Eliseinalaska

I am a floor nurse for a tiny rural hospital in Alaska. We currently use Healthland classic but will be changing to a different EMR soon and we are being asked for opinions. We have had demos from Centriq and CPSI, Meditech is coming next week. I have not used any of these systems. Does anyone have any real life experience with any of these? I'm especially interested in people who have used more than one and can compare. I know Centriq is new (it's the new EMR from Healthland) so not sure how many have used it yet. Our clinic currently uses Centricity and likes it, but their hospital application apparently is not feasible for our size hospital. We would like to go to all one system if possible. I'm not sure if this is the best place to post this. If not, could someone move it? And if there are useful threads, could you post a link? Thank you.

You could fasten the frames to the opening with hooks or magnets or a combination of the two. Ooh, I like the magnet idea! That way you could easily take the frames off when you want sun in the room. Velcro might also work for attaching them. I can sleep with some light, so I use blackout curtains, sometimes only partway closed. I sleep in the guest room on in between days to avoid interruptions from husband and teens, the bedroom when I just want a few hours after the last night on and still be able to hear what the rest of the family is doing.

I live in an extremely small town, and my husband is a pastor, so many of my patients have some idea of what my beliefs are even before I know their name. Occasionally I do get asked to pray with a patient, and I do so willingly, but I do not ever make the suggestion. I do sometimes have serious theological conversations with patients, but again only when they initiate it. And I never ever try to push my views on someone else.

Thanks. It's good to start figuring out how things work. For the moment I'm staying in the hospital and I love it, but I'm interested in the public health arena- eventually.

Twenty years ago when I graduated from school I worked in a place that used care plans effectively. There was a section of the kardex where we penciled them in. They looked something like this: Respiratory distress - AEB SOB, cyanosis - Intervention: Elevate HOB, oxygen, I.S. Where I work now, we are required to make a care plan on each patient. It looks something like this: Nursing Diagnosis: Ineffective airway clearance. Goal: Patient will have effective oxygenation during stay. Characteristics: Dyspnea, Diminished breath sounds, Cough, ineffective or absent, Sputum production, Oxygen saturation below normal limits. Related factors: Infection, Secretions in the bronchi, Exudate in the alveoli. Outcomes: Infection status, Respiratory status: Gas exchange. Indicators: Uncrusted vesicles, Purulent sputum, Fever, Ease of breathing, Dyspnea at rest not present, Cyanosis not present. Interventions: Acid-base management, Anxiety reduction, Cough enhancement, Infection control, Intravenous (IV) therapy. Activities: Monitor ABG and electrolyte levels, as available, Use a calm, reassuring approach, Encourage use of incentive spirometry, as appropriate, Encourage coughing to clear secretions, Isolate persons exposed to communicable disease, Place on designated isolation precautions, as appropriate, Administer IV fluids as ordered, Administer IV medications as ordered. Every acute patient has to have at least one of these written by the nurse. And yes, I can bang out one of these in only about 15 minutes. I might even do two. Is it more complete? Possibly. More usable? You be the judge. Even though we do create them, it usually just seems like so much busywork. There's got to be a better way to communicate with each other what problem the patient has and what we are doing about it.

I'm just finishing my RN to BSN program and have discovered a possible interest in public health. The public health office in town is a one-nurse operation, so no job openings at the monent. Our location is very limited, since we're on a small island with no desire to move. I'm just wondering how it works, with no doc in the office. I'm used to having a doc at the other end of a phone line, anyway. Granted, I would have daytime hours and there would be docs in the clinic upstairs, but I'm accustomed to working off of orders in a chart, and I suspect this situation would be different, with well-baby assessments and such. Any insights?

Best IV skills also best foley skills, etc.

I also work in a very rural hospital (on an island). I work the ER and acute end, with an LPN and CNA on the LTC side; the three of us share duties back and forth. Sometimes boring, sometimes very exciting. I agree about getting your TNCC right away. I also got a copy of Emergency Nursing Made Incredibly Easy when I was new, and found it very useful in role playing various situations in my mind, especially since there are many situations we rarely see but need to be prepared for.

So sorry for your loss. (((Hugs))) What everybody else said. Your grandmother's death was sudden, and a very personal event for you. Your reaction does not mean that you won't be able to work with dying patients. I may mean that when you work with families of a dying patient, you will be able to be compassionate with people who react in different ways. You will not disregard someone's feelings because they left at a critical moment. You will know that people react in unpredictable ways. Most nurses encounter strongly emotional situations sometimes. But most nurses don't have to turn off ventilators on children. In school you will be exposed to various fields of nursing, and you can chose one that is a good fit for your personality. And, being a nurse, you can change your mind later. :)

Now that's just absurd. Sure, starting IVs isn't the most knowledge intensive part of being a nurse. But it's a necessary part of the job, and it takes a lot of practice to get good at the skill. I also didn't learn the skill in school. 15 years later, I finally started my first IV. I'm finally starting to get past all those years of doubt! Do what it takes takes to get that skill solid early on. You won't be sorry!

rneung, In order to qualify for the BSN program, you need to have a valid RN license. The clinical experience in this program is limited and can be done at your own hospital. They do also have an RN program, but it is based only in specific hopitals in Southern California. This would be a full clinical program, and you would need to attend all clinicals at one of their affiliated hospitals.

Yes, I am. I work in a small hospital on a small island in Alaska. I know our four doctors, and they know me. Many of my patients know me as well. I walk down main street, and I hear "Thank you so much for the care you gave my dad when he was sick". Yes, I feel important. Can you tell I love living here?

The job I have- Night nurse in a tiny hospital on an island in Alaska.

I am an RN who works regularly with LPNs. Our LPNs are excellent nurses whose work is very relevant. They may not have had all the humanities/ management courses that a higher level nurse has taken, but the education they have is very patient focused and appropriate for nursing. When I'm working AC/ER and an LPN is working LTC, I do the assessments and give the IV meds. There's a whole lot left for an LPN to do that a CNA can't (at least here). Besides, I'd rather work with a new RN who's worked as a CNA and an LPN first than one who's never taken care of patients outside of clinicals.

A liter over 8 hours is 125/hour. I've occasionally just been told to give it over 8 hours.