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Showing posts from June, 2007

Medication reconciliation

Do you think medication reconciliation works in the ER?

Giggles comes in from home. She lives alone with a caregiver that comes three times a week but didn't accompany her to the hospital. She is a very vague historian, has no clue what med's she takes or what pharmacy she gets them from. She gives me her physicians name so I put in a call to his office. Three calls and much time on hold later I finally get in touch with the medical assistant who is finally able to tell me that the patient is not theirs. Close to 45 minutes wasted and still no clue what medications she is on. He last hospital record is from three years ago and she was admitted by the hospitalist then. I could start randomly calling pharmacies but there are 39 of them in the area and that would take hours.

Nice mid sixties gentleman comes in with Chest Pain. He knows he takes a blood pressure pill, a water pill and something for his sugar, not the names or the dosages. He gets his med's through the mail from …

Rules for non-bedside nurses

We are very concerned about the nursing shortage in
America, if the paperwork nurses actually did some nursing, no shortage would exist.

1. Nurses that do not provide direct patient care on a daily basis should not develop policies for nurses that do. (Have you ever noticed how the policies for your nursing practice are written without any input from the people who have to carry out the policies?)

2. Nurses that do not provide direct patient care on a daily basis should not develop forms for nurses that do. (that way a nurse won't have to waste her time putting the VS on the flow sheet and the graphics form and a report sheet etc. etc. etc.)

3. Nurses that do not provide direct patient care on a daily basis should not represent nurses that do in any advertising portraying them as bedside nurses. If you don't do the job, you don't get to claim the glory. ( I don't know about you but I've never seen any of the people who are portrayed as nurses at my hospital or they are…

Filth

A pet peeve for many is the fact many hospitals are filthy. Housekeepers often come from contracted services that provide the lowest amount they can get away with and pay them minimum wage with no benefits. The turnover is stupendous and they have no incentive at all to do a good job.

Sure, the center hall is buffed to a glossy finish but the patient rooms aren't wiped down every day, curtains aren't changed, walls not wiped and high dusting not done. All those areas are teaming with bacteria.

ER's are the worst. The gurney and surfaces wiped quickly by the RN in between patients but the rooms are cleaned well only once daily, if that. Pull our the gurney and look at what is under it. No wonder hospital acquired infections are rampant. That should be the first thing looked at when a hospitals infection rates go up, how many housekeepers are there....is one person responsible for covering three units?

I think housekeeping services need to be hospital base…