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In looking at some of the teaching of PEG care, placing the split dressing over the bar is done because placing it under that external bar can cause erosion of gastric tissue or abscess of the abdominal wall due to pressure on the internal bar within the stomach. Smith, S., et al. (2008) Clinical Nursing Skills: Basic to Advanced (8th edition). Upper Saddle River: Pearson Prentice Hall.

Hey all. I need some input, if possible. Part #1 of the problem: The primary physician/owner of the facility is wanting to have ongoing, random, critical thinking, "pop quizzes" done with the nursing staff. He wants to use this as a tool to continue the critical thinking process. While I think this is a good idea at its base and would like to implement something to that effect, I don't want it to come across as a "we are testing you to see if you are good enough" or as a punitive activity. I want it to be a true learning experience. Part #2: I am having to basically show proof to the physician/owners of what I have done since I have taken the position in April. I want to incorporate these random "quizzes" but don't want to word it as such. Can anyone help me with how to word this? I don't want these to be a "You answered poorly, so you are a bad nurse" situations, and I don't want the physicians feeling like that is what is occuring.

There seem to be a number of issues I am having issues with. Let me give a little background about the facility. We are a new 60 bed facility acute care that has been open only since Novemeber. There was minimal staff development prior to my taking the position (the educator at the time was the infection control/employee health nurse). So, part of the problem is that there was no orientation to the position, just, "you are an educator now, go for it, we're sure you'll do great." Trying to prioritize where to start is very much an issue. Because we are small, I am the only educator. I think (I hope) I am well prepared for the position, since I have taught nursing school for 6 years, precepted new grads and new nurses, gave clinical inservices at my former facility, as well as clinical orientation to new nurses at my former facility. I am my own worst critic, so yes, I think a large part is that I don't like being the "new kid" again. I was pretty confident in my critical care skills and patient care. Now, I feel like I am floundering in this new role, even though I am probably not doing poorly. I also am having a major issue just switching my thought process from, "I need to be there at the bedside, taking care of this patient or helping in code, etc." After so many years at bedside, it is ingrained in me to be right there in a crisis situation. I was told I need to remember that doing what I am doing now is still being there for the patient, but as the support to the bedside nurses. I have been gathering more information about staff development and education. I am looking into starting a master's program in nursing education from U of Texas, El Paso, which focuses on clinical, bedside nurse education, not as faculty at a school. I have signed up to do a "Getting Started as a Staff Educator" CEU's from Indiana University. I am, in all honesty, not sure what resources I need, though I am trying to get materials ordered. Personnel wise, I do have folks to help with education issues. Also, having our own staff is making this a bit difficult, since we are still working with about 40% agency staff. I am really trying to immerse myself into the educator role (which may be a problem too, but I am not sure). Thanks for the questions. They actually allowed me to do some inner questioning of myself and my fears. I just don't want to screw this up. And thanks for any advice you have.

Hi all. I am a new Staff Educator/Development director since April and I need help. I have been a critical care nurse for 13 years, working cardiac PCU/ICU for 12 yrs as well as a nursing instructor. How do you transition from getting into the thick of things with codes, crises, and the whole clinical world to being more administrative? I love education, this is what I want to do. I seem to be having a very hard time making the transition from clinician to staff educator, though. Any ideas, thoughts, advice?