Signs in the Hotel that it's Monday.
1. Patients are moving around. Can you say bed bingo? No one is where you expect them. I really wish Santa would have brought us private rooms instead of so many doubles (thank goodness triples fell out of vogue).
2. Coworkers get flat tires. Not one, but two of them. Craziness.
3. It rains yet again. I don't care if it's knee high by Saturday, it will get mowed when I don't have to go to work the next day.
4. You find things you don't need to see (or hear about) in the office photo copier, especially things that are not yours.
On we go with the rest of the week. Stay tuned.
Showing posts with label bed bingo. Show all posts
Showing posts with label bed bingo. Show all posts
Monday, June 29, 2015
Friday, June 19, 2009
Nuggets for June 19
There were just too many good things I found out there this week, that I had to add this special edition of Nuggets (special because they only usually appear once a week...).
Enjoy!
Rehab-o-rama
As a rehab nurse, I know the FIM, but truthfully, it sometimes drives me crazy when I have to look at someone and when we talk about them in a meeting spit out their FIM numbers. Some are easy, since we take care of bowel and bladder all the time. Those other ones, however, tend to mess me up.
I found this article about how one hospital educated staff on their FIM scoring. It's very clever and involves a cartoon character. Hey, if it works, go for it!
Play nice
Since my OR pal reminded me...It really sucks that they have to write articles like this, but a recent one from AdvanceWEB talks about how nurses in the OR sometimes need to be reminded to be civil.
Relax
Need a quick, contemplative moment? This article by a certified hospice nurse may help you achieve your goal (also from AdvanceWEB).
And from the blogosphere....
Not Nurse Ratched is a new nurse who talks about making her first big med error. Listen up, all you new nurses!
Crass-Pollination had this great post about the inpatient shell game. Just call it bed bingo on steroids or you know it's bad when someone needs to die for you to get a free bed.
And Keith wins the most interesting day post for this one: Bat in a Basket. We have critters all around Madison, but thankfully, no bats.
Enjoy!
Rehab-o-rama
As a rehab nurse, I know the FIM, but truthfully, it sometimes drives me crazy when I have to look at someone and when we talk about them in a meeting spit out their FIM numbers. Some are easy, since we take care of bowel and bladder all the time. Those other ones, however, tend to mess me up.
I found this article about how one hospital educated staff on their FIM scoring. It's very clever and involves a cartoon character. Hey, if it works, go for it!
Play nice
Since my OR pal reminded me...It really sucks that they have to write articles like this, but a recent one from AdvanceWEB talks about how nurses in the OR sometimes need to be reminded to be civil.
Relax
Need a quick, contemplative moment? This article by a certified hospice nurse may help you achieve your goal (also from AdvanceWEB).
And from the blogosphere....
Not Nurse Ratched is a new nurse who talks about making her first big med error. Listen up, all you new nurses!
Crass-Pollination had this great post about the inpatient shell game. Just call it bed bingo on steroids or you know it's bad when someone needs to die for you to get a free bed.
And Keith wins the most interesting day post for this one: Bat in a Basket. We have critters all around Madison, but thankfully, no bats.
Tuesday, May 12, 2009
Hurry up and wait
Yes, it's my day off again, so now I'm engaged in the latest version of Hurry Up and Wait, the car maintenance edition.
Since the mechanic's got wifi at the shop, I thought I'd keep busy, even if I'd really like to find a quiet corner with a big couch and go to sleep. Thankfully, I'm well-caffeinated with my Starbucks and working away.
Work was finally placid...at least for most of the night. We had bed bingo again because C-diff is loose on the unit again, much to everyone's surprise. It was bound to happen since our docs throw Vancomycin at everything all the time. One of our guys was even on prophylatic PO Flagyl and lactobacillus and still came up positive. So much for that idea...
I tagged teamed with another nurse to get one of my patients cared for, since he's a two person turner. It was nice. We got her guy situated, since he works better when he stays up longer than he wants. He's a rehab patient who would like to stay in bed all the time, but he is just starting to get his conditioning back again. Since the docs want him up, we have a good excuse to keep him there until he's ready for his nightly rituals.
Otherwise, I'm glad I'm off today. I need the break! More later...
Since the mechanic's got wifi at the shop, I thought I'd keep busy, even if I'd really like to find a quiet corner with a big couch and go to sleep. Thankfully, I'm well-caffeinated with my Starbucks and working away.
Work was finally placid...at least for most of the night. We had bed bingo again because C-diff is loose on the unit again, much to everyone's surprise. It was bound to happen since our docs throw Vancomycin at everything all the time. One of our guys was even on prophylatic PO Flagyl and lactobacillus and still came up positive. So much for that idea...
I tagged teamed with another nurse to get one of my patients cared for, since he's a two person turner. It was nice. We got her guy situated, since he works better when he stays up longer than he wants. He's a rehab patient who would like to stay in bed all the time, but he is just starting to get his conditioning back again. Since the docs want him up, we have a good excuse to keep him there until he's ready for his nightly rituals.
Otherwise, I'm glad I'm off today. I need the break! More later...
Monday, April 27, 2009
Who will be "healed"?
Ahh, the joys of waking up...when your sinuses are killing you! Happy allergy season to all!
When you work with people who suffer traumatic injuries (to brain and spinal cord), you don't often see people who actually fully recover and regain their ability to walk and take care of themselves.
When you work on a unit with lots of double and triple rooms, you don't get a lot of opportunities to keep people in the same place during their entire stay. Yes, it's all about isolation status.
The Hotel Rehab will be at full capacity tonight, so let the bed bingo begin. It will be interesting to see how many patients are suddenly "healed" of their various bugs (like MRSA, VRE, etc.) enough to go into a different room.
Gotta go get that saline spray! More later!
When you work with people who suffer traumatic injuries (to brain and spinal cord), you don't often see people who actually fully recover and regain their ability to walk and take care of themselves.
When you work on a unit with lots of double and triple rooms, you don't get a lot of opportunities to keep people in the same place during their entire stay. Yes, it's all about isolation status.
The Hotel Rehab will be at full capacity tonight, so let the bed bingo begin. It will be interesting to see how many patients are suddenly "healed" of their various bugs (like MRSA, VRE, etc.) enough to go into a different room.
Gotta go get that saline spray! More later!
Tuesday, February 24, 2009
Heave, ho!
There was a lot of heaving today. I had Mr. Colo again, and for a while, they had him on a prep. The gallon of GoLytely I delivered at 1600 yesterday was still in his room. He only made it through half of it. Since Mr. Colo was still stooling a bit, that was the beginning of the day. One of the nurse assistants told me the boss should assign him to two people. Yes, he should when we have really heavy patients (literally and figuratively), but he doesn't, so you have to go roaming the halls looking for help, as I normally do. Some people will help you (and I always try to reciprocate) and others will run when they see you going down the hall, so they're "busy".
Thankfully, J. was in charge, and I recruited her and K. and one of the LPNs, so I didn't have to ask the same person too many times. J. does a lot when she's in charge. She goes out looking for things to help people with and it's nice. I helped with a couple of orders, but not many, because my two patients and the meds kept me running literally the whole day. I sat for 20 minutes while I charged my cell phone today and ate lunch and that was it.
Tuesdays can get crazy because the docs have meetings early, then they round with one of the specialists, and sometimes they don't get done rounding until just as lunch is arriving. It makes for some interesting predicaments such as one today with Mr. Colo. I'm in the middle of passing my pills to the whole hall to which I'm assigned. Mr. Colo was very distended with gas. The docs tell me..."oh, we dig stimmed him and relieved some of the gas, so you'll need to clean him up." What.In.Hades.Is.Going.On?! I'm in the middle of passing pills and I have to stop, drop and roll to do a clean up. Yes, this was not a drill. Since no one told me exactly what kind of results I'd find, I had to stop and get J. to go in with me so I could clean up Mr. Colo, then go back to my pills. One of these days, the docs will figure this out!
I also had DQ on my team again and I managed to get him up into the shower and he was all fine and happy until we told him he had to move next door since his double room was needed for two isolation patients. (I so love bed bingo!) Of course, he skipped out on afternoon therapy, since he had to make sure we didn't mess up any of his stuff. He just hung out in the halls and got in the way as we moved Mr. Colo to DQ's room and then DQ to Mr. Colo's room as the housekeepers finished cleaning the rooms. DQ wasn't happy with the way we arranged the room, so he rearranged it several times until he found a configuration he liked. He's not happy with it, but we had no choice. The inn is full of isolation patients!
When I wasn't busy with my own patients, I helped K. get a couple of hers up to go places. One guy went and bought a pair of reading glasses. He was the happiest I've ever seen him. He was sleeping all morning, and when he came back he was so alert and social. K. left him up on his stretcher for the evening crew to return to bed.
At 1400, K. got an order to send another patient to x-ray for a hip film. We got him loaded up for the transporter, then put him back to bed when he returned.
I left the med cart for the 12 hour nurse (and her orienting student) and got everything cleaned up. At 1600, I told J. and K., "Let's run before we have to move anyone else." and so the day ended.
Evenings creeps up again Thursday. I'll rest my heaving shoulders until then...more to come.
Thankfully, J. was in charge, and I recruited her and K. and one of the LPNs, so I didn't have to ask the same person too many times. J. does a lot when she's in charge. She goes out looking for things to help people with and it's nice. I helped with a couple of orders, but not many, because my two patients and the meds kept me running literally the whole day. I sat for 20 minutes while I charged my cell phone today and ate lunch and that was it.
Tuesdays can get crazy because the docs have meetings early, then they round with one of the specialists, and sometimes they don't get done rounding until just as lunch is arriving. It makes for some interesting predicaments such as one today with Mr. Colo. I'm in the middle of passing my pills to the whole hall to which I'm assigned. Mr. Colo was very distended with gas. The docs tell me..."oh, we dig stimmed him and relieved some of the gas, so you'll need to clean him up." What.In.Hades.Is.Going.On?! I'm in the middle of passing pills and I have to stop, drop and roll to do a clean up. Yes, this was not a drill. Since no one told me exactly what kind of results I'd find, I had to stop and get J. to go in with me so I could clean up Mr. Colo, then go back to my pills. One of these days, the docs will figure this out!
I also had DQ on my team again and I managed to get him up into the shower and he was all fine and happy until we told him he had to move next door since his double room was needed for two isolation patients. (I so love bed bingo!) Of course, he skipped out on afternoon therapy, since he had to make sure we didn't mess up any of his stuff. He just hung out in the halls and got in the way as we moved Mr. Colo to DQ's room and then DQ to Mr. Colo's room as the housekeepers finished cleaning the rooms. DQ wasn't happy with the way we arranged the room, so he rearranged it several times until he found a configuration he liked. He's not happy with it, but we had no choice. The inn is full of isolation patients!
When I wasn't busy with my own patients, I helped K. get a couple of hers up to go places. One guy went and bought a pair of reading glasses. He was the happiest I've ever seen him. He was sleeping all morning, and when he came back he was so alert and social. K. left him up on his stretcher for the evening crew to return to bed.
At 1400, K. got an order to send another patient to x-ray for a hip film. We got him loaded up for the transporter, then put him back to bed when he returned.
I left the med cart for the 12 hour nurse (and her orienting student) and got everything cleaned up. At 1600, I told J. and K., "Let's run before we have to move anyone else." and so the day ended.
Evenings creeps up again Thursday. I'll rest my heaving shoulders until then...more to come.
Tuesday, February 10, 2009
Only Grandpa today
Yes, that's what some of the folks call my patient and he was it today. Officially, I had two patients, but one was gone the entire day, so I really couldn't do anything for him. Grandpa was balky and happy, but never at the same time. I did his dressings, but he had to complain about them first.
Next, he complained about his bed, but he's been doing that on and off since the weekend, so I was told. He complained so much, I called the vendor's 800 number, the tech came out and he checked it out. Nothing wrong, the tech said, and Grandpa was happy...for about 2 whole minutes. Happily, since Grandpa is demented, he forgot about being mad and was busy watching TV the last hour I worked.
So I wandered around...and found stuff to do. My admission never showed up since they kept him at Washington instead of sending him here. I helped other nurses transfer people going to x-ray and therapy, I filled isolation carts with gowns, I filled glove dispensers with gloves and I passed out trays at lunch. I picked them up afterward and put them on the dirty cart. I took off orders. I witnessed a consent with one of our docs. It wasn't too bad. I hate sitting around doing nothing!
At 1530, we got a call that one of our patients had to be moved since he's now a double isolation patient, and one organism is C-diff. Joy. Nothing like bed bingo for four people (yes, that's how many we had to move to get them straight) so late in the day. Housekeeping had left the unit, so our charge was left to her own devices to get things squared away. We moved them in pairs and it worked out smoothly.
My second patient came in the building, just as I was leaving for the day. Evening shift was out of report, so I was relieved of my duty. Hooray! The weather's been great here, so I just hope it stays that way...without any tornadoes or floods thrown in. I could use a day to rest!
More to come...
Next, he complained about his bed, but he's been doing that on and off since the weekend, so I was told. He complained so much, I called the vendor's 800 number, the tech came out and he checked it out. Nothing wrong, the tech said, and Grandpa was happy...for about 2 whole minutes. Happily, since Grandpa is demented, he forgot about being mad and was busy watching TV the last hour I worked.
So I wandered around...and found stuff to do. My admission never showed up since they kept him at Washington instead of sending him here. I helped other nurses transfer people going to x-ray and therapy, I filled isolation carts with gowns, I filled glove dispensers with gloves and I passed out trays at lunch. I picked them up afterward and put them on the dirty cart. I took off orders. I witnessed a consent with one of our docs. It wasn't too bad. I hate sitting around doing nothing!
At 1530, we got a call that one of our patients had to be moved since he's now a double isolation patient, and one organism is C-diff. Joy. Nothing like bed bingo for four people (yes, that's how many we had to move to get them straight) so late in the day. Housekeeping had left the unit, so our charge was left to her own devices to get things squared away. We moved them in pairs and it worked out smoothly.
My second patient came in the building, just as I was leaving for the day. Evening shift was out of report, so I was relieved of my duty. Hooray! The weather's been great here, so I just hope it stays that way...without any tornadoes or floods thrown in. I could use a day to rest!
More to come...
Wednesday, December 10, 2008
Pick and choose
That pretty much describes my day, or at least the attitude of most of my patients. Two out of three could get up and go in their wheelchairs and both of them opted out. One didn't get ready until just before lunch appeared on the unit.
The tasks of the day weren't terrible--Foley replacement, WoundVAC dressing and managing ileostomies and colostomies. The Slug did get on my nerves a couple of times, but I managed to hide my irritation, since that would just be something she'd enjoy.
Education showed up and we had an impromptu in-service on flushing and drawing blood from central lines. I learned that our facility actually marks the lumens proximal and distal on our central lines. We don't have too many in rehab, since we mostly have folks with PICC lines.
I helped a couple of other nurses on the unit get their people up and out of bed. I try to do this with at least one person a day because I never know when I'll need help doing the same thing. Since none of my people got up, I just rounded and turned people. One of the other nurses, A., set up two of my patients for lunch, so that worked well for me. I fed Mr. I'm going home next week. He's happy to know he's getting out before Christmas.
Two patients left today and none were admitted, so it was relatively peaceful. One patient got to be bed bingoed to another room since he tested positive for MRSA in the nares. It worked out okay since Mr. W. was being discharged and his room, right across the hall, was a MRSA isolation room. Mr. Hogg (not his real name) in the Clinitron didn't mind at all, since he'll have a new roomie who likes to stay up late at night just like he does. I like Mr. Hogg. He's funny and is another artist on our unit. He draws cartoons that are downright hysterical, particularly of staff and the occasional nursing student. One of the characters he drew recently had a cleft chin that reminded me of Hank from the Family Guy.
I finished my paperwork and got to check out some of our VIP patient's photos from his ceremony last week. They were really good and the organizers even had a book made to commemorate the occasion. I'm sure he'll never forget it!
After that, it was time to get my coat and go home. More tomorrow.
The tasks of the day weren't terrible--Foley replacement, WoundVAC dressing and managing ileostomies and colostomies. The Slug did get on my nerves a couple of times, but I managed to hide my irritation, since that would just be something she'd enjoy.
Education showed up and we had an impromptu in-service on flushing and drawing blood from central lines. I learned that our facility actually marks the lumens proximal and distal on our central lines. We don't have too many in rehab, since we mostly have folks with PICC lines.
I helped a couple of other nurses on the unit get their people up and out of bed. I try to do this with at least one person a day because I never know when I'll need help doing the same thing. Since none of my people got up, I just rounded and turned people. One of the other nurses, A., set up two of my patients for lunch, so that worked well for me. I fed Mr. I'm going home next week. He's happy to know he's getting out before Christmas.
Two patients left today and none were admitted, so it was relatively peaceful. One patient got to be bed bingoed to another room since he tested positive for MRSA in the nares. It worked out okay since Mr. W. was being discharged and his room, right across the hall, was a MRSA isolation room. Mr. Hogg (not his real name) in the Clinitron didn't mind at all, since he'll have a new roomie who likes to stay up late at night just like he does. I like Mr. Hogg. He's funny and is another artist on our unit. He draws cartoons that are downright hysterical, particularly of staff and the occasional nursing student. One of the characters he drew recently had a cleft chin that reminded me of Hank from the Family Guy.
I finished my paperwork and got to check out some of our VIP patient's photos from his ceremony last week. They were really good and the organizers even had a book made to commemorate the occasion. I'm sure he'll never forget it!
After that, it was time to get my coat and go home. More tomorrow.
Tuesday, October 28, 2008
Bed bingo on a crazy Monday
You know you're in for some excitement when you get to work and everyone's all shuffled around. This is known as "bed bingo". Bed bingo happens for a number of reasons, and it's mostly related to isolation status. We had one patient come up positive for a new organism, so as a result, five people got moved around to get rooms ready and everyone in their correct group.
Note: our facility cohorts patients in the same room with the same organism and we only have one (yes, one) private room among our rooms.
I got the same assignment and the med wagon far away again. This can be frazzling, but I dealt with it. The thing that is most frazzling is when one shift forgets to do the things to which they're assigned. Since our boss has been in and out with things, the tasks that normally get done on the floor have gone to the wayside a bit.
The housekeepers are the biggest problem right now. They have had some turnover in the last few months and they can't seem to keep the paper towels in stock in the staff bathrooms, nor can they keep the trash emptied. I've mentioned this to one of the housekeepers who usually sets us up well, but I'm not sure why it's not getting done. A lot of people on the evening shift are getting frazzled, and I'm one of them. I'm not on evenings all the time, but I see things on days and then I go to evenings and it gets annoying. With cold and flu season here, I wish one of the docs would notice and throw a fit, since maybe that might get something done. Running out of paper towels in the bathrooms and patient rooms is not an option!
Besides that, some of our day staff are not even attempting to pull their weight. Unfortunately that saying, "When the cat's away, the mice will play" is very true. I dread working behind some people. You should not immediately have to empty urine bags when you get on your shift, but I have done it every single night on evenings this round. One day, I had to make the patient's bed and get all the linens. This is the job of nursing at the ranch, and the nurse who had this patient couldn't get it done before she left at noon, and the nurse who followed her for four hours had made no attempt, either. Thankfully, I had the bed made...just as the patient was returning with his family from a day pass. I also got lucky and had to empty the bed bag for this guy, too, since this was just one more thing they forgot. I have to say most people are consistent--when they don't do something, they really follow through and miss everything. End of soapbox.
Ahh...that venting felt better....on to more fun stuff. My younger patient is doing more every day. It's really good to work with him. He puts the active in active rehab. He's even paying attention to his diet, which is really important for SCI patients. We talked about his bowel routine protocol and despite the assessment of the docs and the charge nurse, he's probably going to stick to a daily routine.
One of my other patients was really depressed because his blood pressure would not stay up even with his TEDs, binder and Midodrine. We talked about it and hopefully, it can be resolved soon enough.
I'm going to stop here...more later! I'm going to enjoy my off day! (Happy Birthday, Mom!)
Note: our facility cohorts patients in the same room with the same organism and we only have one (yes, one) private room among our rooms.
I got the same assignment and the med wagon far away again. This can be frazzling, but I dealt with it. The thing that is most frazzling is when one shift forgets to do the things to which they're assigned. Since our boss has been in and out with things, the tasks that normally get done on the floor have gone to the wayside a bit.
The housekeepers are the biggest problem right now. They have had some turnover in the last few months and they can't seem to keep the paper towels in stock in the staff bathrooms, nor can they keep the trash emptied. I've mentioned this to one of the housekeepers who usually sets us up well, but I'm not sure why it's not getting done. A lot of people on the evening shift are getting frazzled, and I'm one of them. I'm not on evenings all the time, but I see things on days and then I go to evenings and it gets annoying. With cold and flu season here, I wish one of the docs would notice and throw a fit, since maybe that might get something done. Running out of paper towels in the bathrooms and patient rooms is not an option!
Besides that, some of our day staff are not even attempting to pull their weight. Unfortunately that saying, "When the cat's away, the mice will play" is very true. I dread working behind some people. You should not immediately have to empty urine bags when you get on your shift, but I have done it every single night on evenings this round. One day, I had to make the patient's bed and get all the linens. This is the job of nursing at the ranch, and the nurse who had this patient couldn't get it done before she left at noon, and the nurse who followed her for four hours had made no attempt, either. Thankfully, I had the bed made...just as the patient was returning with his family from a day pass. I also got lucky and had to empty the bed bag for this guy, too, since this was just one more thing they forgot. I have to say most people are consistent--when they don't do something, they really follow through and miss everything. End of soapbox.
Ahh...that venting felt better....on to more fun stuff. My younger patient is doing more every day. It's really good to work with him. He puts the active in active rehab. He's even paying attention to his diet, which is really important for SCI patients. We talked about his bowel routine protocol and despite the assessment of the docs and the charge nurse, he's probably going to stick to a daily routine.
One of my other patients was really depressed because his blood pressure would not stay up even with his TEDs, binder and Midodrine. We talked about it and hopefully, it can be resolved soon enough.
I'm going to stop here...more later! I'm going to enjoy my off day! (Happy Birthday, Mom!)
Saturday, September 20, 2008
Heard on the unit...
Here are a few of the gems I heard this weekend on our unit.
"I'm getting my own room in front to be closer to you." Mr. J.
Mr. J. said this to me when he got moved up to our private room when Ms. R. left this week.
What did he do to win the suite, you ask? Why he came up positive on his last UAC&S for acinetobacter in addition to the MRSA he already has in his wound. He was just saying that because my boss seems to assign me to the patients on the front end of the unit a lot more than the back.
"Ah. My Pepsi angel!" Mr. K.
I brought in a couple for him to keep him quiet but it didn't work. His behavior may or may not have been related to his suddenly missing Gabapentin order. He's got it back now and is more lucid than he's been in days.
"I hear the boss is alphabetizing everyone." Mr. J. (again)
Mr. J. got booted from his private suite when the other Mr. J. came up positive for acinetobacter, too. Besides that, two of our Mr. HIJ's (not their real names, but they are similar) got put in the same room, too, because the boss needed a three-bed room available for our new admissions next week. So much for avoiding similar names in the same room. It just makes for more excitement with the bed bingo that always seems to happen on our unit.
"I'm getting my own room in front to be closer to you." Mr. J.
Mr. J. said this to me when he got moved up to our private room when Ms. R. left this week.
What did he do to win the suite, you ask? Why he came up positive on his last UAC&S for acinetobacter in addition to the MRSA he already has in his wound. He was just saying that because my boss seems to assign me to the patients on the front end of the unit a lot more than the back.
"Ah. My Pepsi angel!" Mr. K.
I brought in a couple for him to keep him quiet but it didn't work. His behavior may or may not have been related to his suddenly missing Gabapentin order. He's got it back now and is more lucid than he's been in days.
"I hear the boss is alphabetizing everyone." Mr. J. (again)
Mr. J. got booted from his private suite when the other Mr. J. came up positive for acinetobacter, too. Besides that, two of our Mr. HIJ's (not their real names, but they are similar) got put in the same room, too, because the boss needed a three-bed room available for our new admissions next week. So much for avoiding similar names in the same room. It just makes for more excitement with the bed bingo that always seems to happen on our unit.
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