abooker

I am a charge nurse in LTC, doing the medication pass, treatments, physician's orders, etc. We have an eMAR. So I'm in the middle of my med pass, and I discover that one of our nurse managers has suddenly edited a lot of medication orders. She set ...

I tell them that the Airway, Breathing, Circulation hierarchy we are taught to focus on seems completely irrelevant to a patient who lacks the capacity to enjoy it. The traditional disciplines help them medically, but we help them make it all worthw...

They're "flicking" you. I think flicking might be appropriate or even necessary if someone needed their egos deflated just a bit to keep the team functioning well and keep things safe. But some people don't do it correctly, or do it to coerce exce...

Hi. I'm an ADN -RN, and I'm only three months into my first job, so take my advice with a grain of salt. I wasn't going to post, but I don't want you to feel like your concern is being ignored. If you're receiving consistent feedback that you l...

Took mine September 1, 8:00am and found out I passed at 8:00am central time this morning. I checked at 7:52 central time, and it wasn't up yet.

I feel your pain. Could there be such a thing as a "good enough" nurse? Winnicott from developmental psych class theorized the "good enough" mother. Good nurse, bad nurse is all-or-nothing thinking. Things appear in black and white categories, an...

Just record it. The data does not flow anywhere, as far as I was able to determine. But the DON had about six inches of printouts so it goes somewhere. Maybe to the MDS? I think our entire eMAR was designed to feed the MDS. The clinical side see...

In Missouri, our school gave us a letter stating we were GNs so HR departments would let us work while awaiting the licensure exam. I take mine September 1st! :)

You're correct - DNR means we will not intervene if this patient arrests / codes. That is one type of advance directive. There are others, that include non-treatment. Not putting a tube in this man is absolutely legal. He has a right to exercise h...

Maybe it is one of those culture change initiatives, where offering the client anything but the cleanest, purest substances indicates a lack of client-centered care?

All of my residents are dehydrated. They're eating and drinking normally, their skin turgor feels good, and their urine looks straw-colored, but they're all dehydrated. I would never have known this if it weren't for our new electronic charting sy...

Flu vaccine time, for the seasonal flu. My nursing home offered it to staff first, then the residents, and in a couple of weeks, we'll be offering it to the general public. I've been thinking about pandemic flu ... surfing the World Health Organi...

My nursing school advisor last year was excited about a nursing taxonomy that wasn't Bloom's Taxonomy that she saw cited in the nursing education literature. If "taxonomy" doesn't ring a bell, let me describe Bloom's taxonomy so maybe you'll recogni...

Here's a different point of view, blaming the hospital: http://www.sgvtribune.com/ci_10563882?source=rss_emailed About 50 out of 3,200 workers were caught. This post contains a comment by someone working for the hospital system. They wrote: I work...

I managed to find three free flashcards claiming to help prepare for the HESI http://www.flashcardsecrets.com/hesi/samples.htm I couldn't find any public domain questions. There might be something at academic libraries or nursing school media cente...

:trout: I'm the nurse for a resident with *severe* symptoms of Obsessive Compulsive Disorder. Her hospice social worker and I were discussing the resident's concerns, and I looked at the social worker's notes and discovered we had discussed "OCD Beh...

I have new nursing home resident with a looooooong history of unstable interpersonal relationships. She has the usual physical problems you'd expect in LTC - mobility, ADL's, multiple meds, some dementia ... but the primary problem is IMHO her diffi...

There don't appear to be any acute problems. She's been evaluated for lots of things, as she has been to the ER three times since Mother's Day. Good to know there are LTC behavior units out there. I was thinking she'd be sent back out to a hospita...

What does a good nurse manager look like? I imagine low performer nurses on the hall leads to low patient satisfaction and low nurse morale, which leads to low manager morale and low performing managers. I certainly wouldn't go to them and say; "You...

Thanks for the video. Always helpful to share different perspectives. People laugh at what makes them uncomfortable, and the whole topic of male modesty is uncomfortable. I'm not surprised that many of us have never heard a male patient complain, an...

I'm having trouble communicating with management. One of the 27 residents on my hall had been having what all of us assumed was a psych issue all night. She was agitated and hallucinating and had a psych history, so nobody apparently had thought to ...

Ghaaaa! I don't want to believe the hoarding might be a cost-cutting issue. I've heard there are facilities like that, but thankfully mine isn't one of them. From my standpoint, it looks like a supply chain issue. After my scavenging expedition, ...

Quality care seems to involve ignoring the information being compiled by the electronic chart. I don't know ... should I ask CNAs to avoid charting inputs and outputs, or should I continue to ignore the messages alerting me to dehydration, or ... ? ...

Great essay! I, too, have seen expressions of disappointment and disgust r/t my employment in long term care. Many folks seem to have difficulty distinguishing between the bedside and the business office. We seem to have "profit" as a business mot...

Mark Twain! Why does this garbage still happen? Maybe some small people just want to feel special. You know ... the ones who walked four miles in seven feet of snow every day just to get to clinicals. They can't deal with what you've got to deal...