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Medical Surgical & Nursing Manaagement
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kayern has 21 years experience and specializes in Medical Surgical & Nursing Manaagement.

Dual certified Medical Surgical Nurse Manager

kayern's Latest Activity

  1. kayern

    Interview Question

    Trend lightly especially if a staff member sits in on the interview. I suggest you use words I.e., my observation is but qualify it by saying something to the effect I haven't worked on that unit. If you can get the new units outcomes you can address those that are below national benchmarks, this way the statistics speak for themselves and are more concrete than observations. A question we always ask is related to your management style, your strengths and an area for opportunity to develop. Good luck. Keep us posted
  2. kayern

    "Do Nots" New to Administrative Role

    As a nurse manager for 15 years one thing I won't do.......ask my staff to do something I would not do. I make sure I stay current with clinical practice so if necessary I can lend a hand. Remember......you are just as much part of their team as they are part of your team
  3. First of all..........I've had multiple kidney stones........and three natural childbirths and I would take childbirth over the pain of a kidney stone. That being said, as another poster posted, pain to someone is an emergency. Patients can't be empathic when they are in pain and they don't want to be told about other patients. They want (need) to think they are the focus of your attention. I would have asked them not to yell out but to try to diffuse the situation by telling them what is going on in the ER is not their problem. Don't tell them what you can't do for them........turn it around and tell them what you can do for them, medication, show them the labs etc. The comment about the tampon.......I think if after a pelvic exam and my patient was bleeding, I'd offer her an abdominal pad
  4. kayern

    CVC dressing change

    I manage a M/S Tele & Step-down unit, neither unit has had a CLABs in over 18 months. Gloves to remove the dressing, sterile gloves and mask to change dressing. We have biotin patches for central lines and our patients with central lines receive a clorhexidine bath daily. Ask your professor this.........if there are sterile gloves and a mask in your dressing change kits, then YOU ARE SUPPOSE TO USE THEM!
  5. kayern

    My preceptor is everything they taught us NOT to be...

    Consider this.........a hospital that has such a sloppy nurse precepting maybe isn't the right hospital for you. I would have advised you from the onset to report some of the practices directly to the educator or manager, now it will appear as if you are covering yourself. I also read some of the other posted comments, I especially take issue with the one "I haven't done a true sterile dressing in 5 years nor have I been required to do one". Sterile is sterile......clean is clean, in the case you sight, was there any exudate in the wound? if so then I agree change your gloves, better to be on the safe side. Scanning all your IV meds at one time, stand firm because you are absolutely correct! The vaccinations = falsifying the record, better to document unable to assess and write a note unless you can go into the old medical record and abstract the info and chart that you did so. Urinary output = 10-20ml/hr at a minimum, IV contrast the previous day with rising labs, you ARE CORRECT. I think the issues you bring up are valid and applaud you for not turning into one of those "sloppy" nurses. Hold your ground and be proud that you are trying to do right for your patient. Let us know how it turns out
  6. This has nothing to do with Magnet status! For goodness sake....get over yourself. Its everyone job to care for the patient and if that means keeping the environment clean and safe, so be it. Prioritize and take care of the patient first, then address the feces/urine and if you need to help pick it up, just do it! I don't want to tip toe through puddles or turds............lend a hand!
  7. kayern

    I saw another nurse assault a patient

    You have an ethical obligation to report it and do not do it anonymously, as some posters suggest. Institutions do not take anonymous tips/complaints as serious. That nurse went over the line and assaulted the patient. Not reporting it, makes you just as guilty!
  8. kayern

    New Grad Interviews - What should I take?

    And PLEASE research the institution that is interviewing you! Do your research........are they Magnet? Do they have awards? etc. I believe you should bring your transcript, we ask for it because we only hire BSNs and have a minimum GPA requirement. Be prepared to discuss your grades, your favorite clinicals and why you chose to interview at that institution. GOOD LUCK!
  9. I ask these types of question on interview.......Do you have any plans that may interfere with classroom orientation/clinical orientation? Write the response right on the interview papers. As a manager, my philosophy is when staff have a personal issue to take care (your honeymoon) let them do it, otherwise their minds/hearts are not into our patients but at home (honeymoon). They will be better employees if you let them know.........life goes happens. We can't expect our staff to take care of patients if their focus is at home. In my opinion............help them work/life balance.
  10. kayern

    Anticoagulant Preventing CVC Insert?

    I think consideration needs to be given to the risks v. benefits. Wait because of the SQ for DVT prop v pressers to sustain life.........in my opinion = no brainer! I work in a cardiac care facilitity EVERYONE is on some kind of anticoagulation. If its really necessary there are many ways around waiting 12 hours, vit K, FFP, think outside the box
  11. Common courtesy....if you picked it up, you should put it down! Think of it this way....if you open a drawer, do you not close it? Perhaps your co-workers view it as being inconsiderate to them. For goodness sake don't be so sensitive.
  12. kayern

    Hiring experienced nurses vs hiring new graduates

    Can we agree to disagree? As a Manager who does a lot of hiring and interviewing, I would not expect an experienced nurse, say in L&D applying for M/S, to progress any differently than a new grad, except maybe in time management and delegation skills. A new discipline is a new beginning, so in my opinion, an experienced nurse with no M/S experience is at the same level as a new grad!
  13. kayern

    Time to vent - my apologies in advance.

    The scenario you describe is not new! Unfortunately, M/S nurses spend a lot of time completing tasks, infusions, admissions, etc from the ED. I know in my institution, the ED nurses cringe when I take report from them because I expect true SBAR HOC and question open orders, transfusions, etc. thanks to the EMR. They don't always take heed and complete the necessary open items when giving report from my staff, but when they give to me things are different. I consistently ask their manager, why that is the case and get a variety of responses. Many times, report comes from another M/S float nurse who is totally overwhelmed. With take being said, I empower my nurses to take HOC the same way I do and ask the questions because once they assume responsibility for that patient (s) every outstanding issue is now theirs. Again, thanks to the EMR, we can support our questions and see exactly how busy the ER is, things are changing but slowly. ER nurses are good in emergencies, but I challenge them to take the patient assignment a M/S nurse manages and see how an transfer from the ER with open orders, transfusions, medications can totally jam up the floor nurse.
  14. kayern

    Hiring experienced nurses vs hiring new graduates

    What the rush? If your institution wants 2 years experience, then wait the full two years. Nurses are still acclimating to their units during the first 12 months. I will be honest with you.........as a manager of a medical surgical unit, I would not take a postpartum RN or if I did, I would treat her as a new graduate because of the vast difference in patient population and disease processes.
  15. kayern

    Nurse Management

    I agree with MrChicagoRN........the patient ALWAYS comes first. I expect my new grads to follow policies/procedures, know when to ask for help and be truthful/honest. I can and will teach them the rest provided they treat my patients with respect, dignity and compassion.
  16. kayern

    Charge nurse is a low performer!

    A few points to discuss..... What do the nurses say about her when she is in charge? Is she facilitating the flow of the unit? Does she make patient care rounds? What do the patients say about her? Is there a peer review process in place? Is there a charge review process in place? Altho I find not everyone is willing to be honest so everyone gets great reviews. My advise to you is to document, document, document the present your case to your AVP/Director? You ARE the manager, check her file and she what is in it. Its your unit run it your way. Keep us posted