LobotRN

I found that the material on Koi Lindsey wasn't very sturdy and they would last maybe 9 months with regular washes after every shift. My personal fave is the Youtility Gen Flex by Dickies. I think they wear like iron, the colors stay true even when using the dryer, and they fit my big butt and thighs. I have yet to have the fabric where my thighs rub get thin and blow out like the Kois did.

I work(ed) acute care (Hey Commuter! Congrats) and my rule for refusals was this type of assessment and documentation: "Pt refusing (shower/bedbath/pericare/turns). Pt assessed for (pain/disorientation-delirium/LOC/mentation, etc). Pt educated for rationale regarding (you stink to high heaven, and if you don't turn or bathe it ain't gettin' any better and prob a whole lot worse!). Pt stated "I know not turning or allowing you to clean me up means I can get an infection, but I don't want to!." Pt educated about options for timing and options of care (bed bath or hose down) and verbalizes understanding, continues with refusal. Plan of care adjusted to continue encouragement of compliance with ABC/xyz activity. (Other team members notified as necessary)." Chart like a lawyer (parenthetical hyperboles in the prior example excluded, user results may vary and the described example is not typical of all clients. Use of the preceding example by any other party is with the understanding that no liability is assumed, express or otherwise, of LobotRN).

Exactly elkpark. Go to bankrate.com and look at their debt calculators. If you know the loan amount and interest rate, you can create all the scenarios you are asking about and see what the numbers look like. Its not a mystery. Don't go into debt if you can avoid it. Acquire as little debt as possible. For any debt you do acquire, get the best interest rate. And if you have debt, ALWAYS pay more than the minimum! Good luck to you. You are smart for at least thinking about the element of cost and learning more.

(FUNNY!) But on a more serious note, How long post op? Immediately after I vote hemorrhagic complication. A day or two later, I vote sepsis. What is the WBC? Lactate? This can really be a chicken-n-egg situation...either way its shocking!

Yes, yes we are. Why thank you blondy! And to the OP, I have been IDDM since I was 2 years old. Now on a pump with continuous glucose monitoring for the last 15 years. As far as your employment physical may go, your A1c says it all. Way to be a self advocate!

Hmmmm. I'm starting to think bathing and lift fairies aren't real?

No, we use disposable basins. In fact if we lowered the volumes of those, it would offset the bath wipe costs. I don't wanna even think what a reusable basin would culture out ewwwwwwwwww

THIS! A few months ago I tried to get a trial of the Medline bathing wipes, which are AWESOME, but was told it wasn't cost effective. Reallllllly? Single use items reduce infection rates, and it would take less than 10 minutes to bathe a patient (from supply gathering to end of bath) as opposed to getting a basin, warming the water, finding (if we have enough for every patient!) at least 8 wash cloths, you get the idea.

Ahhhh. I was hoping to find the bath fairy out there, somewhere. Seriously, thanks for the comments. But what it is seeming to boil down to is that we actually need to 1) have a culture shift that setting up a patient to do some self care with a basin is standard work, and 2) unless they can provide us with a lower ratio, good luck!

How do we get it done? I am looking for ideas on how to address patient hygiene issues in acute care. It is essential nursing care in my book, I am all for it, I try my best to get it done and help our CNAs to get it done. I'll absolutely MAKE it happen if a patient is exceptionally fragrant. But it doesn't always happen, and now it is on the "list" of high priorities for patient satisfaction for our managers. So frustrating..... 1. We often are not staffed to matrix. So when we do not have a unit clerk, the phone traffic becomes another nursing responsibility. I can either answer the phone which could be a critical lab value, physician, or family member, or I can let it ring ring ring and then hang up while giving a bed bath. Bathing is even less likely when we are down one nurse or one CNA. 2. We allow very few people out of bed on their own, so just letting them "have a shower" is not an option for 85% or more of our patients. And I don't like the idea of letting any elder bathe solo on a wet, soapy, slippery surface, even with a shower chair. If you're younger, I might risk it but certainly don't breathe a sigh until you are out and dry! 3. We don't have a "system" for determining who is due...if you are here for surgical observation and won't be here more than a day, are we to offer a shower in that case? On the other hand, we don't have a shower schedule for those patients who may be with us for 3 or more days. 4. Bathing for most of our patient population is at least a 30 minute affair....covering IVs and dressing sites, finding shower chairs and supplies. 4. Can I just have a bathing team? Kind of like a lifting team? Oh wait, we don't have that either.... Is anyone successfully providing hygiene in the hospital? How are you doing it?

In a nutshell, it can still affect you. Virtually any licensure application in any field has some verbiage to the effect of, "have you every had any publicly issued license revoked, reprimanded, or suspended?" That means if you were a licensed home day care provider, cosmetologist, or notary public and had any marks on your license, you are required to disclose. They will do a public records search based on current name, any aliases (maiden/married names, etc.), addresses for the last ten years, and social security number. Yep, it can follow you.

My Uncle works for the FDA. His response is cost re: glass ampules. Medications that are single use and that can be batch created and group sterilized, thus low cost production. And the glass ampules are impervious, so longer shelf life. This works well for meds that can be heat sterilized without damaging the medication, and also no individual sterilizing agent added to the liquid. Compare to rubber stoppers which have to be individually sealed w/ a topper and the capping equip it takes for that = higher cost. These are used for those meds (by and large) that can not be pasteurized.

^^^Exaaaaactly Ruby! Incidentally, we are paid for time in those ancillary meetings. However! Being forced into it and the impact it has on work life balance is horrible. Be on Shared Governance, sure it's only 2 hours for the monthly meeting. If you get assigned a task? Watch out. Pretty soon you are working for free on some project that is more likely than not to just be a song-n-dance routine. And since we cannot work from home, it means I have to come into the hospital if I want to be paid for the task time. Not. Worth. It. Ever.

At Acute HD, they must have candidates qualified for entry into a BON approved program, and that means science, English, and math, right? So then they can charge for that, too. Here's a good read on the subject: These are the schools driving America’s student loan crisis. - The Washington Post Who's up for student loans for nurse monopoly and flash cards and turtle saviours and viewless windows? (I do have to say their sim lab looks pretty dang nice ) I just realized that I'm pretty worked up over this. I think I'm most upset at the populations that are taken advantage of by these entities, the people who start and cannot finish but have loans, and the perceptions advertising like this promotes regarding qualified professional nursing care. I just came off a great shift and a shi++ty shift.

Surprisingly their pass rates are 91% + for 2014 and 2015, and they deliver about 75 or so candidates per calendar year. I just wonder how many enrollees make it to the end and can sit for boards? They pay tuition regardless, and none of the standard schools in our area will accept their classes for transfer. Sad, sad business.