TheGerb

Oh that's good to know. Always love learning new little tidbits. I was using disposable leads. At tried fresh leads on: dry skin not cleaned, skin rubbed lightly with gotten, and then skin cleaned with alcohol wipes. No reading on any of them.

That's definitely true. I tried two sets of wires and two different boxes though (and interchanged them) and they were a nicer 1yo Phillips model. I joked with the patient that my next step was going to be to change the patient so the machine would work. ?

Hi! My mind is really blown by something that I'm sure has a simple answer that another RN would know right away. Looking for some answers. Last night I had a patient on a 5-lead tele monitor and I kept getting an error that the LL (left leg/red) lead was not connected. II tracing looked beautiful, but at no point could I get V to show up d/t LL not connected error. These are the things I tried: replaced the electrodes, wiping down the site with alcohol before placement. No hair on site, great stick. Double check wire connection: looked great. Moved position of the electrodes 5-6 times trying to find a best spot Changed box, changed wires Pt had a recent pacemaker placed and severe ascites. Was told by tele techs that neither of those would impact like this and that is was definitely end user error. I've been a tele RN for 6 yrs. Haven't had this issue before. Thanks!

Such great suggestions on this thread. One thing I used to do while precepting was also to ask them to say something if they saw me deviating from their known standard of care and at the end of the day to both highlight 3 opportunities for improvement for one another. I found this to be helpful because it gave them a reason to really focus on what I was doing, have a regular opportunity to speak up about an authority figure's behavior so they've had lots of practice when it's necessary later and if the ofi was really a difference in state regs or hospital policy from last place, it gave us an opportunity to talk through what was required at new place.

My current employer only posts on LinkedIn, indeed and the hospital site. I've had some really great recruiters message me on LinkedIn as well

Hi! We've been seeing people coming in with more severe community onset sepsis throughout covid because they were waiting. Of course, because of this we're also seeing higher sepsis mortality rates.

Hi, We started a new position for an RRT RN in our hospital which we're very excited about, in theory, but we don't have anything set up about how to orient someone specifically to this new position. Doors anyone else have this position at your hospital and able to share your onboarding structure? Or is anyone in this position and able to talk about what would have helped you onboard to it? Thanks!

Totally agree with this. I work in quality. Mistakes happen and most of them have root causes that are not one person. I'll also tell you what a conscious patient I dropped once said to me, "I need you to stop feeling sorry for yourself and get me off this floor." You've got to move on. Feeling sorry for yourself doesn't undo what happened. Do it the best way you can. Good luck!

I know the agency that staffs our hospital, and just checked. The current posted agency positions are making less hourly than I make staff. Ecarts is an early warning system using AI to predict % chance of patient deterioration. It's really great...for non-COVID patients. ?

Agree. Patients tank so quickly and wobble back and forth. We use ecarts as an early warning monitoring system where I'm at, and the majority of my patients the past few months have had higher ecarts than we normally will keep on the floor. Re: pay, not all hospitals did this, but we received $22.50/hr hazard pay for a while on top of base and differentials. We ultimately reduced this because our system has lost $3mil in revenue due to COVID and just doesn't have the funds to continue paying staff nurses at that level. We do still receive a smaller COVID bonus pay.

At ours, when your unit transitioned to COVID, you transitioned, too. We had a number of staff who bumped their retirements up a few months when this happened and a few who medically were cleared to transfer to other floors or be furloughed, but for the most part, all of my coworkers just transitioned to COVID RNs.

Hi! I work on a COVID floor and rotate to a COVID step-down. We use a system with the primary nurse being the only person to enter a room (no EVS, no PCTs, no ancillary staff) with a team member from another furloughed area of the hospital serving as a PPE monitor/runner. We are required for all care of the patient and cleaning of the room. I really think I've been able to provide the best care with a 1 nurse:1 monitor:3 patients ratio on the floor or 1:0.5:2 on step down. I have worked at 1:0:5 on the floor and 1:0.25:4 on step down. Those ratios were very unsafe and just bare minimum care. Frequently I'm in patient rooms for over an hour with all of the bundle care with COVID patients. I can't speak to ICU ratios with COVID patients from experience. Now that we are getting more patients with COVID as their secondary dx, their sx are just really too complex to have inappropriate staffing.

I normally carry a load of 5-6 on telemetry "successfully," (in quotes because I meet all their immediate needs but rarely have time to do additional education or ambulation for high fall risk patients, more time intensive things that no one will call you out on if you skip but are important at the heart of nursing, etc.) but research does show that every patient over four leads to increased morbidity/mortality even in med-surg.

It sounds like it isn't necessarily the patient type or tasks of the ICU that appeal to the original poster but rather appropriate staffing levels. There are med surg units that staff appropriately (no more than 4 patients during days/evenings). Apply to a number of different environments, but just say no to hospitals that staff with a larger patient:nurse ratio than you feel comfortable with. I know of worst case scenarios with friends where they ended up carrying a load of 10 in an ICU. Bad staffing happens everywhere.

My mother has a number of drug allergies/intolerance unfortunately including all of the NSAIDs. This didn't use to be a problem for her to get prescription pain meds in small doses to keep around the house for her to use for headaches, etc., but in recent years it hasn't been possible. Now she just doesn't have pain control as an option other than nonpharmacologic methods or topicals at home. She went in to the ER after a fall and demanded pain killers for the severe pain in her wrist. It turned out it was broken, but they almost turned her away for "drug seeking behavior" because she was asking for specific medicines. She just knows because she has so many allergies what she can and cannot take. In the fight to make sure they didn't give my "druggie" mom anything for her pain, they almost completely missed that she had broken bones.