I'm tired of working with professional RNs who don't know what their patients vital signs and I & O's are. We have great staffing and the techs are in charge of keeping track of I&O's, accuchecks and vital signs. But why when I ask an RN what how her patients bp is five hours into her shift she can't tell me?
How come when a daily weight is done the RN doesn't compare it to the pattern of weights.
How can an RN go into shift change report and not realize her patient hasn't voided in 12 hours. (I tried to cath the patient in the middle of my shift report and couldn't get in, a gu doc came in and got 2000 cc's).
Am I wrong or are vitals signs, weights, I&O's, accuchecks part of your assessment and things you need to know???
Sorry, I'm so upset about the 2000 cc's I can't think straight. That is so scarey and incompetent.
'Cuz I was just wonderiong the other day and asked my preceptor about this very topic... THANK YOU, TWEETUMS !
I, too, am not used to all this computer charting.. used to the "old way" of going in and doing them myself and/or having a chart or flowsheet handy.. ( I know, you can go to the computer just as you could a chart to look them up, but somehow, it doesn't seem the same). I asked about how do the nurses keep on top of I&O's, temps, etc. My preceptor said she goes into the computer several times each shift and checks all her patients' vitals. We also do our OWN vitals at the beginning AND end of each shift. First ones with our morning assessments.. then again at the end of the shift. We do our own fingersticks, CNA's don't do these at this hospital.
As for I&Os, we have a chart on the patient's bathroom door with the times and amounts listed. I like Mattsmom's idea of also listing all the B/Ps, etc. there as well. Often it gets too busy to be looking stuff up in the computer (even though we have one in each patient room), but I think it's far easier to just glance at the sheet on the door.. AND ASK the patient as well ! We DO ask during assessments, but it sure doesn't hurt to ask again as you pass meds, and check in with the patient during those times you're in the room for other things...right? You can ask about their appetite, did they enjoy the meal... whatever.. COMMUNICATE !
I also like Deb's "brain"... that would be MY preference as well. I do believe this is what I'll do... that way you have this info handy in your pocket for when the docs stop to ask you about the patient. Gosh, I'd HATE to think one would stop me to ask for info and me just have nothing for him/her but a blank stare... I'd prefer to be beat with a broomhandle... and SHOULD be !
Yep... I'm pretty anal about all this stuff, but now for me, it's going to be a matter of figuring out a "system" that works for me.. some little method of obtaining and keeping that info handy. I'd sure hate to have a patient go bad on me and never know it until hours later... no, no... don't think so !!! Can't have that !
I am quite at loss ! I have never had any involvment with Computer charting . if you guys have the time, would you mind explaining the set up for me ? I am in OZ.
Do I understand that the Nurse assigned to the patient care , does NOT take her own VS ect ? I would find this very hard to cope with, and if the primary Nurse can just " get her Obs , sorry VS off a computer , could this not lead to the possibility of nnot actually doing a physical assessment on the patients she is responsible for ? I am not being critical, just enquiring as to the set up there
I have problems with aides having too much to do, and some nurses who feel the aide(s) are there to help her/him only.
!
I agreed with that whole rant !
However, this particular issue of monopolizing the CNA is so annoying. It reminds me of a nurse (who i actually did adore) who when a nurses aide came to our unit would be instantly scooped up never to be seen again by this nurse. we have no idea how they kept so busy with one nurse for the 8 hours but she would come up for air for break and dinner.
we actually called the CNA 'fayes aide' in honor of the nurse.
I've seen the same thing, personal aides, not too cool when you are the other nurse supposedly sharing the aide.
Brownms46, in regard to your earlier post, people leaving all that stuff for you and getting out on time, it's okay though for you (or me) as the following nurse to be staying 2-4 hours late getting all the stuff they didn't do in addition to your own work done.
cannoli, and that is just what happened at the end of that shift! I was there until almost two hours later, charting, as I didn't have the time, or the ability to sit down the whole nite, without jumping up to answer a light or change a PCA!
I'm hoping to find a position in a MD's office or clinic, because that night just reinforced my desire to not go thru that again! I am just too old to play catch up any longer! I don't wish to deal with those who have so little commitment, that they don't bother to give 100% in their care of pts!
Since I am on a roll again...I will bring up another problem area! Calorie Counts! CC ordered for times x amount of days, and yep, nothing on the dang sheet, or several meals left off!!! CC has to be restarted!!!!GRRRRRR:(
Since I am on a roll again...I will bring up another problem area! Calorie Counts! CC ordered for times x amount of days, and yep, nothing on the dang sheet, or several meals left off!!! CC has to be restarted!!!!GRRRRRR:(
YES! We keep the sheet on the door. Since we supposedly monitor amount eaten on ALL patients, how hard is a calorie count?
I am quite at loss ! I have never had any involvment with Computer charting . if you guys have the time, would you mind explaining the set up for me ? I am in OZ.
Do I understand that the Nurse assigned to the patient care , does NOT take her own VS ect ? I would find this very hard to cope with, and if the primary Nurse can just " get her Obs , sorry VS off a computer , could this not lead to the possibility of nnot actually doing a physical assessment on the patients she is responsible for ? I am not being critical, just enquiring as to the set up there
We use computer charting where we work as well. Basically there is a flow sheet on the computer with all of the patients vital signs that you can look them up. Quite easy.
Here we have CNA's to help with the vital signs, I&O, etc. Thus the RN's can take more patients and save the hospital money, I mean, because there is a nursing shortage.
RNs and LPNs are responsible for the head-to-toe assessments, part of which is assessing what their vital signs are, whether they have voided, etc. etc. It's simple. Aides are VITAL, but they gather the data and it is up the nurse to get the information and the analyze it.
I wouldn't trade having aides on the floor for anything.
I have never had any involvment with Computer charting . if you guys have the time, would you mind explaining the set up for me ? I am in OZ.
jnette, ASN, EMT-I
4,388 Posts
Kool.
I love reading this stuff.
'Cuz I was just wonderiong the other day and asked my preceptor about this very topic... THANK YOU, TWEETUMS !
I, too, am not used to all this computer charting.. used to the "old way" of going in and doing them myself and/or having a chart or flowsheet handy.. ( I know, you can go to the computer just as you could a chart to look them up, but somehow, it doesn't seem the same). I asked about how do the nurses keep on top of I&O's, temps, etc. My preceptor said she goes into the computer several times each shift and checks all her patients' vitals. We also do our OWN vitals at the beginning AND end of each shift. First ones with our morning assessments.. then again at the end of the shift. We do our own fingersticks, CNA's don't do these at this hospital.
As for I&Os, we have a chart on the patient's bathroom door with the times and amounts listed. I like Mattsmom's idea of also listing all the B/Ps, etc. there as well. Often it gets too busy to be looking stuff up in the computer (even though we have one in each patient room), but I think it's far easier to just glance at the sheet on the door.. AND ASK the patient as well ! We DO ask during assessments, but it sure doesn't hurt to ask again as you pass meds, and check in with the patient during those times you're in the room for other things...right? You can ask about their appetite, did they enjoy the meal... whatever.. COMMUNICATE !
I also like Deb's "brain"... that would be MY preference as well. I do believe this is what I'll do... that way you have this info handy in your pocket for when the docs stop to ask you about the patient. Gosh, I'd HATE to think one would stop me to ask for info and me just have nothing for him/her but a blank stare... I'd prefer to be beat with a broomhandle... and SHOULD be !
Yep... I'm pretty anal about all this stuff, but now for me, it's going to be a matter of figuring out a "system" that works for me.. some little method of obtaining and keeping that info handy. I'd sure hate to have a patient go bad on me and never know it until hours later... no, no... don't think so !!! Can't have that !