OntCaRPN

I have a particular bug-a-boo .... we let our csections shower. They take off their dressings (because it was wet and yucky) and then pop on their own clothes from home. When the 95 members of their extended family leave they ring and ask for a new dressing. I surely hope they are not the ones complaining that nurses don't wash their hands!

Try looking up DAR format, I think it's a fairly often used note method. Data: Action: Result: For example .... D: pt fell A: staff picked him up, brushed him off and reinforced teaching re using walker R: pt safely used walker rest of shift Now that's fairly simplistic, but you get the picture. I had trouble with it at first because I wanted to write a chronological novel about incidents :) But it works well for most things. Hopefully you'll get more help than this.

I'm not sure I have anything to add other than my own practice and the notation that 'faster is not always better' (the old adage haste makes waste, ya know). If you can, take the MAR to report with you, you can skim and familiarize yourself with some of the meds or times or methods. Each of my pts has a little drawer. I take the bottles out and set them in a row as they are written on the MAR. I then pour them as they are written in the MAR ( check check check ....) and then put the bottle back in the drawer. When the bottles are all gone .... I've got that pts 'lot' and I go give them. Another tip is to make sure there are notations on the MAR like 'needs meds crushed in applesauce' or 'give one tab at a time with milk' That'll save trips back and forth for extras. And to the gal who was slow her first day with 44 clients!!!! Bless you for getting done at all that's humongous! and first days are always slow. There should have been someone with you for orientation anyway. You'll be waaaay quicker in a few days

We've also had a few patients that we tell that an admission bath is something we do all the time. Urine crusted longjohns and overalls, socks, boots! BO! I've had to cut out matted glops of hair. I don't even want to know what was in that. At lewast nothing was crawling out of it. We did have a fellow who brought his own maggots in once. In his leg ulcers. He didn't really plan to have maggots in his leg ulcers, it was just those several days of sitting home alone and not swatting flies.

Oh pt phones! 911 called us one night because the lady in room 16 wanted a nurse and couldn't find her callbell. Another pt called 911 because his doctor hadn't been in for a few days. Another called a neighbouring hospital because she thought she might get better care there, she was looking for a better doctor too. Another called 911 because he was in pain. He'd seen that on TV. But, sir, you're in the hospital!!

I'm being fueled here by a discussion we had yesterday about how many drug errors might not ever get noticed and ones that aren't reported. I agree with whoever said there's probably more to the story. The incidents related did cause me some alarm. I became more alarmed as I thought about what mistakes might have been missed altogether. The more I think about this, the more I'm tending to agree with whoever said repeating the semester might be a good idea. It's a plain and simple fact that in a few short weeks this fellow will be on his own in the real live world. Don't get me wrong. You'll make mistakes when you're long done school too. We all do. But probably not that many in a few short months.

At your scrub top or down it? I had a fellow for a long time and every morning when I was tying his shoes, he asked me to lean a little closer so that he could see "those gorgeous mountains". I started putting his shoes on in bed with my back to him or waiting for the physiotherapist (male) to help me. Ick!

mizzyrite25 ... I was sooooo hoping you were going to say that the male CNA said that he DID like older men!

I kinda debated where I would post this little story, since it both irked me and was revealing of how doctors used to be ..... I worked for a while in the secured unit of a nursing home. We had a resident who was a dr's widow. She was pleasant and easily 'managed' most of the time. Once in a blue moon she got it in her head that we were purposely keeping her from attending functions or from her family. I got too caught up in explaining why I couldn't let her out one evening. She smiled benignly, placed a patient hand on my arm and said "But you don't understand who I am, darling. My husband is a SURGEON." Here's the other thread I coulda posted that under cuz it irked me! https://allnurses.com/forums/showthread.php?t=108479&goto=newpost

Anything smelly .... ditto on the caked on dentures .... mattery false eyeballs ... sour vomit ... I can usually handle most of these if I'm quick and there's a window open somewhere. However .... a suppurating sinus and palate cancer were my worst. This poor fellow had grey, foul slime oozing day and night, from his mouth and nose. I actually cried a couple of times after helping him clean it up. If we're trading assignments? ..... I'll take disimpaction over vomit any day of the week!

Many years ago our facility installed the light system you can speak over. This was supposed to save steps. You can just take the pain pill, glass of water, blanket with you the first time you go. Many, many pts call and say something like ...."I'd like to see a nurse". I say "Can I help you?" .... "Yes, it's Fred here in room 12, I'd like to see a nurse." .... "What's up Fred? Can I help you with something?" ...... "Yes, it's Fred and I'd like a nurse please." Sometimes it's kind of cute. If we're busy and they want something I could have taken with me, it's not funny. I often wonder .... in the middle of the night .... who do they think is answering the call bells? I've started telling pts on admission, not only how to use the callbell but also that it is a nurse who answers. Sometimes it helps, sometimes it don't :)

I hadn't been giving meds in an acute care setting for very long when I made a med error. As per protocol, I had to speak to the Doc. He was an absolute blessing! He wanted to know if he had done something to make the order difficult, if there was some practice we needed to review, could he see the packaging and MAR, was I OK .... On the other hand :) ..... On our med surg floor (three staff nurses and a desk nurse)the other day, a Doc sat in the middle of an absolute chaos of cupboard replacing and am care and family members leaning on the desk and phones ringing and pharmasists restocking and other doc's making rounds and wrote '3' orders either stat or now on three different pts none of which were acutely ill. Then proceeded to lean against the counter and wait.

Several years ago the RN's around here got a big raise and it was published in the newspaper! I don't recall any more what a patient asked for but I expressed that I wouldn't be able to oblige him for a little while (so it can't have been anything critical). He responded by saying that you wouldn't think it'd be too much trouble seeing as how I was making $XX an hour to do it for him.

One other suggestion ... tidy the med cart/room. It is a hectic time and it's tooo frustrating to be hunting around for syringes, med cups, wipes and so on.

Ours are cleaned in a regular rotation and if we ask (in the case of visible soil) and if the person turns out to have a bug of some sort.