MorganO

If you have the time, do you not want to know what your patient needs? I am sure this question is not about who answers the light quicker and ethnicity. It is about why a nurse stood outside the door assessing response times rather than stepping inside the door to assess what the patient needed. Please do not tell me that she assessed the response time while that patient waited for someone to come into the room to ask for pain medicine, empty their bladder or was needed an answer to a question that was just weighting on them.

There is no excuse for not answering a light. That poor patient in the room was probably trying to get on a bedpan or walk to the bathroom. That is how our elderly fall. Where is the :heartbeat in our profession when we stand outside the door to see how long it takes a CNA to answer the call light rather than respond ourself and tend to the needs of our patient. No wonder.

I had to buy my cap because there was no capping ceremony at my college but it was mandatory for work. I graduated in 1986 and it was the beginning of the end for caps...thankfully. I cannot count the number of times I had to peek into areas that would lend for the back of my cap to lift off my head and plop into body fluids. Are you kidding me??? Worried about the Dr's tie???

3 RN's sounds like alot. We have 2 per procedure room. We however do not computer chart during the procedure at this time. We have gone to scanning the intraprocedure record into the EHR as we have not discovered a user friendly computer charting program for this facility. All pre procedure and post procedure charting is electronic, where time and multiple tasks is not a factor. Admission takes max 1 hour. Recovery is minimum of 45 mins. We are currently converting to an all RN staff to reduce the duplication of effort (RN assessment, hanging the first dose of ATB) which has helped significantly. Scanning the intraprocedure document into the EHR may be a solution as staring at the computer screen takes an able body away from the procedure.

I have recently had the sales rep evaluate our costs of repair for our scopes. They were purchased in 2005. The cost to repair these scopes was $25,417.5 since purchase. However we have completed 7447 procedures during that same time. The sales rep quoted the national average to be $15 per procedure which he was able to obtain from the internet. I however have not been able to locate this information. I have asked him to send me a link to this information, but he has not been able to find it for me. For the past 6 months our cost to repair our scopes is $4.34 per procedure. However they are newer than yours and are pediatric scopes. We have 6 pediatric colonscope, 1 regular colonscope, 1 pediatric gastroscope and 4 regular gastroscopes. We have 2 suites, 6 physicians, and 5,340 procedures in 2006. We also use an automated reprocessor. The problem with benchmarking is being unable to find like facilities. Our staff handle the scopes very carefully. It was identified through the description of repairs that the damage was sustained through operator use ie: buckles and insertion tube crushed at varying stages. Hope this information helps.

Our physicians have asked us to stock Biovac, a direct suction device from USendoscopy. Has anyone used them and are they effective?

Just a thought...although you are providing the direct am care for your many patients and Nurse Schmooozer is passing meds and let's call it interacting with the patient's family, why are we not viewing this as a collaborative effort to offer patients holistic care? How do we expect appreciation from our patients and other professions when we don't appreciate each other?...like I said, just a thought.

Where is Nursing on computer charting? Our facility has a "multidisciplinary" charting system that sells itself as a "poweful program that will change charting as we know it". Our facility's goal is to create an electronic chart...sounds good. All the patient information at your fingertips. The problem is with computer "downtime". Scanning information obtained during downtime is the answer to getting information onto the chart that is not entered into the computer. This however is not an option for nursing admissions, assessments, vital signs, recoveries, discharge planning, treatments, pain documentation, RN cosigns for LPN assessments... No scanning for us. Apparently we are to big of a dept to train. We have up to 10 days to enter the missing information. Overtime is not problem. I am furious that this hospital does not think that nursing time isn't valuable. :angryfire I want to go to the union, but I'm not sure where the grievance is other than patient safety issues due to information left out after 10 days of having not been entered onto the electronic chart.

My answers #1 is 1 Knowledge is vague #2 is 1 "Time is muscle" the quicker the doc will consider thrombolytics, the more benefit the patient will have from the med. Pain can be managed with NTG if VS stabke #3 Not sure #4 CPR althought I would rather Defibrillate a pulseless VF Vtach patient I will do CPR until the patient can be defibrillated

Absolutely...schools have them in the hallways and available at sporting events. Not just for spectators, but for the rare sudden death of young athletes. Not that it happens often, but once is enough.

I'm sorry you misunderstood. I was trying to point out to the writer that he assumed RN's have an associate degree and was venting my frustration with his ability to address an RN's bad behavior, but that same nurse has no recourse when she is treated poorly. I don't think that professionals need to shadow one another. Ultimately there should be mutual respect. The problem seems to be that physicians in our facility believe that they can cross the line with their frustration and there is no recourse from administration. Sorry I am new to this..

I'm sorry you misunderstood. I was trying to point out to the writer that he assumed RN's have an associate degree and was venting my frustration with his ability to address an RN's bad behavior, but that same nurse has no recourse when she is treated poorly. I don't think that professionals need to shadow one another. Ultimately there should be mutual respect. The problem seems to be that physicians in our facility believe that they can cross the line with their frustration and there is no recourse from administration.

But, if you do want to come jump down my throat or treat me like you wouldn't spit on me if I were burning, I will not hesitate to write it up and remind you that an associate's degree does not qualify you to question my MEDICAL judgment. :angryfire It is not always an associate degree nurse that may be questionning your medical judgement. They do hand out BSN and PhD diplomas in nursing. If it was an associate degree nurse that has lost their patience with you, I agree that some sort of recourse is needed. Imagine the frustration with the nurses who have to tolerate the mistreatment by another profession with no recourse. Most hospitals do not have a "no tolerance" policy and nurses (nor other paraprofessionals) have any way to correct the abusive behavior. Physicians, on the other hand, use the system to which you are reffering to and have recourse.

Many years ago...Our hospital started the no eating or drinking at the desk rule. The main target of the crack down was the coffee at the desk. When JCAHO came for a survey, we were all especially careful to not have our coffee at the desk. Imagine our surprise when the surveyers asked where our coffee was.:chuckle Now a days, our facility is not so strict.

I'm with Mattsmom. This OR would not be for me. I guess I'm wondering how you got into this mess. Is this new to your area or something that you agreed to upon accepting this position? I work in a rural hospital. As a critical care nurse, I have had to recover after hour cases. It is the policy at our hospital to recover these patients in ICU at the discretion of the shift charge nurse. This is to allow the OR call team to clean up and go home. I never felt that the OR team appreciated the relief. In fact, they challenged the decision made by the charge nurse as to availability of staff. As a nurse who needed to recover these cases, I maintained competencies and ACLS. How else do you not feel incompetent in these situations? I fear we are losing our capability to make judgements and accept our responsibilities as a professional group at the hands of our piers and other professions. I hope you get what your hoping for