I've been thinking about what simple advice we could give to those new to our ranks... a bullet list kind of thing... Tips 'n Tricks... Pearls... ED Nurse-Hacks...
Here's the one that I was thinking about that provoked this thread:
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+ Wear a gown and a face-shield to every trauma, every code, every time.
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It's much easier to discard PPE that you didn't need than to find a shower, clean scrubs, and time for post-exposure labs after you were inadvertently sprayed with ickiness.
A couple days ago, we ran a code for 30 mins or so on a drowning victim... multiple attempts at multiple lines... fem stick by an intern... vomit... feces... difficult airway... you know the story... so after it's called, several of us are working to get the victim tagged-n-bagged... the attending walks in and, for some unknown reason, presses on the guy's upper abdomen... at which point blood came shooting out of his NPA... all over the tech.
I've seen way too many people get blooded, etc for lack of PPE... and once the whole thing starts, there's no time to get the PPE in place.
It took me quite awhile to adopt this approach because the 'salty' ones didn't do it and I didn't want to look green. Now... I don't give a rip what I look like as long as I don't have blood goobers dripping off of me.
So, ED noobs... PPE for every trauma, every code, every time.
Specializes in Emergency Nursing, Critical Care Nursing.
-You can't dilute valium.
-If families are going to be in a room with a patient and are capable, utilize them to assist with the patient's care.
-Label your meds as you draw them up. Which syringe is zofran? Which syringe is 2mg Dilaudid?
-Don't be timid or a doormat. Be assertive if you are advocating for a patient (especially in a teaching hospital environment).
-Know your stuff. This comes with time, but if you have a question, ask a provider. Don't ever say "I don't need to know that." You never know when your clinical proficiency will prevent a provider from killing someone.
-Along the same lines as above, if you don't know something...ASK. A great approach is to say, "refresh my memory on ____" if you feel intimidated because you don't know something.
I'm a newbie, but I've already learned the values of nursing shoes. The blood wipes right off! I was drenched by a trauma patient while transferring him from the ER. I was so glad I wasn't in my $140 running shoes...
When giving a call light, consider saying something like, "Please call me if you're having an emergency, or you feel chest pain, shortness of breath or...(specifics) and otherwise I will be rounding".
I am happy to help my patients, I do have compassion, but I absolutely must prioritize and cannot be adjusting blankets and beds every five minutes for one patient. One q5 minute call light user (I want up, down, new blankets, etc.) patient informed me, "But you are HERE, for my comfort". I replied, "I am here for emergencies first, then health and safety, and then comfort.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
People who feel bad-- act bad---whether it is physical or emotional. That phrase alone helps me tolerate less than polite, nice people and makes me change my approach.
And then there are those who act bad just on general principles.
Be ever mindful of their teeth, nails, fists, and feet.
Loose restraints are worse than no restraints... if they need to be restrained, they need to be restrained well.
If you have to pin them down, pin across the articulating joints.
Know where are your spit masks... and double them up if they're real spitters... the experienced ones know that they can spit on a single layer and then blow it through onto you (I learned that the hard way.)
Not all techs are good, some are meant for the floor, some are natually built for critical care. If you have a feeling your tech is not going to be satisfactory, address is professionally and within the correct channels. Telling other RNs that so-and-so tech isn't qualified or isn't good just turns ALL techs against you. We can make your shift a breeze, or we can **** off a patient before you even get in an assessment, loose blood, etc.
Another point to make is that most techs are not offended if you ask us to do something/ask us to stop doing something. Some RNs don't want techs starting IVs, and that is okay - its a preference thing. Some RNs rely on techs to an absurd amount to the point that it comes off as laziness. Just as RNs have their favorite Nurse Managers or Charges, techs have their favorite RNs and some they resent to work.
TexanTough
9 Posts
-You can't dilute valium.
-If families are going to be in a room with a patient and are capable, utilize them to assist with the patient's care.
-Label your meds as you draw them up. Which syringe is zofran? Which syringe is 2mg Dilaudid?
-Don't be timid or a doormat. Be assertive if you are advocating for a patient (especially in a teaching hospital environment).
-Know your stuff. This comes with time, but if you have a question, ask a provider. Don't ever say "I don't need to know that." You never know when your clinical proficiency will prevent a provider from killing someone.
-Along the same lines as above, if you don't know something...ASK. A great approach is to say, "refresh my memory on ____" if you feel intimidated because you don't know something.