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brcanda3

brcanda3

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  1. I've been nursing for 20 yours in an acute care setting and love my profession and always looking for ways to improve. Please see how you can help me below: I work on a Medical Telemetry Unit where the nurse to patient ratio is 4 to 1 and at times 5 to 1. Our length of stay averages 2.8 day and there are 36 beds. With the business of the unit I find nurses are unable to reach out to teaching so that it is effective. On an average day it looks like nurses are focusing on completing all their tasks, Meaningful Use and Public Reported documentation... which leaves minimal time for teaching. With the Federal Government wanting hospitals to decrease readmission by 20% it seems more time is needed with our patients and families for teaching. An example is a new heart failure patient. During your first morning round you assess the patient knowledge and management of heart failure. The patient knows nothing but to decrease his salt intake. You provide teaching sheets and DVD to view. You also pull up information about new medication like Coreg, Lasix, Potassium... The next nurse comes in and teaches information about the side effects of Coreg only. The next nurse comes on shift and talks about reading nutritional labels to determine the amount of sodium per serving. All teachback by the patient was done properly with each nurse. On the 3rd day this patient is discharged. Did any have time to share with this patient to weigh daily, write it down, and when to notify MD of weight gain? NO!. This patient is given a follow up visit to PCP within 3 days but doesn't go and is readmitted with SHOB after 9 days. After review of readmission it was identified that this patient didn't have a scale at home and didn't know he was to weigh daily. The process starts all over again because the nurses still don't have the time to reach out to teaching. What are your thoughts about the time staff nurses have to devote to quality education to our patients? Share what you are doing differently in your organization to allow more time with patients and families for teaching and teachback?
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