QUEENIERN

One of the ways to help facilitate the new admission process, I feel is to walk in "their" shoes, so to speak. Because I used to work on a med-surge floor I know full well what it is like at shift change, or at any other time you are getting slammed with admits and or discharges. There are a few things I try to do to help with this process. Granted not everyone does this or would even attempt. (of course they have not walked in your med-surge shoes either!) (I work in surgery now). Anyway...Most all of our surgery pts. come from ER, Day Surgery, or are already a in-patient. If they are to be admitted to the med-surge unit (or anywhere else) we call for a room as soon as possible. The pt. may not even be on the table yet but we call for the room early and this seems to help our nurses, because @ that time we don't give a full report but the unit at least knows if the patient is male or female and if they have any special needs they can set up for as soon as they are able. (like over-bed trapeze). So at this point the nurse knows ahead of time they will be getting a new admit and hopefully an aproximate time. After the procedure & while the pt is in recovery, the PACU nurse (sometimes myself) looks over the orders and at that time calls 1st report giving a few details about the patient & type of procedure etc. plus any special orders (like oxygen setup) and an aproximate time of discharge from PACU to Med-surge. At that time if there is going to be some type of problem this is their time to say so. We have at times taken a pt. to their room, but stayed with them continuing recovery until "a" nurse. (house sup, whoever) can fully accept the pt. This does not happen often but if things are going crazy (code, etc.) We (surgical team) do what we can to help. Also if the pt. was admitted thru day surgery we have already filled out the assessment and admit papers. This saves a lot of time for the nurse. This also gives our department surgery/PACU the ability to know our pt. better and therfore give a more complete report to the admitting nurse. It' helps for all departments to know the policys and flow of other departments to give a better understanding and enable each department to know they are not a lone department. We ALL rely on each other to give quality care. Our med-surge nurses always take report, because @ 1 point they WILL have the pt, and if they or someone else (charge nurse, mgr, house super) can not accept the pt. @ time of transfer we do what we can to help. Take 1st set of vitals etc. until someone is available. Just knowing we are "having" to stay with the pt. makes them make great effort to get there as soon as possible & not take advantage. So it is not just a unit working as a team but the facility as a whole working as a TEAM.

NON-SMOKERS SHOULD TAKE BREAKS TO. LIKE A "I'M GOING TO GO CHECK THE WEATHER" BREAK OR WHATEVER JUST TO GIVE YOU 5 MINUTES HERE & THERE LIKE THE SMOKERS GET. AS FAR AS THE SMELL WE HAVE A POLICY THAT A COVER-JACKET MUST BE WORN. SEPERATE JACKET FROM YOUR REGULAR LAB COATS ETC. AND YOU HAVE STRICT HANDWASHING ANYWAY. AND TO FURTHER COVER SMELL OF SMOKE I ONCE MET SOMEONE THAT ALWAYS CARRIED FABRIC SOFTNER SHEETS IN HER POCKETS AND IT TOOK THE SMELL OUT OF HER CLOTHES. PLUS WITH THE COVER GOWN AND ALL. ANYWAY WHAT I AM SAYING IT IS THE "SMOKERS" RESPONSIBILITY NOT TO TAKE ADVANTAGE OF OTHERS HELP AND TO MAKE SURE THE SMELL IS NOT SO BAD. AND JUST BECAUSE YOU DON'T SMOKE DOESN'T MEAN YOU DON'T DESERVE A BREAK TO AND CAN TAKE ONE. EVEN IF YOU HAVE TO DARE SAY "I'M GOING TO SMOKE W/SO-N-SO. EVEN IF YOU DON'T YOU STILL GET THE BREAK!

THANKS FOR ALL THE ADVICE! AND YES THIS CRNA DOES HAVE A BIG PROBLEM. IT'S CALLED LITTLE MAN SYNDROME. AND TO MAKE MATTERS WORSE WE HAVE NOT HAD A MANAGER SINCE MARCH OR A DON SINCE THE END OF MAY. THINGS ARE REALLY TOUGH LATELY. IT'S ALWAYS THE LITTLE STUFF THAT IS SENDING US ALL OVER THE EDGE. THANKS AGAIN FOR YOUR HELP. STAY AROUND I'M SURE I'LL NEED YOU ALL AGAIN.

WE HAVE ALWAYS PUT THE FOLEY UNDER THE LEG WHEN PATIENT IS IN SUPINE POSITION. BEING AN OLD MED SURGE NURSE THIS IS WRONG. GOES OVER THE LEG. ANYWAY NOW ALL OF A SUDDEN A CERTAIN CRNA AT OUR HOSPITAL HAS A PROBLEM WITH THE POSITIONING OF THE FOLEY AND IS CAUSING PROBLEMS WITH CIRCULATORS AND RNFA. SOMETHING IN WRITING ALWAYS GETS HIS ATTENTION SO I AM WONDERING WHAT POSITION OTHERS ARE USING OVER OR UNDER.