It's always an adventure on our unit on Mondays. The booking agents (a/k/a the NPs) try to get our people in on Monday or Tuesday, so hopefully, they can get someone home by the weekend. This is particularly true in the case of folks coming for tests or general stuff.
I only had two patients and no med cart. Hooray! I know this will change when I go back to evenings, so I'm just enjoying it while I can. It is bliss!
I got to do some fun stuff today...get people up into a wheelchair with a head and shoulder control. It's a little dicey, but it works. Why the patient won't use the controls all the time is another story.
My other patient had an undetermined suprapubic catheter. Since I searched the notes and couldn't find one with a date when it was last changed, and it wasn't on our board, I got the pleasure of changing it. I don't think this is a coincidence. I am noticing that I'm one of those people the docs and NPs ask to do stuff when they want it done. It's so nice to feel wanted! This same character just got put on a Clinitron bed last Friday and his wounds are really healing well. They look incredible compared to the last time I took care of him.
I had to report to the next shift, and my head and shoulder guy came back late, so I had to get him in bed and undressed before I left. Thankfully, one of our new nurses helped me get him back to bed. I finally escaped at 1625 after I wrote my last note. I had all my other charting done, since I did it as I went along, or I'd have been there later.
More tomorrow...we'll see how it goes. Stay tuned!
Showing posts with label clinitron. Show all posts
Showing posts with label clinitron. Show all posts
Monday, February 9, 2009
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, September 30, 2008
Vacation...all I ever wanted!
Yes, I'm now officially on vacation until next Monday from Madison. Hooray! Hooray!
Yesterday's evening shift wasn't too terrible, but had enough weird little things going on to keep me busy. Our charge nurse, C., was busy getting mechanical problems resolved. One patient's bed stopped working (no head up, no head down, no lifting up or down.) and the air handler in one room became so noisy we could hear it hundreds of feet down the hall it was squealing so loud. It only took three hours, but the maintenance guy finally showed up to fix that.
I was the IV nurse, so I was busy hanging all the piggybacks on the floor. We have a couple of people on the famous osteomyelitis combo of Vancomycin and Zosyn and one guy on Phenergan and Tygacil. To top that off, Mr. K. was still on IV fluids. I brought him his Pepsi, so his locker should be full of them. Sometimes he won't take in any fluids, but he will cave in for a Pepsi. That usually gets him in a good enough mood that he'll actually take in enough orally for the shift. It's a sneaky way of getting him to drink, but we have to do it.
One of our patients will be coming back from flap surgery to a new Clinitron bed. The main problem: his roommate, who's also on MRSA isolation just like him, has an allergy to something in the Clinitron. (He had to move rooms the last time he was with a patient on a Clinitron) The charge nurse will have a fun task today figuring out what they'll do with Mr. HIJ #2 when Mr. HIJ #1 comes back and they have to turn the bed on and run it.
I had my same three patients that I had all weekend. The two in the same room were reasonably pleasant, and they work well with their third roommate, who is really funny. The three of them were having a blast making fun of the rubbery roast beef served for dinner. That's always helpful, especially, since the one patient, a COPDer can get anxious pretty quickly. He doesn't get so bad when he's busy chatting with the other guys. My other patient, Mr. AB #1 was vomiting again, but not as much. It never fails...he vomits just before I can hang the Promethazine, and then he promptly falls asleep once I hang it.
We had an interesting chat at the nurses' station last night. Some people are amazed that certain people on our unit have so much time to chat and lounge around when they have a bunch of patients and others seem to disappear for way longer than their assigned breaks. How do they do it? One RN figured out that they aren't doing the work. You look at their patients, the charting that's done on their shift and what do you find? Nothing. Our state says you have to have two assessments in 24 hours (usually no more than 12 hours apart) and if you leaf through our flowsheet book, sometimes you only see one assessment and that's from the night shift.
I followed one nursing assistant on our unit and took care of her patients on evenings. I discovered when she worked a double shift recently, she only recorded vital signs. She didn't record even one assessment. This is also the same person who has a habit of disappearing off the unit for a couple of hours each day (she's not a smoker) without notifying anyone. I discovered one of her hiding places on my way into work yesterday--her car. She goes off the unit to the parking lot and sits in her car, so she can avoid any of the end-of-shift work, like putting people back into bed or taking care of her assigned patients.
As I talked to some other folks about this, they mentioned that this is a management problem. It surely is. Our manager is loathe to call anyone on any infractions because he/she is afraid that the person will retaliate by not showing up to work for upcoming shifts. And, surprise, surprise, there are no regulations at Madison which say if you're out of work for three days or more that you need a doctor's excuse. It is just terrible. I understand now why I'm not a manager! What good is it if you cannot enforce any sort of rules of conduct?
Alas, I am on vacation. I'm going to putter around the house and do stuff, like get the cars maintained, get a manicure and pedicure and then get all dressed up and go out with my husband on Friday night to celebrate our anniversary. Bubba will be staying with my friends and their children and will get to have a day running around with them this weekend. It should be fun!
Stay tuned...back to work next week!
Yesterday's evening shift wasn't too terrible, but had enough weird little things going on to keep me busy. Our charge nurse, C., was busy getting mechanical problems resolved. One patient's bed stopped working (no head up, no head down, no lifting up or down.) and the air handler in one room became so noisy we could hear it hundreds of feet down the hall it was squealing so loud. It only took three hours, but the maintenance guy finally showed up to fix that.
I was the IV nurse, so I was busy hanging all the piggybacks on the floor. We have a couple of people on the famous osteomyelitis combo of Vancomycin and Zosyn and one guy on Phenergan and Tygacil. To top that off, Mr. K. was still on IV fluids. I brought him his Pepsi, so his locker should be full of them. Sometimes he won't take in any fluids, but he will cave in for a Pepsi. That usually gets him in a good enough mood that he'll actually take in enough orally for the shift. It's a sneaky way of getting him to drink, but we have to do it.
One of our patients will be coming back from flap surgery to a new Clinitron bed. The main problem: his roommate, who's also on MRSA isolation just like him, has an allergy to something in the Clinitron. (He had to move rooms the last time he was with a patient on a Clinitron) The charge nurse will have a fun task today figuring out what they'll do with Mr. HIJ #2 when Mr. HIJ #1 comes back and they have to turn the bed on and run it.
I had my same three patients that I had all weekend. The two in the same room were reasonably pleasant, and they work well with their third roommate, who is really funny. The three of them were having a blast making fun of the rubbery roast beef served for dinner. That's always helpful, especially, since the one patient, a COPDer can get anxious pretty quickly. He doesn't get so bad when he's busy chatting with the other guys. My other patient, Mr. AB #1 was vomiting again, but not as much. It never fails...he vomits just before I can hang the Promethazine, and then he promptly falls asleep once I hang it.
We had an interesting chat at the nurses' station last night. Some people are amazed that certain people on our unit have so much time to chat and lounge around when they have a bunch of patients and others seem to disappear for way longer than their assigned breaks. How do they do it? One RN figured out that they aren't doing the work. You look at their patients, the charting that's done on their shift and what do you find? Nothing. Our state says you have to have two assessments in 24 hours (usually no more than 12 hours apart) and if you leaf through our flowsheet book, sometimes you only see one assessment and that's from the night shift.
I followed one nursing assistant on our unit and took care of her patients on evenings. I discovered when she worked a double shift recently, she only recorded vital signs. She didn't record even one assessment. This is also the same person who has a habit of disappearing off the unit for a couple of hours each day (she's not a smoker) without notifying anyone. I discovered one of her hiding places on my way into work yesterday--her car. She goes off the unit to the parking lot and sits in her car, so she can avoid any of the end-of-shift work, like putting people back into bed or taking care of her assigned patients.
As I talked to some other folks about this, they mentioned that this is a management problem. It surely is. Our manager is loathe to call anyone on any infractions because he/she is afraid that the person will retaliate by not showing up to work for upcoming shifts. And, surprise, surprise, there are no regulations at Madison which say if you're out of work for three days or more that you need a doctor's excuse. It is just terrible. I understand now why I'm not a manager! What good is it if you cannot enforce any sort of rules of conduct?
Alas, I am on vacation. I'm going to putter around the house and do stuff, like get the cars maintained, get a manicure and pedicure and then get all dressed up and go out with my husband on Friday night to celebrate our anniversary. Bubba will be staying with my friends and their children and will get to have a day running around with them this weekend. It should be fun!
Stay tuned...back to work next week!
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