I know I sound like a hardened old bitch but I actually work very hard to make sure that my patients are as clean, dry, wrinkle free and comfortable as possible. When I went to nursing school we were taught how to be a nurse which is a lot more that being able to read EKG's and titrate drips. The high tech stuff is important, it's what makes our patients get better but it won't mean a thing to them if they are laying in a pile of wrinkled linen with no blanket.
So in case you missed nursing 101:
keep the linens wrinkle free. Have you ever been sick and laying in a damp wrinkly bed, it makes you feel worse. When your patient comes back from a test is in the rest room, take 5 seconds and straighten out and tuck in the sheet. If it is damp, throw it in the linen hamper and grab a new one.
Keep them warm. ER's are cold and the patients are scantily clad. Bundle them up. I am a 50ish, post-menopausal in full hot-flash city but when I had to go to the ER I was freezing! Those warm blankets were the best thing in the world. A great deal of our patients are elderly and frail people who are cold all the time any way.
Keep them dry. Nothing peeves me worse than to go into another nurses room to answer a call light and find the patient laying in sopping wadded up sheets.
Give them food and fluids if they can have it, tell them what is going on, what to expect and an estimate of how long things are going to take, if there are delays let them know why. This only takes seconds and means the world to someone. You are NEVER to busy to poke your head in and tell someone that the place is falling apart, they have not been forgotten but the doctor is tied up with a critical patient so there will be a delay.
Keep them comfortable. I don't mean drugs either. Find them a pillow. Get them into a hospital bed if there is a delay going to a room. ER stretchers SUCK!!! I laid on one for 4 hours and it killed me. I'm well padded, a lot of our patients a frail elderly.
Floor nurses - when I give you report have the damn room ready. when I tell you the patient is on 4 liters of oxygen to keep his sat 93% then you probably need to have an oxygen set up in the room. What do you people do with the christmas trees off the flo-meters anyway? Why do you take them off? Move the furniture, have an IV pump and be in the room to greet the patient as soon as they arrive.
Little things that they don't see - label you different IV tubings. I hate to go to a code on the floor and the patient has two or three things running with no labels so I don't know what line I can use to push meds without spending extra time untangling them, put a little tape on the end where they connect to the primary.
Have suction ready in your rooms. I routinely take patients to the floor and there are no suction buckets set up in the room. What do you plan to do if your patient starts vomiting and aspirating? That is not the time to run to the clean utility room and find one. Pretend you are a boy scout and be prepared.
Know your patients labs. If your patient has a high potassium or a low 'crit - you should know, unacceptable to not know.
I know we all get busy but most of these things take seconds or a few minutes at most and they are the things that our patients and families will remember.
13 comments:
I'm not a nurse, or even in the medical profession. I read here more as a voyeur than anything. Unfortunately, I've spent more than my fair share of time in hospitals and, every time, it was the nurses who either made it tolerable or a horrid experience.
Before my twins were born I was in for an extended period of strict bedrest. For the first 2 weeks I wasn't even allowed up to shower. One night, one of the nurses came in and wheeled my whole bed to the sink, scooted me up and washed my hair in the sink. I know it wasn't actually part of her job and she probably had 100 other things she could have been doing but it made me feel better than anything else she could have done for me that night.
I know nurses frequently have thankless jobs and deal with patients who think you're maids and not medical professionals but there are those of us who know how busy you are and appreciate, even more, the extras you are sometimes able to do for patients.
Thank you for doing all that you do.
Its not a lost art. How to change a bed and keep a patient clean and happy is the first thing we learned as a new nursing student. All we hear is culturally competent care, and patient satisfaction and such. We get nailed if we don't have everything perfect looking, IV tubing labeled with not only whats in it, but also when it was hung and when it needs to be changed. I can't hang a bag of fluid w/o relabeling everything and changing all the tubing. I was once scolded for not getting my patient a cool rang when he complained that his head hurt.
You are so right, we need to think of our patients in terms of how we want to be cared for. Damn nursing shortage makes that kind of care near impossible some days. I agree with a great blogger "my goal is to do something extra special for at least one patient a shift".
whitecap nurse says:
AMEN! especially the pillows - it makes all the difference!
I was so thankful for the ice chips when I had to go in for a breathing treatment - amazing that the right virus can kick in childhood asthma - I thought I'd outgrown it.
I'm too lazy to look for a source, but I learned in my nursing program that wrinkly sheets=bedsores is a little bit of a nursing myth. Of course, a "wadded-up sheet" is uncomfortable and should be fixed, but a wrinkle or two is really not associated with bad outcomes.
However, the chafing and friction from frequent boosting with a draw-sheet is very much associated with bedsores in addition to other things such as wetness, not turning the patient, and overall bad health/frailness. Oh, and don't get me started on backboards. Gr.
A few weeks back a total *Saint* (who happened to be a tall bald guy) brought me a stack of warm blankets when I was in the ER after a car wreck with a concussion and cracked ribs. After I had been checked out and was waiting for - whatever- he tucked them in all around me completely - even around my head to muffle the noise. He mentioned that being comfortable keeps people from needing more pain meds than is good for them. He was right. I was able to nod off a bit even after that. His name is Todd and I did send him a thank you note. :) oh, and I feel better, thanks!
You can make lots of friends with warm blankets...at least I have, anyway. ;->
I give them whatever they can have, and I keep my eyes on new people coming onto the unit. I let them get loaded into their bed, then I go back and ask them if they're okay.
If I get them into bed, I make darned sure their call button and phone works and is right there next to them and verify it before I leave. I'm also of the Boy Scout mentality, and I really don't like it when reporting nurses leave out important stuff like high humidity O2 when they give you report (this has happened) or your respiratory people just don't think it's important to get up to that patient's room pronto when you ask them.
There should be some hospitality in the hospital...hello! People are freaked out as it is, so you need to make them a little comfortable to keep them out of at least some mental anguish. People who think it is beneath them to make a bed or get someone ice or water really irritate me.
Great post. Keep it up!
I had day surgery once and those warm blankets were pure heaven. What's more, I could have all of them that I wanted. My nurse was wonderful. I was quite doped up but I hope I thanked her.
I love it when I have time to do the little things like that.
Some of us floor nurses are carrying 6+ sick/post-op patients. Cut us a little slack if everything's not perfect and we don't get there right away, huh?
-lpnmon
Amen, sister... I am not in the hospital setting anymore but remember ALL of those complaints well. I think all new nurse should have to be a pt. for a couple of days to appriciate all the little corners that get cut! After my last c-section when I was up looking for a new draw sheet or sheet without wrinkles the nurse thought I was nuts!!!
I want to say bless you for labeling the IV lines, I consistently hear nurses say that they don't have time to label lines, double check insulin and narcotics, and other little things that when I worked on the floor was just how it was done. The worst part is how we allow ourselves to feel powerless about this because management or staffing ratios or the acuity of our patients is such that we have to spend the shift just being happy to keep our heads above water and not kill anyone. There are hospitals where the staff nurses have taken the power to dictate the terms of their job - and these aren't necessarily magnet or union hospitals.
Thanks for your words. I want to know on what planet There are hospitals where the staff nurses have taken the power to dictate the terms of their job - and these aren't necessarily magnet or union hospitals. I want to work there. I work at a magnet, non-union (never will be union) hospital and trust me, magnet means BOO for the nurses on the floor.
Also...when you ER nurses give us floor nurses report, keep in mind that I have 6-8 other patients to juggle, along with their demanding families, and I might not necessarily have the room ready with a smile to greet my new ER admit who is pissed off because he didn't get a private room.
For you floor nurses complaining about having 6-8 sick patients. Think about this, we ER nurses typically have at least 3-4 patients, and often times up to 5 or 6. Okay, so we don't have as many patients as you. But, when you consider that your patients are "stabilized" by the time you get them...that makes a difference. Who do you think stabilizes them? Those of us with 4 others that need stabilized at the same time.
All this, and management screaming down our throats about "getting the patients to the floor, now". So, yes, we would like it more if you would please have your room ready. You have CNA's and housekeeping to help. We don't.
Post a Comment