patwil73

patwil73

ICU/CCU, Home Health/Hospice, Cath Lab,

Member

  • Content

    261

  • Visitors

    5,336

  • Followers

    0

  • Likes

    0

All Content by patwil73

  1. Question about patient's death and ethical issue

    patwil73 replied to AZO49008's topic in General Nursing

    Your question is asking about how to prioritize ethical decision making. 1) Ethic - honesty is more ethical than lying. 2) Ethic - Harming others (through word or action) is unethical. 3) Ethic -...

  2. How does your unit handle mandatory cancellations?

    patwil73 replied to ms. ann's topic in General Nursing

    My hospital has established a fund for cancelations. It equals out to 300 shifts or 2400 hours. So if census is low we cancel agency, then OT/extra shift people, then per-diems. After that it goes...

  3. New Male RN wanting A supervising job

    patwil73 replied to James_Adam's topic in First Year After Licensure

    Unfortunately burnout is common in LTC. One good healthcare reform would be patient ratio limits in LTC. I am truly astounded that people can make it in LTC (I lasted only 3 months). However the...

  4. New Nurse...Need advice on dealing with death

    patwil73 replied to pcurn2008's topic in First Year After Licensure

    Sometimes the patient will have gas built up in their abdomen - whether from compressions or misplacement of the ET tube. When the code is called and the tube is removed that gas can slowly escape....

  5. New Male RN wanting A supervising job

    patwil73 replied to James_Adam's topic in First Year After Licensure

    It might be possible to get such a job quickly depending on how desperate the facility is - however, judging strictly on your length of time as an RN, I think more training would be advisable. You...

  6. Insulin drips

    patwil73 replied to blondy2061h's topic in General Nursing

    He died a few days later if I remember correctly. End-stage just about everything. It just stuck in my mind because of his reaction to the insulin and the levels I reached with it. In 7 years I...

  7. Insulin drips

    patwil73 replied to blondy2061h's topic in General Nursing

    We have some judgement in following the protocols - for instance, if we had a patient described above with the routine hypoglycemic reaction we would moderate the adjustments and then call the doctor...

  8. Hourly Rounding / Walking Reports

    patwil73 posted a topic in General Nursing

    Hello, My hospital is thinking about moving to hourly rounding combined with walking reports. Has anyone out there used these and how well do they work for you? Some information out there seems to...

  9. stopping a CODE

    patwil73 replied to creekster_16's topic in General Nursing

    At our hospital the residents are usually running the codes (as supervisor I help run with them). If the code lasts a long time, they will often ask if anyone has any objections to stopping the code...

  10. acute renal failure scenario

    patwil73 replied to cocolococna's topic in General Nursing

    If some called me for a medical response on said patient - this is what I would do: Set of vitals - I am looking for hypotension, tachycardia, elevated respiratory rate, low saturations, and elevated...

  11. Would you have called rapid response?

    patwil73 replied to uscstu4lfe's topic in General Nursing

    As the person who runs the RRT at my hospital I would not have been put out at all by being called for a SBP of 87. If you had called I would assume that you are worried about something - so to me it...

  12. No experience in Nursing but wants to start a Career in Nursing!! PLEASE HELP!

    patwil73 replied to Aloha86's topic in General Nursing

    I actually had my bachelors already so most of my prereq's were out of the way. I did have to take sociology, microbiology, anatomy and physiology (2 quarters worth), statistics. I had to challenge...

  13. IVs

    patwil73 replied to sureshooters wife's topic in First Year After Licensure

    One of the differences between school and the nursing world is that in school you are expected to know every step the teacher wants you to know - in the real world you will develop your own steps as...

  14. what you do to void a code, and during the code?

    patwil73 replied to luce2008's topic in First Year After Licensure

    I would disagree. Nothing is worse than explaining to a sobbing family member that the patient died because no one called a code. Most people are. You are dealing with death. There is a lot of...

  15. Did I handle this correctly?

    patwil73 replied to litlamp's topic in First Year After Licensure

    I would say your charting was correct, but I do have one question - why didn't you just restart the IV? Is there a reason you have to wait for the doctor to determine if IV is ok to use or not?...

  16. Clinical Practice Guideline

    patwil73 replied to ruse's topic in General Nursing

    We fill out an anonymous reporting sheet that indicates what medication was given, when, and what the errors surrounding the administration was - for instance did the medication get cancelled but the...

  17. Anyone put in a-lines?

    patwil73 replied to teenycar's topic in General Nursing

    I've put in 2, but only by accident - trying to find a vein near the elbow Otherwise our doc put them in at our facility.

  18. Morphine doses while dying?

    patwil73 replied to Medsurg Mama's topic in General Nursing

    Babs0512, I think in the end we are essentially in agreement - perhaps just using different words to express the same thing. From your passion describing how you care for your patients I would have...

  19. Morphine doses while dying?

    patwil73 replied to Medsurg Mama's topic in General Nursing

    Thank you for your response. If you are assisting the family with the process of grief and dying then in most cases they would not be requesting pain medications for "no reason". It has often been...

  20. AED's

    patwil73 replied to nursemaggie's topic in Patient Safety Issues

    Our new defibrillators have an AED option. Turn clockwise to monitor regular defib, turn counterclockwise for AED. Don't really like it but there you go.

  21. help with ethical issues

    patwil73 replied to loran's topic in General Nursing

    I'm afraid I have to disagree here. This is clearly an ethical issue, as how we treat this woman and how we feel about how we treat her is tied into our sense of right and wrong which is clearly an...

  22. Question about hours - 36 for 40?

    patwil73 replied to ChgingmyCareer's topic in First Year After Licensure

    Purely depends on the contract where you work. At my hospital any one who works a 0.6 FTE or greater (which is 48 hrs in 2wks) gets OT for any extra shift they pick up. I have worked others where I...

  23. Calling in sick (question)

    patwil73 replied to uscstu4lfe's topic in General Nursing

    At my hospital which is union - I can't ask people what they have only if it is the employee who is sick or family (it gets coded differently). However, you can use your sick time for either one so...

  24. Checking IV patency

    patwil73 replied to linsey_dawn's topic in First Year After Licensure

    On a peripheral IV you can't always get a blood return. To check for patency, you flush 7-10 ml of NS. Place your fingers above the IV site (about an inch or 2) on the vein itself while flushing....

  25. Calling in sick (question)

    patwil73 replied to uscstu4lfe's topic in General Nursing

    As a nursing supervisor i prefer earlier calls rather than later. Much easier to cover you with more time. I also hate having to cover someone who comes in sick and then has to leave half-way...