makes needs known

Make time to use the the bathroom or leak a little urine when you sneeze, cough or laugh. The choice is yours.

Do your patients like you? Are you responsive to their needs and health problems. That's what you're their for. Not your crabby complaining critical co-workers. But, it's really a good idea to get along with the people you work with. Just keep at it. Take care of yourself and hold your head up.

Our old fire policy was to pull the alarm 1st, and then to rescue pts.that were at risk. The reason made sense because, if we became overcome by smoke or injury, things could become worse. No one would know there was a fire. Pulling the alarm 1st would activate the system. Now we use RACE that dictates that we rescue pts. and then pull the alarm. I have looked online and it seems that RACE is the prevailing system. What policy do you use?

We are also short on supplies, and short on people who will put them in proper place. We have all new cabinets and drawers for storing supplies. Whenever we request gloves or sterile water,etc. it is always brought to unit. It is never put away. I always find boxes of supplies that we are pulling supplies out of, even though there is plenty of storage space. Looks like abomb exploded in clean utility room. Things are just tossed everywhere. We used to have a staff person who monitored our supplies and knew what we needed and brought supplies to us before we needed them and took the time to put supplies away. That position was eliminated, and now it has been tacked onto another person responsibilities. We have a newly redecorated facility, but we are short on staff, short on supplies and short on organization.

Of course not, in fact more documenatation to prove that said breathing tx was effective with VS and sats before and after. " oh wait a min dear pt, before you can have this tx that you are needing, I need to get your o2 sat level." And where the heck is that pulse oximeter?

We just had a pulmonary inservice. We have been told that we are to stay with the patient the whole time they are recieving their neb tx. Sorry no resp therapist. Just me giving meds to 20- to 40 pts. I always tell pt that neb will take 5-7 min depending. If they refuse to have the HOB up during tx it may take 20 min!!! The rational is that they would be dispensing there own med if I leave thier side, mind you this is a rehab floor and we are teaching these people to be as self sufficient as possible when they get home. Sounds like I'm going to have to teach that they have to do their neb tx when they are sitting up.

We had a elderly female patient die last night. While she was dying of course she was not wearing her dentures but her family requested that we put her dentures in after she had died. Question- put them in or give them to funeral director to put in? We put them in at family's request.

We have been experiencing the same lack of respect where I work. We have new management and an even newer DON that has made that threat to many of my coworkers, and she has made 'good' on that threat, too. Many of my coworkers are gone. I got into trouble last month and was disciplined for it, she did threaten to let me go but instead took me off my floor (rehab/20 pts) and put me on a heavier dementia floor. I have been working my whole shift without a break to get everything done (40 pts/1nurse). I unhappily put my notice in the other day at this rehab/ltc after working there for 22 years.

I guess I could call and ask if there are medical supplies I could pick up at the drugstore/walmart before I come in.

The other as night as I was working, a nurse from another floor came to me and asked if I had any extra bottles of 325mg tylenol, I went and looked I had no unopened bottles in my stock supply for my floor. I gave her my supply from one of the med carts I am responsible for. I ran out of glucoscan strips and asked the SV to please find me some, he returned with 1 box he had to search all over for. The other night we had some fleets enemas that were supposed to be given as part of our bowel protocol, and we had no enemas in our building. We contacted the Dr. and got an order to hold until the next day when we could get some enemas. The next day we still didn't have any enemas. Thankfully our pts that had not moved their bowels, did move their bowels without any further intervention. We might not have all the medical supplies we need, but we have a bowel- movement- load of paperwork to document on to prove that we are doing our jobs.

When I became a nurse, I was told by a superior that most of my days as a nurse were going to be disheartening, but every once in awhile you would go home feeling you made a difference. Be kind, be patient, and try to be the best you can be. To error is human. Tomorrow is a new day.

Nascar, this sounds great. I like your "Praise in public" theory. We hardly ever hear praise, and I have seen nurses crying while they were being lectured in front of others. 2-3 nurses/aides are being let go almost every month. I am a nurse and I have 23 years at my facility and I am worried that it is my turn. I am not perfect, but I do listen and I do the best I can and I know I am a good nurse. I have seen so many others let go that I can not even keep track of them.

Thank you again for your help, I honestly thought my superviser called the family. We have paperwork that is sent to the hospital and I never saw it. The chart was taken and the transfer papers prepared somewhere else. I stayed with the patient until she was shipped.

I goofed up, but I did not realize it until after. I never sent a hospice patient to the hospital. I have been punished and educated. Thank you for your comments.

Recently a pt of mine started to severely desat (40's-50's) on 4L o2, and I notified my SV, she assessed the pt, who happened to be on hospice. She contacted the MD for orders and got an order to send to the hospital for eval. She discussed the fact that the patient was on hospice. Pt did not want to go initially (anxious and confused) but did agree when we reassured her they would be able to determine what would make her feel better. She was admitted with pneumonia. She was started on antibiotics and began to feel better. The SV did not inform the family that she had been sent to the hospital, they were mad and pt was sent back to us the next day with orders not to continue antibiotics. SV was new and did not call the family. She did the paperwork and on it there is a section asking which family member was contacted. I feel like a fool. I'm in trouble, for sending a hospice pt to the hospital and not letting the family know.

Maybe you are really hungry.

How frequently do you, based on laws, replace a patients o2 tubing. I thought it was q 7 days but a new nurse at our facility says it is q 3 days. I just looked it up online and all I could find was 'every 7 days or when visably soiled' Have there been changes? Thanks.

We are still having a problem with management not removing narcotics that dc'd pts had. I counted 26 blister packs dated back to August. Mngmt. does not care if we are hanging onto these narcs as long as we watch over them. They even gave us more space to hold them. We want them to take them, but they will not and I want to know what to do to let them know that they really should take all those narcs. Also, what is not funny, we get new patients with orders for narcotic pain meds and even though we have a supply of e-kit narcs, we are told that they don't have enough to give our new pts and our pharmacy is taking more than 24 hrs to send their narcs sometimes. We're all fustrated.

Bloodsugar checks ac and hs, and coverage given only at ac. Have you ever seen how some orders are written? All nurses can read, all nurses are crazy busy, and all nurses are human.

I know what you are talking about, tx written in the medex and meds written in the tx book. Too many people making too many changes and things not getting checked to make sure they are correct and match. The first of the month comes around and then the stuff hits the fan. And the charge nurse passing the meds based on all the changes that were made and not transcribed correctly. This is a crazy and dangerous system for patients and staff. I am sorry you lost your job, but I also think that it must have been a very fustrating place to work and now things will get better for you.

The idea that nurses are supposed to be perfect. Hey- we are only human.

And a refreshing shower to wake up your mind and body. Never underestimate the power of water!

What time is breakfast? Most of our am glucoscan checks get done 30 min before breakfast. Is this using a sliding scale or is a maintenance dose of insulin being given by the oncoming nurse?

oh and for 6 months we did not even have an ice machine on our floor.

Interesting. In my facility, in the past the dietary dept. has done it. 3 floors, and on only our floor dietary does not deliver pitchers anymore. Our floor cna's are responsible for giving pitchers to our floor. Dietary still does other floors. We have 40 patients, 3 cna's. There is not enough staff for 1 cna to devote time to filling the pitchers 1 by 1 and then taking them all to deliver to rooms. It would take almost an hour. There are way too many other requests. Passing out snacks, ambulating, toileting, showering, answering bed/chair alarms, obtaining wts., the list goes on and on. We have tried to find out why our floor is different, and the only thing I have heard is that our pts (rehab/sub acute) have more dietary requests and that dietary does not have time or staff to deliver to our floor. If they want water they should ask for it. Our dietary staff has been educated in the fact that some patients may have types of fluid requirements (restricted/thickened) that they need to adhere to. I'm not sure what is going to happen, but we have to find a good way to handle this, because we are all running as fast as we can.