doing stuff differently

[cvryder]

Going from one hospital to another I've run up on some interesting differences and expectations of what nurses are allowed or expected to do. The only constant seems to be a sort of "what's wrong with you?" attitude if you say you haven't done a procedure before. I've worked mostly in critical care areas and differences can be vast. For instance, in one hopital where I worked, nurses did *all* ABGs; in others, nurses got the ABGs from A-lines, but RT got the rest; where I'm just leaving, RT does all of them, A-line or stick. As far as A-lines, I just no learned that in some places nurses are allowed to insert them. Another: I'd never worked anywhere nurses were allowed to put down small-bore feeding tubes. That one earned me some *looks* here. In some hospitals assorted fecal collection systems (rectal trumpets or pouches or the flexi-seal tubes) are routinely used and don't even require an order, in others not. What differences have others encountered?

[Littlewonder]

I don't work critical care, but OB (labor, delivery, postpartum, and level one newborn nursery.) I have found that different areas of the country do many things differently. Some area's have nurses rupturing membranes of laboring patients and putting in scalp leads and IUPC's while others won't even let a nurse give translady partsl cytotec for inductions - they require the physician come in to insert it. :monkeydance: Does not bother me, I just go with the flow in that state - although for liability reasons I do not rupture membranes or place IUPC's - too much risk for me! Also, policy and proceedures vary so much I have to look them up in every hospital during my first week as a traveler... Sigh. I really dislike those books...

[swater]

Does anyone know if Hawaii has different ways for nurses to do things? I will be leaving the 11th of June to work in Kona, an I am an LPN-I would guess I still have to work under an RN or MD.