foragreatergood

The majority of my coworkers are adhering to social distancing - taking it very seriously including not eating out, not having meals delivered at work, only going to work and back home. But we found out that a small group is out socializing during th...

Just wondering how important is privacy in your triage area? Do you limit visitors? Close curtains? If a patient had a very personal complaint, could they describe it to you without others hearing it?

I think its surprising that hospitals aren't more concerned with protecting private health information in the triage setting. So much emphasis is putting on privacy ( minimizing computer screens, removing patient identifiers etc) yet its a free for a...

I think using a number would be best - but making it clear when the patient is assigned a number that it not sequential. So random numbers could be assigned - like 67, 4, 22, 952 - then patients would not correlate their number with the order in whi...

We are trying to start a new process of not having anyone but the patient (unless its a child) back to the triage area. Most staff and patients seem to be fine with it. It makes the process faster and less complicated without input from the visitors....

In our dept the fast track area RN has 5 patients but they are all 4's and 5's. No easy 3's, no kidney stones, migraines, they don't even want the severe back pains. The rest of the dept is 4:1. We have been trying to get this better balanced. It see...

I am looking for suggestions on the most helpful review material for the CEN. There are a lot of books out there! I have about $150 to spend on review material/books. How can I get the most bang for my buck? Open to any advice on how to prepare for/p...

Stick it out for a year. I lost track of how many times I almost quit, walked out in tears and felt like I was never going to manage 4 patients. 6 yrs later - I still have days I struggle. But I am so glad that people encouraged me to stay.

Not so well! But it also prompts the RN to identify that the patient is high risk and implement precautions - leave curtain open, offer toileting, bed alarm, siderails up etc.. The contract always has to be addressed - so the RN, at a minimum, need...

A written agreement for high risk patients to sign that states they agree to use their call bell to ask for assistance. Time consuming, but reduced our falls.

#1 will earn you a lot of respect and improve your chance of success!

Our ED does still use it. But it's our older docs that order it. It is linked to fatalities related to mesenteric ischemia. From what I understand, the pathophys has not been established but there is enough research out there that many docs don't w...

I have recently had patients that I have questioned the safety of NG tube placement. Are they certain diagnosis/history/symptoms/labs that flag you that NG tube is a bad idea? For example - alcoholic patient with critical H&H...

Is it just some good drugs to relieve pain and relax muscles? Or is it procedural sedation that requires 1:1 monitoring by a nurse? Looking for details in specific combinations of meds/timing of meds and doses for adult patients. Ex: If you give morp...

I worked night shift for about 2 yrs. I took a few weeks off as you did. I didn't realize how crappy I felt until I started sleeping 7-8 hrs every night. As soon as I went back to work I requested a move to days - and was fortunate enough to get it. ...

Part of ACLS training is to evaluate the compressions and encourage the staff member to adjust them if necessary. We have orderlies come to our codes and sometimes I have to tell them to lighten up - slow down and decrease depth of compressions. Just...

It sounds like you have a tricky medication/fluid admin system. Our system its clearly written how much is ordered, and it keeps a running tally - and it has a stop time. I have found that with critical patients that have gotten multiple bolus's - it...

I have often heard the phrase " getting stomach pumped". Hearing the description of the Ewald tube now I understand where that term came from! YIKES.

Just wondering why sterile water? Do you place OG in patients that are not sedated? Seems like that would be tricky if they are awake!

I can only remember doing this once. We didn't use sterile water ( stomach not sterile, right?) I think the most important thing would be verifying placement of the tube. We used to verify placement by air bolus heard by 2 RN's, but that has recentl...

I think that being able to associate the death of a family member to the patient lying in front of you makes you a better nurse. I cant explain why or how - but these situations seem to be easier to cope with over time. Don't fight your sensitivity- ...

I understand you're rattled because of what almost happened. But for the rest of your nursing career, this experience will effect your decisions in a positive way. The next time someone hands you a syringe you should feel confident in simply statin...

I cant count how many times a priority 1 unresponsive patient or cardiac arrest has rolled into my room at shift change. I have no option but to deal with it. I know I will get out late, but that's the nature of our work. When IMC wont take report be...

Our department has been overwhelmed since beginning of December. Staff is stressed, we are short staffed. But not to the degree of OP. When you start feeling like your license is at risk its time to get vocal or leave. We just got some agency staff ...

My friend works at hospital that uses Paragon - It has been a huge nightmare for them. And she talks more about Paragon issues than patient care issues. She said its difficult to see any documentation done in other areas ( such as ER) and she cant se...