SixFive

We use a red/yellow/green system. On admission, the admitting nurse completes the FAST = Fall Assessment Screenint Tool. The result of that puts the patient at either a high (red), moderate (yellow), or low (green). Any patient who is a red 'tag' has a bed alarm and wheelchair alarm. They can not be left unattended in the bathroom or in their room unless they are in bed. All of our red tagged patients have this red tag/sticker on their wheelchair, above their bed, and at the doorway. A yellow tagged patient may be left alone in their room unattended, and they do not have alarms. They can call for help appropriately, and may sometimes also have BRP or be independent in their room. We rarely use the green tag, but it is very similar to yellow. Usually that person is independent, but they don't have to be. Is this what you're talking about, or was I totally missing your question?

we've never had anything but multi-dose vials, so I can't relate. The prefilled syringe with safety needle does sound nice though!

be thankful you have a pension. Lots of us nurses have nothing but what we put into an unmatched 401K now. To answer your question, I can work 1 extra shift per 2 week pay period and see the biggest difference. More than that, you do make more money, of course, but you don't see it as much in your take-home.

They won't ever be phased out. I have worked with a few surgeons who refuse to even prescribe IV pain medication; they always go with an IM injection.

she has no acute pain? Why did she seek medical attention? That's where you get your ND. Also sounds like a poor patient for a case study; I mean how long is she really going to be in the hospital with gastritis? The PP talked about walking around with it untreated for 6 months.

How about Bacteriostatic for this one. I think it fits a little better since your question only asks about bacteria and antiseptics cover all microorganisms

I've been in that situation before, and it's my understanding that the DNR can be revoked at any time if that's what the patient or the person making decisions for them decides.

It was either clogged with sediment or blood (not likely since it was new) or he was having bladder spasms. I guess it's also possible that the catheter wasn't all the way in the bladder.

Didn't think I was going to find another Bowling Green person! I'm from Bowling Green and a graduate of Western Kentucky University. Go Tops!

like you said, the cost of living is a lot less in Kentucky. Whatever apprehension you have about your salary will be outweighed by how friendly the people are. I think you'll also find that agencies are not used in Kentucky like they are in other places.

sounds ridiculous to push your flush that slow, but other than that, I have no suggestion. If every nurse on the floor took 20 minutes with every IV push, not much work would get done!

put what is applicable in the ( ) below. Your list doesn't mention the old dressing, but I think that's important. Also chart if the wound is 'hot' or warm. Also describe the wound bed. I would also chart if there is an odor or lack of odor. For approximation, if you have a wet-dry dressing, it's obviously not approximated. A non surgical wound is open, while a surgical wound would be dehisced. If this is a non-surgical wound, chart like this... Wet to dry dressing change to the coccyx (or wherever it is) completed with (sterile or clean technique) using (whatever you made the dressing wet with; normal saline, 1/8th strength Dakins, etc.). Old dressing with (minimal, moderate, copious) (serous, serosanguinous, bloody, purulent) drainage. Wound bed (is red, has yellow slough, has necrotic areas. ((There are lots of things you can chart here; how specific do you need to be? You can be very technical including measurements.))) Redness (or no redness) present (describe where if present like distal, proximal, lateral to the wound etc.) and (1+, 2+, 3+, 4+ /I like to use scant or mild if this is allowed and it's very little) edema. (Foul or no) odor present. for a surgical wound, add in staples or sutures (and if you are required list how many there are) and where the wound is dehisced. a final product would like this... Wet to dry dressing change to the coccyx completed with sterile technique using Normal Saline soaked gauze and covered with an ABD pad. Old dressing with minimal bloody drainage. Wound bed is beefy red. Redness present in the proximal skin surrounding the wound and surrounding skin has 2+ edema. There is no foul odor. good luck!

sounds like a good system, and I like the orientation check at the beginning. I would add in skin assessment and of course any other tubes or lines they may have besides an IV. I also want to know when they last had a BM. The mistake I see nurses make is concentrating on the primary diagnosis and missing other things that a general head to toe assessment will show. For example, if your patient is post-op with a femur ORIF, don't just look at that hip incision.

well, if you aren't solving for ml, then you have that as part of your problem information, right? When you're solving for ml, your time is known hr=1 hour or 60 minutes. ml/hr is the same as saying milliliters per hour. so, if you have an IV antibiotic mixed in a 250 ml bag, how long will it take to infuse if you run it at 125 ml/hour. (Is that the kind of question you're talking about I assume??) 250 ml = 125ml x.......... 1hr or 60 minutes cross multiply and solve for minutes (you can also solve using hours, but just in case they throw out something weird, solve for minutes). 125x=250 times 60 min 125x=15000 min 15000min = 120min 125 120 minutes = 2 hours The IV antibiotic will infuse in 120 minutes or 2 hours. hope that helps.

I don't have to use a calculator too often, but there are times that I do. For most basic conversions, I can write and calculate on paper just as fast. If it's not basic, I double-check my math. A handheld calculator will probably be a thing of the past soon just like a typewriter is now. Most any facility has a computer or terminal with a calculator program on it that you can use.

probably not a good choice from what you posted. Too, around here it's not that easy to even get into nursing school. I know lots of people who can't get accepted.

with a continuous feeding, check the residuals every 4 hours and before any flush or medication administration. With bolus feedings, check the residual before the bolus.

I can't stand nurses who belittle CNAs. It's repugnant to me and shows a total disrespect. I'm glad you stood up for yourself, and I'm glad you did it in a productive way (you the nurse, and the nurse manager) instead of in the patient's room or in front of other staff.

I don't remember implying that. Last time I checked, I was in the vast minority in a female dominated profession also.

on admission, we use the FAST (tool) which stand for Fall Assessment Screening Tool. That gives you a number, and if it is over 60, then that patient is a high risk for falling. That means bed and wheelchair alarms. Other patients who might not score 60 but have fallen recently in the hospital or at home, have periods of confusion, family reports they are unsafe, etc. we bump them up to a high fall risk. High fall risk patients have a red sticker at the door, above their bed, and on their wheelchair. They can not be left alone in their room unless they are in bed (or with a competent family member who knows not to leave them in the room unattended). They can not be left in the bathroom unattended. They are rounded on q 30 minutes at minimum and more if that is needed. All patients must have some sort of non-skid footware when transferring. All patients must have the gait belt used on transfers. We are not a restraint free facility, but they are only used in the rarest of circumstances (both physical and chemical). SR up x 4 is also considered a restraint. We also do not utilize 1:1 staffing. We do encourage and sometimes mandate that the family provide 1:1 supervision either by the patient's family/friends or with a Home Instead type service. If a patient is made a red tag or high falls risk, and they are not confused or have shown no unsafe acts, the nurse can make the judgement and per medically approved protocol write an order and decrease the patient to a moderate risk.

I don't experience it every day, sadly, but I do get it enough to remind me what I do and why I do it. Just this week, I had a rancho IV TBI have a breakthrough period where he was lucid and at least a rancho VI. He reverted back to his confusion and agitation later in the shift, but while he was lucid, he knew a whole lot of things and remembered a bunch. Hopefully, he'll continue to improve!

My experience is in inpatient rehab (freestanding hospital), andI think it's too many. We run 12 hour shifts, and the night techs have 7-10 (sometimes more if terrific problems with call-ins). 15 isn't doable for a rehab tech unless you are getting help from your nurses. "Rehab Unit" can mean lots of things though. Seems like every swing bed and nursing home has to get in the word rehab now. If it's nursing home type patients, 15 is a good number.

this is an older thread, but I'll answer since this is a passion of mine as well! I've been to Haiti 3 times on 2 week surgical/medical mission trips. The group I go with is very established so you don't have to worry about where to sleep, clean food and water, security, etc. That's what I would recommend for you. www.nwhcm.org is the url (hope that's allowed, mods). There's a link on that page for upcoming mission trips.

go with an established group. Heading to Haiti on your own is not what you want (trust me on that).

I've known plenty of chitty nurses in my career who passed their boards on the first try. I've also known several who had a terrible time passing but ended up being great nurses. The NCLEX is what we have, but imho it isn't the greatest. I recently helped my new-grad cousin study. I would have had a heck of a time passing the test if it was anything like the online review she was using. We spent hours on it, and it was hard as he//! She had a terrible test taking problem, and it took her 4 attempts to pass. She's certainly not dumb, and I think she's made a good nurse.