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smf0903

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  1. smf0903

    Sterilize and Reuse Mask

    Same here. I have also asked how they are planning on doing this (**insert cricket chirps here**)
  2. We used to have a few people do this, look up their patient info prior to clocking in. Legal put the kabosh on that saying it was technically a HIPAA violation as you are not in the chart clocked in as those patients’ assigned nurse.
  3. smf0903

    Thoughts on a new grad RN going straight to ICU?

    It really depends on the facility. Where I work, a new grad has zero place being in the ICU for a number of reasons: orientation is way too short (maybe 6 weeks), the support staff can be literally non-existent on shifts as we have many supervisors and charge nurses who have never worked ICU, some of our docs like to dump off hot messes of patients, and there are many times it’s just you and an aid in the unit. This is a setup for disaster for a new grad. Now, if you have a facility that does a superb job of orienting and has a great support staff then I say go for it.
  4. smf0903

    Stressed out about overnight urine output

    I’m sorry but that nurse was out of line chastising you in front of the patient, groggy or not. Issues should be taken up outside of the patient’s room. It’s completely unprofessional. That being said, sounds like your patient was *maybe* a bit dry. Yes she has fluids going but 75/hr is 900mL in a shift (give or take with antibiotics and any PO intake...which sounds like PO intake was pretty non-existent). You said she had at least 2 liters out for previous shift, sounds like a lot of fluid loss with the diarrhea. And sorry, you can’t run a c-diff if your patient didn’t poop for ya 🤷‍♀️ No two ways around that one LOL I wouldn’t sweat it. We have a lot of patients who don’t pee during our shift (nights) or go all night and then pee like the dam burst. People tend to look at their 12-hour slice of the pie without taking into account the full picture and/or trends. Sure you could have bladder scanned her, but honestly I don’t think I would have been alarmed given the scenario you described. Next time that nurse tries to pull something like that in front of the patient tell her you’ll discuss it further outside of the room. Sounds to me like you did just fine, don’t let people treat you like that.
  5. smf0903

    I feel like I’m not taken seriously?

    Aren’t people fun 😂 We recently had this happen with a nurse during a code situation. Literally the patient’s family asking how someone got to be in their position...during the code 🙄 The family stated how much better they felt after one of the older nurses came I to the room. (If they only knew how little help the older nurse would be when tshtf) Just keep on doing what you’re doing...your work will speak for itself ❤️
  6. smf0903

    Nursing Smells You Love?

    Liquid potassium, bleach wipes, and we have this awesome-smelling no rinse wash that we use. Housekeeping also uses some vinegar-smelling concoction on some of the rooms and I love the smell of vinegar LOL.
  7. smf0903

    Question regarding minimum staffing

    Apparently this is coming from above our manager and she doesn’t agree with it. But they’re going to do what administration forces/tells them to do. Our unit is set up weird so even our supply room is outside of the unit. Technically, we can’t go grab a snack for a diabetic or a sheet from the supply room without leaving the unit. The nurses at the other end of the hall are WAY down the hall and even if we screamed for help they probably wouldn’t hear us. As a temporary thing I think everyone is going to refuse the assignment if there’s not another person back there. We’d rather lose our job than put a patient or ourselves in danger.
  8. Hey all! I am hoping someone can guide me in the right direction regarding safety policies. I work in a 10-bed ICU. Administration is trying to implement a 1 RN in the unit unless there are more than 2 patients. What I mean is 1 RN and that’s it. No aide, no other human body back in the unit. I understand not paying a second RN be back in the unit but having literally no one else is absurd in my mind. Number 1, there is no one to watch monitors if I would be in a room with a patient. Number 2, we get combative alcohol withdrawals/overdoses. We have had nurses assaulted by other staff (I won’t go into that here but suffice to say it was not pretty). Irate family members, I can name a hundred scenarios in which having a lone staff member is unsafe. Administration does not get this. We have one charge nurse that covers the unit and 3 med surg floors, so they can’t possibly be at our beck and call. The charge nurse is also the medication nurse for caths if we have a STEMI, so in essence they can be off the floors for a couple of hours if we have a STEMI roll in. We don’t have nighttime pharmacy so we are mixing our own gtts and overriding non-profiled medications, so we would literally have to call to have someone come back to witness a controlled med that hasn't been profiled yet by pharmacy (wastes as well). We can go literally hours in the unit without seeing another employee. I don’t fault the charge or supervisor for this at all, they run their butts off every shift. I just don’t see how putting 1 RN in a closed-off unit is safe by any stretch of the imagination. I already told my husband that if they implement this he can expect me to lose my job because I will refuse to clock in. But there are people working there that don’t have that luxury—this job is not our primary source of income, most people working the unit this IS their income. It really ticks me off that our administrators don’t seem to have even the little sense that God gave an ant. In my eyes, this is a train wreck waiting for a time to happen. Any advice? Thoughts? Directions in which I can get basic safety requirements? I’m in Ohio. I’m trying to find something to help us plead our case. (And before you ask, yes I have applications out at other facilities.) I appreciate your input! ❤️😊
  9. smf0903

    Charge nurse with patients?

    Our facility has a 10-bed ICU and around 60 (?) med surg beds. We have one charge nurse to cover for all of that. Not to mention that we have no pharmacy to profile meds after 10 during the week and 3pm on weekends (don’t get me started 🙄) so the charge nurse pulls/overrides all meds (except for us in the unit, we pull our own stuff). The charge nurse only takes patients when absolutely necessary, it’s not a norm by any means.
  10. smf0903

    Echolalia

    LOL Davey 😊 This post made me smile...my daughter has high-functioning autism and had severe echolalia as a child. It made it challenging when we were trying to figure out if she knew how to read because she could recite a kid’s-sized book from memory after hearing it only once. That kid’s brain was like a vault, if she heard it once it was in there!
  11. If this has been brought up to management and nothing’s been done, then I think I would report anonymously to the compliance hotline (or whatever it’s called). The HIPAA issue is one they wouldn't take lightly, I should hope. Good luck!
  12. Our interventional program started relatively recently, within the past year. We currently have 2 cath lab teams, and the issue is that cath lab personnel don’t want to be on call as much as they currently are. Our facility decided to try to alleviate the situation by opening up opportunities to train other nurses to be the med nurse during off hours (nights, weekends, holidays). People jumped at the chance, until they were told they would not get paid to be on call. Understandably people were not going to turn down guaranteed paid hours to be sitting at home—unpaid— waiting for the possibility to be called in. So, instead now they are having ICU, float, and charge nurses take on the role...an hour in the cath lab to see where supplies are located and a printout of commonly used meds. And they are having nurses go down during scheduled caths to become familiar with the process, although the cath lab staff is still training so the nurses basically just stand and watch. None of us are the least bit comfortable with this. Everything I’ve read as far as the efficacy of non-CV lab nurses in the lab reads as a big fat “don’t do that”. So I am curious if any of you have experienced this...Did you can the idea? Or if you do this, how did you make it work?
  13. smf0903

    Impella training

    We use IABPs as opposed to Impellas but we got an online course and about a 2-hour deal with a rep. We were told we wouldn’t have any balloon pumps for a long while and we showed up to work one day and guess what? Patient on a balloon pump 🙄 The rep we called the one time was less than helpful.
  14. smf0903

    First-time ICU preceptor: any tips?

    I think one of the most important things is making sure your orientee becomes comfortable coming to you with issues/questions but also tempering that with giving them a chance to figure things out without spoon-feeding them everything. The worst preceptors at our facility are the ones who do everything and let their orientees watch...when those orientees are on their own they tend to sink quickly. I am big on making orientees stock right out of the gate. People think that’s weird but you have to know where things are at and what’s available. Stocking rooms and carts is the best way to get familiar with your supplies! Use any downtime to show where policies and procedures references can be found. Drips always seem to freak new people out so touching on those helps too. I am a chart nazi (because my preceptors were chart nazis LOL). I go over charting as they are doing it so that corrections/additions can be made right then and there. Have fun! I love precepting new people...it’s fun to watch people learn and become more confident in their skills and thinking.
  15. smf0903

    Expiration date checks on supplies

    Our facility is pretty anal about expired stuff too...not to the extent of writing dates on individual alcohol pads though 🤔 I try to look through things as I stock and if we’re slow we check through stuff. I didn’t realize how many dang things had expiration dates until I started looking (like the long handled swabs...the ones that look like a q-tip...who knew?) Bigger ticket items like CVC kits and HD lines, stuff like that we are sure to rotate so that the nearest to expire will be at the front of the pile to use. If it’s due to be expired within like 6 months, we have bright stickers on them that say “use first”.
  16. smf0903

    OG tube securement, or NG?

    We secure to ET tube with clear tape. The trauma docs don’t like it because (as stated above) if the pt pulls the OG they’ll displace/pull the ETT. So far I have never had an intubation patient pull at their OG...if they’re going for a tube you can bet it’s the ET.
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