crystalcnd

At the hospital where I work we (nurses & PCAs) do hourly rounding. The PCAs round on odd hours and do ADL/Safety checks. The nurses round on even hours and do the same. We chart each time we round. The PCAs also do vitals checks at different times (Q2, Q4, Q6, or Q8). So really there is someone checking on a patient every hour and sometimes more often. If the patient is a total/complete, the PCAs will go in on the odd hours and turn the patient. You also have respiratory and lab coming in throughout the night doing breathing treatments and drawing blood. We do not have to sign anything in the room whenever we go in a pts room but we do chart when we do our rounds. This has really cut down on the use of call lights and on patient falls. On night shift if a patient is sleeping we do not wake them up, although it seems that most of our patients do not sleep at night!

Hello everyone! I live in Corbin which is in Southeastern Kentucky and currently work at Baptist Regional Medical Center. I am new to the medical field. I graduated from EKU in 2003 with a degree in education and taught high school for 5 years. I decided that teaching was not where I wanted to spend the rest of my life. I think I was bored with being in the same classroom day after day teaching the same thing over and over again. So...after 5 years in the classroom I quit and now am working as a CNA at the hospital. I will be starting school in January to get another degree and be an RN.

I think its a good idea to have an aide/tech on hand to help during a code. Yes they can't push meds but they can run for items that may be missing from your crash cart or that you run out of. For instance we had a code a few weeks ago and the ER doc showed up and needed XL gloves and all we had on hand were M and L, so the aide ran to the supply room for the right size gloves. They usually don't stay in the room during a code as it is already crowded in there but they are usually right outside the door if needed.

Our vitals are usually obtained Q4 RT (1 time per shift) Q8 Q6 or sometimes we may have a patient come form ER that is Q2 x6 or Q2 x4 (usually depends on the admitting dr.). I also work some in CCU and there we obtain vitals Q2.

We have charge nurses on our unit. They do not take patients themselves but assist the nurses in their patient care. The charge nurse handles all new admits/databases, etc., discharges, transfers, witnessing meds/wastes, starting IV's, assisting in foley cath placement, and basically helping the nurses if they need help.

Several things to address... 1. Some of you have mentioned that when you have a patient who has a fever or who is constipated you automatically give certain meds. On our Med-Surg unit we can not administer meds unless a doctor orders them. That means that if a patient develops a fever at 2AM you must call and wake up the doctor to get meds ordered. 2. I&Os. Our nurse aides document patient oral intake and output and do a very good job at it. We have I&O sheets that hang in each room and when a patient drinks something or eats something it is documented on this sheet. Also, when a patient has output it is documented. If they are incontinent it may be documented as X1 and if they are not incontinent it is documented in volume either through a foley cath or using a hat/urinal. We have cheat sheets on each board in the patient rooms, right next to where the I&O sheets hang. It has the measurements for popular things that the patient might consume. Like a small cup of coffee is _____ cc or a popsicle is ____ cc. This also helps that we can quickly look to see what a patient has consumed or there output without having to go to the computer. 3. If you notice than a new nurse, or even a nurse aide has messed up or forgotten something, tell them in a calm manner. Jumping onto someone, especially in front of patients or patient families can be very embarrassing to your coworker. 4. Amen to the person who suggested that RNs put a patient on the bedpan, take them water, etc. without hunting down the aide. I get so upset when I see coworkers who will spend more time hunting down the aide to tell them that the patient needs the bedpan or needs a cup of ice rather than doing it themselves. Yes I understand that we are all busy but for the most part you could have done that simple task in the time it took you to find the aide. Just because you are an RN or an LPN doesn't mean you are too good to clean poo! 5. Please answer the call light. I don't think it should just be the aide's job or the unit secretary/ward clerk's job to answer call lights. Our unit has a policy that if you are within 3 feet of the call light when it rings, answer it. I've seen so many nurses who will stand right outside a patients room or right next to the call light at the desk and never check to see what that patient needs. It's everyone's job to answer call lights!

I work at Baptist Regional Medical Center in Corbin and I think it is a great hospital to work at. Right now there is a hiring freeze on at BRMC so the number of open positions is limited until probably after the holidays. St. Joe's London (formerly Marymount) is a good hospital as well. They are in the process of building a brand new 300+ bed (all private rooms) hospital in London and I've heard rumored that the current hospital will become a VA hospital. So in the near future the job market for RNs in this area looks pretty good.