6mostogo

At my ltc job, had an outbreak of cdiff right at survey time and we had some related infection control tags. Also had a related pt dignity tag because outside of isolation rooms we had a regular, same as what's used in the room bedside chest of drawers, in which we kept ppd to be applied before entering the room. Dignity issue because other res could pick out who was infected by who had the chest of drawers outside the room. Intervention, moving the drawers inside the room, so you have to enter the room and apply the ppd. The intervention for the infection control problem? All res in contact precautions for cdiff must apply a bright yellow ppd gown anytime they leave the room, for therapy, to the dining room, etc. Even A &O, continent, ADLs per self Residents. But not gloves. Because that would be a dignity issue. And it's not like cdiff is spread by hand to surface contact.

3.4 not a critical level, but our cardiologists like pts on monitored units to keep K+ above 4 and mag above 2, so we bolus pt with non-critical levels frequently. They do expect the on call cardiologist to be notified of a "low" level when results are available; for the most part they are all on the same page about this, and that's why the is always someone on call. Labs results start coming in prior to change of shift on our unit, so i usually will make those calls around 6-630a. But that's our unit's culture, even on other floors in the hospital I'm sure this isn't the same. It's just one of those things you pick up on after working the same unit for awhile. Now you know that doctor's preferences for the future.

Agreed. Also could have been lab, imaging, housekeeping, etc. All in scrubs and all interact with nursing, and thus may have complaints about a particular nurse.

Not discounting that the op's perception as totally inaccurate, but she did state she had AMS, feeling panic, disoriented, was getting up per self and wandering the hall, and still is fuzzy on some the the details. She may not realized that her own behavior was a threat to her own safety (walking halls per self with head injury) or that she may have been bordering on hysterical at the time, understandably. Her nurse's priority at that point would not be hand-holding and coddling, it would be ensuring her safety. Get her back to bed. Administer anti-anxiety meds. Best way to deal with any confused and upset pt? Short directive statements. Firm tone of voice. You go here. Stay here. Swallow this. A brain in panic mode can't comprehend much more information than that, let along drug information, side effects etc. A "You are safe" or "You are ok" may have added to the therapeutic relationship and kept the nurse from sounding too short, rude or offensive. Maybe in fact she did say something along those lines but the OP doesn't recall. In triage they would have assessed for hx of drug allergies/reactions, again op may not recall. Assuming this Nurse is a competent member of our profession, she would have checked this before administering an ordered anxiolytic, and we have no reason to doubt she did so. The ER doc and RN used their judgement and deemed the med safe and necessary in that moment to keep OP safe and calm, whether or not she deemed it an appropriate time for med education. OP calmed down, had no detrimental effects, remained safe while in ER, even became less fuzzy after med was given and able to give information to admitting when shortly before she was in such a state of panic she couldnt remember where she was or why she was there. Does anyone really think a little handholding and gentle redirection would have such effective results? So no, I see no reason to encourage OP to report her nurse for showing "lack of compassion." And while sharing her opinions of OP's friend may be blunt or unprofessional in that environment, many are giving op similar advice here without OP being offended. I don't see a point in encouraging OP to report her nurse just because she can. "How dare that nurse point out such a truthful thing to me in such a direct manner! She may have a point and I appreciate similar advice from strangers on the internet, but when treating me in the ER she has no right to express such an opinion, so I will file a complaint with management, for she told me things I did not want to hear!" Really? And how often do y'all have vent and rants on AN when other pts complain that they weren't handled with kid gloves and told exactly what they wanted to hear? "They said Billy needed to lose weight. They called him fat!" Or "They wouldn't let me order mom a milkshake (just because she had a BS of 385!)" I've only floated to ER a few times, but that short of thing seems magnified in that environment, because most of the pts, even (esp) the noncritical ones, are experiencing a crisis of their own and so are very focused on their own needs in that very moment. Kudos to ER nurses who routinely juggle and prioritize the needs of multiple such pts; its not my cuppa tea. In truth OP you have experienced a truly terrifying event and I hope you do find the support you need to recover from it. The ER is only the first step in that process. Hopefully you and your loved one will never experience such an event ever again, but bring with you into your nursing career the realization: there was no way that ER nurse could have dropped her pt load and held your hand and listened to you talk for 30 minutes. It would have been lovely if she could have,and you may have truly needed someone who could have done that in that moment, but in the ER there is no way she have done so and still provide safe and competent care to all her pts. It's just not the nurse's role in an emergent care environment. If this was a case of sexual or domestic abuse, in our ER anyway, a specially trained RN or counselor would be available to provide for that need - it still would not fall under the primary RN's role. Depending on what kind of position you accept as a nurse, you may find that providing that level of support is not your role either. You are the co-ordinater for all of the pts needs, not the provider. This may very well be a wake up call for you in this regard, or at least a realization that ER nursing isnt for you.

I haven't read the rest of the thread yet, but I'm sure I'm not the first to say this: I would jump at the chance to learn from Ruby Vee for a day.

We've just had one of those families leave our SNF. Brought mother to our facility for PT/OT after a hospitalization, and there was a family member at the bedside 24/7, always taking notes. For a while they didnt cause too much trouble and actually helped with mother's care, ambulating her to the BR and so on. But then they would start finding things to fixate on and worry about excessively. To the point that they brought in her home glucose monitoring supplies to take BS at randomn intervals, and requested prn neb tx exactly 4 hours apart day and night whether or not mother wanted them or if lung assessment warrented them. Finally they raised a stink that the nurses weren't providing enough of mother's care, and if they weren't there, why nothing might get done at all! They might as well take her home! So they did.

Agree with everyone else. You were out of line. Furthermore, a NURSING supervisor has no authority over dietary matters. A cursing member of the nursing staff calling a nursing supervisor demanding information neither party has a right to? Sounds pretty intimidating to whoever this gets passed along to. Definitely demonstrates a lack of professionalism on your part. And if later you were to mention that Suzie Nursing Supervisor said such-and-such, she would also be out of line. She has her own butt to cover. Think about what you did, and sincerely apologize for your behavior. Make no rationalizations. Just apologize, state you understand why you were out of line, and that it will never happen again.

In my years as a CNA I've never come across a resident on Airborne Precautions - not droplet precautions, but airborne - until recently. Pt tested positive for a active drug-resistant infection and definitely is on airborne precautions. From school, I know that this normally requires a special mask which staff should be fitted for, use of negative pressure rooms, etc. My concern: I've seen two boxes on N-95 disposable masks. Once those were gone, these were replaced by boxes of regular procedure masks. Once the facilities store of masks were exhausted, we went the weekend without. Pt is is a regular room, with the door shut AAT. Without proper equipment, most staff avoid the room as much as possible, and address pt by standing at the open doorway. Pt is able to complete ADLs independently, but after several weeks on isolation is incredibly lonely, call light happy, and eager to engage in lengthy conversations - can't blame the poor guy. questions: Is the disposable N95 adequate protection without proper fitting and education of the staff? My unlicensed coworkers mistakenly believed these "duck masks" were cheaper due to the uncomfortable fit and preferred the regular masks. I've advised several on how to ensure the mask formed a good seal to the face. Since this pt isn't dx w/ active Tb, but a drug-resistant organism, are regular face masks adequate protection? A regular unpressurized room? (Standing with the doorway open to address the resident in lieu of mask??? ) A couple of the nurses must have seen how this was going to go, wise prescient beings that nurses are, and have labelled and saved their disposable n95 mask for repeated use, keeping them in plastic bags in the isolation cart outside the pt's door. I know that airborne precautions are specified for organisms that must be inhaled to cause infection, so theoretically, is this practice ok? Cause for me it still carries an ick factor. But if disposable masks can be used by the same nurse for the same pt, then if those "duck bill masks" make a reappearance, I may do the same. Is this better than a regular mask, or no mask? And on a personal rant, why isn't the activity department required to provide one-on-one time with residents on isolation precautions? Shockingly, for me, this facility is one of the nicest I've worked in. It is evident that price wasn't a concern in the design of the building or when it comes to satisfaction scores. Employee satisfaction and safety, sadly, are not as important concerns. No reason why the weekend manager couldn't pick up some masks for the staff at the pharmacy down the street!

I never initial and time the depend. In my experience, it's always been a nurse or member of administration bent on catching a slothful CNA who sneaks into rooms to do this, not other CNAs. I also *love* when little notes are left under the resident's rear end: "Please return this note to the charge nurse as soon as possible" to see how soon the aide goes in to turn someone. People with that much time on their hands should just turn or change the resident while in the room and give the CNA a break.

Foreign terms drilled into my head when I was in CNA training: patient = resident diapers = briefs or Depends bib = clothing protector toileting is a verb poop = BM I'm not sure they still teach this in my area, or if they do, its not as emphasized as I remember. These just roll off my tongue without having to think about it anymore. Some of these new aide look at me like have two heads when I report Ms. So-and-so was last toileted at such-and-such time. For the most part, residents have always looked at me like I have two heads the first time they hear "BM" and I usually have to break down after a few rounds of "Can I assist you with your clothing protector" and just say bib. But I still cringe when hear it. It's better to show an attempt to maintain the pt dignity than to show total disregard. And it's much easier for an A&O resident s/p CVA to accept the use of a clothing protector than a bib - good for his dignity, good for me, one less shirt to change. Just saying.

Depends on your state. I was certified as a CNA after a 2 week course - one week in class, one week on the floor. Then I was able to work for 3 months before taking the certification exam. Also, if you have completed one semester of nursing school, you can apply to take the certification exam. That's how it is in my state. A PCT (patient Care Tech) in a hospital does the same thing a CNA can, usually the same training is required to be hired. The hospital, depending, may train you for other very specific tasks, such as inserting a Foley Cath, d/cing an IV, very simple dressing changes, etc. Nothing invasive (IV starts) and no med administration. I have found my CNA experience to be both very rewarding and very enriching to my education. I have found nurses with CNA experience are better prepared for the workload, the general environment, etc - they are used to juggling a lot of very needy

Not in Indiana. I took a CNA course the summer I turned 17 and worked LTC through my senior year of high school.

I've been a CNA for several years, but never in the hospital setting. Since I know where I want to work when I graduate from nursing school, I've been keeping an eye out for any CNA/PCT openings at this hospital, thinking it would give me a foot in the door when the time comes. Unfortunately, it's been several months of watching and waiting for a position to open - the recession even affects UAP! Never thought I'd see that happen. Anyways, a listing finally opened this week and I immediately applied. It's for a 3-11 CNA position in the OR department. Now what exactly does a CNA in the OR department do? I wouldn't be surprised in any of the inpatient departments, but I will be going into an interview with no idea what to expect as far as job responsibilities. Some vital signs, some moving of people from one stretcher to another, some paperwork (what kind of paperwork???) is the most I can come up with. The job description just stated must be able to lift up to 50 lbs and have computer skills. Cross-posting to the CNA board.

I'm a certified nursing assistant and home health aide.

Infection Control Mnemonics - Nursing for Nurses I've used this for tests before and found it helpful. :)