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allthesmallthings

allthesmallthings

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allthesmallthings's Latest Activity

  1. allthesmallthings

    How NOT to suck at turning a Pt, esp. w/ trach/vent??

    Thanks, orion81...you took some time w that reply! That's helpful. :)
  2. allthesmallthings

    How to do one-person turn for quadriplegic / trach/vent Pt?

    Thank you
  3. Hi, there. I need help learning best (or just good!) technique for turning my patients in their beds, especially the trach/vent patients. Of course, it's just me (one-person turn) turning them. (Yes, yes, I suck - I've been a nurse for ten years, but worked in hospital, and had second person to help with turning patients in bed for incontinence/bed baths/putting onto hoyer pads, etc. Somehow, I did not learn well the technique, back in nursing school, and it shows! I'm inefficient and awkward at turning my quadriplegic patients by myself, and I'm genuinely uncomfortable turning the quadriplegic trach/vent patients, afraid that I'm going to pull on their vent tubing and pull out their trachs. I wind up having to turn my patients multiple times to get sheets/pants/diapers/hoyer slings underneath them correctly, and I take forever to get things done with them.) Anyway, I want to not suck at it anymore. I've watched youtube videos/nursing education videos, but these don't show quadriplegic patients, or total-care trach/vent patients, or one person doing turns on these types of patients. They show two people turning a "patient" who's about 30 years old and assists in her own turn. Really?? Please help! Thanks.
  4. Hi, there. I need help learning best (or just good!) technique for turning my patients in their beds, especially the trach/vent patients. Of course, it's just me (one-person turn) turning them. (Yes, yes, I suck - I've been a nurse for a while, but worked in hospital, and had second person to help with turning patients in bed for incontinence/bed baths/putting onto hoyer pads, etc. Somehow, I did not learn well the technique, back in nursing school, and it shows! I'm inefficient and awkward at turning my quadriplegic patients by myself, and I'm genuinely uncomfortable turning the trach/vent patients, afraid that I'm going to pull on their vent tubing and pull out their trachs. I wind up having to turn my patients multiple times to get sheets/pants/diapers/hoyer slings underneath them correctly, and I take forever to get things done with them.) Anyway, I want to not suck at it anymore. I've watched youtube videos/nursing education videos, but these don't show quadriplegic patients, or trach/vent patients, or one person doing turns on these types of patients. They show two people turning a "patient" who's about 30 years old and assists in her own turn. Really?? Please help! Thanks.
  5. allthesmallthings

    New Atlanta Contract

    Jaw drop. 20K???? Did you just typo in a 0 in the 20K? Sign on for how long a commitment?
  6. allthesmallthings

    New Atlanta Contract

    I live in Midtown Atlanta in a 100-year-old building, and I'm doing a travel nursing job 3 miles up the road at Piedmont Hospital. I'm sorry, I can't give you any advice on high-rises, or downtown. My 2 cents: are you taking/have you heard of MARTA? The 110 bus goes right up and down Peachtree Road past Piedmont Hospital, if you're not into driving (although it may take you longer than driving...I don't really know about traffic, because I don't drive, but I imagine that it won't be too bad, if you're coming and going for day shift. If you're driving for night shift, that's probably a different story). Anyway, Piedmont seems really great! I'm about mid-way through my 3-month assignment on a cardiac/pulmonary floor. There were lots of travelers during my orientation week (maybe 40, 50% of the orientees). One couple is married, and I think they're working in CV-ICU together, which I thought was cute. I guess you'll be starting at Piedmont pretty soon; congrats, and take care! PM me if I can give you any other advice/input. :)
  7. allthesmallthings

    Probably getting fired from ICU...how can I move into full-time LTAC from prn status?

    I hope so. The LTACH job would be easier on me, yes. I worked there last night, and was thinking about how much my peace-of-mind is worth.
  8. allthesmallthings

    Probably getting fired from ICU...how can I move into full-time LTAC from prn status?

    Funny you should mention a lawyer, HarryTheCat! My roommate is a liberal New Jersey journalist, and he got pretty darn fired up (as he does about many workplace issues), and offered to have his father, a federal attorney, look over the contract. At first I laughed, thinking it was kind, but overkill; but now that you've suggested it, maybe it's a good idea.
  9. Hi, there. I found out today that I may get "let go" from my ICU job, and I'm wondering how to best position myself to ask to go full-time at my prn LTAC job. Background: After 4 years of med-surg nursing, I got into an ICU residency (for RN's with no ICU experience). During 12-week orientation, I didn't do too well on the unit with critical thinking, and administration was helpful enough to extend my time under my preceptor and give me feedback. Now, it's 5 months later, and, try as I might, I'm still not performing well. They say I don't quite "get it" and my critical thinking suffers. They're still giving me the stable patients (basically, LTAC patients, or patients about to transition to the floor). Today, I learned that if I don't improve within the next 6 weeks (by September), I'll be let go, with 2 to 4 weeks notice. I'm going to keep trying to improve (particularly because I have to pay up about $8-10,000 for some form of breach of two-year contract if I'm fired), but I need a Plan B. I have a prn job in the ICU floor of an LTAC (just got off orientation for this LTAC job - my first off-orientation night is in a couple of days). These patients are trachs, vents, wound care, sedative drips, some hemodynamic drips, central lines - and I've felt more comfortable working there than in ICU; this work seems more "do-able" to me. My question is, how do I best present myself to move from PRN to full-time, with my current situation? And when? I just checked the LTAC website today, and they are hiring for full-time in the ICU portion of the facility, the same floor that I currently work at prn. When I go to the supervisor and mention that I want to move to full-time, is there a good way to avoid stating that it's because I'm being fired for ICU incompetence? Or, if it comes out that I've been fired, how do I best present that information? **Important: I'm not trying to put any patients at risk, and I don't really think that I will, in the LTAC. I have felt more comfortable there than in my ICU job. I never really had any "red-flag" incidents in the ICU where I put a patient at risk (except for removing restraints too soon from a fall-risk patient when he appeared more oriented) - the thing is, I'm just not really functioning as a full-fledged ICU nurse (not seeing the big picture, lack of confidence, not focusing on "if this happens, what then / what does this mean / what should I be looking out for" - which wasn't really so much of an issue for me when I was working medical-surgical). Obviously, if I find that I'm still not cutting it in the LTAC ICU and that my judgment is putting patients at risk, I'll look for another type of nursing job.** Fortunately, I live right within a couple of blocks from my LTAC job - literally walking distance -- so I'm thinking that I could present the ultra-short commute as a reason that I want to make the LTAC job full-time? And WHEN should I approach my LTAC job manager? Maybe just make some casual comment about it now (about how friendly the people are - which they really are - and how convenient a commute it is), since I still have 6 weeks? I don't want to wait too long and, if I wind up fired, maybe the full-time LTAC job is gone. I feel a little weird about the whole thing, because I'm normally a very honest person, and I don't really like to feel sneaky...but the reasons that I'd like to work at the LTAC are genuine (I just want to leave out the whole getting-fired thing). And obviously I gotta pay my bills and avoid becoming homeless. If I get fired from ICU, I'm thinking that transitioning from PRN to full-time in my LTAC job will be a lot easier than starting from scratch, going into job interviews and having to explain why I "left" ICU less than a year after starting, or filling in "yes" to the "Have you ever been fired from a job?" question, or trying to figure out the "Can we contact your former employer?" question. Appreciate your advice. Take care.
  10. allthesmallthings

    How to properly clean your stethoscope

    Hee hee. A wow is a cow, w/ a politically correct name. Anyway: workstation on wheels = wow; computer on wheels = cow. (Often spelled in all caps.) One of those computers w/ a little work/desk area, rolled around on wheels. Probably not all facilities have them. They're a newer thing, probably last 5-10 years. You can google image it, probably. Used to be called COW's, until some nurse called out, "The COW is in the room already," or something like that, and some overweight patient heard it, thought that the nurse was talking about HER (not about the computer), got offended, and raised heck. Now, we have to call them WOW's. My non-nurse roommate thought that was hysterical.
  11. allthesmallthings

    How to properly clean your stethoscope

    Rather embarrassing to say, Hygiene QUeen, particularly to someone w/ your screen name and your cheery signature, but I don't think I've seen anyone at my hospital wash their stethoscope...and washing their cow/wow? Nope...have never seen it at my place. Frankly, I myself just quickly slap some alcohol gel over it when I remember. But I'll try to be better from now on. A good scrub down w/ a sani-wipe makes the world go round, and God knows those wow/cow's are probably crawling. At one of our staff meetings, they recently told us that our unit, usually sterling in press-gainey compared to our medical floor rival, scored poorly on "nurses washing hands." One of the reasons may be that the alcohol gel dispensers are kind of out of view of the Pts, so although we (maybe!) are gel-ing in, gel-ing out, the Pts might not see it over in their beds, and if they are of the old-school mentality that "washing hands" means physically washing them w/ soap and water, then, yeah, they have no idea that we're performing hand hygiene. We're supposed to inform Pts that we're performing hand hygiene, even if they don't see it. I've started saying, when I come over and touch them to do my physical assessment, "Sorry that my hands/stethoscope are/is cold - I just disinfected them." (Kills 2 birds w/ one stone, because Pts are always saying my hands are icy!) I also don't really bother w/ gloves when cutting up pills. If my hands are clean (and they are - I'm the hand hygiene queen), and my pill cutter is clean (I wipe it down), and the pills are clean, then I see no mortal sin in touching the pill w/ my clean fingers, but I only touch the pill anyway if it doesn't slip right out of the pill cutter, which is a minority of the time. (Really, since most of the immune system is in the digestive tract anyway, I don't think it's a big deal. Stomach just chomps up most of those germs while bathing them in a hydrochloric acid pool pH of 2 or 3.)
  12. allthesmallthings

    How to properly clean your stethoscope

    Do you pay for those wipes personally, or does your hospital supply them? My hospital has "purple wipes" (I'm sure there's a name for them, but we just call them that because of the color of the lid on the cannister).
  13. allthesmallthings

    How to properly clean your stethoscope

    I just use the alcohol swabs. Sometimes I dump on a glug of alcohol gel from the dispensers that we use for hand hygiene. Plus, I just use disposable stethescopes (after multiple stethescopes that I'd bought for myself disappeared), so every few weeks or months, I move onto a new stethescope. Makes me feel better that not too many germs can be setting up camp. The other day, a Pt actually laughed at my "OCD" ("I saw you wiping down your stethescope w/ those little swabs, now you're doing it w/ your business phone!") Yeah, dude, and I wash my hands, too. (This guy was 46 years old and had actually never spent time in a hospital in his life, other than being born, I guess, so maybe he really was ignorant of hospital germs.)
  14. allthesmallthings

    Empty the foley they said...

    I had one guy who did that 2 nights in a row. During the day, he was oriented, but around 11pm was the witching hour. In the morning, he'd be all owl-eyed - "Wait, miss, you say I did WHAT?"
  15. allthesmallthings

    Control Issues

    Disagree w/ SoldierNurse22. I don't believe that most Pts will receive the impression that a hospital shower will ACTUALLY be "just like a spa." I believe jadelpn is correct in her idea of gently pushing Pts towards an outcome. This "just like a spa" comment is correctly directed to make the Pt smile (no one believes it will be a spa experience), get them in a good mood, nudge them towards activity. Not to be condescending towards Pts, but it's like a teacher creating a cheery mood w/ her students to get them to do some task. It's bright to create this supportive atmosphere while also providing limits (e.g., the Pt gets some choice in WHEN he'll do it - as long as it's before 3pm. And if you're afraid that they'll wait until 2:59, then tell them that the aide leaves at 2PM to give yourself some leeway. Then they call for the shower at 1:59 pm, still 61 minutes before the aide leaves for the day.)
  16. allthesmallthings

    Nursing: Art vs Science

    lol...
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