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!

One of our patients is constantly whining, very anxious and on his call light every 10 minutes. He has been with us for over a month now, so we keep rotating nurses that take care of him. For this particular patient though, it was a good thing that he whines. He has been sent to the ICU three times from our floor. The nurse would know that something was wrong and monitor him more closely because he would actually STOP using his call light, and would not 'whine' so much. This was totally uncharacteristic of him that the nurse would check on him more often, and eventually he was sent to the ICU for those three times. It wasn't a good thing when he was off the call light!

We have a "No Pass Zone" on our unit. If a light is on, you are not allowed to pass it up, you have to go into the room and at least find out what the patient needs. The nurse has her phone number listed on the white board in the room, so whoever answers the light can call the nurse and remind her what the patient needs. Sometimes the patient hits the light on accident, and this saves the nurse from leaving a patient that needs her (him). This creates more teamwork on the unit because we help each other out more. When we started out the program, we would hand out 'tickets' if we saw someone else answer our own patient call lights, and the tickets would go in a drawing at the end of the week for a small prize our manager would purchase. It works :)

We only give it SC; I was not even aware it could be given IV. Most of the time, if our patients are inpatient, we give neupagen. Neulasta is given IV as an outpatient in the Cancer Care Clinic. This can only be given as an outpatient though, so sometimes the MD will have the patient on Neupogen in the hospital, and then discharge them early so that they can get their Neulasta as an outpatient. Oh, insurance.

I was put in this situation...my manager was leaving and wanted me to step in as interim manager until the hospital found a replacement. I knew that I didn't want the postion permanantly though, as I only had 2 years of nursing experience. I had the position for 3 months ( I actually wanted the position after 2 months, but decided against it). The most challenging part of it was what you stated in your post- the previous week I was working alongside these nurses who were now coming to me with issues that they had with each other. They were treating me like a different person at first, which I didn't want! My team respected me when I was a staff RN, so I knew that they would respect me as their leader. But like the other posters said, just be fair, don't play favorites. Don't try to be everyone's friend though either. You will learn a wealth of information regarding management and leadership skills. Be honored that you were chosen for this position, and good luck!

You can use a regular huber needle to access the port, but if the patient is to have any kind of CT scan, DO NOT USE IT. A power port needle is specifially made to withstand the pressure used to inject the CT dye. If the dye were to be injected into a huber needle, that needle would break inside the port. So 'yes', you can access a powerport with a huber needle, but 'no' if there is a chance that the patient will have a CT scan.

Awesome!!!! Now how about an HCAHPS one?

Nope, it was a spectrum pump, not sigma. Sorry!

Now you have me thinking...I will have to go and check tomorrow when I go back to work. I have a pump locked up that I can look at when I get there.

Ours are going to be going live on June 14th. We are going to be training the staff next week. The super users have already gone through training. I wasn't aware of any recall though. That's interesting.

I know that I will be taking a pay cut...but when I was thinking about going for the position I did ask myself to take the money issue out of the equation and then make my decision. I don't want to do the job for the money, I really do enjoy what I am doing now. Thank you for responding, I do have a lot of thinking to do!