NurseRachet

I love the "look" approach. At our hospital, we have a written policy in the patient handbook when they are admitted Patient Rights and Employee Rights. That includes that we are to treat each other with respect and courtesy. Our administration supports us dealing with rude families. We also have a "Patient Representative" that deals with conflict - both ways. We also allow the nurses to request not to take care of the patient...or at least do not assign them with that patient day after day. Thanks.

The most embarrassing moment in my 32 years as a nurse, was walking into the restroom, and who did I find, the CEO of the hospital, sitting on the stool with his pants down around his knees. Needless to say, the only thing I could say, "Oh my God, I am so sorry", backed out and closed the door. Apparently he has a habit of not locking the door. I can hardly look him in the face now when I see him. My face turned beet red.

We also chart by exception. All units have 24-hour Flow Sheets that have multiple boxes to check. The critical care units check boxes and write out long hand the same stuff....can't change them. All other units are pretty good about charting only the exception, but we have found some that write basic info that is in the boxes. They just feel that they MUST write out info as well as checking boxes. When we went to electronic charting, they get away from doing this since the forms are all check boxes, or multiple select boxes. That really stopped this "long-hand" writing. Legally, if you write lots of stuff in a chart, it is more damaging then if you write very little - at least that is what we were told. The key is chart what is abnormal (and expound on that info) and what your intervention was. There are always going to be some nurses that fudge either way and chart non sense stuff or don't do a very good assessment and miss something. Everyone works under their own license...that is enough incentive for me to watch what I chart.

I work in a 224 bed hospital. We utilize admission/discharge nurses in the critical care units (CCU/ICU/Telemetry) and the medical/surgical units (4 units). They come in at 11 am and work until 9 pm. They work 6 days a week. Every Sunday off. We also have a "preadmission" nurse (M-F) that sees scheduled surgery patients one week in advance of their surgery that completes all the admission paperwork. When these patients report to the hospital, the receiving nurse validates all the info on their admission paperwork. When these nurses (the ones that work in the hospital directly) are not busy - when that happens???, they are helping to start IVs or transcribing physician orders. They are never assigned direct patient care or given assignments. They stay within their own area and do not overlap. Pediatrics and OB prefer to do their own admissions/discharges due to their speciality. In our hospital, the staff nurses love them and can hardly function when they are not there. In fact, if one of them call in ill, they will give up one of their nurses to fill this role. All of our admission forms and several others that are continued throughout the patients hospitalization, is on the computer, so it is easy to follow and continue these forms. These nurses are figured in the budget of their areas. One key issue with hiring these nurses are that they must have excellent people skills, clinical skills, good rapport with the physicians, and most of - self starters that will not sit around when they have down time. Good luck with anyone anticipating starting this program - it works!

AMEN to the response - boy, have we all heard that response before!

Hello - the field of informatics, although not new, is growing leaps and bounds. I have found that most companies and hospitals are hiring nurses for these positions. they need our expertise. I went for training about 2-3 years ago for just building electronic nursing forms. Although my primary role is management, I work in about 3-4 days a pay period doing electronic work. I also teach the nursing staff when new forms are released and follow-up with doing QA audits following the release of the forms. When I combined both roles, I received a significant increase in salary. I have found the salaries vary widely among these type of positions. I have a friend that also does the same thing I do at another hospital within the same city and earns about $5,000 more on the year than I do. Good luck with your role. It is very challenging and exciting!

Hello. I also started out in the OR. I worked there for about 5 years, got bored, and went to work for a surgeon as a private scrub nurse for about 4 years. Pay was not good, so returned to the OR for about 8 months and quit, as I ran into him all the time I worked, or had to scrub for him - ugh! I then took a night relief charge nurse job on the Orthopedic floor. Worked there for 8 months and quit the hospital. I then worked for the VA Pscy hospital for 11 years. I have since returned to the general hospital. Hired in on the med/surg floor and worked 8 months, have now been in management for the past 9 years. In the past 2 years, I have been taking training in electronic documentation form design, and hopefully will do this full time in the near future. Oh yes, I am 56 years old and have been in nursing for many years. I say go for what ever makes you happy in your career, that is what makes nursing such a great profession, so many opportunities. You go girl!

It depends on the assignment. At our hospital, a nurse can refuse an assignement if they have had a major conflict with the patient (patient hit them, spit on them, etc.), they feel incompetent to care for the patient clinically (Ped nurse floating to ICU and given a patient on a vent), but, they cannot refuse to float to an area they are competent in, if they are requested by the house supervisor to do so. They cannot refuse going based on RN versus LPN. The house supervisor determines what level of nurse floats, if the need arises. We have these policies and procedures in place. We rarely have a problem with this process at our hospital. Good luck

I have seen this situation occur at two different hospitals that I have worked. At one hospital, the "shift war" got to be so bad, that the DON said, each shift will rotate forward one shift until they have worked all 3 shifts - then they will see what the other shift does and can come back to their own shift and make some logical, realistic plans to stop the "war". Believe me, that caused a war in itself. We had a union, and they couldn't stop the rotation as it was only "temporary". It was a real eye opener for all the staff and stopped the "war". We rarely heard any grumbling after that, if so, it was done outside of the hospital. One of the biggest things that I see is the inability of nurses to understand that all nurses do not develop organization and clinical skills at the same speed - if at all. Too bad, we are all needed. Good luck with your problem.

I am interested in what some of the House Supervisors role/responsibilities are in other hospitals. I work in a 225 bed facility, that averages 50-60% capacity. I currently work the 3-11 shift, but the night House Supervisor is wondering the same thing. What is the average pay scale? Are they required to attend meetings, and/or serve on hospital based committees? Just curious.