RyanRNBSN

I always do a basic baseline assessment prior to med administration. I usually do a diagnosis focused assessment and then anything related to a medication I will be giving (i.e. HR with dig, etc.). Sometimes I defer some of the assessment until after my medications depending on how busy I am. For example pnuemonia patient... I don't focus on GI right off the bat. However, usually the majority of your assessment can be done by interacting with the patient during medication administration.

Our ICU is very similar to yours. We are 5 beds with almost identical patients. We staff with 2 RNs... primary care, no unit cleark, etc. just as you do. If we are full (5 patients) the on-call physican must decide what patient is "floor ready" in the case of an admission. Anywho, potentially our ratio could be as high as 3:1 for one of the RNs but usually is 2:1 as we do our best to keep one bed available at al times. However, it has been a concern for many of our seasoned nurses who may feel uncomortable leaving a new ICU nurse with a full ICU when they respond to a code or trauma (traumas which can last up to an hour or more to stabalize the ED patient) and the most seasoned ICU nurse is to respond the codes as they are the "code leader" in our facility. I guess I really have no advice, other than your department is not alone.

Do other hospitals require double checking on SQ Lovenox? With the huge push for DVT prevention our facility has largely increased in Lovenox administration... curious if other facilities are doing the same with double checking.

I think this is a common thing. I worked as a CNA on the floor that I work on currently as an RN... now from one CNA inparticular there is animosity as I have transitioned into my new role. It can often been seen that she hides her unwillingness behind her "inability" or passing off that now that I am an RN I don't do patient care (which is completely untrue, because patient care is my favorite aspect of nursing). And my reputations has been backed up by all of the other CNAs on the department. Although it is not right, often it is easier to do things yourself than argue with your aides. However, at least in my states, this is a delegatable task. If the PCT is unsure of how to complete the task she needs to seek the needed education to do her job. Good luck and sometimes making teamwork actually work is the biggest challenge.

I guess it is important to realize every nurse has a niche. As everyone has said... it is common for nurses in the hospitals to not eat, not drink, no pee and be stuck at work for hours after the end fo the shift. But every nurse has the option to leave their position and go to an MD office, home health, public health, etc.... these are jobs where you get your lunch, breaks and have more control of your work enviornemnt. If you are unhappy with the "characteristics" of hospital nursing then find the area of nursing that meet your personal needs. I work on a small town, but very busy 20 bed med/surg floor and I know going in for my 12 hour shift may and often is 12 hours of on your feet, running, no meals and maybe one bathroom break if I am lucky. What do I do? Brings snacks that you can munch on on the run or while charting, limit fluid intake and wear good shoes :) Is it all worth it at the end of the day? Absolutley! NO job is perfect. I do not do my work with the intent of eating delicious hospital food and taking coffee breaks... I work because I love what I do (patient care) and need the money. This is why I consider these "characteristics" of hospital nursing... not negatives. Any nursing students reading this... PLEASE talk to senior nurses about job characteristics of ALL branches of nurses.. learn about weekends, holidays, NIGHTSHIFTS and job expectations of each job: home health, LTC, hospital, etc.