gator mom

I get comments like this since I became a hospice RN. Even though I maintained by ACLS and worked for 9 years on a difficult post surgical floor, fellow RN's and even non medical people make comments like"oh you don't have to worry about "this or that" since your patients are dying."Or, that I have no clue about patients who are expected to be kept alive. I have total respect for school RN's. People are just ignorant about many specialties. I don't blame you for wanting to vent!

Thank you for confirming what I thought. I too figured "over charting" can lead to trouble. We are supposed to be going all computer charting in near future so hopefully it will get easier. Yes, many RN's chart in progress notes every time a pain med is given with FLACC score etc. and then on pain flowsheet and MAR too. Then again in pain flowsheet and progress notes to chart outcome. This is very time consuming when giving multiple pt's frequent pain medication admin. I sure appreciate your feedback!

Hello, I am a new hospice RN on a IPU, coming off a post operative floor after 10 years. We were totally electronic and charted by exception. I now am paper charting both care and MAR. I see so many different ways other experienced hospice RN's chart. Literally writing a book at times. They do their initial assessment via flowchart and then rewrite almost all of it in the progress notes. Also, documenting care CNA provides even though CNA has their own flowsheet where care is documented. I find if I do that I am always behind and spending too much time "in the chart" when I should be at the bedside. I realize I need to paint a picture of the care pt is being given, document the care provided, and show that there is reason pt must be in-pt hospice for medicare reasons. I just do not feel I must be redundant in my charting, nor write a book. I also realize some situations may warrant more charting than others. I feel scattered in my thoughts while charting too. Guess that is from being used to computer charting and not writing out all my care and assessments on paper. Any advice or resources that give example of proper hospice paper charting and not just someone's opinion on how to properly paper chart? The answers I have received thus far are just RN preferences. I want to work smarter not harder. Thank you!

As far as IVPB-we run it concurrently when we have a pt that is NPO. Zosyn is ran at 12.5ml/hr over four hours. If you hang it q8hr-the NPO pt is not getting enough IV hydration if not ran concurrently.

I also was in the category of not working during nursing school. I did not brag about it -it was just a fact. Even though I was fortunate to have a supportive spouse we also had our finances somewhat under control-no new cars, new electronic gadgets,vacations, just basic cable,etc. we were frugal and got by just fine. I still see it now as an RN. Those certain nurses always working overtime 5-6 nights/week...and most,though not all, do it because they need the extra money...and the cruises, expensive cars,i phones for the whole family,etc. They are the ones who do not understand how some of us only work our 3 12´s? Do not fault someone for not having to work. Maybe they have their finances in order and put family before work...just a thought. The students that really upset me were the so called ¨single¨ mothers who lived with their working boyfriends had more babies while still in school and got a free ride from the government because they were not married. Free groceries,free college,free NCLEX, free books,free health care,etc. and then they told me how lucky I was to not have to work....yeah right.

Hello-I work on a ortho/PCU post surgical floor. I am ACLS certified as required. Our nurses are offen required to float to ICU where we are given 1-2 of the least critical pts. The other night I floated and was told I would be getting an admission from ED. Pt. being admitted for CVA,Resp failure and rapid a-fib. She was to be on BIPAP and a cardizem drip to be titrated. I was not comfortable taking this pt. We do not have BIPAP on my floor if it is being used for rescue breathing. Also I have zero experience with titrating drips (we also do not take these pts). The charge RN understood my concern and gave me her one pt. who was basically stable. I had a RT comment to me that the pt was a DNR so I could not hurt her and why did I not want to learn new skills? I was totally amazed by the RT comment. I always want to learn new skills, BUT.....1) I do not believe I am even allowed to take a titrated drip (will clarify this tonight) 2) I am not an ICU nurse-would not this pt. be better off with an experienced ICU nurse? 3)I believe this pt. was beyond my scope of practice and accepting her would be both morally and legally wrong 4) When did it become acceptable to practice nursing skills on a pt because they are a DNR? Your feedback would be appreciated.

I am just curious-Those of you that get such a nice weekend shift diff (which I think is awesome and deserved)-Are you part of a union? Our hospital is not unionized but another in our community is and they too get a weekend shift diff.

WOW!!! I work nights and our weekend begins on Fri 1900 to Monday 0700. We get shift diff-but NO weekend diff. We are expected to work six weekend nights a schedule (which is a 6 week schedule). There are constantly issues with low staff on weekends and complaints when someone has more than their required six. We do have a lot of freedom when it comes to requesting days off. But we must do our six weekends!!

I am curious as to the best way to make a possible change to IT. I have 3+ years experience as an RN.What would be the best way to gain experience for a future job in IT? Thank You

I have worked night shift for a few years and find I have had a chance to practice a lot of my skills. Why not ask the day charge nurses to have day shift RNś leave a few of these things for you to do when you come in. If they are not real time sensitive I am sure they would love to have you do it. Also volunteer to come in on your own time during the busy time of day a few hours here and there-That would help you and them out. Good luck

I am working on updating our current method for assigning an acuity # to a pt. I work on a PCU-post surgical/ortho floor. Currently we use a 1-2-3 system with 1 being the most acute and 3 being the least. Currently the individual nurse writes the # next to the pt. before change of shift so the teams can be assigned appropriately. It seems that we use #2 too much and reserve #1 for those that tend to be a difficult pt to deal with and very rarely #3. Some nurses will give their pt. a #2 just because they are pleasant and cooperative even though they need blood,multiple meds and have a lot of pain. We used to have a standard to go by but it has fell to the wayside quite a few years ago before I worked there. We get a lot of total joints,abdominal surgerys,chest tubes,isolation pts.fem-pop bypasses.TURPS etc. Any help is appreciated. Thank you.