RNeyez

I work weekend option which means 2 12-hr shifts and an 8-hr shift during the week for a total of 32hrs/week. By choice, I end up working 4 or 5 12-hr shifts during a week to cover the unit due to our staffing shortage. Generally, anything over 40-hrs is overtime. Luckily, at our facility, anything over and above what you are actually scheduled to work is overtime. So, anything over and above my 32-hrs is overtime. So, yes, I sometimes have 30 hrs overtime in a week, and based on our two-week pay period, it will equate to 60 hrs overtime on my check.

Along the lines of armbands, I really wish our hospital would begin using those. Thanks for all the feedback, guys...It all helps. Ahh...wouldn't life be somewhat easier if I could go back to the flowsheets at the bedside, but alas...this hospital is as paper-free as possible...no paper MARS, no flowsheets, no paper nursing notes, etc. (wait a minute...what AM I thinking!!!~~~I'd rather type my notes than write them!!!) Seriously though, the only thing on paper are the MD orders, everything else is computerized charting and computerized medication delivery (so-to-speak).

Thanks for the input, Beth. It's appreciated. As part of a "Code Idenitification Committee" at our hospital, I'm trying to gather ideas on how other facilities operate. Do you guys also use red armbands when a patient is Type/Screened for blood transfusions? I'm also leaning towards the idea of armbands, but feel the patients are going to have an armfull of "bangles" by the time they are discharged. We use so many of them! ...armbands for patient identification upon entry to the ER, one for barcoded medication administration, one for being typed/screened/blood transfusion, one for allergies... I'm thinking if we can combine them on one armband, life would be simpler not only for the patient but for the nurses as well. The quest continues....

I'm trying to find a universal way for our hospital to identify code status on our patients. Currently we put the code sheet in the front cover of the chart and the MD will mark the box that is appropriate per the wishes of the patient (Full Code, No Code, DNR/Comfort Measures, Code With Restrictions, Etc.). My concern is that our first instinct (collectively) is to initiate CPR and call a code when we find a patient is not breathing. Worse yet, if the patient happens to be in the furthest room from the desk, we are wasting precious time running to the desk, trying to find the chart and by that time, someone might already performing CPR on the patient. Not a good thing if the patient is a No Code. But then again, precious seconds are ticking away by trying to hunt down what their code status is. What protocol do you guys follow at your hospital? Really interested in your input...and thanks! Lori

I'm a med-surg nurse and we deal with many dialysis patients on our unit. My gut instinct was always to hold meds (especially the BP/DM meds) before dialysis. However, at the hospital I currently work at, the MD will specifically write "give meds before HD" or something to that effect with the BP parameters specified. Makes it cut and dry for us nurses....especially when we get the docs that are too quick to say, "you are not to 'interpret' my orders...just follow them". Lori p.s. By the way, how do you guys pass on reports to the HD unit (if at all). The first hospital I worked at didn't pass on any reports at all...but the hospital I'm at now is trying to get some type of uniform system going. Too often, we're wasting time trying to find out if the Vanco, epogen, etc was given after HD while IN HD or not...among other things...like if the patient's BP bottomed out, etc.

I'm wondering what is the best way to relay a report from the nursing unit to the dialysis unit regarding your patient and vice versa. Do you find a hand written report (like a transfer summary) works best for you, or do you feel a verbal/phone report works best. I'd like some input on works in your hospital. We use computerized charting at our hospital for 99% of the patient interventions, however, we also use hand written, fill-in-the-blank transfer summaries for ICU transfers. What works for you? ...and thanks!