2monkeys

that has happened at my job too, and mostly because of flirtling and occassionally inappropriate (yet funny ) comments made while working. Although it's fun to flirt and joke around at work, this+jealousy=baby games. Best thing to do is laugh it off, be sure that although you and your boss are friends that he doesn't play favorites. People who are good friends with their boss are usually the ones who work the hardest, and the boss has respect for them, which is part of the reson they are friends.

When we have critical patients, they are in the ICU. We also move a med/tele patient there if we think they require closer monitoring than is able to be given on med/tele because our ICU beds also double as med/tele beds if we have the need. In that case, they would be cared for by the ICU nurse, who would be right there by the monitors.

I am the Clinical coordinator, and I also funcion like you did which is one reason I really like my job. Thanks for your input!

I work on a small 25 bed unit in a Critical Access Hospital. Out of 25 beds, 3 are ICU beds. Our Units are attached, with the ICU basically within the med/tele unit. Our census is generally 5 or 6 patient on med/tele, and about 1 in the ICU. With all of the worries about cost savings, we are trying to utilize our staff appropriately, and I need some suggestions and experiences from other nurses who may have the same thing going on. Normally the ICU nurse monitors the tele right at the ICU nursing station. This is the only place the rhythms are visible, and this monitorcan be seen from the med/tele nursing station also. Lately, if the census is low on the med/tele and there is no ICU patient, we will put a med/tele nurse "on call" and keep the ICU nurse (for monitoring tele) and one med/tele nurse. (we normally staff with 2 med/tele, one aid/unit clerk, and one ICU nurse). The ICU nurse has been taking an assignment of patients on med/tele, which brings her away from moniroting the telemerty patients for periods of time. We do have beepers available, but these are not to be used as a first line alert for rhythm alarms, (their intention was to alert the nurse caring for the tele patient about an alarm, althought the ICU nurse actually sees the rhythm). I hope that was clear...so here is my concern: I feel that the ICU nurse is putting patient and her license at risk by not directly monitoring the telemetry in the ICU, this prevents her from leaving the ICU unless she finds a qualified replacement to monitor for her break, etc. As an ICU nurse, it can also be a very long 12 hours if you don't get and ICU admission. Our rule of thumb is you can leave for the amount of time it takes you to take a potty break, and we are able to hear the alarms from the bathroom (yes, we are that small). But there are several ICU nurses who disagree, and want to take an assignment of med/tele patients (althought the census is low and it is not necessary) because they feel that they are not doing their share of the work. There are some potential solution such as a monitor in one hallway allowing nurses to see and respond to alarms, but that still leaves an opening for missing an alarm due to a small staff (everyone could be in a patient's room). Any ideas or experiences? I am looking for a solution to this that would allow for appropriate staffing for the census and safe patient care, of course... thanks!

I am curious how my hospital ranks in vacation time given to RNs on hire and for years of service etc. We get 2 weeks for 10 years, then 3 weeks for another 10....I think this is low for the job that we do. Some people get as much as 5 weeks for higher ranking positions. Thank you for any help you can give me.

thank yo all for your help! you are giving me a lot of good ideas. We have to have a really solid plan and make sure the guidelines are followed if we wnat our manager to agree.

We used to do self scheduling on the med/surg unit here at my hospital. Our most recent manager has me doing the scheduling completely. The nurses would like to go back to self scheduling, but I am looking for some examples of guidelines that have worked in other places. We didn't have much in the way fo guidelines before. The nurses basically wrote what they wanted to work, sometimes leaving days without appropriate coverage. Any help is appreciated! thanks.

currently we tape report and then the nurses coming off duty wait until we are done to asnswer lights and allow for questions. but we also have too much extraneous info in the reports, like aaox3, skin pink warm and dry, etc. what i am looking for is sort of a "template". we have tried many things before, i want them to tell about the diagnosis and conditions relating to it, and any new diagnosis since admission. report by exception. we have a little trouble with this because some nurses want to know lung sounds even if they are clear, they are afriad the other nurse forgot to report it. the charge nurse is supposed to come in 15 minutes early and setup the assignments and kardexes etc. that rarely happens. i am going to enforce it at our next staff meeting. thanks for your reply!undefined

We are searching for the best way to give report. There are changes that are occasionally missed. We are a small rural hospital with about 30 med/surg beds, and our average census is about 18. Our report takes about 30 minutes but can be longer. I read somewhere about "silent report" where the nurses read the patient charts and then ask questions before the next shift leaves. Has anyone tried that and how did it work?