pk1

I do believe in allowing families to be allowed to be present in a code if they wish. I am all about the patient and family. I just could not believe that a nurse would insist that the room remain trashed and the patient left as he was just so the family could see all the work they did. Makes the hair stand up on the back of my neck. Even years ago when I worked ICU, it was a common practice just like you said, let the family know what happen and ask for a moment to get things straighten up for them. That also allows the family a moment to get themselves togehter. Do you know of any articles on this subject?

question---after a code blue has ended and the patient has expired---what do you do, (1) leave all the tubes in place, all the trash laying where it fell, code cart visible and trashed and bring the family in to see their love one in this state, so they can see how hard you worked to save their life? or (2) clean up the room the best you can,and remove all visible tubes before bringing the family in? I am told that it is evidenced based practice to have families witness their love one in this state. But--I as an old ICU nurse, who is presently working Med/surg, don't agree. It should be about the patient and the family not about demonstrating how hard we work. I as a family member would not want to have the experience of seeing my love one in that state. Am I wrong? Does anyone know of articles or research that I can read that would help me.

Anyone have suggestions as to the best way to get a Rapid Response Team up and running in a rual hospital with limited staff. Day shihft is not a problem. Evening and nights, where it is needed the most, there is limited inexperienced staff and contract nurses. Help!

I have worked it both ways. Scheduled visiting hours-they come in by the herds and don't want to leave. Our ICU now has open visiting hours, but they also have a lock on the door, so when there are times visitors should not come in, the door is closed. It appears there are less visitors coming when there is a open door policy. I have also been on the other side. Not knowing whats going on is not a good feeling. Family and patient do much to reassure each other.

Please keep the ideas coming. This is really helpful. Really good idea on inservices. Also, how do you get people to pass on information, not report? We have a write on board in the break room, they have individual mailboxes, communication box in nurses station, and send emails. Can count on one hand how many people read the messages or even check their mail box.

Need ideas that would make night shift staff happy. Already do self scheduling, with changes ongoing between them as they desire, already have increased staffing numbers on nights, have staff meeting at convient time for them-they do not attend, eucation inservices offered at convient time- they do not go, staff hired nights- requested nights. Ask for suggestions-they give none. Grape vine gossip says they are unhappy and plan to leave, but none of them tell director, just smile and say nothing. What can we do to increase moral?????????????????????

Voice care is a program that can be purchased for recording reports and or messages. It is tied into the phone system.Each nurse is assigned a number and use a password to record or listen to the previous report. What is SBAR? How is your institution handling the National Safety Goals for handoff reports?

Are there any facilities using voice care reporting system, for handing off reports shift to shift on your units? If so, do you think it will meet the National Safety Goal for handoffs?

You are lucky to have others who willingly help, from other units. I saw that more years ago, but less often these days. Everything is so rush-rush!

Lori, where are you located? I'm in rural Virginia, in a small hospital also. Our unit is telemetry with 24 private rooms. We have a discharge planner that helps coordinate home care needs and transfers to nursing homes. We are interested to trying an admission nurse to try to take some of the load off the staff. We have a big turn over in patients almost every day. Working the nurses to death. What is your nurse to patient ratio? Do ya'll have to float to other units? This is also an issue with us. Due to call outs on other units, we get pulled frequently.

I like the sound of a pharmacist on the floor. How many beds do you have on your unit?

Good point! Our Charge nurse picks up the slack and helps as much as she can with the admits and discharges, but its working her to death. Plus, there are too many people doing parts, easy to miss something!

What two shifts is there an admission nurse present? What are their duties exactly? Is there a written job description for them? Do they recieve, complete interview, discharge planning, care paln, initiate orders?

Tell me about your team. Who and how many, does it consist of? How many patients does your team care for? And who is responsibable for what?

Does anyone utilize an Adm./Discharge nurse during the peak hours that adm./discharges occur? We stay on diversion alot, and were trying to think of a way we can speed up these processes. Possibly create a position for a nurse to work these busy hours with their focus on the adm/discharges. Has anyone tried this, is there a job description for this?

What shifts are nurses at your hospital working? 4-8-12 hour? 7a-7p, 7p-7a, 8a-4p, 7a-3p. 11p-7a. We are thinking of going to all 12 hour shifts and do away with all others. Anybody doing that?

This may a little late for you, but, our hospital just redid our policy also. We changed ours to auscultation, aspiration and check the pH of the gastric content. If really in doubt, x-ray. We looked at the research when redoing ours.

I do appreciate all of the replies. Each one has given me something to think about and consider. Ideas are starting to surface!

Looking for what other hospitals are doing when the lab calls with a critical lab value. After you read back the value, then what? Where do you document what you did with it? Do you call the doctor with improving criticals? Do you save them until the MD rounds? I'm in a small rural hospital that the docs only round once a day, unless there are problems. I have one week to come up with a solution to as what we will do, so we can change our policy to say what we want it to say. HELP!

In our area, staff get FMLA for everything. We are very small, and everybody knows everybody. Docs just can't say no when they are requested. Have to play it by the book, but slowly weeding out the trouble makers. Please tell me, just where are the good nurses. The ones that want to make a difference! We have a really special manager that is trying to change things and wants the staff involved with everything, especially decisions on how our unit will be run and what we need. We get a new employee that has potential and as soon as they are turned loose, the staff eats them up, then sits back and complains about not having help.

Don't get me wrong. I have even used a FMLA once before when my father was dying. But we have people in our institution that call out at least once a week or when the weather is bad, and when their time is used up, they come to work as posted. It gets old very quick. We even have to schedule people on call when these others are posted just to keep it from being hard on the rest of the staff. I disagree about management being responsible. There are alot of nurses out there that only think about what they want, no consideration as to how their actions affect their coworkers. Maybe a leave of absence would be appropiate in some situations. Then come back into the work force when you can focus on the job at hand. It's hard to be caring for others when your heart isn't in it . I could go on and on. We have a group of coworkers on our unit now that is so negative, and no matter what we do we can not please them and they are influencing our new staff members in a negative way. Our manager is fighting hard to get our nurse/patient ratio changed and they can not see past the end of their nose what she is trying to get done for them. Best manager I have ever run across, and believe me I have seen some that were useless!

Best of luck with yor new family. Butttttttttttt, on the other hand, remember that while you are out with them, regarless of how long or for what reason, your coworkers are working short handed. Makes for long days or nights when we work short. Plus, you may not be the only one who wants or needs off. I've been walking the walk for thirty years now, in med/surg and ICU, and I've seen alot of nurses take advantage of FLMA's. And for some reason, everyone wants to blame the manager for being short handed, not the person who called out. I don't understand! I have been very lucky, and have changed shifts and specialty's to accommodate my family, my education, and my sanity. Look around, there are so many things that nurses can do these days, and I'm sure there is something that will suit your needs, and make you happy. Life is to short! Good luck