly. During those rounds we will be asseseeing the 5 P's (explain the P's) and although I may not speak to you about each of these P's every time I am assessing them. I will be discussing this P and that P with you each time since that is a need specific to you. When I round hourly I would like to meet all of your needs at this time; so if there is anything you need please ask at that time. If you have a need that CANNOT wait until the next hourly round then please use your calllight. (But we are to "gently reeducate" them if they call in between rounds for something that could wait - ya that'll make them happy!) It is our goal to ALWAYS provide you with EXCELLENT care. If at any time you feel you are not receiveing EXCELLENT CARE please speak up so that we can better provide you with EXCELLENT CARE. Is there anything else I can do for you while I am here; I HAVE THE TIME? (even though they just called me over the intercom to tell me that there is a doc on the phone, another patient needs pain med and there is clearly a commotion in the hall behind me). Oh and during bedside reporting we must introduce so and so your night nurse who has been a nurse for 1 year or 100 years and has no experience here as it is her first night or she has been here for 50 years and either way she is a great nurse who will provide you with EXCELLENT CARE! Just let us provide excellent care an not talk about it! And don't expect us to score 9 and 10 or ALWAYS on a survey with questions that are worded to make us fail! Sorry so long, but now imaging actually saying that to every patient you care for today. Oh yeah and I also need to assess them, give their meds, provide their treatments, draw their labs, order their meal when they don't like the first one, call the doc because they want to know when they are being discharged, etc etc etc!

I have worked peds oncology for the last 6 years and love it. I did not start in it as a new grad but have seen many other nurses start out in peds oncology and do just fine. It is a specialty field so you will have the opportunity to learn alot about a specific area of medicine, but many people with cancer also have other medical issues that still need attention. One of the things I love is that you get to really know your patients because you see them over and over, for some people this is what they find so difficult. Find out nurse/patient ratios and also go by how the unit makes you feel; did the staff seem stressed, did management give you a good impression. Good luck with whatever you decide!

How to become a CNA depends on the state you live in. Some states require an actual certification test, others will allow facility training. Check with your local healthcare facilities. I was a home health aide during nursing school (basically a CNA that does home care) and it definately can get your "feet wet" in the medical field and help you become more comfortable with the basics of patient care, like that dreaded first bed bath. I was also an EMT before going into nursing and that exposure to medicine is what drove me to become a nurse. It also helped make alot of those strange medical terms more familiar to me. I think you are smart for looking for something to do to help you prepare! Good luck!

Not used by many at my workplace. We tell each other in report what the patient is there for, so why look at some piece of paper with vague nursing diagnoses that don't really tell you what you need to do anyway?

Giving you narcan makes no sense and seems to have had no medical basis. I was always taught that if you have to give narcan because of apnea you need to monitor your patient LONGER than if it wasn't necessary because the narcan wears off faster than the opioid. So even if they wanted the bed it would be even less safe to discharge you after reversal. I'd follow up with the someone in the ER (medical director maybe?)

It is very important to only apply approved skin care when a person is receiving radiation treatments, so ask your Grandmother's nurse what to use. Many "normal " treatments contain ingredients that will cause further or worsening burns. They make special treatments, such as radia-care gel, which I believe is aloe based. Good luck and best wishes to both of you.

I have always liked to go to NPs for my medical care because usually they spend the time to actually see you as a whole and not as a chief complaint. I feel that this is because they were bedside nurses first. So if someone doesn't want to become an RN before being an NP, then I think maybe NP is not their true calling. The N does stand for Nurse.

We change peripheral IVs every 72 hours, except you can get 24 hour extensions up to 144 hours if there are no problems at the site. I work pedi onc so most of our kids have central lines, dressings on hickmans and accessed ports are changed Mon, Wed, Fri and whenever wet or soiled or falling off. We use clean technique, not sterile, with a low rate of site infections. Parents are taught to change central line dressings on hickmans. PICC dressings are changed twice a week, typically Mon, Thurs, except they always need changing more often because nothing stays put on an antecubital site! We have a checkbox on our nursing flow sheets for dressing appearance and change for documentation Q shift.