Double Dunker

I'm probably just annoyed because this hits entirely too close to home...but to talk in your introduction about having a house fire or losing a loved one and then in your article talk about your car overheating or your iPhone becoming outdated, is rather insulting to those of us who have endured real loss. In the last 16 months, I did endure a house fire in which my house was stripped down to the studs, and become a widow when my husband unexpectedly collapsed in my kitchen from and MI and we never got him back.

I guess I'm not seeing what the big deal is. You have to use hand sanitizer between patients anyway. It's just gloves. I know a lot of nurses that use gloves when giving all meds, regardless of isolation status. Many patients prefer it. I put on gloves every time, and yes I work in the hospital.

What are you interested in? If you want to circulate, you should take that job. In my city, it's hard to get into the OR, and the residency programs won't take you if you have more than 2 years of experience in any area of nursing. And don't underestimate the beauty of no nights, weekends, holidays, or call. That's dreamy. Also to consider, that day/night variable is a crock. It's HARD to switch back and forth. Even though you might do other non-nurse things on your opposite shift, doing nurse things when your body isn't accustomed to having to think that hard is tough stuff.

I'm a float nurse, and as such don't accumulate PTO despite being full time and benefitted. But the pay is awesome.

I once had a family member who was related to the patient by marriage, who also happened to be the chief of surgery at our sister hospital. Said chief told me he wanted me to put in an order for a bunch of labs. Nope. That's not how this works.

Aren't most of the hospital employees required to have BLS certification? If so, the assumption would be those staff members in the room at the time of arrest would begin CPR, so it is important to know. My facility doesn't use armbands, or anything else for that matter. I wish we would.

My hospital is always short on patient care techs at night. My hospital also has unit secretaries at night, but I don't know how common that is.

Search for heparin errors in the NICU. Lots of devastating errors to read about.

We are seeing a lot more creative pain management plans because of the nation wide shortage of narcs, and because the DEA is cutting the production of prescription narcs.

Do you have a unit educator you ask about charting?

It seems no matter where I am (I float between floors and hospitals) thete's always animosity between day and night shifts. It's unfortunate many can't see that each shift has its own unique stressors. I wonder if you see it more due to working mid shift. Good for you for reporting patient safety issues. I'm saddened your experience and expertise are not valued and instead you were subjected to practical jokes.

This isn't really what you asked, but rather a medication lesson learned the hard way! If a patient is receiving meds through a g-tube or NG tube, make sure it's okay to crush the med or open the capsule. Dilute with plenty of warm water! (One place I worked required sterile water, which I couldn't warm, which I hated). And flush well after administering. Unclogging tubes is such a pain.

I would have told the family member the patient indicated she was finished with her meal. She has no food restrictions (or outline what restrictions she did have) so feel free to offer her something.

Interestingly enough, my facility is studying whether these IV starts are more likely to infiltrate than other types. Apparently the ICU nurses were noticing a trend and so now we chart which type of IV start kit we use (some floors have alternatives) to try and track it.

Anybody ever heard of this? I'm wondering how it's legal - whose prescribing the toradol and the "zolfran"? Mojo Hydration

I have some experience with the Nexiva. No, you can not float the catheter in with saline. I hate them.

Yep, us too. If the patient is unable to get up and get his own drink, then he's on a fluid restriction, tough cookies. If the doctor wants to lift the fluid restriction, then she can. But I can't. If the doctor had already put in the order for the discharge, then that patient is going unless the doctor puts in a new order to admit. If the patient wants to sue because he wasn't allowed to change his mind, that's not your problem. We had a patient situation sort of like this - patient signed out AMA and then changed his mind (after only being on the floor a few hours) The hospitalist told him to go back through the ER.

We had a form to fill out to document a 2 person skin assessment had actually been done on admission and documented in the chart. It did actually help to make sure this was getting done so we weren't artificially dinged for "hospital aquired" pressure ulcers. Once the practice was ingrained in the staff and consistently passed on to new employees (took around a year) the extra paper document was discontinued.

One of my preteen daughters used to come home from school yelling at the top of her lungs at her brother, knowing full well I was sleeping, all while complaining all I ever did was sleep all day. So I actually did just that. I made sure she didn't have any tests at school the next day, and then woke her up at 2:00 and made her fold laundry and sweep the floor. I let her go back to bed 30 minutes later. The yelling in the afternoon stopped immediately!

I started off in med-surg and have since been trained in postpartum once I went to our float pool. You absolutely are NOT over reacting. The patients are completely different! I know how lost I felt going the opposite direction, and I had 3 weeks of orientation to PP. I know that in our hospital, if a PP nurse gets floated to med-surg, she goes as a tech, not as a nurse.

Some women still menstruate when pregnant. If it was a planned csection, she wouldn't have had any contractions to push it out. Or did she insert it after the csection d/t the bleeding?

I don't understand why so many are giving the OP such a hard time. Anyone who has worked med-surg for any length of time has cared for many of these types of patients and knows how exhausting they can be, especially with Q1 hour pain meds. Being frustrated with the state of affairs does not mean she is judging. She asked a clinically relevant question. Honestly, I thought she asked the question in a reasonably detached, impartial manner. It's the same question many of us have asked ourselves, and our coworkers, before. As others have said, you can't refuse to give an ordered med without documented justification. Does your charting system have an opioid sedation scale that you have to chart on before giving pain meds? If the patient is schnockered, document and call the physician. Otherwise, dilute the heck out of the morphine and push it really slow. Your patient will still get pain relief, but less of any type of "high" she might be getting.

This is absolutely true. Some SNFs I'd recommend in a heartbeat based on how their patients present upon admission. Others, as soon as you hear a patient is coming from them, you know their skin is going to be a hot mess.

Someone recently updated the labels in our nutrition room. The saltine crackers were right next to the "chicken broff".

I think it can be both boring and challenging. Some days it is super tasky and list checking. But if your patient's condition is constantly deteriorating, your brain will be tired from all the assessing, evaluating, and advocating you do in a short amount of time. Other days interactions with patients, families, other staff, can be emotionally draining and challenging. Since I've joined the float pool, I find it less likely I will get bored because I never know what type of patients the day will bring ahead of time. I don't mind my job, but I don't get up every day thinking "I love this job, it's truly my calling." It pays the bills. And right now, that's enough.