Texas Tornado

Thanks! That makes a lot more sense to me. I think people are way too caught up with the restrictions of their particular system. And also the cover your a** factor. I always try to think of what is best for my patient and then think of how to make it happen with the computer system I have ... that way the system we have doesn't dictate my patient care.

We have similar uniforms to what Wales is starting and I've found that it is much more beneficial to the staff that come up to the unit than it is to the patients. Having said that, patients that are there for a long time, and our revolving door patients and their families find it helpful. Of course there are a lot of patients that have no clue and don't care.

There are things I won't tolerate. But the type of thing you mentioned I usually just use humor to deal with (which can be risky I realize). I did have a pt whistle at me a while back and I turned around and said "woof, woof". We both just laughed and I reminded him what my name was. Not everyone was raised with the same sense of manners or respect of others. Most people are pretty stressed out when in the hospital or when they have a loved one in the hospital and don't always behave the best. Do I like it? No Can I work with it? Usually. If I were in their situation I would want me to cut them a break.

We throw away bag and tubing together, emptying bag if needed as the prior poster stated. Leaving the spike in the bag protects anyone emptying or digging through the trash. In the not so common event that I need to throw away tubing that is not attached to a bag, I cut the spike off and toss it into the sharps container and then just toss the rest of the tubing in the trash.

Just wondering what everyone thought about having a National Nurse Uniform. Sounds like it will be throughout Wales. Is the rest of the UK planning on doing this as well? http://www.walesonline.co.uk/news/health-news/2010/04/08/national-nurse-uniforms-launched-in-wales-91466-26197221/

How about "Butt-wiper"? Very gender neutral :nuke: Ok... just kidding... and thinking about my last two days at work!!!!

What exactly are you researching? A specific patient and their care, or is it more global, like auditing for statistical purposes?? It's good to hear someone out there is reading them :)

I read you loud and clear on the CYA aspect of charting, and that class sounds like it would be great. Having said that I somehow felt better thinking my time and effort was actually contributing to patient care.

With the exception of a few auditors and maybe the wound care nurse, the only people who routinely read my assessments are other nurses. My MD's will check out the tele strips I post and look at flowsheet data, but otherwise don't read our charting. Who reads your charting?

We don't use that same system, but one that shows what the previous nurse charted and gives the option to click the same thing. Pro's - nice b/c a lot of stuff stays the same. I also have learned a lot about charting from seeing what other nurses have written and how they worded it. Frankly we all pick up on different things and it is helpful to see what others have found in their assessments. Con's - people get sloppy and just click what the person put in before them. I've see people click on stuff from my assessment that I know had changed even before my shift was done, and in a hurry it is tempting to rely on what others have assessed. We will be changing over to an entirely new system soon that will not have this option and I must say I'm sort of dreading it. Reason being a lot of "little" stuff does not get passed on in report that is good to know if this is baseline or a change. Good luck with whatever you decide.

Any more of that good old Christian love and that poor boy might be dead! Sounds like a rather septic environment. It's great that you were there to support the young lad. Maybe you weren't the one who made the call but I bet if someone hadn't you would have.

I seem to have developed a reaction to the N95 mask. My employee health department is of no help. I've heard there are hoods available but haven't found any info on them. Anyone know of any alternatives to the N95 mask for protection against TB? Thanks!

Really? I've never heard of such a thing. Was your patient a horse?

Are you talking about a patient that has a medication running through the IV? If so there are two concerns with turning it off. First depends on what the medication is. Some medications need to run continuously (ie Cardizem) and will cause a problem if stopped. But most can be stopped without a problem. Secondly if an IV runs dry (the medication in the bag is all gone and the IV is still connected to the empty bag), this puts the patient at risk for losing their IV access. Best thing to do is flush with normal saline until you can get the next bag up - if there is more to give. I don't understand the discharge part. Is the patient being discharged to another unit or facility with their fluids running? If not - if you are planning on stopping fluids and taking out their IV then "get 'er done" - there are patients waiting in the ER who need the room!

I've worked on units that use fitted sheets with a draw sheet on top, and others that use a flat sheet under patients who need q2 hour turns/boots, etc. Personally I like the flat sheets. Does anyone know of any research on which is better/worse regarding skin breakdown? Thoughts? Experience?

ok... so whenever you access a PIV you are increasing the risk of infection - I get that. But why would a blood draw increase the risk of infection more than just hooking up a piggyback or running a primary?

We swithed to central monitoring about a year ago. It has taken some getting used to, and there have been some growing pains. However, our monitors are in real time. I like the central monitoring, but only use it as a back up. I've found that working with them (rather than against them) has paid off. I try and call them before I take my pts off monitor. If I'm starting someone on a gtt I give them a call and let them know what I'm up to and what the parameters are that I'm looking for. Hopefully it will get better as time goes on. It did for us.

I'll be curious to see what you find out. Pls let us know!

I can only think of one major gloveless event. Call light went off. I go in and see his O2 sats are at 70 and drop to 55 before I even get to his bed. Vent tubing was disconnected at pt trach. Without hesitation I reached in to sort it out. Unfortunately copious amounts of multicolor sputum were tangled throughout the velcro straps loosely holding the parts together. It only took seconds but by the time I got it sorted out and connected, both hands were slimed up with pseudamonus sputum. Although I handle sputum frequently, never before with bare hands - Yuck! :barf01: Could I and should I have put on gloves? Well yes, but it was instinctual to just jump in.

Can you spell out how you do this? I guess after getting your IV in you pin the vein down with one hand and connect the little little plastic thingy to the hub of the IV cath with the other hand. Do you do this before stabalizing the IV? Sounds like it could be tricky.

Compression is the action related to no circulation or poor circulation. This step implies that circulation was checked. I'm not sure what your instructor is talking about. There are definitely some parts to this puzzle missing. Was the instructor an employee of the home care agency you are with? Maybe they were stating the agency policy, b/c it is not BLS. Can you contact the instructor for clarification on what they are talking about?

Ouch... are we all feeling the love here???? :chair: Anyway - at my hospital the techs on my floor are trained and do draw off central lines. The techs that float to our floor can not.

I wear these scrub pants and love them. Lots of pockets and light weight (unlike EMT pants). http://www.medweardirect.com/Merchant2/merchant.mvc?Screen=PROD&Store_Code=MD&Product_Code=8501&Category_Code=Landau+Scrubs I also wear a hip pack: http://www.orangebayequipment.com/index.asp I have the ER pack. I've heard all of the criticisms against them, but I find it very helpful. :wink2:

yes... I clamp - that is I clamp if there is a clamp. We have several kinds of PICC's and not all of them have clamps. If they do I use it. We also use SASH unless the pt can't have heparin or unless it is one of the new SOLO PICC's that we sometimes see on the unit these days. We flush bid at minimum. Usually the line gets flushed much more with meds throughout the day. I have no idea what the doc was talking about

It is ok not to continue with nursing school. It may not be for you at this time, or may not be for you at anytime. That is ok. There is no shame in trying something and not have it work out the way you hoped. You are young. Nursing school is not a now or never career - it will be around if you decide to pursue it at a later date. However right now it sounds like your health and your family is more important to you and I think we can all understand and respect that. This is not a right or wrong decision, but rather it is about what is best for you. I wish you luck in whatever you decide. :icon_hug: