DBK99

I hate having to take a team plus be charge, which I haven't had to do very often, thankfully. We typically have "enough" staff to where the charge doesn't take patients. It's not a hospital wide rule, but my floor's rule is if they have to take pts, charge takes no more than 4

I had just turned 23 the month before

It may not take "effort" to explain every little thing I'm doing and why, but you better believe it takes too much time. And when all 6 of my busy med surg patients want something and they want it NOW, it's easier and faster for me to just do it myself. You know what response time affects? Patient satisfaction survey scores. You know what survey scores affect? Hospital reimbursement. You know what hospital reimbursement affects? My pay, my raises, my bonuses.

Personally, I've never seen it ordered or have ever given it via those routes

Transdermal patch. Med surg floors cannot give it IV at my hospital

Thats BS. If the pt was A&O, she can make her own decisions regarding her care.

This is almost the number one thing that annoys me the most at work. This and playing middle man between the other departments. I've never understood why lab must call criticals to the nurse, who then must turn around and page and notify the doctor. On my floor, nurses do not draw any labs; peripheral, central or otherwise. Lab calls me: There was an order put in for a BMP now and one at 0400. Is that what they meant to do, do you need one now? (Its 3 PM) Me: I don't know, I didnt order them. Lab: Oh okay. Quit wasting my time and use some common sense! I think sometimes these other depts think that the nurses just have the docs available at the tip of our fingers, like they're just always sitting beside me, ready to answer every question I have. When really, some of the hospitalists on my floor could whiz in and out of a pt's room and then leave the floor and be entering orders in on the other side of the hospital, and the nurse has no idea that he'd ever even been in the pt room. Lab comes out of confused restrained pt's room and says with attitude: He won't let me stick him and we're not allowed to hold patients down to draw. What do you want me to do, cancel it? Umm really? No, I guess I will stop what I am doing and come hold the pt's arm for you so that you dont cancel it and write a note "RN stated not to draw." Enrages me.

I graduated with $4,500 in loans for my ADN. Currently owe $3,068. I pay $100/month

My nursing school degree is AAS- associate's in applied science

Bladder scan first. It's a nursing intervention you can do on your own first without an order. The pt may not even be making urine, thus why they are not voiding, which would then warrant that call to the doctor, if bladder scan showed zero. The doctors where I work used to actually get attitude with you if you called about no voiding and didn't do a bladder scan. Now we have a protocol in place that lets the nurse straight cath without a physician order, dependent upon what the BS volume is. Also, when I was in school, we were always taught to not always be drawn first to the option that is "call the doctor" because they said that will never be the answer on NCLEX because they want to know what the nurse can/will do :)

Oops just realized this was a NP thread

I work med/surg at the hospital. Had someone ask for a haircut. Ummm =\ lol

Does anyone else get this a lot? I work on a geriatric M/S floor and I'm annoyed with pt's whose toenails look like they haven't seen clippers in years, all grown out and curled over, yet the family demands grandpa's toenails are an emergency and be taken care of while he is in the hospital. We are not allowed to clip nails, toes or otherwise, and the diabetes nurse will only come do footcare (with a dr's order) if the pt is a diabetic. Who was clipping their nails at home?! We will tell them they are more than welcome to bring clippers and do it themselves. Grrr!

Dang it, two things I forgot, we do that too! Lol

We do bedside report on my floor, and this is what we give during report: Name, admit dx, relevant medical hx, are they A&O or confused? If they are on a heart monitor or not, how do they get up? (up ad lib, assist x 1, max assist, dependent bed rest?), if they have PT/ST/OT, how do they go to the bathroom? Bedpan, bedside commode, incontinent in their brief, catheter, ostomy, or do they walk to the bathroom? etc. Do they have a PIV, PICC, central line and where is it, what IV fluids and what rate. If they are diabetic, how often are their accu cheks and do they have SSI? Are they on O2, or RA? Do they swallow okay, or do I have to crush their pills? Any skin issues, pressure ulcers, wounds, drains, dressing changes. If they are on tube feeding, what rate is it running? What have their residuals been, any water boluses? Where they were living before they came in? Home alone, home w/ family, nursing home, and who is family contact I can call if I need anything? I work on a geriatric M/S floor and most are confused, and almost no one can get up by themselves, so knowing who their POA is or family contact who can make decisions for them is very important for us. Also, any tests/procedures/surgeries scheduled for that day. Then I will step out of the room and tell the oncoming nurse any psychosocial/family dynamics issues. We have a kardex sheet for each patient that has all of this info on, that we use pencil to erase and write in anything new or updates during the day, that we use for report, and I love it. I don't know about you, but after getting report, I don't have time to go digging for all of this info in the EMR for 6 complex patients before AM rounds and meds. I know it's a lot of information, but our bedside kardexes really do help, and it doesn't take much time as one would think :)