Thought this would be a good topic for venting and to maybe help others realize why they may be annoying the next shift.
Came into work this morning to find the w/c blocking the door into the childs room. HOB is flat on a kid with aspiration precautions. Both rails are down...falls and seizure risk. Trash bag sitting in floor filled and tied up. Pulse ox turned facing wall. Ambu bag on the floor. Paperwork out of order/missing. Narcotic sheet not filled out. Flow sheet full and not replaced. Cabinets left open with items falling out. Bag of diapers upside down with diapers falling on the floor. No toilet paper, but empty roll left on top of the toilet and not even in trash. Dirty syringes and med cups. Meds signed off that aren't even in the home. Of course, its not worth complaining to the office, coworker, or parent. So I just fix everything and document to keep the peace and remind myself I don't have to work after that nurse very often.
What annoys you when you get to work after those certain nurses?
While most nurses I work after are fine. There are also the nurses I like working after because everything is ready to go when I walk in. I try to do the same for the next shift after me, knowing that if things go wrong with the patient that at least they will be organized and ready to handle whatever comes up.
Specializes in Complex pedi to LTC/SA & now a manager.
I thought every pt with a gt needs the HOB elevated because of increased risk of aspiration?
Not always. I have one that needs to be supine or trandelenberg during and post feed (sometimes almost inverted post feed). More likely to reflux or aspirate if 45-90 degrees upright. Highest I can do an enteral feed with this child is 30-40 degrees. Nothing is absolute
And GTs don't automatically mean a person is at risk of aspiration. Sometimes the GT resolves the risk of aspiration if the only real risk of it was an inability to swallow and protect the airway at the same time or a fundoplication was done when the GT was put in, etc. Often patients with a GT have a risk of aspiration, but many times it's correlation with the GT, not causation from the GT.
Specializes in Complex pedi to LTC/SA & now a manager.
I've seen GT due to inadequate PO caloric intake /failure to thrive. Just not enough energy to consume enough calories especially if ambulatory. The child cannot consume sufficient calories in 30 minutes, longer than 30 minutes kiddo starts burning more than consuming. But interesting the kid is ambulatory and active. GT is supplemental concentrated calories. Just try and make this child lie in bed never mind sit still post feed. Child has neither a history of reflux nor aspiration.
wooh, BSN, RN
1 Article; 4,383 Posts
Just because there's a GT, it doesn't meant he patient needs the head of the bed elevated.
Just because a form doesn't say it, doesn't mean the patient doesn't need it.
Need to think about what each patient needs as an individual.