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RE: Being floated

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  • Carlese, Cristina/Nursing
    It is true. It is very hard to take care of a very sick CRRT patient and at the same time have another patient assignment. It is also unsafe and the question
    Message 1 of 85 , Jan 31, 2005
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      It is true. It is very hard to take care of a very sick CRRT patient
      and at the same time have another patient assignment. It is also unsafe
      and the question is, what kind of care can you provide for those two
      patients? If you look at it you will be spending more time with the
      CRRT patient.
      The other case scenario which has been done before is that the patient
      on CRRT is stable, no drips, and you have another patient who is chronic
      on a ventilator and nothing much is going on (meaning just turn,
      suction, medications). This has been done before and it worked.
      But again, this depends on the institutions policy vs. unit acuity vs.
      staffing issues vs. competent RN.

      -----Original Message-----
      From: Erin T. [mailto:can_erin@...]
      Sent: Saturday, January 29, 2005 1:45 PM
      To: nursebob@yahoogroups.com
      Subject: RE: Being floated



      I honestly can't picture how one can handle two ICU patients with one
      being CRRT. What is going to happen if the CRRT pt has a few pressors
      to titrate and you are tie up with your other patient (doing a dressing
      change or bedbath). When I have a CRRT patient, I actually stay inside
      the room for the whole shift and do all my charting and paperworks
      inside like taking care of an balloon pump pt. I think 2:1 ratio with
      one being CRRT is unsafe practice!

      >From: nancy partos <nancypartos2002@...>
      >Reply-To: nursebob@yahoogroups.com
      >To: nursebob@yahoogroups.com
      >Subject: RE: Being floated
      >Date: Sat, 29 Jan 2005 10:26:35 -0800 (PST)
      >
      >--- Jane <jane.wedgbrow@...> wrote:
      >We always have two patients in the MICU. - even if we have a patient
      >with CRRT or preparation for organ donation. There is never a time we
      >have a single patient. Management seems to think this is fine.
      >Frankly, I am quite troubled by the workload. I am still in my
      >orientation, and worried about dealing
      >with two extremely sick patients at one time. Our
      >RTs do our extubations and much of the trach care.
      >They are also in charge of the the ventilators (although nurses must
      >also assess ventilatory status).
      > After 6 weeks of orientation my preceptor told me yesterday she was
      >confident I could handle two STABLE ICU PATIENTS. Now she says we must

      >tackle the unstable territory. Here I am thinking all my patients are
      >unstable (because they are in the MICU and presumed critically ill).
      >Apparently I am in for several more treats. WE start CRRT next week
      >(while I am taking care of a second patient).
      > > Hi, I've not posted here before, but from a UK perspective, we do
      > > all of the mentioned only we nurse 1:1. On a 1:2 basis I don't see
      > > how u cope! We don't have RT's so we cover everything including damp

      > > dusting and the laundry skip! Filing is included too, but I draw the

      > > line there. Only time we have
      > > 1:2 is when we are short staffed (which is becoming increasingly
      > > frequent) or when we are nursing HDU patients.
      > >
      > >
      > >
      > >
      > >
      > > _____
      > >
      > > From: nancy partos
      > > [mailto:nancypartos2002@...]
      > > Sent: 24 January 2005 21:25
      > > To: nursebob@yahoogroups.com
      > > Subject: RE: Being floated
      > >
      > >
      > >
      > > I am relatively new to critical care. I started at the MICU in
      > > September, and have completed an extensive critical care internship
      > > and orientation. There is something that is very concerning to me
      > > about being an ICU nurse. And this is it: Why are critical care
      > > nurses responsible for intense, critical, care of patients and still

      > > responsible for the most basic of tasks? In a given day with my two

      > > very critical care MICU patients I am worrying about full assessment

      > > of two critically ill patients every four hours which may include
      > > all of the above in a given day:
      > > controlliong
      > > hypertension (250/90), controlling sinus tachycardia or ectopy,
      > > controlling pain, controlling seizures, controlling bleeding from
      > > just about any orafice; dopamine, dobutamine, fentanyl, insulin
      > > drips, atatvin drips, swans, wedges, PAPs, cardiac outputs, cvps,
      > > labs, cultures, peritoneal dialysis, vent settings and respiratory
      > > status, wound care and skin care, rectal tubes and trumpets, anuria
      > > and renal failure, tube feeds, residuals, and correct tube
      > > placements, transporting patients, dopplers, and PCA pumps, central
      > > lines and arterial lines, medications, medications, medications,
      > > fluids, antibiotics, FFP, plasma, and PRBCs. You get the idea. All

      > > that I have mentioned above is fine and dandy. HOWEVER - while I
      > > am achieving the above tasks I am also expected to complete these
      > > tasks: spending 20 minutes walking around the unit to find "the
      > > doppler"; spending 20 minutes to find the "PCA key"; entering orders

      > > because we have no clerk; cleaning a patient and changing his bed 5

      > > times in 3 hours due to 5 bowel movements; waiting for secure codes
      > > from pharmacy at the tube station, labeling, packing,, and tubing
      > > labs, emptying foleys and rectal pouches, obtaining hourly blood
      > > sugars, completing forms because we have a lost PCA key,calling for
      > > transport, MRI, pharmacy, or central supply, taking the laundry to
      > > the laundry shoot, etc, etc, etc. --
      > >
      > > How am I to successfully care for my two critically care patients
      > > when I must do all of the above and more? We do not have any PCAs.

      > > The other nurses are as busy as I am... Why are nurses still
      > > resposible for EVERYTHING?
      > >
      > > I would also like to add that at our hospital our staff is comprised

      > > of 80% or more travelers - we can't keep staff nurses. And is there

      > > any secret why?
      > > > > To: nursebob@yahoogroups.com
      > > > > Subject: RE: Being floated
      > > > >
      > > > >
      > > > >
      > > > > Do you get floated very often?
      > > > >
      > > > > "Hughes-Myers, Carolyn"
      > > > <carolyn.hughes-myers@...>
      > > > > wrote:We only get our regular pay, but it comes
      > > > off of the receiving
      > > > > wards budget. C.
      > > > >
      > > > > Carolyn Hughes-Myers RN BScN CNCC(C) Clinical Nurse Educator
      > > > > Critical Care Unit Kelowna General Hospital Kelowna, BC, Canada,

      > > > > V1Y-1T2
      > > > > phone: 250-862-4277
      > > > > fax: 250-862-4128
      > > > > e-mail: carolyn.hughes-myers@...
      > > > >
      > > > >
      > > > >
      > > > > -----Original Message-----
      > > > > From: Candy Benton
      > > [mailto:bentoncandy@...]
      > > > > Sent: Wednesday, January 19, 2005 10:53 AM
      > > > > To: nursebob@yahoogroups.com
      > > > > Subject: RE: Being floated
      > > > >
      > > > >
      > > > >
      > > > > Thanks, everyone that has replied. You all hav
      > > > egiven me great input.
      > > > > I am going to try and get where we are floated
      > > to
      > > > changed. I think
      > > > > our work is hard enough taht we do not to have
      > > the
      > > > worry of being
      > > > > floated over our heads everyday. I ahve to admit
      > > > it has gotten better
      > > > > on the floors that we are floated to. It used to
      > > > be we would get the
      > > > > patients no one else wanted and no would help
      > > us.
      > > > 'When you are
      > > > > floated do you get any extra compensation for
      > > > going? Thanks Candy
      > > > >
      > > > > "Hughes-Myers, Carolyn"
      > > > <carolyn.hughes-myers@...>
      > > > > wrote:We have a multisystems ICU and if we
      > > floated
      > > > it is always to a
      > > > > critical care unit: CCU, ER, Recovery. We would
      > > > take a regular
      > > > > patient assignment. C.
      > > > >
      > > > > Carolyn Hughes-Myers RN BScN CNCC(C) Clinical Nurse Educator
      > > > > Critical Care Unit Kelowna General Hospital Kelowna, BC, Canada,

      > > > > V1Y-1T2
      > > > > phone: 250-862-4277
      > > > > fax: 250-862-4128
      > > > > e-mail: carolyn.hughes-myers@...
      > > > >
      > > > >
      > > > >
      > > > > -----Original Message-----
      > > > > From: Candy Benton
      > > [mailto:bentoncandy@...]
      > > > > Sent: Monday, January 17, 2005 12:49 PM
      > > > > To: nursebob@yahoogroups.com
      > > > > Subject: Being floated
      > > > >
      > > > >
      > > > >
      > > > >
      > > > > Hello, I work in a open heart unit. We get
      > > floated
      > > > a lot to other
      > > > > units, particularly to the telemetry unit. Do
      > > you
      > > > all have this sam
      > > > > problem? If so where do you float to and what is
      > > > your assignment
      > > > > like? Thanks. Candy Benton
      > > >
      > > >
      > > > __________________________________________________
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      > >
      > >
      > > __________________________________
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      > >
      > > Visit http://nursebob.com
      > >
      > >
      > >
      >=== message truncated ===
      >
      >
      >
      >
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    • lee
      Hi Edelyn........ this is the link to ENA and their store. The newest program and book are excellent. http://www.ena.org/store/index2.asp?DEPARTMENT_ID=46
      Message 85 of 85 , Feb 22, 2005
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        Hi Edelyn........ this is the link to ENA and their store. The newest program and book are excellent.

        http://www.ena.org/store/index2.asp?DEPARTMENT_ID=46


        edelyn censon <simplyjessy777@...> wrote:

        Hi There is anybody working in Accident and Emergency Unit, Can you help me find a good book about Triage

        nancy partos <nancypartos2002@...> wrote:We also need to be politically active, politically
        conscious, and class conscious. Physicians, physician
        assistants, speech therapists, and physical therapists
        and even NPs lobby and organize for their issue of the
        day; however, registered nurses do not uphold the same
        professional, political, social, economic, and ethical
        responsibility. Perhaps nurses do not feel they are
        worthy as a group to demand certain rights and
        privileges that are given automatically and without
        question to other professional (mainly male
        domintated) groups. We are still wearing our caps,
        giving up our seats, and bowing our heads at
        authority. Thus the reason we worry about dress codes
        (white scrubs versus colors) and shoe color rather
        than the looming issues of the day.


        toddbac@...> wrote:

        > No. In fact it seems like a lot of nurses with
        > advanced degrees are out
        > of touch with bedside nursing and don't understand
        > what's actually happening
        > on the frontlines. They're really good at writing
        > papers and coming up with
        > new ways to thoerize how they think things should be
        > done. Which usually
        > means more paperwork and loss of time at the bedside
        > for nurses who actually
        > take care of patients.
        > An advanced degree is not a prerequisite for a
        > good nurse lobbyist. What
        > is? Assertiveness, persuasiveness, being
        > articulate, and having a sense of
        > reality with what is going on at the bedside. We
        > don't need anymore
        > paradigms. Just more common sense and a passion for
        > justice to help nurses
        > get what they deserve.
        >
        >
        >
        > From: rjfandal@...
        > >Reply-To: nursebob@yahoogroups.com
        > >To: nursebob@yahoogroups.com
        > >Subject: Re: Being floated
        > >Date: Tue, 15 Feb 2005 20:24:00 EST
        > >
        >
        >
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        >
        >




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