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jherman

jherman

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  1. jherman

    S. O. S.

    I am a critical care RN and have been working in Quality Improvement for a while now. Medication errors are a focus nationwide because they are the most common error in medicine. A medication error usually doesn't happen because one person or process failed. There are usually several failures along the was starting with how the prescription was written (legibility, correct dosing) to the nurse who actually gives the meds and the 5 rights. Unfortunately nursing usually gets the blame because we are the last protection to the patient. (We are on the "sharp end" of medical care. Administration is on the "blunt end" everyone else is somewhere in between)In our hospital there are 24 steps from the time an order is written to when it is given to the patient, and a mistake can happen at any of those steps. So the message is, it's not all your fault, there were several failures along the way. If you want to do something, work on changing the SYSTEM- ie. computerized order entry, (with checks on dosing, allergies, etc), robotic filling of rx's. barcoding on the patient the pill etc., education and reinforcement to all involved in the medication process. I would love for you to take care of me because you are consciencious and you care.
  2. Whew! I just read the message board on the nurses eating their young, and I must say I am overwhelmed. I would like to avoid that situation here. My co-workers and I are in the process of redesigning our orientation for a large medical/surgical ICU. As new grads, or seasoned nurses transferring to ICU, what has been most helpful in your orientation and getting your skills up to speed? What was not helpful at all and a waste of time? What are things that other staff did to make you feel welcome, and what were things that were done to make you feel unwelcome? Also which way do you learn best? ie written material, explaination, demonstration, video, interactive computer etc. Thanks for your help ------------------
  3. jherman

    ECMO

    We had a 35 yo male that had a pneumonectomy and subsequently went into ARDS. Was on ECMO 2-3 weeks. Spent another 5 months in the ICU, but eventually went home to see his then 1.5 year old son. (He got sick when the baby was just 3 or 4 months old) ------------------
  4. jherman

    Teaching your staff

    OK Dolfin, you owe me big as this is the second time I'm typing this in. My favorite analogy for adult learning involves Coca Cola. Easily 80% of the people in the world know about Coke and can recognize the red and white waves, yet Coke spends HUGE amounts of time and money on advertising. This for a simple product that tastes good and has a little caffiene kick to boot. They use SIGHT (red and white waves) ACTION (people enjoying Coke), SOUND ( jingles, slogans, the hissing sound of a can opening), TACTILE (showing a cold can of Coke "sweating" do you can actually imagine what it feels like in your hand. So why does nursing expect nurses to learn complex policies and procedures from one meeting shown just one way? Most Important--Be Redundant-- The rule of thumb in advertising is that your message must be seen/heard at least 6 times before it sticks. (Becomes sticky) Send your message using as many channels as possible. ie. face to face, posters, interactive software. If you can get taste, touch and smell in there all the better. Repetition is NOT redundancy. Redundancy restates the message in different ways until every one "gets it" ie. Read a poster, Watch a Video, Listen to a tape, give a return demonstration. Redundancy improves memorability and enhances enjoyment. Organize your message for impact-- Know the goal and purpose of your message. Eliminate extraneous information. Put your most important points first and last (Primacy, recentcy). Group information into catagories. Don't mix topics in the same session. Make your audience participants--use games, who wants to be a millionaire, scavenger hunts, etc. Have influential members of your staff prepare and teach sessions. Break information into approx. 7 bits. That's all most people can absorb at one time ie. phone numbers. The message has to make sense, otherwise people won't stop to figure it out. Answer the question WIIFM-What's in it for me? If you can figure this out the message will become sticky. Hope this helps
  5. jherman

    Nursing as a profession

    I've had many careers, but I keep coming back to nursing. I've been in sales, pharmaceuticals, and home building,and had a great time doing all of these things, but my niche is nursing. It is far more rewarding as a person than any of these other professions, and really, the pay is comparable. I belive the last number I read is that the average American FAMILy earns around $40,000 per year, and most nurses make that all by themselves. The only negative that I can't get around is the 24 hour a day, 7 days a week, holidays and weekends that inpatient nursing requires. People work to buy the goods and services that are important to them, and health care is a very sought after commodity. If you add together the availability of work, steady pay, satisfaction from helping others and making a real difference to human kind (Think of the starfish story) then all in all its not a bad deal. Also, as a bedside nurse, when you are done with your shift, you're done--- no budgets to write, no personnel decisions, your time off is yours. I am married to an executive and yes, he makes a lot more money, and yes he has more prestige in the eyes of the community, but he is also responsible 24/7 and averages a 60-70 hour work week. We have almost lost our marriage over "the job." I do think we are cannibalizing our numbers. There are studies that show that even people who have a positive or neutral feeling towards a given topic will "catch" the negative feelings of others. This encourages current nurses to leave the profession and discourages new nurses from coming. If all the "discouraged nurses" who have left the profession came back, would we be in the middle of a nursing shortage? Probably not. There are too many opportunities that nursing offers to be disgruntled in what you do. If you don't like bedside nursing, try a doctors office, get an advanced degree and become a practioner, go into ancellary areas such as quality improvement---And a big opportunity looming for all of you experienced nurses is teaching. The average age of nursing instructors is 54, and we have to train the next generation. Yes, this will require more education and certifications, but that's real life. A very high percentage of these young people you see making money in business have MBA's, and I would be surprised if 60% of nurses have BS degrees. It's up to you to like the life you live or choose the life you like.