DVorahRN

I am a BSN prepared RN with 18 years of experience in various areas, including oncology, critical care, telemetry, and postpartum. I am considering seeking employment in Canada, and I would like to know what the experience of other nurses has been working in Canada. I have considered this possibility of travel nursing, however, I have 2 dogs who I am not willing to leave behind. Also, I am 58 years old (nursing was a midlife career change). I anticipate working at least 14 more years as I have been blessed with good health and good longevity genes?

I have an obese female pt on BiPAP for COPD exacerbation who needs a Foley catheter placed. She cannot tolerate supine or lithotomy position, or lateral position. Has anyone else faced this circumstance? The only thing I can think of to try is reverse Trendelenburg to keep her breathing comfortable, and raising the bed up off the floor so I can see what I'm doing. Suggestions?

I think NRP and STABLE are good resources

On my unit we run compatible gtts together frequently. Waiting for another line when someone needs vasopressors could result in a very poor outcome. Obviously, it’s best if you can have a triple lumen central line, but use what you have to save their life.

I was 38 when I went to nursing school, and while I was in the older half of my cohort, I was far from oldest. One of my classmates was using Social Security retirement benefits to pay tuition! And as has been said many times before, how old will you be in two years if you don't go to nursing school? Go for it! Don't be a slave to the calendar.

We jury-rigged a better female urinal by attaching an ambu bag mask to a urinal. The squishy edges of the mask held it in place well so we didn't have any leakage.

I've been straight nights for 8 years. I keep my sleep/wake schedule the same, so even on my nights off I sleep during the day and stay up at night. If you have family obligations (I don't) this probably won't work for you, so you should try to get all your shifts in a row so you can flip back to days on your days off. A lot of shift workers have "shift work sleep disorder" and can be prescribed Provigil, Nuvigil, or methylphenidate (Ritalin) to help stay awake during the night. Good luck!

Our ratio is 1:4 and very, very rarely 1:5 if they are extremely low acuity patients and we are understaffed d/t a sick call or something like that. I am fortunate to work on a unit that puts patient safety above finances -- our unit director has even come in to take a group when we were short-staffed, rather than risk patient care.

All clinical staff may choose whatever scrubs they like (well, OR has their own hospital-supplied and laundered scrubs). Specific coloured polo shirts with the department and hospital logo are supplied to the non-clinical staff. Our CNO did a research study some years back to determine if it made sense to transition to colour-coded scrubs and concluded that it didn't matter that much to the patients and visitors and that it was despised by the staff.

Our hospital pays 7% over base pay for relief charge duties. We no longer require the charge to take a full pt group as a general rule, although it does happen at times depending on staffing.

I have two pairs of Keens and two pairs of Pearl Izumi running shoes. They are all really comfortable and I alternate which ones I wear. There are several shoe stores in my town that actually give health care workers a discount -- don't forget to ask!

I like Allheart.com and Tafford.

I like White Swan. I also frequently get scrubs by Allheart.

Our facility introduced the concept of Bedside Shift ReportSM as proposed by the Studer Group a few years ago. Frankly, I think they did a poor job of introducing it and an even worse job of training us (yes, scripts and role play feel silly, but it does give you a starting point -- something my hospital skipped over completely). My unit has really had a difficult time with implementing this process as we find it takes far more time to give report this way, and off-going shift RNs are inevitably leaving late. One of the challenges is that the patient decides that "as long as you are here" they need to go to the bathroom, get pain medicine, get nausea medicine, get a warm blanket, get ice water/coffee/food, etc. Obviously some of these needs can easily be met by ancillary staff, however, since there are 2 RNs at bedside, the RNs have to do it right then. This eats into the time available for report on the remaining patients. And if you are giving report to/getting report from multiple nurses, an awful lot of time can pass. Our unit management is really cracking down on us to do it every patient, every shift, and it is causing a lot of push-back and stress. Has anyone who is using this program found a way for it to work smoothly, without making shift report last forever?