justjRN

this is the only place I can ask any questions anonymously so I don’t have to fear being canned for it- whats your medical floor covid + ratios (non ICU)? Ours lately is one nurse to 5-6 covids. Ten on the floor today NO TECH for them. And Saturday one poor tech to the ten... Also level two mask and shield in the rooms. I’ve asked before if we wanted to wear n95 can we? Repeatedly told same answer “you don’t need it” . Luckily it is not my home floor but I do get floated there- I have refused to care for them without n95 . I realize n95 per the CDC is the recommended PPE but that level 2’s are acceptable. I don’t see the problem with wanting the most protection. Many nurses have not been fit tested at all or in a very long time on this floor as well- what the heck do they expect to happen if a covid patient codes?????! It’s just wrong and I’m venting and truly curious... maybe it’s the same everywhere or I am being a complete whine bag... thanks in advance for your input.

Hi there! CONGRATS on the new position! I’ve worked med surg about 6 years now and these are my most common iv push meds reglan, Pepcid, toradol, morphine,dilaudid,Lasix, solumedrol at times, protonix and zofran (lots of zofran!!) IV meds are usually antibiotics flagyl,ancef,rocephin,vancomycin and zosyn are the most common. Good luck to you!!

Good old bedside report.. We have been forced to do it for several years- I don’t mind it as much anymore. Like others have said it does take longer most times- my opinion what takes longer are the requests made by patient during/just after report before leaving the room. I think you really have to learn how to delegate requests-even simple ones at report time- that being said there needs to be a tech or someone available to do these things so these nurses can get report done. We had the problem of the techs getting tech report at the same time as nurses- patients would either have to wait or we would do the tasks while in room and report time took longer. Suggestion: Our manager changed the tech start times to 15 mins sooner and left 15 mins earlier end of day. Works great! Nurses are to be avail to help patient needs while techs do report and they are done with report and available to task while we do report also... my pet peeve when an offgoing nurse asks the patient at the end of report “ is there anything we can do for you right now?” OMG.... noooo you are just opening up bathroom and task central LOL!!

I work med surg and our hospital recently started new protocol that ER does not call report to floor patient is being admitted to. We are told we will be getting ER patient such and such and what they are generally being admitted for and to expect them within 10 minutes of notification they are coming. We are to look up any other info (our entire report basically). It sucks for us and it sucks for the poor patient who has questions etc when they get to the floor and we know nothing yet as it usually takes about a good 15 mins UNINTERRUPTED (which is nearly impossible as we are working short most times anyway) at a computer looking up history, labs, notes ,iv's, meds given in ER, new orders etc to put together why they are there/plan. Many of us have complained how unsafe it is and even many near misses that have happened because of it. But of course.. it falls on deaf ears. I was told it's understandable but they don't see it changing anytime soon...?! So- I wanted to vent and to also see if this is the process anywhere else out there?

Ours was recently changed due to some staff taking advantage of the previous policy which was similar to yours- you could call in one time every 3 months and then you'd have a clean slate again. Now we get 4 in a year with 2 tardies counting as one absence ( even a minute late). Once you are to 4 absences you're on grounds for termination. Sucks.

These type of patients are manipulative of your time- whether they realize it or not sorry to say. Easiest thing i have found to do is tell a CNA, secretary or even the charge nurse to call my zone phone if i am not out of the room in such and such minutes depending on how long i will need to get done what needs to be done. When they call i will say something like "oh... i'll be RIGHT there" and immediately after hanging up say you're sorry but you have to go. Or have someone knock on the door and say Lab is on the phone or the doc or something.... just a couple ideas for you!! They have worked pretty good for me. I really have only had to "use" them on a couple ppl the past couple years- i do try to take some time to listen... but 30 minutes is excessive. That is 30 minutes i am not able to help my CNA or my other patients.

That sucks- I was stuck about a month and a half ago. All they did was draw a hep panel and hiv testing on patient. The only blood drawn from me was to see if my hep B titer was still good. All tests on patient were negative but man that was hell until i heard that call. Sounds like all will be fine for you also- but i know how it feels. No sex for 6 months??? They didnt tell me that?? I wonder why it would be different for different people????

thank you all for your input!

Our facility is switching to bedside report in april- we have been doing report in person at the nurse station otherwise... i was wondering if anyone had some feedback on bedside report? Does it work for you? Pros/cons? How has your facility dealt with confidentiality in semi private rooms? My concern also was the time it could possibly take. I work overnight in a rehab facility ( our ratios at noc are 1:9 ) so usually in the a.m. i am giving report to 2 or 3 different nurses. Our report time is 30 minutes... I am afraid the "wakeup pees" alone pts will want to do will put us behind!!!

We have a spinal cord injury unit so I am unfortunately all too familiar with bowel routines!! Our procedure: Give suppository to pt in bed and let it melt for approx 10-20 min. Then we get pt up to a shower chair (a good high back one for a quad if you have them) with pan underneath- much easier to be able to reach under and do the dig stim than say on a toilet. I usually let gravity work for about 10 minutes or so at first. Then do one dig stim- lubricated finger just inside and make a slow ring around wall. Sometimes it will relax also if you keep in one spot putting pressure on wall. Give gravity another chance and come back in 10 more minutes to try a second dig stim./see if any more stool came down in bowel. I think some places probably do bowel routines in bed with a bedpan but really for Quads especially it won't be nearly as effective. Hopefully this helps a little!

I am so sorry - i will be praying for your husband to continue improving.

OMG the 911 ones!!! That reminded me of the pt i had one night who was "pleasantly confused" - called 911 from her room at 2am b/c she needed to have a bowel movement! We didnt know it until the 911 dispatch called us to inform us of our pt's need!!!

wow I cant believe they expect that from you!!! Totally unreasonable!!! Our hospital offers 3 days with 7a and 1500 times each day for a meeting each month. That usually accomodates most ppl.

Hi! Congrats on being a new grad! I started off at a rehabilitation hospital as a new grad a year and a half ago and am still working there. You really get to see a little bit of everything and you will still have IVPB's, Neb tx's, wound vac's, stumps, trachs, GT's/PEG's/TF's, dialysis patients, PICCs,portacaths I/O caths (especially with spinal cord), halo's, craniotomies/ bone flaps, Burn patients... LOTS!! So yes, I believe it would be a great place for you to learn and start to get a great base for your med/surg skills. Good thing about rehab (my opinion) is that you can really get to know the patients. Most are there weeks and some months even. I love seeing the progress patients make. Especially alot of the brain injury patients- some will come in coma awakening and leave walking and talking doing great. Amazing. As for ratios- i think it is the norm for rehab units/hospitals to have higher ratios due to the patients being "more medically stable" Our day ratio (7a-11p) is 1 nurse and tech to 5 or 6 patients. Night is one nurse and tech to 8-9 patients. I work 7p-7a shift and it can get pretty crazy with 9 patients.But i think our hosp. tries to get all the high acuity patients they can. Hopefully with your 11-13 they are not all/most high acuity? That might be something you would want to ask them. Good luck to you!!!

Sorry you have to hear that - this guy sounds like a complete moron. I like mr ian's idea- tell them you will come back. Even several times if needed. Let's them know YOU are in control. I always like the saying ( maybe this is not word for word)- "be nice to your nurse- they choose the size of the needle" :)