KneKno

Thanks, tippeny!

Does anyone have a template that they can share? I work pre/post anesthesia in a hospital based endoscopy unit, with the majority of patients being outpatients. We’re going to be starting follow up calls, and I only have an outpatient surgical script to use. A lot of that just doesn’t apply to us! Thanks for any help.

My search works. This is from someone that said she had copied it from another post: My Chicken Hez TB---Spiderman---Mrs. Wee. Its how you remember the mnemonics for isolation precautions. AIRBORNE(private room, negative pressure, DOOR CLOSED, N-95) My - Measles( Rubeola) Chicken - Chicken pox Hez - Herpes zoster (shingles) TB - Tuberculosis DROPLET - Just remember SPIDERMAN (private room or with pt with same infection, 3ft between infected person and visitors/patients, DOOR CAN BE OPEN, mask with transport) Sepsis Scarlet fever Streptococcal pharyngitis Pertussis Parvovirus B19 Pneumonia Influenza Diptheria (pharyngeal) Epiglottidis Rubella Mumps Meningitis Mycoplasma Adenovirus CONTACT - Remember MRS. WEE Multiresistant drug organisms (MRSA, etc) Respiratory infections (except those listed previously) Skin infections Wound infections Enteric infections (C. Diff., etc) Eye infections (conjunctivitis) SKIN INFECTIONS - Remember VCHIPS Varicella Cutaneous diptheria Herpes simplex Impetigo Pediculosis (lice) Scabies

We gathered ideas on about this several years ago, but none were implemented. Some ideas, based on years of service (we were talking about staff that had 20-25-30 years in the hospital and most were scheduling tweaks--no cost): Limit number of all holidays worked, have off all of Christmas/New Years (eves and days of) holidays, less week-end requirements, dedicated parking area.

pocketmod.com It's really just a fancy way to fold a sheet of paper to make a little 6 page book. I have the info I like in small font saved in my documents and just paste and copy what I want--Unit specific numbers (manager, charge, all the phones) are on the front, hospital numbers on the back (all units and the charge nurse, xray, lab, OR, PACU, phlebotomy, CRNA); my middle pages are ICU gtt and coronary artery info, and a blank page. I like that I can change things easily, and I keep a few extras in my locker for when the paper gets too shredded up.

At work, I'm paid to be nice.

One of my coworkers wants to post a notice: If you can't do it at WalMart, you can't do it here!" Must have shoes, shirts; can't eat food walking in the aisles; can't follow staff into areas where it says Staff Only....

Why don't we trust A+O people to take meds in the hospital (can't leave meds at the bedside, must watch them swallow), but we send them home and expect them to do it?

I'm a diploma graduate from about 25 years ago. Many hours of clinicals and 1 hospital taught me how to be an entry level nurse at that hospital. I think orientation would have been easier there only because of familiarity with the MDs, RNs and ancillary staff, charting, layout of the place. I would have been able to concentrate on the nursing. I went to work at a different hospital--and had to learn all of the above, and the "how to be a nurse" part. I believe longer clincial hours would help acquiring skills. 3-4 hrs a day 2 times a week seems to be the average of students where I work. 1 8 hr shift would give a much better idea of "flow," you'd have a better chance at seeing pts clinical condition change for the better or worse, and you'd have a chance to see how interventions turn out. That would almost be like an externship!

re: a pt with both a living will and MPOA--The language in most LWs says something like "in the event of a terminal illness or persistent vegatative state" I want /do not want.... In my work place, MDs still pretty much believe that terminal illness only pertains to very metastatic cancer. Also, by definition, a vegatative state takes a few weeks to months to become persistent. Because of this language, LWs are pretty much worthless in my opinion, other than serving as a limited guide on a pts thoughts about end of life care. If the terms of the LW do not apply, the MPOA gets to make any decision they want. They are supposed to be giving the directions that they believe the pt would make in this circumstance. However, many rely soley on emotions to make decisions, or may have never even discussed EOL issues with the pt. There can also be major issues when a pt has named 2 MPOAs to serve jointly--if they don't agree on a plan of care, the effort of the pt in making an advanced directive is worthless.

I've worked nights since for 20+ years, the first 2 were 11-7, 7-7 since then. My "schedule" has changed greatly over the years, it really depends on your life. I've gone from single and living with parents to married, to 1 kid, to 2 kids. Every change in my life resulted in a change in my sleep patterns! With kids (I was a late bloomer, they're 11 and 7) I believe I see more of them now than if I worked 12 hr days. My dad was a coal miner, as was all the men that lived around my parents. They took night shift and allowing the men to get their sleep seriously--as a kid, I knew what neighbor was sleeping and knew not to be yelling near their yard! That respect for sleep made a huge difference in how I adjusted to this schedule. It amazes me that coworkers get phone calls all during the day while they're trying to sleep from their families, who are amazed that they're sleeping! Over really stupid stuff! Be willing to try nights--you might like it. And, we have cookies.....

When do the nurses get a chance to "fill out a survey" about the patients? Did they smile, did they show interest in learning about their meds, did they volunteer to walk 3 times on post op day 1 or did the nurse have to "encourage" them, did they use the inspirometer without reminders? And, I'd also like to give my opinion about the visitors..... think they will they "Strive for 5?"

Self scheduling--as long as you schedule a combination of 3 Fri and/or Sat and 1 Mon and 1 Thu. That's 5 of 12 shifts. I guess the "self" part comes in cause you get to pick which Mon you want to work!

There was recently some information in my local newspapers about the use of pictures with dementia patients. I can't find any references about it right now, though.

FMLA? For your own mental health if not covered by "primary caregiver of family member."