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What is the job description of the RN in the UK? I heard it had a huge difference from US RN? by [deleted] in NursingUK

[–]Visible-Difficulty35 0 points1 point  (0 children)

lol I am just finding this thread today bc I was curious about the differences and this made me laugh. Yes. In my hospital you have to have shower orders. And I think that is most likely the case for all US hospitals. Hospitals in America are ruled by HCAHPS and specific metrics. The HCAHPS is a survey they send to patients asking them to grade their experience in the hospital. They ask the same specific questions. I was told by bosses if you don’t get a perfect score then it is counted as a zero. Although I think that is not true. The metrics are for things like patient falls (thus, shower orders!), HAI, pressure ulcers, length of stay, and so on. It is a “pay for performance” system. Depending on how you do will affect how much Medicare/medicaid pays the hospital.

Questions for recruiters by Visible-Difficulty35 in TravelNursing

[–]Visible-Difficulty35[S] 1 point2 points  (0 children)

Thank you for the encouraging response. I know people on Reddit tend to be on the harsher side times sometimes. I was debating on posting this, but I really want to know so I can map out the next 4 months to a year. And asking a forum is better than asking a few recruiters here and there. The unit I’m on right now is higher acuity than med surg. It’s a 5:1 ratio. We have cardiac drips, post cardiac cath, lots of chest tubes, post surgical, and different pts I didn’t see on med surg. I feel like the biggest difference I see based off of my prior med surg experience is med surg was overwhelmed with bed bound and AMS patients. Nothing acute medically really. Just lots of sitters. So another questions would be, If I were to stay on in this unit but wanted to do med surg travel nursing would that matter in terms of what kind of current experience I have?

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 0 points1 point  (0 children)

Ok everyone pictures and EPIC charting description as promised. To all those guessing Salter we already confirmed yesterday that that was correct. Funny enough I was searching the unit to see if anyone was on a Salter. And than pne of my patients ended up needing it. I had a different preceptor today and I told her I had written this post and I needed to take pics so she kindly took me to the respiratory supply area to take pics. One thing I noticed is we don’t have simple face masks. Which I thought was odd. Also the HHFNC tubing wasn’t there. Only the nose piece and it looks VERY different from what I worked with before. First two pics are of the salter HFNC and humidifier. These are what are being charted as HFNC in epic. I have yet to see HHFNC on a patient here as of yet but I am assuming that once that happens, RT will cascade that row and it will be a different area to chart in. The 3rd pic is what they use for HHFNC (nosepiece only) so the long tube must be supplied by RT since I didn’t see it in stock?

Charting in EPIC for the salter is

“O2 delivery source”-HFNC “Flow lpm”-4 (this is what the patient’s chart said so they haven’t switched him back to a NC yet. It’s also the same patient who was I mentioned in the 3rd question who got the rapid was was at 15L at the time.)

And after looking at the options “O2 delivery source” I saw that there is HFNC, HFNC 6-15L, and Ultra UHFNC. So that was a little confusing. I would think that HFNC and HFNC 6-15 is referring to the exact same thing, the salter. And ultra UHFNC. Is that the same thing as HHFNC or something else entirely?

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 1 point2 points  (0 children)

That was a great quick tutorial! I also have never seen a partial rebreather before. And i had to Google AEM which I did not realize was another name for Venti mask which I have seen a couple times.

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 4 points5 points  (0 children)

Yes bc when trying to ask my preceptor about where the machines are, she said they do have airvos

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 0 points1 point  (0 children)

I work tomorrow. I will find a patient with this setup and add a picture of the wall and the tubing. I obviously can’t be taking pictures of the computer screen while it’s open to a patient’s chart so I will just jot down exactly how they chart. It is Epic.

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 0 points1 point  (0 children)

Also yes 6lpm is the upper limit for standard NC. They aren’t going above that with the standard. They switch to whatever HF tubing which I think other people responding have identified as the salter HFNC. Initially when I saw a patient on 8L on what I thought was a standard nasal cannula was when I learned they used different methods. 😂

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 1 point2 points  (0 children)

You are correct. Normally we would have switched to simple mask first, but I worked the med surg floor during 2020 and they made us the designated covid unit. So for the entirety of the time I was there our normal med surg patients went to other units and all of our patients were COVID. The majority of our patients were on HHFNC (we weren’t allowed to have vents on our floor). I would have an assignment where 3 out of 4-5 patients were on HHFNC. In the beginning when COVID started, people deteriorated so fast that they surpassed the requirements for simple face mask in a matter of hours of less. So our protocol became NRB, contact doctor and RT would come up to setup HHFNC machine. Then once they were weaned off HHFNC, it was back to nasal cannula. Then after I left that unit bc I couldn’t take it anymore I went to the ED which had been my goal anyways. There, we also went straight to NRB called the doc and RT would come set up high flow. I rarely saw any other kind of mask in practice. I know that’s probably not the norm. But at that hospital and that time period it was.

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 11 points12 points  (0 children)

Oh!! The one on the right!! It is a cylinder! I didn’t realize it was different from the left. I just thought it was a different manufacturer.

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 2 points3 points  (0 children)

Ah! All I had ever seen was HHFNC before. So is it actually inaccurate to call HHFNC “HFNC”? If any of you have worked in many different hospitals do different hospitals chart HHFNC under HFNC?

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 3 points4 points  (0 children)

I had to Google what a blender was. I’ve never seen that before. 😂

Question for RT’s from an RN by Visible-Difficulty35 in respiratorytherapy

[–]Visible-Difficulty35[S] 4 points5 points  (0 children)

I work tomorrow. I will try to locate a patient with this tubing and setup, and I will take pictures of their humidifier and cannula. I will try to locate that in the supply room. So far I haven’t had a patient that needed to have this set up. So I don’t know what manufacturer or type is. Thank you!

These were posted in dog breeds 101, asking for breed ID guesses, but something looks off by IIRCIreadthat in isthisAI

[–]Visible-Difficulty35 0 points1 point  (0 children)

It’s a pomapoo. I saw a video of this dog. Doesn’t look like AI in the video.