zoopnever

Hi, our floor has been deemed the highest fall risk floor in the hospital. Seems our patients are on the floor more than their beds, usually on their way to the bathroom. My question to you is, how do you yourselves, go about preventing falls? I've read through some of the historical comments and nurses always say the same thing, increase staffing, but the truth is at 1:4 and PCAs 1:10 it really doesn't get better than that in the real world unless you're going 1:1 all the time. So what's the secret? How does your place prevent falls? Thanks in advance, as always.

We can give less than the prescribed pain meds, up to the prescribed dose. for instance the order is for Dilaudid one mg every 2 hours. I can give you a half mg now and a half mg in an hour, for a total of one mg in that 2 hour time frame. I just can't give you more. That's not a grey area as far as I know; it's the way I was taught and I've been doing that for ten long wonderful years now.

Here's one we haven't seen before. There's an HIV positive patient here, about 35 years old. He has had a visitor in the room (private) all day, identifies him as his son. They have been in the bed together almost cuddling, and the RN and Social Worker both feel there's something wrong there. The Megan's Law website was checked and the patient appears to be there and in violation of his probation, which means there are warrants. I say "appears" because the picture on the website is of a healthier person and the patient is thin and sickly (HIV) but the resemblance is there and the name of the patient is one of the aliases. So we have called CPS and asked their advice, which is to say there is no advice unless we can get a positive ID on what we believe to be a child unrelated to the patient. The police at this time are not warranted. Any thoughts? Advice? How would you handle it? -----------Z

" CHW has its share of problems as well." CHW is the last place I worked, and indeed, nurses were getting called off due to low census. It was in San Bernardino. Poor area. CHW was also trying to dump their San Bernardino hospitals at the time for low performance. I suspect they still are, I don't know. I moved on. "And poor people need health care too, and they usually will have the highest census in those hospitals." And the lowest record for paying their bills. Yeah I can be Mother Teresa too. But a hospital is a business. "Telling someone not to work there for the reasons that you mentioned just does not make any sense to me." Because you don't see the hostility and back biting of nurses when they're not getting their paychecks. I do. "And the private hospitals also have low census as well, more so at certain times of the year." As previously mentioned, this has been going on for 6 months. Six months of getting called off takes the nobility of the profession away and leaves broke people who can't pay their bills. "So please get the facts right first, before just assuming something" This is a blog and I'm telling a poster what I think. It's not a student paper I'm handing in for a grade. It's not a speech I wrote for Obama to be picked apart by pundits. I told a new nurse what I'd found after my years' experience, which in that experience, are facts. But I thank you for your opinions.

Try to stay away from the hospitals around poor areas, they drain funds out of the system and the companies try to dump them. AMMC is not the only one doing that. If I may say, try the Catholic hospitals, or University hospitals, they're usually well off and keep their census high. Of course ER always needs their nurses. Good luck.

That's it all right. We've all been putting up with it for so long even though all the administration bailed months ago. Nurses for some reason put up with a lot and try to believe the good stuff is around the corner. Time to be more realistic. Thanks for your answer.

I'm in the OC and we've been down to about 2/3 capacity since the beginning of May. It's gone down to half capacity a few times. As a result nurses are getting called off left and right, and now, after almost 6 months of this, the staff is getting angry and uptight. We all have bills and this is supposed to be a recession-proof business. so what about you? Are you low census? How are you coping?

I have a similar problem and I've been an RN for 9 years. I've gone to walk-in interviews, I've called the unit and spoke with the Director, I've filled in apps online to the hospital, I've faxed my app to HR. I'm beginning to wonder if there's something on my resume that says I'm box office poison. My present job I've had for a number of years and I was very careful in the interview because I needed to be hired. These days I interview some candidates and I know some things, like don't chew gum, do wear nice clothes AND shoes, stuff like that, but ultimately it's a personal decision by the interviewer, meaning did she like you personally. Anyway all I can say is keep trying and be careful to come across like a professional. I should add that some HRs and some Directors just suck at their jobs and wouldn't know a good candidate if she jumped up and hit them with a shovel. That's why you get units filled with nasty nurses.

First, I think your manager mishandled this by saying one of your coworkers complained (that you're not doing someone else's work). The issue sounds like it lies with the complainer and she should have been dealt with, not you. However: If I may be blunt, I think you are making a mistake. These are coworkers, not your family, and they're not even "like" a family, unless you include backbiting and telling on you. You'll forget about them soon enough when you get another job someday. I wouldn't confront them because it'll give the complainer more ammo for gossip. But I wouldn't do their work either. Help out exactly as much as you are helped. By the way, there really are better jobs out there, traveling is a way of feeling them out.

The patients are the ones sending their complaints to management, about the nurse never coming in the door. I personally don't think most management is that far removed --although a lot are!

Someone asked me and I can't answer, but I knew where to go: an End Stage Renal patient on dialysis with chronic constipation and stool like rocks, always backed up. What food can he be given to get that stuff moving, maybe soften it up as well? Thanks all.

Holidays approaching, and the signup list is already in the lounge. Last year we got $10 grocery cards, I think, and the year before we got $10 gas cards. No, really, I think that's all we really got, not to sound greedy. What are the best gifts your hospital every gave you? Thanks!

I try to reply to the issue and not the poster, but sometimes, well... hospital management is an enormously difficult job. When the floor nurse punches out on a difficult patient and goes home, the issues are still there: the lawsuit threats, the state audits, the mounds of paperwork and staffing issues (you want next Sunday off, well, someone's got to work that out between you and the other 35 nurses with the same wants). If your managers stink, I'm sorry. They're not all cut from the same cloth. Back to the issue: I've retired my other name because I was recognized by a coworker.