Ellen

In the hospital, the first thing I do when a pt seems particularly agitated I always offer tioleting first, then change of situation - i.e.bed to chair, chair with lock table, even recliners. Sometimes I get an Aid to take them for a wheelchair ride. Of course, I check all the obvious things first like pulse ox, did they throw their O2 on the floor? And I really try to understand their needs, sometimes you have to use your powers of understanding to interpret what they are trying to say in a very round-about way.

Protect your back! Learn the all important steps to protecting yourself during the lifting of patients, like always using your leg muscles. Use simple back exercises to keep your back strong and flexible. Back supports are no longer recommended because too many people thought they were to protect the back and they were only for support. And remember when helping someone else lift don't proceed with the lift if it is not right for you..the bed too high? Patient head needs to be lowered? Make it safe before you proceed.

I get concerned about the importance placed on the statistics of Patient satisfaction. Every monthly staff mtg we look at our current 'ratings' - percentages of satisfaction - sometimes based on as few as 23 responses to a patient satisfaction survey! It really bothers me when I am telling my Nurse Manager about a Nursing Assistant I feel could be dangerous but she doesn't tell me to write her up until I say a patient complained. The concern is too much patient satisfaction and NOT patient safety issues! I have found it's mostly the family members that cause the most problems, not the patients. With lawyers on TV telling them how unsafe medical care can be, the general public is showing a general loss of respect to healthcare personnel. Waving the threat of lawsuits over our heads at every turn. I recently had a patient call his lawyer about signing the consent to GET blood! Malpractice has touched our profession in soooo many ways !

Our telemetry floor has 36 beds and we get patients back after sheaths are pulled with sytec dsgs in place. We hang drips and we also have chemical rapid detox patients on telemetry (usual stay 48 hours). Our ratios with CNA is usually 8:1 - no CNA 5-6:1. The detox patients are usually 4:1. I hate direct admits from the Dr's office, they haven't been assessed, nothing initiated - you start from scratch, which can eat up all your time.

Our telemetry floor has 36 beds and we get patients back after sheaths are pulled with sytec dsgs in place. We hang drips and we also have chemical rapid detox patients on telemetry (usual stay 48 hours). Our ratios with CNA is usually 8:1 - no CNA 5-6:1. The detox patients are usually 4:1. I hate direct admits from the Dr's office, they haven't been assessed, nothing initiated - you start from scratch, which can eat up all your time.

If it is a same day late entry..like the dr. finally called back. I'll just add it to the clinical note for that day's visit titled 'late entry' Next day requires a Medical REcord Addendum note. We try to NEVER add to the record after discharge! Doesn't look good..

Hi! Here in Florida we have lots of supply problems too because of the heat..BUT as far as normal saline..most of these problems were solved by going to spray saline for all wound care. They have long expiration dates like 11/01. They come in 3oz and 7oz and really are a great savings!

I find alot of good Patient teaching stuff right off the web sites like the American Heart Assoc, Cancer society, American diabetes Assoc., etc. I find half the fun of the internet is surfing around discovering new places. My patients love it when I bring them info from the internet!