Daliadreamer

I was about to post this same question! I'm lucky that my hospital provides free certification review courses from a company called Ed4Nurses, so that is what I am using to study now. I plan on taking the exam in about 2 months, but I have no idea what to expect!

My dad and I had a discussion about this the other day....he said that he never fills out surveys that are "excellent" because he feels like that leaves them with no room to improve. My response to that was " you probably got someone fired for those responses". (I know I'm exaggerating but you get the idea.)

We are actually having a contest at the hospital I work at called "The Sacred Cow Contest". We are to think of things that we always do without any real evidence base, or something that we "have always done" and don't really know why (like taking vitals at midnight..it's something we have always done). Those whose ideas are chosen will be able to receive grant money to do research and see if we can make changes. It will be really interesting to see what comes forth!

When I worked in LTC, we had special low beds for residents that were a high(er) fall risk than the others. We would also put mats down around the beds. The only problem with the beds that we had were the amount of beds available, and the side rails. There were only two very short rails at the head of the bed, so the resident was more apt to "roll" out of bed. Even though it was only about an inch or two above the ground, if the resident was found with their legs or any part of their body on the mat, it was still considered a fall! They were much much much safer than the regular beds, however, so I couldn't complain about the safety they offered. All beds in any hospital should always be in the lowest position possible.

Hi everyone, I took care of a patient that had a PEG replaced the day before because his previous PEG was leaking. Patient was post CVA a few months ago and in the hospital now for hypoxia, non verbal. Everyone was going well with his feedings. When I went to check his gastric residual, all I was pulling into the syringe was air. I pulled three syringes of air before I stopped (because I was just amazed at what was happening). There was no resistance when I aspirated. I asked some of the other nurses on the floor if they had ever heard of such a thing happening, because I was very confused, and no one had an answer for me. Luckily, his GI doctor was calling the unit at that exact minute asking about another patient, so I told her what was going on. She also sounded confused, told me to stop the feedings and she would re-evaluate the patient in the AM. I am off today, and just curious what could have happened. Has anyone ever had this happen? Could the PEG be dislodged? I admit I did not auscultate the placement of the tube during this time via air because I was afraid I would do some damage if something was wrong with the tube. Thanks!

CrossFit! I feel like this gives me the biggest bang for my buck- it's usually a full body workout that you can do just one or two times a week in between your running schedule, and it does not take a lot of time at all!

I usually just flush .5 to 1 ml (if I remember!) after pushing an IV med because some of the med is still in the hub. If you don't flush, sometimes you can get precipitate with incompatible meds you are pushing if you use the same hub/port.

This has happened at the facility I work at several times. I was surprised to hear, though, that your manager was not aware of the situation right away. Was the charge nurse taking on a full load as well? As a charge RN, it is my responsibility to take care of my staff RNs in any way possible, either by running my butt off helping everyone else, or taking a full load of patients (or both). My first duty would be to let the manager know what is going on in the floor, and then call the staffing office, and then take out the unit phone book and call everyone (nurses and aides) on the list!

It REALLY depends on whether or not they are on active chemo, where they are in their regimen, and the type of ca but I guess a simple answer is YES.

Get him a sitter for a shift. I know it goes against productivity, but at least you would find out if he was just lonely or playing games.

I LOVE putting on L'Occitane hand cream before I go to bed, especially the lavender scent :)

I use Lush Dream Cream...I bring it to work and leave it at the nurses station, and everyone uses it, even the MDs. A teeny tiny bit goes a long way, so the $20 it costs lasts forever, I have had it for over two years. It's wonderful and very soothing.

Don't you just love when that happens?? And it doesn't happen very often. I took care of a little confused lady yesterday...I had to irrigate her bladder several times, and it was extremely painful (I had to close the door because she was screaming so loudly). I felt horrible, and her family arrived about an hour later. I thought that the patient was going to tell horrible stories about 'the mean nurse', but when I rounded on her, she placed her hand on my cheek and thanked me for being patient with her! It just made my day. This is why we become nurses; we do really make a difference! Keep being the great nurse you obviously are, and your good days will outweigh the bad!

Just like the previous post, we also have to identify the tele box with the correct patient every shift, and enter it into the computer charting system so that this does not happen. I don't know how this could have been prevented otherwise.

This is the one issue that always gives me heartburn during the shift. I used to always take the patient if the nurses were busy, but then I was busy with this new patient for the remainder of the shift, instead of doing my charge nurse duties, and things would tend to fall apart in the unit and I couldn't help the others. Always always approach the nurse and say they are getting an admit. If they are clearly swamped, then try to do the actual admission part of it (the paperwork, info gathering, med rec, etc.) and then hand off the patient to the nurse that was supposed to get the admit. Leave the assessment for them to do as well. This alleviates work for the nurse and keeps the flow in the unit by not having you tied to this new patient. Just introduce yourself as the charge nurse, state who the patient's nurse will actually be (and have the nurse come into the room and introduce herself to alleviate confusion later), and what you will be doing. This helped me a lot!