HamsterRN ADN, RN

It seems to vary widely by unit and even by shift in a particular unit. In my experience on my unit, night shifts seem to work better as a team than days, which might be due to the support available at night vs the day. This seems to be because the...

Actually it's both. The ANA is made up of many constituent unions, including the one that represents me. There is a layer that separates the ANA at the national level from front line collective bargaining representation of nurses, but they are stil...

It's not really electrolyte replacement, but sodium bicarb can cause electrolyte shifts that can result in hypokalemia so it's always a good idea to check and replace potassium prior to giving sodium bicarb, particularly if the patient is prone to ve...

We use strict charting by exception which I thought was becoming fairly common these days, although it sounds like many nurses still chart lengthy descriptions of normal findings. Is this still that common or does it just seem like from this thread?

The hospital I work at actually posts our staffing at the front desk of each unit for everyone to see, including what our nurse to patient ratios are for that shift compared to what they should be based on special staffing and other variables. It ha...

Mistakes happen. If it makes you feel any better, our Infectious Doctors say it is no longer considered to be good practice to culture PICC or central line tips. They have a high chance of being contaminated on the way out by skin bacteria which re...

I have noticed that I don't share the same view on Physician ordered fluid restrictions as most of the nurses I work with. I agree with educating the patient about why they need to limit their fluid intake as well as addressing issues that might be ...

Agree with AsystoleRN, insubordination is a clearly defined legal term and this isn't it. Refusing to do something you were told to do, assuming it is in your job description, is insubordination.

I don't consider arguing to be a bad thing. There is nothing wrong with airing opposing viewpoints about what is best for patients and trying to figure out where the other side is coming from and how they formed their decisions. Yes, sometimes an e...

I got that assertion from "Yes, they can refuse the treatment plan, and they can do so by GOING HOME" and "If they don't want the treatment they need, go home". (stated by cherrybreeze) You don't think it's part of your description to evaluate wheth...

What are you basing that assumption on?

So if the MD D/C's the order simply based on the patient's refusal then you would give extra water? How is this not still "enabling a bad decision". If the patient's condition hasn't changed then how is no longer a bad decision on the part of the p...

Yellow nylon, with the blue available at our discretion. I wore one once while I was putting an NG tube in, it came in pretty handy (the pt's belly was beyond full).

I should admit that I also used to enforce fluid restrictions and I don't think a hospital should be a free-for-all where patients are given the keys to the med room, free to treat themselves with the help of wikipedia. I don't believe patients can ...

I think you may have missed the posts between the original and now, as everything you mention has been addressed elsewhere, I don't blame as there have been many long posts, and yes I am very interested to hear the other side of the argument and I th...

It would seem like they would need better evidence before publicly (at least to staff) declaring that a particular nurse was responsible for an infection. Particularly since they seem to be making some assumptions that aren't as absolute as they see...

Maybe we've been naive, but where I work RN's cover holes in the CNA staffing all the time. Some nurses like it (no passing meds) others not so much (nurses don't always take direction well from other nurses, particularly when the direction is to de...

From what I remember, a positive Homan's sign is when there is pain the calf resulting from dorsiflexion (toes towards knees). I've sort of intentionally let my memory of it go because it's supposedly of little clinical value if any. Many people wi...

What if the Dr. D/C's the order because the patient refuses and the patient's condition is the same as before?

That' s nothing compared to where I work: We are required by policy to chart medications as "Given" in the computer before even walking into the patient's room with the meds, we've questioned this and been told it's ok, it's policy.

According to the law in my state, not giving water to a competent patient who requests it is a crime, which is far worse than a bad survey result. Free access to water for a competent patient is the patient's right, no one will argue that the patien...

Exactly, it's not the nurses place to decide that the patient is not competent although you seem to be arguing that we can deem the to be not competent. Unless there is an order otherwise, you have to assume that patients still retain their rights. ...

I agree there is a point at which patient's are no longer competent to make their care decisions, where that point is could be a thread all on it's own. In my experience, it has to be pretty severe for a Physician or LMHP to declare their care invol...

I would suggest you take the math placement test at where ever you are planning to take your pre-reqs and start with the class you place into. Some schools allow students to argue their way into higher level classes and then those students often str...

From a legal standpoint, I think we may be a little off track. It has been asserted that the decision maker is the MD, although the law sees it differently (below is an excerpt from a legal summary) "During the past three (3) decades there has been...