Raicho

Thanks! Although I don't see the actual app? I just took it and passed so all good. Thanks for responding.

Has anyone taken this recently and/or looking to sell their study books/guides?

We are a stand alone facility with 24 beds. We usually will have 3 or 4 nurses, plus a Charge, and 2-3 CNAs, depending on census. Apparently, in the past, when admissions gave hospitals specific times, the hospitals saw that as pushback and stopped sending us referrals. We lost a huge amount of business because of it. So we are not allowed to set times. So I am trying to work around that as it cannot be changed.

Hi all, Anyone who works in a hospice inpatient unit, how do you deal with multiple admissions at the same time? How do you prepare, so when you get slammed, its not so bad? How have you become more effective and more efficient? How do you use volunteers to help, or do you not?

Thanks everyone! I agree, Daisy4rn, using specifics, especially his name and the name, and room number, of his patient (and stating it was his patient), is something I will do in the future. I'm back tomorrow and curious to hear what the other Charges reaction was. I also realized that I have never been told what disciplinary actions I can take, as a Charge Nurse, if any. And/or, what is the expectation of us as Charges, in situations like this. I plan on asking my manager tomorrow but in a hypothetical/I'm still new way as she does not love me yet. ?

Yes, I definitely should have done that. However, I dont think he (yes, male, not that it matters) would have actually taken them in. And they were needed asap. In fact, I could see him saying "thanks" and then going to another room or area just so he would NOT have to go into that room.

Hi all, Semi new Charge Nurse here of a 24 bed hospice unit. Had a situation the other day that I need some advice about. Its shift change so I'm giving report to the oncoming Charge. We also have to count narcs so we are in the med room for about 10 minutes. When we come back, we notice a call light has been going off for 6.5 minutes. Still report time so double the staff is there. She and I go to the room and she figures out the patient's colostomy has exploded all over her and in her bed. She starts trying to clean her up as we realize we don't have the supplies we need. She has me go get the supplies and on the way I stop to let that patient's nurse know about the situation. That nurse and the one who is going off are obviously done with report and they both verbally acknowledge the situation. I also see the CNA and ask her to help. I grab the supplies, return to the room, and the other Charge and the CNA are working on her. We realize we need different ostomy supplies so I run to get those. On my way, I see the assigned nurse sitting at a computer. By this time it's about 7:20, so way past report. I say to that nurse, "hey so Charge is in there with CNA but they could really use another-". That's as far as I got. "THANKS FOR ALL YOUR HELP, I GOT IT". And yes, the nurse pretty much yelled it at me. I go to the supply room, get the additional supplies and return to the pt's room. The assigned nurse is still not there. Charge and CNA are needing even more supplies; they pretty much ended up doing a full bed change AND re-dressing all 7 of her wounds. Took about 45 minutes. And then I see that pt's assigned nurse was back at the computer. I briefly brought it up to the other Charge and she said she would handle it. So I need some advice. I know that I am not strong in these types of situations. In this case, part of the issue was I didn't know how much of a responsibility I had, to address this night nurse that I didn't know so well, AND I didn't want to step on any toes with the other Charge. I chose not to say anything at the time because: 1. I froze because I was so shocked at the response and this is the first time I have seen that sort of thing since I started working here (9 months) 2. The pt situation was more important. I know there have been issues with this nurse before as this nurse was a night Relief Charge but then had that position taken away. And I have heard about, and seen, some pretty poor behavior but nothing that came close to this. What techniques/phrases could I have used, in that situation, to get this nurse to go to this patient AND not be so pissed off they either walk out or just go and hide somewhere for the rest of their shift? I just have no clue how to handle situations like this. If it were the day, and 1of my nurses did that (actually, I cant see any of them doing that), I would offer to take over whatever they were doing so they could go see this patient and not really give them the option of saying no. But I didn't feel I could do that in this situation. Especially as I have no idea what they were doing on the computer. They hadnt even seen any of their patients so they couldnt be charting... What do you all think? How would you handle it? And specific steps would be super helpful, including wording. Or suggestions on books, articles. Thank you!

"Lesson learned: no more giving her a head's up. It was not owed to her, nor was it required. This counselor is unprofessional and intimidated by your relationship with the students." It doesn't matter how she reacted; you must put the student first. And if that means her coming in to yell at you when you give her another heads up, then that is something to deal with. The student comes first.

Thanks for posting that link!

Hi! I am applying for a job with the VA and would love to see that proficiency as well. I have 9 years of experience, with 7.5 in spinal cord (which is the unit I am applying for) a BSN, a MSN, and a MBA, as well as CRRN. I would love to have that proficiency information when I interview. Thank you!

I would hope that within a 12 hour shift you take the time and effort to actually talk to those who are able and get to know who they are and what their name is. Even if I get a patient 1 hour before shift change, assuming they are coherent, I find out as much personal info as I can. We need to remember these are not just patients; these are people. "Room 1107" is not good enough.

So do you just print out the SBAR form? Or is there a,way to print out a Kardex like report for each of my patients? I just started with EPIC but need something to write on.

I LOVE it when they are a nurse! I feel like it is a great way to establish rapport immediately. Especially when I ask what area they are in. I am very specialized so when someone tells me they work nights or less, I thank them effusively because, and I tell them this, I could not do the job, so they are helping for making me not feel guilty. Additionally, this is an issue within our community. Why would you NOT mention It? Do you know of ANY DOCTOR who would NOT mention It? Why are we nurses so conflicted? Why would we respond negatively to someone who states that they are?? Yes, it may be someone who is actually a CNA, but perhaps in their home country they are a nurse. Who cares? At the very least they are advocating for their family member, or themselves, and showing that they have some knowledge and may be able to help. We say that the nursing model is all about treating someone holistically. Wouldn't it help all of us, to give the best care possible, by knowing as much information as possible?

Hospice ll, HAVE a PT with extreme wound odor from his sacrum, amputation sites, amputatioN sites. SACRUM is to the bone. Parts are already gangrenous. Odor is so bad they had to move his roommate out of his room. Are using crushed flagyl in the wounds. What else can we use? Any help is greatly appreciated.

I hear a lot of people saying this isn't gossip, but constructive feedback. I have to say, that may be the case, but it may not. If this is happening on a regular basis AND she is asking YOU about other people, it could be a manager playing the "divide and conquer" role. Whole I was in Nursing school I worked as a unit secretary on the Medical ICU of a Level I Trauma center in the middle of the city, 24 beds, lots of non English speaking. After a few months, I would get called into my managers office for "constructive critucism". It was always, "they think you are too________. " But she could never give me [email protected] and as I was still really new I made a point of telling EVERYONE how much I didn't know and would they correct me when I did anything wrong. But no one ever would tell me that I was doing anything wrong. Then my manager started calling me into her office asking me " what people were saying about her?" We were all sniping at each other so.much that it took us a solid year to figure out what was going on. Noone was complaining about the other, at least not to her, but she was attributing it to us. The last time I got called in I was told that I was being "too friendly". I asked did they really mean that I was talking with people too much and therefore not getting my work done and I was told that no, I always got my work done. So then I asked some more questions and all I got was that I spent too much time on the non-English speaking visitors. That was the day I put in my notice. Thank goodness. Later I heard that she hadn't done any of thus with the nurses, but did with ALL the techs and secretary's. So sad.