Flowerchild6065

Hello, I work on a locked acute inpatient rehab brain injury unit. I am interested in improving safety/quality on the unit. Our staff is trained how to interact with a patient with a brain injury at a Rancho level 4 (confused and agitated), but our family members come to us without this knowledge. So, there is a gap of increased risk until that education is completed. (Problem #1) Occasionally there are those family members or partners who do not benefit from education. (Problem #2) These individuals can be overstimulating and create a distrust in the patient when complaining about care, policies, or staff in front of their cognitively impaired loved one. In the more extreme cases family/partner dissatisfaction can be expressed with high stress and raised voices and can be a pattern for how they express themselves. Do any of you work in facilities that have protocols or algorithms for managing these situations? Are they successful? Are they evidence based? Thank you for your time. Kathy Warehime, RN, CRRN, CBIS Sent from my iPhone

I suspect this is more common than we think....and having a term associated with it can give women more of a voice. I was a perfectly healthy educated 24 yo delivering a perfectly healthy 6 lb baby girl with my husband and sister at my side. My labor was progressing beautifully and I was the most quiet, compliant patient you could ask for. Because my OB was apparently in a rush, he manually dialated me, under the guise of "checking my progress", while I cried, "No, please stop" for the entire minute or so. My husband cried beside me. After my daughter was delivered, he didn't want to wait for my placenta to deliver so he pulled it out prematurely causing it to tear and leave sections attached to my uterus. He then said, "you are gonna really hate me for this" and proceeded to manually scrape my uterus for all placenta remains. Those two interventions were by far the most painful aspect of my daughter's birth. I was traumatized! i share this to counter some of the misconceptions I am reading. I will say there is something validating about giving this a name. 27 years later, I am now going to process all these feeling again! With all that said, this experience, along with many others, has left me a heck of an advocate for patients.

This morning I read a Facebook post by Allnurses: "I firmly believe that 'too stupid to live' should be a diagnosis." This post is receiving 'likes' and 'shares'. I'd "like" to take this opportunity to not just passively read such a post, but really consider the message. Is this post a favorable representation of the nursing profession? Do we want to encourage this type of thinking among our peers? Is this how some view our fellow human beings who have entrusted their care to us? Is this really about nursing arrogance? May I counter such thinking? (I love to read the definition of a word to be reminded of its full beauty) Humility - acknowledging that acheivement results from the investment of others in my life Meekness - Yiedling my personal rights and expectations with a desire to serve Self control - rejecting wrong desires and doing what is right Altruism - unselfish regard to the welfare of others Empathy - The ability to share and understand the feelings of another Compassion - investing whatever is necessary to heal the hurts of others Advocate - the act of pleading, supporting or recommending and then..... there is basic Kindness Such a post does not leave me in judgement of the patient, but the nurse. "The world is put back by the death of every one who has to sacrifice the development of his or her peculiar gifts to conventionality." - Florence Nightingale

Boring people complain of being bored.

We're hiring new nurses!! I work for a new state-of-the-art surgical and rehab hospital in pennsylvania - it's a great job. I say this, because jobs are out there - good jobs. Our thoughts and words lay the ground work for how our lives play out. There is much power in our thought choices! When we choose differently, it will be different. This is scary! Whats scarier than not finding a job? FINDING A JOB! Life is scary. Consider this a life test that you intend to pass - Summa Cum Laude! Life is full of these tests! Thoughts of defeat and discouragement are real but it's your choice whether to give it your attention. As for this loan and time pressure you have looming over your head....money comes and money goes. When you have it, they'll have it! There are a lot of needs in this world...got meet some of them. Get your mind off of this for now. As for the fiance', he/she is scared too. Model different thinking and love them up!

I graduated from nursing school with no prior nursing nor aide experience at the age of 45. My age has not been an issue. I think attitude and health can make you or break you. I had a classmate graduate around the age of 50. She had the highest grades in the class. I believe she met some prejudice from instructors but has found employment in her desired specialty - hospice. I have observed that my mind doesn't work as well as it used to, but I bring much life experience to the table and can relate well to all patients and respond with maturity to challenging situations with patients, their families and co-workers. I am now 51 and doing very well in a position I love and could not have imagined for myself and feel valued by management/administration.

Thank you all for the feedback. I found it to be helpful/informative.

Is this common practice in writing orders? If so, why? For example: 3 mg coumadin 1/2 tab daily. Why doesn't it read, 1.5 mg coumadin daily? OR at least give the complete order: 3 mg coumadin 1/2 tab for a total of 1.5 mg daily? I would expect that there should never be a number present in an order for a nurse to read that is not being administered, when possible. I've seen this cause med errors on both the part of the nurse and the pharmacy.