The "Teach a Student Something-a-Day" thread!

Brownms46 · Aug 31, 2003

Originally posted by jjbaby
Yes 02 is a doctor order, but a registered nurse can apply 02 to a sob patient pending a dr. order forthcoming. This is within the scope of practice for an RN. I learned this from clinical #1. So although it is a dr. order, an RN can apply 02 to a patient before the order is written.

2 quarters to go too......woo-hoo....

Sorry but a RN is not the only one who can apply 02.:)

essarge · Aug 31, 2003

At our hospital, it is not usually the doc that orders the O2, it is respiratory therapy. The nurse can take sats and determine (through critical thinking) that the patient is in need of O2, call respiratory therapy, and (depending on patients diagnosis) administer O2. The nurse can also tell the CNA to put O2 on a patient and take sats (with pulse ox).

My advice to students is also to remember those coming up behind you in school. Offer help to them when you can.....in other words...PAY IT BACKWARDS!!

Brownms46 · Aug 31, 2003

In every hospital I have worked at, placing a pt. on 02 can be done as a nursing decision. And an order obtained afterwards, especially if the pt is c/o SOB or CP.

agent · Sep 11, 2003

Any other tips?

Its a new day ya know

Rapheal · Sep 12, 2003

Of course agent, we are full of ..... them.lol (just got my sense of humor back and was taking it for a test run).

Ask the aide if you can help when they are changing linens on an occupied bed. Learning to do it right will save you so much time as a nurse.

Do not assume renal failure or bleeding problems when a foley cathater starts running blood red. Most usually the patient has pulled on it and the irritation has caused the bleeding. Of course you will watch it and check their labs but this is usually the most common reason.

Your elderly mouth breathing patient has suddenly developed trouble breathing. They are turning color. OMG! Before you scream for help, or grab the pulse ox or put on 02 please check and see that their dentures have not become displaced and are now obstructing their breathing. Seen experienced nurses panic over this type of thing.

Look at the Physicians's H&P for info on your patient. You will find that the patient admitted with an UTI has a hx of CHF, COPD, ect., ect. Helps you to understand the bigger picture of patient care such as why pushing fluids on this type of patient may not be a good idea.

Hope these help. I am enjoying this thread and hope to pick up nursing tips from other nurses.

Noney · Sep 12, 2003

Always flush your saline wells at the beginning of your shift, so you know it's good for an emergency.

About diabetics: when they come to the hospital and the same insulin dose is ordered that they take at home, be careful! Alot of diabetics are noncompliant with ndiet at home so when we give them the same dose of insulin along with a diabetic diet there blood sugar drops. If a diabetic says they're hungry find them something to eat or you'll have a problem later.

Noney

agent · Sep 12, 2003

Thanks! Great tips

Noney · Sep 12, 2003

Just thought of another. If your doing a routine site change DO NOT dc the working iv until you get another started. I'v seen new grads do this on hard sticks and it's a scramble to get it restarted.

Noney

kimmicoobug · Sep 12, 2003

Noney, good tips. I always flush my saline locks at the beginning of the shift. Not because of an emergent situation that could arise, but because it is on the MAR and with me working on the night shift, I usually pass meds at the beginning of my shift and my patients are still awake. I am also guilty of DC ing an IV before starting another....

cheripa · Sep 12, 2003

Great thread! Please keep them comming! I need all the help I can get! I don't know much about nursing. I just started the program and am learning.

Thanks for all the advise!!!! :0)

proud2basn · Sep 12, 2003

okay..... i may just be a 1st yr nursing student but i got a doozy, so pay attention.

whenever you become a nurse, or are even a student nurse doing your clinicals, DON'T TAKE IT UPON YOURSELF to inform the patient about the results of any biopsies, exploratories, stuff like that. That is what the DR is for.

I had a bad experience with this.......

My mom was in the hospital to have some what she thought was just spots (cancer) removed. After the surgery she was half-drugged out of her mind, had a tube down her throat, couldn't talk. Well, her nurse came be-boppin into her room, and (I kid you not) says in the brightest voice, "Well, you gave us quite a surprise! We took a 15 pound tumor out of you." Never mind the fact that she basically had just came to and thought it wasn't serious. Well, of course it scared her to death. I can't imagine a worse thing being done to a patient. My sister told me when she found out I was going into nursing that if she ever saw me doing that she was going to *itch-slap me. I think I would to.

So, just keep in mind your patients feelings. Stuff might not seem like a big deal to you, but it could be huge to the.

jennifer

live4today, RN · Sep 12, 2003

My one tip in nursing is this:

Do NOT allow yourself to become bogged down in unit gossip against your peers. Be a positive asset to the unit WITHOUT taking any BS in the process! Protect your right to remain human and take time off when you are too sick to nurse anyone but yourself, and do NOT feel guilty doing so. Keep yourself number one in health, spirit, and emotional balance. If you don't, you won't have two cents of energy to give to anyone else.

Last but not least: Do NOT add to the nursing abuse that is already thicker than mud in nursing! Be a motivater, an optimist, someone who MAKES things happen and not one who watches things happen and tattles about it! :nurse: