maporcrn1

Patient safety is the key issue. Sleep deprivation has been has been studied. Reaction times and the judgment of sleep deprived persons have been documented. Pilots can't fly, truck drivers can't drive, but Nurses and other OR staff can work? Hopefully, they will not be sleep deprived when they are taking care of me or my loved ones! I have worked many "On Call" night shifts. I worked 8 hrs during the day and came in at 11 pm till 2 or 3 am. I was expected to work the next day as well. I was was allowed to be the 1st to leave. If I worked more than 5.5 hour into the "Night Shift", then I would not be expected to work my scheduled shift for the following morning. Sleep deprivation leads to impaired reaction and judgement skills, no one should be expected to provide care to patients without a significant rest period. You may need to hire more staff. You may need to adjust the start time for those "On Call " the night before. 10 or 12 hour day shifts will not cover the 11p-7 a "On Call". I know that not having staff in the morning for the OR is a nightmare.

I will never forget the fear and stress I experienced when taking my nursing exam! I studied and worked hard in clinical rotations while in nursing school. I took the test, two 8 hour days, sitting at a table, answering all the questions. Tests are stressful. I liked to believe that my grades in Nursing School meant that I would be successful to pass the RN exam. I had to wait 2 months to know if I would be a RN. I received a pass letter. Believe in yourself,and the knowledge that you have!

Nurses need to feel safe in the work environment. Deescalating training and Security support is essential, especially in the Emergency Departments. Defense training may not be a bad idea as well.

As nurses, we have seen many things. We try to ease the patient's anxiety about non urgent matters. Cudos to you for recognizing her true sense of "impending doom"! I always hated if my patient said "I am going to die" or "I don't think I feel so good", right before passing out. I try to reassure the patient that I am listening to their complaint, assessing their status, that I am there to help them and will call for necessary support. Like you, I would rather be scolded by a doctor than risk the safety of the patient.

Never rely on one reading. Take it again, on the same machine, while telling the patient to keep the arm still. I look at the patient and get several readings before I call the MD. Good luck finding the "one" sphygmomanometer. Plus or minus 20% of the prerecorded systolic pressure can be considered WNL for that patient, unless specified by the MD.

A nurse is a person who worked very hard to learn how to become a nurse, regardless of gender. We all passed the tests. Granted, the Nursing Profession, has been and still is, predominately a female profession. Nurses remain to be the most trusted profession over several years in the polls. Nurses earned this trust and respect from patients and physicians because of what RN's do for them every day! Patients put their trust in our knowledge and ability to be caring. Physicians trust RN's to be their eyes and ears at the bedside. We chose this profession and worked to become an RN. "Hello, my name is...I will be your Nurse today."works well. Personally, I have never used the term, "Murse"or referred to a colleague as a "male nurse". Nurses have been known to "eat their young". Do we have to chew on the men as well? Let's move on, please!

What is 1/2 of 1/3? Mg/kg/min is different than mg/min. Nurses must recognize the difference, math is essential. Cardiac output vs Cardiac Index? Body weight vs BMI? 1 ml of a drug is different than 1 mg, depending on the vial. Correct dosage is the key, especially in the pediatric population.

As a student,I was raising the electrical bed to waist height, so that I could change the bed sheets. The telescopic IV pole was in the low position, not in use for that patient. The IV pole sheared the O2 flow meter off the wall! Lots of noise and commotion to my dismay.

I work in a similar environment. I need/want someone (support staff) to do a specific task at a specific time. I do not hesitate to interrupt 'social conversations' to ask the support person to perform the necessary task. Usually, the support person acknowledges my request and acts accordingly. Support personnel are often at the mercy of professional staff. They clean, stock and are expected to respond to requests by multiple staff. I will do the task myself if I know that they are busy helping others. Some professional staff are more than willing to wait for the support staff to perform the task. I am not defending the support persons who chose to defer work, but appreciate those who try to respond to multiple requests.

Staying at home, taking care of your husband can be stressful in itself and is a fulltime job. Look for opportunites that may exist within your knowledge base and expertise that will not require you to be away from home. "On call" nursing advice, working for a reputable organization, could be an option. More organizations are allowing people to work from home. One does not have to physically present to be effective with advice or teaching, "Skype visits" are happening now. We need to use our skills and knowledge to our advantage.

In the past, (25 yrs ago) I worked with a Pain Management specialist who ordered lidocaine infusions for pain management for patients with chronic pain. I am not sure if this worked for the patients or not. A patient recieving a lidocaine infusion should have continuous cardiac monitoring and be observed for signs of local anesthesia sytemic toxicity. Lidocaine or similar drugs given in a specified area or close to the nerve roots is definitely helpful. Lidocaine is a shorter acting medicine and may only be benificial for a short time period.

Is hourly rounding is a requirement? If so, charting should be simplified. Previous assesment unchanged is an option.