Nurse: Are You An Expert Juggler?

January 31, 2012 By Leave a Comment

One thing to remember about nursing:  the patients are not the hardest part. Nursing, especially the hands-on specialties, is an ongoing juggling act of the desires and needs of the patient, the rules of the institution and standards of care, the orders of the docs, and our own personal perception of what’s REALLY going on. Be prepared to forever feel like middle management, and get the rap from both sides when neither is happy and both are looking for someone to blame.

I suppose other professions can seem like that, but none has the urgency or the stress associated with nursing. The point of nursing is to not try to make everyone happy, although in an ideal world, everyone would be. The point of nursing, in all its juggling glory, is to care for the patient. [Read more...]

Filed Under: Blog, Inspire/Lead, Jessica RN, Learn Tagged With: , , , ,

Amanda Trujillo: Exposing the Truth

January 26, 2012 By 7 Comments

For those followers of this blog that are not yet aware of what has recently come to the attention of the nursing community, I wanted to make sure to promote awareness of the landmark case out of Arizona concerning Amanda Trujillo. This nurse has taken her case to the public nursing community in order to gain support for herself, and our profession as a whole.

The truth has been exposed. We who have been in the nursing profession know it, and now it is time to take the truth to the public. FACT: Nurses and the core of our profession–patient care–are at the mercy of the medical and political powers-that-be when we interfere with the revenue of hospitals, doctors, and the government, including the boards of nursing that govern our practice in each state. [Read more...]

Filed Under: Blog, Jessica RN, News, Profession Tagged With: , , , , , , ,

Balancing Act: Thinking and Doing

January 24, 2012 By Leave a Comment

We have the thinkers and the doers…in life and in our nursing profession.  I consider myself more of a thinker. I admire those who can just jump in and DO, although sometimes not necessarily being able to describe the WHY of what they do; they just DO. My husband, a paramedic, is a doer. Case in point:  one evening I was attempting to cook taco shells in my toaster oven. One fell down between the grate bars, landed on the red-hot burner coil, and promptly burst into flames…which then set the other nearby taco shells on fire. So, I’m standing there debating the pros and cons of using either the fire extinguisher or water from the faucet to put out the flames (meanwhile making strangled screeching noises), when my husband calmly walks into the kitchen, [Read more...]

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Core Measures, Lookup

January 22, 2012 By Leave a Comment

Points to Remember:

  • These items listed are to be practiced and reported to TJC as part of obtaining or maintaining accreditation.
  • Requirements for facilities vary, but most facilities should collect data for at least FOUR core measure sets for accreditation.
  • Core measures to be added in 2012 include:
    • Emergency Department (ED)
    • Immunization (IMM)
    • Tobacco Treatment (TOB)
    • Substance Use (SUB)

 

Source: http://www.jointcommission.org/assets/1/18/ORYX_for_Hospitals_1_25_11.pdf

Filed Under: Lookups, POC Stickits, Safety Tagged With: , , ,

Do Not Use Abbreviations

January 22, 2012 By Leave a Comment

(for HANDWRITTEN charting and orders, including on pre-printed forms)

WRONG MISTAKE CORRECT
U Mistaken for the number 4, letter O, or “cc” Write out “units”
IU Mistaken for the number 10 or for IV Write out “international units”
Q.D., QD, q.d., qd (daily)

Q.O.D., QOD, q.o.d, qod

(every other day)

 Mistaken for each other, and periods mistaken for other letters such as O or I Write intended phrase out fully
Trailing zero (X.0 mg)

Lack of leading zero (.X mg)

 Period is missed Write X mg

Write 0.X mg. Exception: Use X.0 when indicating precise lab results or size of equipment or lesions. Do not use in medication documentation or orders.
MS,

MSO4 and MgSO4

 Confused for each other Write out “morphine sulfate” and “magnesium sulfate”
     
Additional Items Suggested

(NOT on Official List as of 2010)
< and > Confused for one   another, the number 7, or letter L Use “less than” or “greater than”
Abbreviated drug   names Mistaken for other   drugs Write full names of drugs
Apothecary units   (drops, gtts, grains, etc.) Not understood by all practitioners Use metric units
@ Mistaken for number   2 Write out “at”
cc Mistaken for “U” Use “ml,” “mL,” or write out “milliliters”
µg Mistaken for “mg” Use “mcg” or write out “micrograms”

 

From: The Joint Commission. Facts about the official “Do Not Use” list. Posted June 2010. Retrieved December 15, 2011 from http://www.jointcommission.org/assets/1/18/Official_Do%20Not%20Use_List_%206_10.pdf

Filed Under: POC Stickits, Safety Tagged With: , , , , ,

Serious Reportable Events (SREs)

January 22, 2012 By Leave a Comment

 

Definition: Events that result in serious patient harm, should never occur, are preventable, and of great concern to the medical community; as of June 2011, 29 events have been named as SREs
Surgical/Invasive Procedure Wrong site
  Wrong patient
  Wrong procedure
  Foreign object retention
  Intraop/immediate post-op death in Class 1 patient
Product/Device Death or injury from contaminated drug, device, or biologic provided by the healthcare setting
  Death or injury from misuse of a device in patient care
  Death or injury from IV air embolism [Read more...]
Filed Under: POC Stickits, Safety Tagged With: , ,

Abuse of Elderly and Child, Lookup

January 22, 2012 By Leave a Comment

Points to Remember:

  • Call the USA National Child Abuse Hotline 1-800-4-A-CHILD to report suspected abuse
  • Call Eldercare 1-800-677-1116 to be directed to your local state reporting agency
  • Suspicious or abnormal actions or affects
  • Unusual injuries or bruises shaped like finger imprints
  • Absent or indifferent caregiver or parental concern or attention
  • Suicidal attempts or ideations
Filed Under: Lookups, POC Stickits, Safety Tagged With: , , , , , , ,

Thyroid Storm, Lookup

January 22, 2012 By Leave a Comment

Points to Remember:

  • Results from untreated hyperthyroidism triggered by a stress (e.g. trauma or infection)
  • MEDICAL EMERGENCY
  • Patient may present with MI symptoms, but temp and SBP will be markedly elevated
  • CHF and pulmonary edema can result
  • Meds such as propylthiouracil (PTU), methimazole (Northyx, Tapazole), iodide, and beta-blockers (e.g. propranolol) are useful in treating

 

From: http://www.emedicinehealth.com/thyroid_storm/page6_em.htm

Filed Under: Diseases, Lookups, POC Stickits Tagged With: , , , ,

Sickle Cell Crisis, Lookup

January 22, 2012 By Leave a Comment

Points to Remember:

  • Oxygen, fluids, and narcotic pain medications are the primary treatments
  • Address infections STAT
  • Hydroxyurea (Hydrea) may reduce painful episodes in some
  • Sickle cell disease affects all organs of the body, including the kidneys, eyes, and sexual organs

 

Saunthararajah Y, Vichinsky EP, Embury SH. Sickle cell disease. Clinical features and management. In: Hoffman R, Benz Jr. EJ, Shattil SS, eds. Hematology: Basic principles and practice. 5th ed. Philadelphia, Pa: Churchill Livingston; 2008:chap 43.

Filed Under: Diseases, Lookups, POC Stickits Tagged With: , , ,

Melanoma, Lookup

January 22, 2012 By Leave a Comment

Points to Remember:

  • A: Asymmetry
  • B: Border—irregular, blurred, notched
  • C: Color—irregular
  • D: Diameter—greater than 6mm, or a marked increase in size
Filed Under: Diseases, Lookups, POC Stickits Tagged With: , , , , , ,
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