Going for magnet status...must do PI/evidence based practice study..any suggestions? We have already done handwashing, pain, IV checks/infiltrates, need for 4am VS, cont nebs vs. q2 hr. Running out of ideas... thanks for all your help!
LisaRn21 replied to Nascar nurse's topic in Geriatric
Can I rant too? If I hear one more time already this season, "You don't have kids why can't you work xmas" I am gonna shoot myself! Really! Like Idon't have a family and then for the nurse to say "Well in 15 years come talk to me" I don't care how long you have worked there your holiday is your holiday geez. ok I'm done :)
In my facility it states that either LPN or RN can give narcs and anyone with a professional license can cosign the narc and the waste. I have always used another nurse (RN or LPN_) but I have used MD's in the past.
So what would you do if you followed a nurse who only worked 4 hours with the patients and they didn't chart anything no assessment some I and O's and only signed out some of their meds....would you say something next time you saw them? Do you guys chart an assessment if you are there only 4 hours? I do but I was thinking maybe everyone doesn't when I saw this
I work in a pediatric facility and we give everyone a flu shot at discharge...doesn't matter the age .. we have already started giving them this year.. I am intrested to hear about the mercury thing I never heard of that but I guess we could be giving mercury free ones.. I'll have to look into that :)
that makes sense!!! Pt had a femoral line and it was pulled due to infection...at tthe time they thought he was septic so hmm I don't know why not another central line.. the doc kept saying no more centrals..
Yes!! Never draw blood from anything less then a 4... we have a lot of 2s (babys) and the pressure can break it apart and then it can get caught in the heart or any other part of the patient (fyi that is not good)
From my experience... you can use either.... as long as a med isn't infusing through them... and you always want to waste 2-3 cc of blood prior to drawing the sample. If I had to choose I would choose the brown lol but its a random guess...but technically you could draw blood from either... oh and if you are drawing med levels you want to use the port that was not used to infuse the med unless you have to and then you flush it really well :)
I work in peds so it may be a little different... well i think the saftey of all should have the same standards no matter what age .... but we
Have premixed K solution bags available 24/7 we never mix and pharmacy is available 24/7 if we run out *never has happened it comes shipped to us that way*
We double check all narcs.... every single ones needs a cosignature no matter if its a waste or not
We double check all herparin and insulin... drips we check when settings are changed, a new bag is hung, and before and after shifts...
PCA's we double check all setting before and after shift and if they need a new syringe... we also check them hourly (without a cosignature) to get the demands and injects and such...
We also check the Iv hourly to make sure it is patent... our pumps beep hourly to remind us to double check for infiltrates and if the iv is still in and not laying on the bed haha
Everything needs a cosignature... and I have never had a problem getting it from another nurse... If you feel in doubt always double and triple check something ... and if you still aren't sure always ask... patient saftey is one of jacho's biggest goals!!!
LisaRn21 replied to perfectbluebuildings's topic in NICU
We get pulled all over the hospital too. I have been arguing this for over a year now. I"m not a icu/ccu/nicu nurse .. I am a general floor nurse! I was acctually pulled to the ccu one time and the girl who started with me was still on orientation and here I am off orientation and in the critical care area by myself.. I said I feel like this is so wrong. Apparently we always get the most stable patients..but you know what? that doesn't always happen... and their opinion of stable is not my opinion of stable. I once was pulled to the nicu and in report and I said.. Are you sure this person is ok for me to take? and they kept saying yes yes. So like a dummy I took it. The kid ended up on a ventilator (which I know nothing about) and they the nurse coming in was the rudest person I have ever met!!! She came in for report took one look a tthe kid and said I'll figure it out myself... you probably have no clue what just happened to the kid. It really made me mad. I said fine. took my stuff and ran out of there I hated every second of it! lol We have a lot of nurses in the units that thinkthey are God in training lol They think they are so much better than any floor nurse.. its discusting. I've learned to call them out on certain things when they try and degrade me .. but a lot of the times they are right.. I don't know certain things...and thats because I don't work there everyday and see what they see!!!
Ihave done some research and they have also said the needle can break off in the patient if used more than once.. but I was thinking if they use it like 5 tmies lol I think he was only trying to use it like 2 times so its one needle a day .
Has anyone ever heard of a diabetic using the same needle twice? Once for their morning 70/30 and once for the pm dose? A nurse advised a family member of mine to do this because insurance does not cover the needles and they are in a finacial bind. I know in the hospitals we don't do this for the obvious reasons but I can see both sides to this one... what are yall experiences?
LisaRn21 replied to crazy4trauma's topic in Emergency
We do a family center care approach... so as long as it is possible we have parents in the room for everything. Even if they are really upset..we just have a social worker with them. We even let our parents in the PACU .. I think its better for the kids and the parents themselves