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.

Hi Nutella, Did you have a laptop stand in your car? If so, did you like it and where did you get it? If not, how, physically did you do your charting in your car? Thanks!

In some situations, we do develop relationships like that with our patients and their families. I work in acute rehab and we have our patients any where from 30 days to 10 months, or longer. In that time period ito is impossible to not develop some sort of relationship where compassion truly comes in. That said, our rule about relationships, with patients and their families, is intentionally vague but states that once you, the provider , is getting more out of the relationship than the patient, you have crossed a line.

Yes!! I always tell and I always love it when my patients, or their family members are. Especially if they do, or did, work nights. I did for 6 months the and was absolutely miserable so whenever I meet a night nurse, I thank them profusely. It means I don't have to work nights.

I work in rehab and for the most part I let my patients swear. However, because we have kids and others around here, if they are loud or outside their room, I will tell them to "watch their language!" I have never had anyone NOT comply. Even those who just got out of a 14 hour long surgery and are in excruciating pain. But we all know each other pretty well and I usually do it with a smile. To which they usually respond, "Yes, mom". I think using the excuse that there are others around who may be bothered by it is perfectly fine. It is really all in your delivery and if it does bother you, especially if it is every other word, I think it is quite fine to politely ask them to stop. Or I just give them a hard time, " Really, you can't come up with any other words?"

I understand that many nurses in certain facility settings may not discuss insurance with their patients. However, some of us do. I work in a specialty rehabilitation facility focusing on only spinal cord and brain injury. We have our patients, and their families, for 2-10 months. We talk about insurance all the time. Especially since there are very few insurance companies that really have good trauma/long term coverage for patients like these. It is a daily issue these patients, and their families deal with. Especially because their spouses have stopped working as well. As a result, us bedside nurses need to be able to discuss these issues. Yes, we have social workers, but they are not here 24/7, nurses are. You all are right, there is no law that states nurses are required to explain insurance to patients. But there is also no law that requires nurses to be compassionate. There is also no law that requires nurses to care about their patients. And yet we do. As nurses, I believe part of our job is to always strive to be better. I believe that means educating ourselves on laws and issues that affect our patients so we can discuss them intelligently. For those of you who think the Affirdable Care Act is a piece of garbage, please make sure you have done your own research and come to that conclusion on your own instead of listening to the propoganda and repeating stuff. Here is why I believe it is beneficial for all and these benefits outweigh the negative: 1. You cannot be rejected, or dropped, for pre-existing conditions 2. The insurance company cannot cap your benefits 3. There is a basic core of services that all insurance plans must contain 4. Maternity and newborn care is included 5. Preventive and wellness care is included. As a single female, with no kids, and no intention of having kids, I still believe all of us will be better off with all of this.

Having read 300 of the 900 pages (I am slowly working on the rest) of the actual Affordable Care Act, I can tell you that most of this article is FACT. Additionally, as pointed out above, it is also now LAW, so as nurses, especially bedside nurses, we need to be able to explain it to our patients. If you don't agree with it, that is your right, but it is the law so you can't just refuse to answer your patient's questions. At the very least, give them that list of resources so they can make up their own minds.

I work in rehab and we have patients for 3-10 months. As a result, we get to know them AND their families and friends very well. Its almost impossible not to. Especially when you are dealing with issues such as intermittent catheterization and bowel programs. As many have mentioned before, treating the person as a person and NOT a diagnosis is huge and the patients really like that. Including them in their plan of care and decisions, even if they are small, are very important as well. I also like to remember that it is not about me, the nurse. I have to remember that this person has just gone through a horrific tragedy and even though they may be acting out by spitting at me or cursing at me, I cannot take it personally. This does not mean I allow it, but it is so not about me. I also think that sitting down when you are asking your patient questions, etc. really helps. If the patient is 6'4" and now is lying in a hospital bed looking up at everyone, they may feel a bit uncomfortable and less willing to give you information that you may need. There have been studies that have showed that patients perceive sitting down as spending more quality time. Basically, I think you should treat each patient as like you would want to be treated. When I go into a hospital or doctor's office, for anything, I want to feel that I am welcome and recognized and that someone is going to take care of me. I don't want to feel like I am a burden or just another patient.

Nothing guarantees credit transfers to other universities. It all depends on the school. My first degree was from the George Washington University, considered by many to be a very good school on the East Coast. At one point I was trying to get into their Master's program (before Nursing) and they had some issues with GWU because of how GWU designs their classes. The classes didn't teach the exact same things and as a result, some credits transferred and some did not. So it all depends on the schools themselves and every school makes its own decisions regarding transfer credits and it is not the same for every subject. Platt is now approved by all state agencies as well as the NLNAC which is different from the NLN. http://www.nlnac.org/About%20NLNAC/whatsnew.htm Most facilities require graduation from "an accredited school". They do not distinguish between the NLNAC and any other. I currently work at Craig Hospital which IS a Magnet facility, we were jus re-accredited by Magnet and won another nursing quality award. http://www.rehabpub.com/RMN/2011-02-07_02.asp Having graduated from Platt over 2 years ago, I have always felt that I had an excellent education and that I was definitely prepared for the real world. I think my co-workers would agree and I know my managers would agree as I just had my yearly evaluation and passed with flying colors as well as a raise. In addition, I just finished my MBA through the University of Phoenix (also accredited) and am continuing on with my Masters in Nursing. I have NEVER heard any disparaging remarks regarding Platt College from ANY MDs (Craig and consultants included), other nurses, administrators, facility recruiters or school recruiters. That being said, nursing school, and Platt College are not necessarily for everyone. I am proud of my degree from them and of how I am progressing in my nursing career and believe it is mainly due to my education at Platt.

FYI Platt is now accredited by the NLNAC. http://www.plattcolorado.edu/content/nlnac-accreditation-update

FYI: Platt is now accredited through the NLNAC. http://www.plattcolorado.edu/content/nlnac-accreditation-update