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When I first joined this site, I felt it would be a great place for learning more about my field. Maybe nurses sharing tips and techniques about their fields, helping others, and I thought there would be more evidence-based posts because EBP is an important concept. No one on this site knows everything and I am sure at some point we have all made dumb comments. Here is mine. I once asked a patient with home PEG tube feedings how their Thanksgiving was. I then felt immediately stupid. Whether intended or not, this post seems to be a catalyst for a catty ***** session. It the intent was to bring some humor into our job (which we all need), it would be more effective if self-deprecating and not about the dumb nurses we work with. This type of discussion has no value, is unprofessional, and will only hurt us as people and our field in the long term.

In my facility and many others Foley's need to be documented q24hr to prevent them from being forgotten and causing a CAUTI. CAUTIs are an HCAPS measure and a hospital that accepts Medicare and Medicaid can have reimbursements withheld based on HCAPS scores. In my faciility the RNs have to document the reason for the Foley q24hr but not reorder. If there is no good reason we contact the MD to get a remove order. The longer the Foley is in the greater chance of UTI. Hope that helps.

Those fancy looking tubing covers that cover a steth. scope are a major fomite and infection risk. They make it impossible to wipe down your scope when needed. Better to go with an allergy band with your name or something like that like others mentioned. I have my name typed on a small piece of paper taped on one of the ear tubes. Very simple and I have never lost a steth. scope. Been a hospital RN for 5 years. The other key already mentioned, is keep your scope with you; in a pocket or around your neck. Don't lay it down.

There are a lot of lists out there about what makes an outstanding nurse. I guess I didn't agree with some of them because I created my own. Thought I would shared for Nurses Week... THE OUTSTANDING NURSE... 1. IS KNOWLEDGEABLE Has the knowledge to do the job or know where to get it. Knows what he/she doesn't know. A willingness the learn the rest. Knows where to find the information. Willing to pull up the policies to verify information or ask peers when necessary. Always asking questions and seeking new knowledge. 2. IS EFFECTIVE This comprises three skills. 1) Time management. 2) Prioritization. And 3) Critical Thinking. Not only understands the how to perform tasks, but understands the rationale behind them. Without this understanding it is difficult to individualize care and trouble shoot when problems occur. 3. IS TEAM-ORIENTED Always helps peers in trouble (to keep the team strong) if his/her patients are stable and safe. 4. HAS GOOD CHARACTER This comprises three qualities. 1) Confidence. Being able to tell a patient, I don't know that, but I will try to get you an answer.” Able to set boundaries when necessary. 2) Self-Awareness. Knowing your own judgments and biases and keeping them in check. 3) Integrity, honesty, and trustworthiness. 5. IS RESPECTFUL To patients regardless of their history, to peers and team regardless of past experiences, to themselves. 6. IS AN EFFECTIVE COMMUNICATOR Clear and constructive communication with the ability to communicate in various styles and to patients with various levels of educations and backgrounds. Communication with patients and the team should be verified to confirm the intended message was receive properly. Communication should be limited to necessary information that benefits the patient or team. Always follows up on tasks delegated to others. 7. IS SAFE Puts safety first. Always considers potential threats to a patient and taking steps to prevent them. The safe nurse has all the qualities above. They are able to use their knowledge to critical think through problems, communicate with the team, get further information if needed, set boundaries, and treat patients and team members with respect which fosters a solid and safe team environment.

This is solid advice. If you want the right answer, always go to the policy yourself.

The first thing is not to make any assumptions. When confronted with this question, I would ask "How can I make you happy?" so see what the patient is trying to communicate. Once I understand what the patient means by that statement, I proceed based on the patients level of cognition. Individualize the response to the patient. If the request is reasonable and will make the patient "happy", I will try to comply if possible. After all happy patients experience less stress which equals better overall healing. I don't take a patient's meretricious attitude personally. If I cannot comply right away, I explain this to the patient. Sometimes I give the patient options. I always tell the patient my number one priority is their safety. If the patient has dementia or delirium, then my response might be minimal. If the patient's cognition is intact then this is a boundary setting issue. I correct the patient and set some boundaries. I always explain to my patients that we are both members of the same team and I am there to help them heal and recover, not do it for them. They must do their part as well (IS, deep breathing, work with PT, etc). At that point if the patient continues to argue and is unreasonable, I offer them to discuss it with my supervisor. I never argue with a patient. I also will document something immediately even if I need to go back and fill in some details later.

This is what I did since I did not want to give up my biking. Use your phones record app to record a question, pause 3 secs, then speak the answer. Do this for all the info you have a hard time remembering (eg, cardiac diseases for patho class). Break down complex things into smaller question/answer pairs. Now copy these into a playlist and shuffle. Go ride your bike, run, walk, or work out at the gym and study at the same time!

The more stuff you carry around the more cleaning and risk for infection transmission. I would try to use floor stock for everything you can if feasible at your workplace. Just keep in mind and figure out a balance that works for you. For example, grab a sharpie from the floor at the start of shift. Once it is used in an isolation room, leave it there and grab another one. Otherwise you need to wipe down your own equipment with chlorahexadine or whatever your facility uses. This takes time, which was my most precious resource as a new nurse. Good luck and welcome to the profession.

Nurses are busier than ever. A 5-minute verbal report can give valuable overview on pt status that would take a much longer time searching through charts. Besides that, I have received pt that have deteriorated on the way to the floor. Not getting a verbal report before or at least the same time as receiving the pt would seem to be a safety issue in many cases.

I don't think banning families from visiting their sick relatives is the answer. It is what it is. This is what I do... Families can be difficult sometimes, just as patients can. I try to remember that they are under a lot of stress and I am probably seeing them at their worst. Some people are just always rude and feel entitled. I remind myself to be thankful that I am not the sick one, and healthy and able to work. I try to remember that it is my choice to work in health care and I can change this choice at any time. I try not to complain for the results of the choices I made. Also it is not my fault they are in the hospital, just my job to provide care and treatments while they are here. If I can comfort a family member with a cup of coffee and I have the time, I am happy to do it. Family members can be needy. When I hear this in report, I over accommodate them at the start of the shift. I usually experience them feeling grateful and eventually they back off realizing I am there for them and their sick family member. Some people will never be satisfied. I feel sorry for those people because they will suffer their entire lives playing the victim card. Again I feel grateful I am not stuck in that cycle. I always prioritize and will explain this to my patients. If they want coffee, I will give them a choice but explain my current duties to the patient is my currently priority. I am usually up front with patients. "Your Dad is very sick. I will hang his antibiotics and then I must see two other very sick patients as well. I would be happy to get you a coffee after that. You can always go to the front desk and see if an aide is available to get you a cup sooner. Also the cafeteria is still open." Finally I always set boundaries. If a family member's behaviour is destructive or interferes with treatments, I let my charge and super know, and call security. Many family members are an assets. They stay over night and help their loved ones to the bathroom and are involved with their care. This can be a huge help. This has a lot to do with the strong family Japanese, Filipino, and Hawaiian cultures in the families that we serve. This is not my first career. I believe every career and job has good and bad. All I can try to do is enjoy the good, and let go of the bad as soon as possible.

In my post I explained why I like it. But nursing judgement needs to prevail over blind policy. After all, we are individualizing care, and that may mean, not to share certain info with the patient until the MDs have already done so.

In my post I explained why I like it. But nursing judgement needs to prevail over blind policy. After all, we are individualizing care, and that may mean, not to share certain info with the patient until the MDs have already done so.

I work med/surg on a floor with all private rooms. We changed to bed side reporting about a year ago. Been an RN for 3 years. I think it is irrelevant whether it is liked or not” by the nurses. I think the discussion should be Is it better for patient care?” I think it is. Having a visual during report is valuable. It can prompt many questions that are important and might otherwise be missed. It gets patients and family involved. A lot of times after hearing the care plan a family member will ensure the patient complies! Yes, that is a win for me! If the patient is disruptive to the process, then you need to set boundaries like anything else. If a patient has too many questions it might indicate there is a communication problem somewhere. For confused patients, I answer and then redirect them. Sometime I will tell them we will discuss it in more detail when the spouse or care giver comes. I have never seen a patient or family member object. Even sleeping ones. If they ever do I will give report in the hall and chart bedside reporting was refused. When I ask visitors to step out of the room, I have never had anyone object. Sometimes the patient may say, They can stay”. I never ask the patient if someone can stay in the room for report in front of the visitor because it puts too much pressure on the patient. Esp. with the Asian/pacific islander population I work with. Sleep is important, I agree. Our shift changes are at 7 (just before breakfast) and 19 so we are not waking for report at normal sleeping times. I will get/give bedside report it the room of sleeping patient some times with the entrance light on and let them sleep if they need to. At the end I ask if the patient has any questions or anything to add. This is a good opportunity for the patient and the oncoming RN. Although, I usually get no, that was everything”. I do not use the computer when I do report. I go off my notes and use a clip board. We have stacks of clip boards at the nursing station for that reason. If you rely on computer for report, I could see how that would slow you down esp. in isolation rooms. For isolation (non-airborne) we enter into the first 3 feet of the room and do report there without touching anything. Otherwise we gown up if we need to show and tell. I have never found it inappropriate. I think it is extremely appropriate to involve the patient directly. Doing report q12 hours allows for repetition and reinforcement. It is more transparent. Personally I want my patients to understand their dx and tx as best they can because it makes my shift easier. I will often be very frank. Although Mr. X has bee told not to get up on his own, he has use the bathroom without calling. I explained this was a safety issue...” This allows shift to share boundaries so patients don't try to play the oncoming staff. The only exception I have run into is the CA or similar terminal patient who has not yet been told. I will preface my report with this info in the hallway and then go into the room for report. If you are stuck with bedside nursing, I hope my post helps in some way. I have not found it to take longer. It depends on the patients. If it is policy well then you might find a way to make it work for you or work on getting your policy changed. I don't think it takes longer” is a good enough reason not to use bedside reporting. Ask yourself, if you were a patient, would want bedside report? I would.

I think it is an honest question. Here is my honest answer. I could go through the chart and find all the info I think I need to know for the case. However, doing live or phone report has two distinctive and important advantages to me. 1) The ER nurse can present the most important info first, they can stress certain info, give their insights and concerns, and many times they may report on data that might have been skipped for the type of case. Pt in for left big toe cellulitis and "Oh by the way, his troponin was 1.2". And 2) it is an interactive process. I can ask questions. "Hey, did you get a blood sugar, I don't see it entered". Going deeper into human communication, there are mechanisms built into languages that help weed out errors. If I said, "A 36 year old male, and her vitals are"... You would stop me and ask "wait is this a male or female we are talking about". This is a sort of builtin redundancy. Phone communicate also has similar builtin error checking over just reviewing a chart. Why do we need to perform 5 rights on meds AND scan them? What if the EMS just dumped the pt in the ER with the paper chart on his chest and said, "I'm outta here". I am a med/surg RN, not an ER nurse so I don't know if this is a fair comparison. No sarcasm intended. But it seems similar to me. Lastly, I think speaking to a real person is important. It help us get to know each other and helps us be more of a team. When I see the ER nurses bringing up pt it is nice to put the face with the voice and I truly believe it fosters a team mentality. I think questions like yours help us (differing departments) get to know each other better and can only improve our practice. Thanks.

I have been slowly phasing out facebook altogether because it has become a distraction from "real life" for me. Everyone is different. I have found I don't miss it. But here's the thing. I generally kept coworkers OFF the facebook friends list. Here's why. There are two types of coworkers. 1) good friend who I see often out side of work and their is no need to facebook them since we catch up in person anyway. 2) coworkers who I don't see outside of work. No need to facebook them because I see them at work and can catch up on the basics over lunch. These days I only have my family and out of state friends that I want to keep in touch with on facebook, and I usually only check facebook once a week. Facebook has gooten more annoying with filling my feeds with friends likes of their friends I don't know. Can't turn these off, so I just defriend them and email or text them if I need to catch up.