VA_CCRC

I too work at a hospital that is downright FILTHY!! On more than one occasion I have entered a 'clean' room to check for set up prior to admit and found dired BLOOD on the call bell, phone, side rails etc. I have also found dried crud on the bedside tables. Our unit is carpeted, even in the pts rooms. It is absolutely disgusting, we all hate it. When an 'accident' happens (whether it be poop, pee, blood whatever!) we have to call for a carpet extraction. After an hour or so a guy shows up to clean the affected area, by simply running dirty stinky water over the area. It is very hard to eliminate odors from the rooms. On a weekly basis when no one in housekeeping can be found (on nights). I regularly wipe down surfaces throughout the nursing unit, empty trash cans (better than watching them overflow on the floor), fill alcohol sanitizer dispensers that are empty. When I am really gung-ho I have actually gone around with a broom and dust pan and swept up all little pieces of gosh knows what off the floor. The place is gross!!!!!!!! I hate that I have to clean up the place at night, but it is SO dirty, I cant stand the sight of the place. Not to mention, I truly believe that what a units atmosphere portrays presents an image of how we take care of our patients. oh PS wouldnt it be nice if while housekeeping was 'cleaning' the rooms they would turn the tv off, stop yapping on the phone and stop entertaining their co-worker who is comfortably lounging in the chair while they 'clean'!!!! :angryfire

Lizz, it saddens me that you (and probably others) think you get in the way and cause stress!! PLEASE do not feel this way. I work in a university medical center and look forward to the students coming. I know my peers feel the same way. It is such a great opportunity to teach something and help build confidence in students. Okay, okay YES once in a blue moon there is one student who can really make your day challenging, but for the most part when the students come it is fantastic!!! Just try to remember when you are finished with school and you are out there on the job and get assigned a nursing student....treat them how you would like to be treated. Best of Luck

I think nurses in general (ICUs, ED, floor, outpatient) have much more autonomy than some of us utilize. There are tons of nurse/physician driven protocols. I personally have never worked in the ED but I know that even on the surgery floor I work on if someone c/o chest pain you're going to get an EKG, slap some O2 on, asa if indicated, trop draw etc. You're not very likely to wait for the doc to show up before doing those things. Same with pts that are tachy, low bp, low uop etc.....get a second line and start bolusing fluid, make sure they have recent cross match etc. I believe nurses should utilize their critical thinking skills!!! You don't want to sit around and wait for a fresh intern to scroll though his PDA while the pt is hemodynamically unstable. I'm not suggesting start them on a dopamine gtt, transfuse them etc. Do things that a PRUDENT nurse would do in a given situation. Don't tell the docs what to do. Make gentle suggestions and then move on but cover your butt. After the episode always make sure the doc signs an order for your interventions. Remember no matter what department you work in, unless there is an approved protocol in place, you need a physicians order for your actions.

Ewwwwww :rotfl: :rotfl: :rotfl:

I prefer face to face report. And if it is a pt that I have had before and has been in the hospital forever sometimes I play the 20 questions report. Please dont go through the whole history again for me.... hows their urine output? fever today? ambulating? pain control? great...thanks...on to the next one. What chaps my hide is people who spend time focusing on the little stuff and will spend five minutes trying to remember if the IV is in their right or left arm!!! WHo cares!? Give me the down and dirty and let me go make my own assessment and get on with providing them care. Nothing is worse then a long drawn out report that essentially tells you nothing about the pt and their status. I'll shut up now...

Every afternoon there is a formal 'discahrge planning' session that usually last 30-45mins. The charge nurse, social worker, home health nurse and sometimes PT/OT are present. I find this duty is more of a 'legal' obligation to satisfy documentation in the pts care plan. On the other hand, am rounds by the docs usually happen anywhere between 5-8am. I think it is the primary nurses resposibility to be present and contribute to rounds. I think a lot of nurses feel that they don't have anything to say at these 'pow wow's' at the bedside. How many times have you been cornered by pts and their family memebers with tons of questions that should be directed to the doctors? I make sure and tell my pts "the docs are rounding so if you have any questions now would be a good time". By making yourself visible during rounds you ensure pts get their questions answered by the doctors AND you get to give your very VALUABLE input. I find that half the time the docs have NO clue what is going on with the pt and appreciate my input, whether it be about poor pain management, hey man they are getting a diet but not eating how about a nutrition consult or they are not going to be able to do this dressing change at home we need home health etc... We are their eyes at the bedside!

RN4NICU, you hit the nail on the head!

As a general rule ALWAYS make sure the head of bed is elevated before administering in a GT. I usually make sure that the meds are ordered as suspensions or elixirs if available. ALWAYS dilute meds down with warm water. NEVER juice or cola. Juices and colas have sticky sugars that over time WILL adhere to the inside of the tubing and eventually clog. That's my 2 cents! Take care all!! :rotfl:

I work on a med-surg unit that performs gastric-bypasses rather routinely. I don't mind this pt population, and when the outcome is good you are thrilled that the pt has a chance of a somewhat normal lifestyle. As a general rule all of our GB's are up out of bed within 8hrs of surgery. We all dread the first time! Our hospital is wonderful with supplying us with all the 'equipment' needed BUT hey man we need manpower too. These pts sometimes look at you like your nuts when you tell them it may be a while until you can help them up because you have to round up the posse. I don't like their sense of entitlement and their demands they place on staff at times. (I am not including all GB's in the word 'their' just some) My personal pet peeve: suddenly these pts 'forget' how to wipe their own bums! :angryfire

DUH!

Just trying to gather some general information about cruise ship nursing. What cruise line? How long were assignments? Salary compensation? Crew relations? Destinations? What was your experience prior to cruise position? Would you do it again? Why or whynot? Thanks for any and all responses!!!

At my place of employment we refer to 'incident' reports as Quality Reports. I think this conveys a less disciplinary-type image. I do not hesitate to 'write' myself up. I feel that USUALLY a report needs to be completed due to a SYSTEMS fault and that completing this document calls attention to things that need to be tweaked out to prevent further errors. Completing QR are important in instances of near misses as well. If I find an error from someone else I usually talk to that person and try to leave it up to them to complete the QR themselves. Still so many of us automatically associate reports with negativity. Let's use these tools to make our working environment safer for nurses and patients!! Take the time to complete these reports.

The hospital I work at actually had the nerve to call it "The Week of The Nurse". I must say though, last year (before all the talk of budget cuts) on our floor we all received nice leather-like bound portfolios and $15 gift certificate to a local shopping center...AND a very nice catered luncheon. Not to mention, all the 'suits' come out of the offices to cover the floor so we can ACTUALLY attend the luncheon....that's always a nice touch! But this year....totally sucked. I feel so insulted....let's see...I won a coupon for a free ice cream cone. Oh yeah they were having a 'traveling breakfast bar'....it shoulda kept right on traveling...youhad your choice of a bagel or biscuit. The biscuits were stale and dry and nothing to put on 'em. Then they only gave you half a bagel!! what cheapos!! I woulda been happier with a calculator or something cool like an umbrella!!

Priceless!!!!!

I absolutely love the idea of all white. Whites are crisp, refreshing and are often easily recognizable for patients. HOWEVER, they just aren't practical. Whether it be a slosh of coffee from your travel mug on the way to work, a splash of a body fluid (take your pick!) while emptying a drain....or just a simple ink pen that decided to leak in your pocket...by the end of the day you and your 'whites' soon turn into an artists canvas! I prefer scrubs, wash & wear! Lets talk about ACCESSORIES! Can anyone say Mr T? I am still amazed as to how many nurses wear excess jewelry (not to mention the one who wear heavy perfumes). It should be simple. A clean, uncluttered professional look and ATTITUDE is all you need!!