In case you missed it, the yearly celebration of nurses has begun. We got the whole week covered at the Hotel with "fun" stuff in between work.
Since the theme for this year's celebration is "healthy nurse, healthy nation", maybe it is time for some nurse-centric play-by-play from yours truly.
Yes, the Hotel has some great facilities, so we are fortunate that a lot of the celebrations occur right by our unit, but the problem: many people don't attend. Why? Because they don't have time.
So consequently, if we could get ANYTHING we asked for this Nurses' Week, here's what would be on the list.
1. Unlicensed staff that actually listen, work, and communicate with the RNs. Too many of them on our unit have a bad habit of dissing the RNs. It needs to stop. Period.
We work together as a team. If you diss the RN you're assigned to on your shift, it's a rubber-glue scenario. You make yourself look bad, too.
2. How about the Captain Obvious question: if you want everyone to document everywhere, why not make it easier at the bedside?
Just saying! If you think logging in after walking 300 feet to the nurses' station, then opening the software, then logging in again, finding the patient, then starting your note is good, you haven't taken care of a bedside patient lately.
No, rehab supposedly has stable patients, but you really need things, like computers that accept the data from the beds, the scales, etc. without double charting.
3. Since I went big on #2, why not on this one. How about a fully stocked cabinet outside each room with the basics, a la TCAB projects of the not so distant past? It would have helped if they had planned this on the last remodel, but here's some food for thought.
Having supply staff actually supply it, would also be nice. If you can't do it outside every room, how about on every wing. Steps do make a difference in a workday (you could be charting, checking labs, etc.)
Finally, no matter where you practice, I wish you a very Happy Nurses' Week. Your work matters and you make a difference.
More to come...
Showing posts with label charting. Show all posts
Showing posts with label charting. Show all posts
Sunday, May 7, 2017
Sunday, November 30, 2014
Serendipity
It can't exactly be summed up in one word. When I read this article, I thought of my own experiences on subway trains all over the place.
Consequently, I find the same thing happening as I do my job. Sometimes, when I was on the floor, I'd have those moments with those super-needy patients where I felt as if every ounce of caring was sucked out of me. I was spent.
Before I knew it, someone would come and change everything, in that very moment. One particular moment I remember was working on Mother's Day. My coworkers swore our weekend always encompassed the holidays, like Mother's Day. I finally got everything done for my patients and headed for the nurses' station to chart (since we don't do bedside, nosirree!). One of our chaplains came to the desk and gave all the mothers a rose. It was sweet. He has moved to a different area, so I smile when I see him and think of that day.
That same article made me think of one of those super needy patients. Partly because he lived in New York City for a while. I think of some of our folks, like him, even more this time of year, because he died not long before Christmas. His sister, an old nurse, liked to bring donuts.
We may not be in a subway car, but in our little unit at the Hotel, we find fortunate happenstance in places we never expected. I hope you do, too, wherever you are tonight.
Consequently, I find the same thing happening as I do my job. Sometimes, when I was on the floor, I'd have those moments with those super-needy patients where I felt as if every ounce of caring was sucked out of me. I was spent.
Before I knew it, someone would come and change everything, in that very moment. One particular moment I remember was working on Mother's Day. My coworkers swore our weekend always encompassed the holidays, like Mother's Day. I finally got everything done for my patients and headed for the nurses' station to chart (since we don't do bedside, nosirree!). One of our chaplains came to the desk and gave all the mothers a rose. It was sweet. He has moved to a different area, so I smile when I see him and think of that day.
That same article made me think of one of those super needy patients. Partly because he lived in New York City for a while. I think of some of our folks, like him, even more this time of year, because he died not long before Christmas. His sister, an old nurse, liked to bring donuts.
We may not be in a subway car, but in our little unit at the Hotel, we find fortunate happenstance in places we never expected. I hope you do, too, wherever you are tonight.
Monday, July 16, 2012
Don't let the door...part 2
Not my favorite vintage of whine, but nothing new...
RPIA Doctor: "You mean I have to do the paperwork for that appointment?" (audible, loud, obnoxious 14 year old sigh).
RehabRN: "Yes you do. I'll get you some help." (calls tech support)
Dept. Tech: (shows RPIA what to do with in-person demo) "Okay, well I guess I can do it." (RPIA walks away)
Dept. Tech and I banged our heads into the nearby desks. Ugh!
Some people just don't get that bad four letter word...work! Technology is a means to get it done, don't you know?
RPIA Doctor: "You mean I have to do the paperwork for that appointment?" (audible, loud, obnoxious 14 year old sigh).
RehabRN: "Yes you do. I'll get you some help." (calls tech support)
Dept. Tech: (shows RPIA what to do with in-person demo) "Okay, well I guess I can do it." (RPIA walks away)
Dept. Tech and I banged our heads into the nearby desks. Ugh!
Some people just don't get that bad four letter word...work! Technology is a means to get it done, don't you know?
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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