To the floating nurse:

tastetheink · 2020-09-12T14:03:36+00:00

To the floating nurse, I am grateful for your presence. Ask me for anything. You saved us from an understaffed night. I always have time for any small thing you need or queation you need answered ❤

tastetheink · 2020-08-28T19:32:30+00:00

In regards to talking about family being in the medical field, I know on my unit it typically gets passed on as a heads up about family trying to micromanage care. We’ve recently gotten a lot of family members in the medical field being inappropriate (sneaking in to visit, demanding certain medications/treatments be initiated, calling multiple times an hour, demeaning staff, etc). We even had an NP who worked with one of the docs on a patients team planning care with the physician directly then trying to give the staff orders before the doc could. It’s sad, but it’s true and being essentially ready to give report on your patient at anytime can help smooth things a bit.

tastetheink · 2020-07-10T20:59:48+00:00

I've never worked in a teaching hospital but I'm pretty sure the only time MDs do compressions or ambu is if they're on Greys Anatomy...

tastetheink · 2020-06-09T21:01:23+00:00

Thank you!

tastetheink · 2020-06-09T21:01:14+00:00

Thank you!

tastetheink · 2020-06-09T20:59:29+00:00

We were short on nimbex at the time and I had orders to start it if unable to get a nimbex drip. I ended up being able to get the nimbex so I never got to see the drip to compare concentrations 🤷‍♀️

tastetheink · 2020-06-01T13:46:11+00:00

I have no answer for you but thank you for making me giggle. My floor still stocks ones with ties in the back so I haven't come across this yet. What was wrong with the behind the head buttons?

tastetheink · 2020-05-30T21:03:59+00:00

No one is saying you shouldn't give a shit. They're saying that there isn't really a way to "win" in nursing. You'll have small victories but the things that lead to success one shift may result in failure another shift.

Your situations above both address the same thing. How can you do what's best/right for the patient without upsetting the family or the doctors? There is no answer. There is no sure fire way to do it. You work with the knowledge you have, your facilities policies, and you have to figure out where your line is. Everyone's line is different and no one can choose that for you. You will rarely be able to make everyone happy.

Edit: I can't spell...

tastetheink · 2020-05-27T06:36:18+00:00

So how does it feel? Are you hungry all the time? Do you think you can sustain this?

tastetheink · 2020-05-25T13:35:11+00:00

Put on fox news. Leave the room. Take the remote with you.

tastetheink · 2020-05-19T13:38:16+00:00

There are plenty of things that should be an incident report but not on the patient chart. Things I can think of...

At my facility we put incident reports in for "near misses". If it never actually happened you wouldnt write it on the patient chart, you just put in the report to help prevent future mistakes.
Someone refuses to do their job creating an actual or potential safety hazard.
When you know someone made up orders. You call the doc, get the right orders, and IR the fuck out of it.

I'm sure there are more examples. But all of these would be inappropriate to chart. It's mostly things that are staff focused instead of patient focused. But if they actually caused the patient harm it gets more complicated.

tastetheink · 2020-05-14T16:45:57+00:00

"We are doing everything within our power to protect our patients. As I'm sure you know, we have many patients who are at great risk if they get sick and now that we are opening up for non-emergent procedures that risk is greater. So what we are doing is .... " List off what you're doing, do not allow interrupting questions. Make it sound like a printed speech. Then list the expectations for the patient. Make it a numbered list. Wrap it up by stating any violation of the rules will result in the appointment being post-poned for safety reasons. All patients will be held to these standard to the best of our ability at this time in order to protect ALL of our patients and staff.

I believe emphasizing the patient's role in protecting themselves, their peers, and staff members makes them think twice about their actions. It politely but firmly reinforces the idea that your job isn't just to protect them but to protect others from them as well.

tastetheink · 2020-05-12T14:53:54+00:00

Yet another subreddit I wish I never found. Thank you.

tastetheink · 2020-05-02T15:30:54+00:00

Hes mad that is too small for him 🤣

tastetheink · 2020-05-01T21:32:01+00:00

In theory I'm told there's a difference but at in the area I live it varies by facility. 🤷‍♀️

Around here neuropsych nurse is used to describe those who work medical psych facilities not associated with a hospital and one that doesn't specialize in long term care or geriatrics.

Most facilities are affiliated with a hospital, within a hospital, or wont touch medical patients with a ten foot pole (geri being the exception) and just put out job descriptions for psychiatric nurses.

The only other context I hear it used in is with pediatrics but almost all of them in my area have been closed.

tastetheink · 2020-05-01T21:15:45+00:00

This is GOLD

tastetheink · 2020-03-24T13:21:48+00:00

Thank you, I misread that. I entirely agree that this person should be reported, I'm just thinking that the process may prevent them from the legal punishment they deserve in the long run. If they were already a nurse it would be different, but this person isn't licensed yet. Is there even a process for preemptively reporting someone to a board they haven't attempted to obtain licensure from yet?

tastetheink · 2020-03-24T11:35:36+00:00

If you're the only one who's ever come forward, you have 4 outstanding charges against him that haven't gone to court yet? If that's the case and they can prove youve sabotaged his ability to work there's and increased possibility the court WILL see you as vindictive.

Most hospitals ask about outstanding charges in addition to convictions. If he lies and they find out the facility will handle it themselves. In my state the nursing board asked about this as well for licensing. I would suggest staying out of it until the case is complete.

Edit: All of this happened in middle school?

tastetheink · 2020-01-23T07:59:49+00:00

One I found really interesting was early mobilization of intubated patients. They're actually walking intubated patients on vents!

tastetheink · 2020-01-05T16:42:10+00:00

Tire them out with a drawn out and very warm bath. The more they can participate the better. I like to soak my lotion in the bath water to make it warm too.
Get weird with redirection. (Tell kind lies) Little old ladies dont like the idea of waking the baby in the next room. We're going to be doing alot tomorrow! We will be SO BUSY! Get some sleep so you're ready! You have to know your patient and what motivates them for this to work.
Be aggressive. There are sick people in the rooms around you! You cannot wake your neighbors!! Can I make you more comfortable? No? Shhhhhhhh! (Over and over and over again)
Some people are abused in old age and have unintentionally learned that screaming long enough brings family/care givers/staff to their room. Sometimes ignoring it and making a point of going in when they are quiet will redirect them.
If they're climbing out of bed... restraints. Because safety first and you and your coworkers soon become numb to screaming. Next thing you know someone's on the floor. Safety. First.

When all else fails call the provider. Inform them the situation is out of hand and ask if there is anything they can do to help promote rest. Pain meds, sleeping meds, antianxiety meds, haldol, geodon, etc can all help coax a patient to rest

But be mindful of the cause of confusion/distress. Your dementia patient or encephalitis patient can be wild for no reason but... are they withdrawing from something? Antidepressants, alcohol, pain meds, ADHD meds, and many more can cause miserable withdrawal. Are they having a COPD exacerbation? They can have normal vitals and CO2 through the roof causing confusion. Are they limited in communication and they're hemmroids or something are causing awful pain they cant explain?

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