CareBayer

I agree with a lot of what you say......thanks for the post!

The nurse who passes the med is the one who is ultimately responsible for checking labs that pertain to that med.....what if the INR was 5 and they still gave the patient coumadin?

The MICU that I work in is closed between 7am-9am, 3pm-4pm and 7pm-8pm (for shift change.) We allow 3 visitors at a time, children may only visit between 5pm-7pm. One support person may stay overnight from 9pm-7am. Does a more open visitation policy help or hurt the nursing care that you deliver? Most families are very respectful of my needing to be with their loved one. May times, I will ask them to step out of the room while I do an assessment....and they are fine with that. Once in awhile there is the family that is all up in my face (or my intubated patient's face.) What are you visitation hours like and how do you feel about them?

In the past few weeks, I have made mental notes of the things that I do at my job that are not "on my list of job requirements" so to speak...... 1. Emptying trash in patient's rooms and cleaning up said rooms 2. Rearranging the room as to please the patient and/or family 3. Calling dietary multiple times to request tray's for patient's families 4. Going to great lenghts to obtain beverages, snacks, etc. for patient's and families 5. Calling hotels to inquire about vacanies for patient's families who are from out of town 6. Taking patient's who are discharged down to waiting cars I don't mind doing these things, but there are times when I find myself getting behind with medication passes, etc. because I am busy being the housekeeper, transporter, and nurse aide. (Our hospital has cut back on these ancillary staff, so these tasks now fall on the shoulders of nursing staff.) What other hat's do you wear at work?

In my hospital, LPN's are no longer allowed to work in crital care nursing areas (step-down units, etc.) We lost an LPN who has worked at our facility as a critial care nurse for over 20 years. She had loads more experience and knowledge than most of us RN's on the floor.

I am a fairly new nurse....I just hit the 6 month mark not too long ago. I work on a busy step-down unit. I arrived at work yesterday at 3PM to four monitored patients and a new admission. The new admit was a SBO who was vomiting all over. I tried to place three different sized NG tubes (with the help of another experienced nurse) with no success. I spent 45 minutes with this lady in all trying to get her (and the room) cleaned up. Right after leaving her room, I was given another admission (now I have six patients.) This patient had profuse diarrhea and a potassium level of 7.1. We don't have an nurse-aide after 6PM, so while giving insulin, D10, calcium gluconate, and kayexalate to this patient, I was cleaning up her as well. My other four patients were busy too....I had families coming up to me in person demanding my immediate attention......so I was trying to do damage control and then run back to clean up the vomiting and pooping patients. I was a crappy nurse yesterday, my charting was awful, I did not leave work last night until 1AM. It was one of those nights when you are just happy that all of your patients are breathing at the end of the shift.

How far are you into your first year and how many times have you come home and cried? I've been off precepting for five weeks and have come home and cried three times....most of the time it's because I was so overwhelmed on the floor....once I almost started crying at the nurse's station because I was being pulled in a million directions! How about you?

I posted this in the California nurses forum but have not received any responses.... What type of floor/unit do you work on and what is your nurse/patient ratio? Has the mandated nurse to patient ratios increased or decrease the quality of patient care and if so, how? Just curious!

I'm trying to make my way for awhile before making too many waves....

http://www.massnurses.org/pubs/positions/magnet.htm

Fortunately, another nurse on the floor was able to look in on my patients......she witnessed the pandemonium that I was going through. Most of the nurses on my floor are awesome team-players.....it's the few that aren't that negatively effect us all!

I am a new nurse....this is my second week on my own (off of precepting.) I have been taking care of five patients on a busy step-down floor with no major complications...until yesterday. There is a nurse on our floor who is sometimes charge. This nurse cannot even handle the stress of being a bedside nurse let alone being able to be in charge of the unit! I had the day from hell yesterday....two patients scheduled for procedures (at the last minute) that the charge nurse failed to tell me about (the charge usually enters in MD orders and lets us know about any stat drugs, procedures, etc.) Both patients were refusing the procedures....one patient was playing me for a fool the whole day (a serious personality disorder!) I was trying to call the patient's families to talk with the patients, get them all pre-medicated, get consents signed, trying to pass morning meds to my other patients, etc., etc. The charge nurse was zero help. I finally convinced one of the patients to go for her MRI. Unfortunately, I had to go with her (because her MD considered her to be unstable...I begged to differ!) So now I had four patients on the floor without a nurse. As you all know....an MRI can be lengthy. I was off the floor for almost two hours. When I asked for the charge nurse to please check on my other patients while I was off the floor she said "I'll try." Thanks a bunch! I am ever so grateful to those charge nurses on my unit who really excel and step up to the plate everyday in order to keep everyone on track. Everyone is human and makes mistakes and has a bad day, but this particular nurse has ZERO teamwork-skills. Thanks for listening to my vent!

There is a nurse that I work with who I HATE giving report to. She shows up and expects me to give her ALL of the info about a patient. I go early so that I can write down the names, doctors, allergies, diet, activities, etc., etc., and she is too lazy to do the same. She then berates (sp?) me if I don't have a piece of information that she thinks that she needs (I have begun telling her to look in the chart...in a nice and smug way.) I feel your pain......don't let it keep you down. Ask at the end of the report if she has any questions about the patient you are reporting on. If she has no questions.....assume that your report is complete!!

Why are hospitals still stocking latex gloves? Are non-latex gloves more porous (or more expensive) than latex?? I think that I may be developing a latex allergy. My hands are becoming red and irritated lately. How many of you have developed a latex allergy or sensitivity since becoming a nurse? My facility stocks non-latex gloves, but most rooms still have latex gloves....sometimes you have to search (and search and search) for non-latex.

If this organization truly cared about patient care, then they would be mandating SAFE nurse to patient ratios instead of harassing nursing staff about why there is a box of gloves propped on the handrail in the unit's hallway. JACHO is a bunch of bullies made up of people who have no clue about what comprises safe care. Can you imagine how screwed almost every hospital in this great nation would be if JACHO mandated ratios that mirror those that are state law if California??? Sorry, just my thoughts....