Friday, January 29, 2010

Exciting Changes - kinda

There are some major changes coming to my unit at the beginning of March. First...we are getting rid of all the patient care techs on our floor. Second...our nurse to patient ratio is supposed to be 3 to 1. I will believe it when I see it. I get the feeling that it will be more like 4 to 1...which will be difficult. 3 to 1...that's doable.

The whole idea behind this is to increase patient satisfaction. Medicare came up with this policy that if the patient's (65 & older) are not satisfied with their hospital stay, Medicare doesn't have to pay the bill. Thus, this is giving hospitals quite an incentive to base everything around patient satisfaction. A lot of the questions are based on nursing...ex. "Do you feel your nurse kept you informed with what was going on? Did you have good rapport with your nurse?" etc.

Sooooooo they think if the nurses spend more time with their patients, the patients will respond appropriately. It's worth a try. I'm not sure it will be successful...because as any nurse knows...a good tech is quite a help. With no techs for assistance, we're going to be relying on other nurses & if we are all busy with our are we going to help each other? Time will tell.

On the other hand, I am hoping this will allow us to have more patient/nurse interaction. With having 5 patients & pretty much less than a 4 hr window (7pm to 11pm) to assess, medicate & establish a good makes it difficult. Most of our older patients want to go to sleep around 9 or 10 & get mad if we are in there beyond that time. I would like to spend more time doing nursing stuff as opposed to charting or orders or talking to MD's. Let us be nurses who care for the patients & have everyone else be less reliant on us.

I heard at another one of our hospitals, they got rid of the patient care techs and the respiratory techs. I guess the nurses are doing the breathing treatments. I would be worried if I were a respiratory tech...I'm sure more hospitals will be switching to this in the future & probably only need a couple of them in the hospital for intubating critical patients.

I still have my orientee for the next month. I love it. She is really doing well & thus making my job easier. She's taken on a lot of challenges & I have stepped back to allow her to start using some of her own critical thinking skills. It's hard to not want to take over & do what needs to be done...but it's the best way for her to learn.

A bunch more nurses left my old hospital. Pretty soon there will be no one left that I know. I'm happy for them. They deserve to work somewhere that they are respected & appreciated.

I read Dear John....very quickly. It's an easy read. I can tell it's going to be a sadddddddddd movie. I don't usually cry when it comes to movies, but I'll have a few tissues with me for this one. I thought it was a good story. I'm going back to reading the True Blood, not much to cause tears.

Still planning for the cruise, but don't have an exact date as my friend is still waiting for her Canadian passport. I hope we are able to take off work at the same time...not sure with all the new changes coming up.

Sunday, January 17, 2010

A little of this & a little of that

Gosh, I feel like not much is really going on...even at work. It seems like the same old stuff. I still have my orientee. I'm trying to teach her the ropes. It's kinda neat to remember back to being a brand new nurse & all the things I used to be scared of...but now have the confidence & patience to get thru pretty much anything.

We had 2 patients last week that were drug seekers & they would watch that clock or call early for their pain meds. I gave both those patients to her...I didn't know at the time that they were addicts. She was so frustrated by the end of the first shift. I had to keep reminding her to relax, let it go, don't let their neediness wear her down. By the end of the second night, she wanted to refuse to have one of them back. I told her to be careful when it comes time to refusing to have someone back...because you could end up with someone even worse. Besides, these two will teach you patience...which she needs. I sent her home with the homework assignment of learning to meditate & letting frustrations go.

The beginning of our third shift....she was a new person. She had a new attitude. I told her to stand her ground & let them know that she was in charge....but in a nice way. I had already demonstrated that morning of how to handle them when they are asking for pain meds early & saying "the other nurses get it for me early." I told her you can be honest, but be kind are their advocate. I think she learned a good lesson...hopefully.

I've been trying to teach her to ask other people for help...that I am not always going to be around to help & she needs to turn to others. So far that hasn't gone too well. She had a patient whose 02 sat was something like 62%. Normal is better than 92%. I was in a room with one of my patients & she could not find me. So what does she do when someone asks her if she needs help...she sends them looking for me. Wrong answer! Turns out the patient's oxygen tubing had gotten pulled out of the wall & had to be hooked back up. That's it. We're going to have to work on her trusting other people, just in case I am not available.

I remember those days though. My preceptor would often leave the floor to smoke & that seemed like when everything would go wrong. Live & learn.

I had my niece for a couple of days. We went to see The Lovely Bones yesterday. I tried reading the book, but I absolutely hated the storyline. So depressing. The movie was just as depressing. It was well done, but just reminded me of how many creeps we have in this world preying on children. My next book to attempt reading is Dear John. The movie comes out soon, but I will make myself read the book first & finish it.

Some good news...looks like I'll be going on a cruise sometime in March. My friend/co-worker & I are both born in March & want to celebrate by taking a cruise. We're just waiting on her to get her passport from Canada, then we'll book it. I cannot wait. The plan is to head towards Mexico. I just want to be on the ship, I don't even care about the ports.

Have a good week everyone!

Friday, January 8, 2010

Still Here!

Happy New Year 2010!!! I'm still here...just taking a little break from writing. I have an orientee now...a new nurse & it has been enjoyable teaching someone new the ropes. It's also nice to have an extra set of hands to take care of my patients. Luckily she's a lot like me, so we get along well.

I'll write more later next week when I have some time off. Just wanted to say Happy New Year & word of advice...go see Avatar in is well worth it!!!!!

p.s. Can you believe they are predicting snow in Orlando in the morning???'s so cold!