Today was one of those two day visits. In theory, everything is clean and shiny, but it wasn't. The big shots got in before the housekeepers started mopping up the big dried coffee stain in the lobby.
I was fortunate to stumble upon the visitors as I was leaving my office to go to the restroom down the hall. Since I am well acquainted with one of them, I escorted them to the meeting room. They were thrilled with the coffee and pastries.
As luck would have it, I was scheduled in not one but three meetings. Since they ran over, I excused myself from the second one, so I could escape and do some work. Since the Slug needed someone to impress and was being a total toad, it was really for his/her own safety (and the safety of my license) that I left.
When I went back to my desk, I kept making phone calls. I called several patients and checked on orders for equipment. It was fun to get away.
Finally, the visitors had had enough in the last meeting and we finished by 5PM, over an hour past my usual. I was so glad to go home.
More excitement is coming...stay tuned.
Monday, February 27, 2017
Saturday, February 11, 2017
Sometimes you have to go with your gut
New nurses: this one's for you.
We take care of a lot of people at the Hotel Rehab, and it's normal for us to see a variety of society strolling through the front doors. Sometimes we are given plenty of information to do our jobs accordingly. Other times, we aren't.
Since I work with all of the folks who complete rehab, as a specialty nurse, I have to understand how to use my assessment skills. When something seems strange, it usually is. Police come and go in the Hotel for a variety of reasons, and it's always for something.
I took care of one of our folks in the SU. Said patient did well in his/her rehab stay, and would seem like a good fit for our aftercare program that I manage. While I do chart reviews of all of the patients to determine eligibility, and this one passed all of my normal reviews, something still wasn't right.
Said patient was getting ready to discharge. Since he/she was not exactly confident about this program when I discussed it, I didn't worry about it. I do not push patients to participate, because it's voluntary. In one of our discharge planning meetings, another consulting staff member, who I greatly admire, voiced concerns over this patient's "legal issues." In rehab, this, too is not uncommon, as many people may be in rehab due to accidents and may be managed by legal or worker's comp case managers from outside.
When I looked at my credit monitoring service e-mail recently, I found out why Officer Friendly was pacing through the unit. It wasn't because we have staff parking scofflaws, it was because my SU patient was a registered sex offender. His/her pending litigation might end up in a prison sentence. This, consequently, disqualifies SU patient from my program.
So for all you new folks: what does this mean? This means you tailor your care to the specific patient, and remember, no matter what to be professional. This article mentions a number of things you can do to make this happen, as a floor nurse, and discusses things your risk manager may ask you.
In my decade of practice, I've seen nurses act like fools and discuss these patients loudly and use computers visible at the nurses' station. My advice: don't do it. You will look stupid, and you may be disciplined. You should discuss this with your nurse manager in your area in a private location to make sure you ensure the safety of staff, visitors, as well as the patients on the unit.
Finally, all of those things you learned about therapeutic communication and ethics come to the forefront in these situations. Yes, you can take care of these folks and be honest and direct. I often tell students this is why you don't overshare in ways that may make your patients uncomfortable or create other issues. Seek help from other team members, such as psychology and your chaplains, so you can make your care plan appropriate for your patient.
We take care of a lot of people at the Hotel Rehab, and it's normal for us to see a variety of society strolling through the front doors. Sometimes we are given plenty of information to do our jobs accordingly. Other times, we aren't.
Since I work with all of the folks who complete rehab, as a specialty nurse, I have to understand how to use my assessment skills. When something seems strange, it usually is. Police come and go in the Hotel for a variety of reasons, and it's always for something.
I took care of one of our folks in the SU. Said patient did well in his/her rehab stay, and would seem like a good fit for our aftercare program that I manage. While I do chart reviews of all of the patients to determine eligibility, and this one passed all of my normal reviews, something still wasn't right.
Said patient was getting ready to discharge. Since he/she was not exactly confident about this program when I discussed it, I didn't worry about it. I do not push patients to participate, because it's voluntary. In one of our discharge planning meetings, another consulting staff member, who I greatly admire, voiced concerns over this patient's "legal issues." In rehab, this, too is not uncommon, as many people may be in rehab due to accidents and may be managed by legal or worker's comp case managers from outside.
When I looked at my credit monitoring service e-mail recently, I found out why Officer Friendly was pacing through the unit. It wasn't because we have staff parking scofflaws, it was because my SU patient was a registered sex offender. His/her pending litigation might end up in a prison sentence. This, consequently, disqualifies SU patient from my program.
So for all you new folks: what does this mean? This means you tailor your care to the specific patient, and remember, no matter what to be professional. This article mentions a number of things you can do to make this happen, as a floor nurse, and discusses things your risk manager may ask you.
In my decade of practice, I've seen nurses act like fools and discuss these patients loudly and use computers visible at the nurses' station. My advice: don't do it. You will look stupid, and you may be disciplined. You should discuss this with your nurse manager in your area in a private location to make sure you ensure the safety of staff, visitors, as well as the patients on the unit.
Finally, all of those things you learned about therapeutic communication and ethics come to the forefront in these situations. Yes, you can take care of these folks and be honest and direct. I often tell students this is why you don't overshare in ways that may make your patients uncomfortable or create other issues. Seek help from other team members, such as psychology and your chaplains, so you can make your care plan appropriate for your patient.
Wednesday, February 1, 2017
Back to business
Working always makes things interesting. From my space near the front door of the Hotel, I see a lot.
This week, I've had a lot of visitors. Folks looking to learn stuff I can teach them, families learning about when and where they'll go when they go home. I've even gotten to plan some projects and pitch new ones that need resources. I feel like I'm going somewhere, even though I'm running.
My regular characters come see me. One rolls in and it's obvious he needs help. His leg is dangling. He's slumped a little more than usual. He tells me the new wheelchair is having issues. His headrest is messed up and his foot pad won't stay on the chair, so we have to carry it upstairs.
Thankfully, he didn't have one of those spasms, that to the uninitiated, look as if he could just fly right out of the wheelchair. If I had a dollar for every time he's frightened new staff, I'd be rich.
Nevertheless, I fix what I can, empty his leg bag, and get him to the motor pool, otherwise known as therapy, so the wheelchair specialists can fix him up, literally, and figuratively. One smiles and tells him she knows where the "real tools" are.
He follows along, and I leave, knowing I've done my warm handoff to the next discipline.
Now for more fun...FIM certification!
Stay tuned.
This week, I've had a lot of visitors. Folks looking to learn stuff I can teach them, families learning about when and where they'll go when they go home. I've even gotten to plan some projects and pitch new ones that need resources. I feel like I'm going somewhere, even though I'm running.
My regular characters come see me. One rolls in and it's obvious he needs help. His leg is dangling. He's slumped a little more than usual. He tells me the new wheelchair is having issues. His headrest is messed up and his foot pad won't stay on the chair, so we have to carry it upstairs.
Thankfully, he didn't have one of those spasms, that to the uninitiated, look as if he could just fly right out of the wheelchair. If I had a dollar for every time he's frightened new staff, I'd be rich.
Nevertheless, I fix what I can, empty his leg bag, and get him to the motor pool, otherwise known as therapy, so the wheelchair specialists can fix him up, literally, and figuratively. One smiles and tells him she knows where the "real tools" are.
He follows along, and I leave, knowing I've done my warm handoff to the next discipline.
Now for more fun...FIM certification!
Stay tuned.
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