31
May

5 P’s of Rounding 

One of the ways to improve patient satisfaction is hourly rounding. Each hour, the nurse should enter the patient’s room and assess for the5 P’s:

  • Position - does the patient need to be turned? Are they in the right position for their specific disease process? Can they reach the call button/lights/remote without danger of falling?
  • Pain - assess for pain every hour ->  quality, radiates anywhere, severity, time 
  • Potty - does the patient need to go to the restroom? Need to be changed? Do they have a foley? If so is it in the correct position? Kinks? Need to be emptied?
  • Possessions - does the patient have the things they are supposed to? Are they in reach? Are cell phones charging in sockets designated for pumps or other equipment?
  • Pump - Do the IV bags need to be changes? Lines? Is it charging? Ringing alarms of pumps can be distracting to the patient and the staff.
31
May

Leadership Day One 

I just completed my first day of Leadership. Here are some thoughts before I take a bath and get some work done:

  • I’m going to do research for an in-service on “soft” bedside shift reports to convince the nursing director whether or not to implement the practice. Look for updates here.
  • They want me to work the night shift for my Capstone preceptorship (insert crazy gif here of a woman screaming or passing out with terror)
  • I thought nurses were incredibly hard workers, but I was floored today to see how INSANE the job of a nurse manager is—this woman spent all day jumping from meeting to meeting while spending any transit time putting out fires and all the while staying completely calm and poised. I have a lot to learn.

Thoughts? Does your site do warm hand-offs?

20
May
The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or his recovery (or to peaceful death) that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.
— Virginia Henderson, adopted by the International Council of Nurses as the classic definition of nursing.
20
May
Nurses deal with not only normality and pathophysiology but also with the lived social and skilled body in promoting health, growth, and development and in caring for the sick and dying.
— Patricia Benner - “Called to Care”
19
May

Definition of Evidence-based Nursing Practice 

“The integration of the best evidence available, nursing expertise, and the values and preferences of the individual’s, families and communities who are served. This assumes that optimal nursing care is provided when nurses and health care decision makers have access to a synthesis of the latest research, a consensus of expert opinion, and are thus able to exercise their judgement as they plan and provide care that takes into account cultural and personal values and preferences.”
Sigma Theta Tau International

14
May

 

Starting my LAST semester of nursing school tomorrow!! I can’t believe it, seems like I just started. I can’t wait to be an RN, and to continue to share this amazing journey with everyone!

12
May

APA Made Simple 

I feel like such a jerk! I was just browsing through the nursing tags and I saw someone complain about APA and realized that I have never shared my class’ trick for APA.

If you haven’t already, I HIGHLY recommend you buy a kind of software like this as it has save my butt throughout nursing school. You pay a one time fee of around $28 and it formats EVERYTHING. You have to have a certain kind of Word I think so read the webpage, but it does all your margins/cover pages/in text citations/references pages/etc. It’s super easy to use and best yet, it saves ALL your references in a database so that you can get them for any paper if you need them again.

For those of you who say $28 is too much, you can actually share the download with I think three people total so you can split it either between computers or among friends. We all use it, and it updates as the APA changes versions. Since I got it, I have yet to be marked down on an APA paper. I used to dread writing papers all because I hated doing references, etc.

Okay no more sounding like a commercial. Sorry for not sharing earlier.

29
Apr

Beck’s Triad: Cardiac Tamponade 

Beck’s Triad of the heart:

Beck’s Triad of the heart includes three medical signs that indicate cardiac tamponade. Cardiac tamponade is medical emergency in which fluid accumulates around the heart and decreases the ability of the heart to pump blood. The result is the triad of low arterial blood pressure, jugular venous distention, and  muffled heart sounds. In cardiac tamponade a narrow pulse pressure is regularly observed. The cardiologist, Claude Beck, who was a Professor of Cardiovascular Surgery first identified the triad of medical signs which was later termed “Beck’s Triad.”

Beck’s Triad (in basic terms):

1. Distended Neck Veins;

2. Muffled Heart Sounds;

3.  Hypotension.

 The reasons for the cardiac causes of Beck’s Triad include the following:

1. Physiological fall in arterial blood pressure, which is the  results of pericardial fluid accumulation within the heart that acts in order to impair the ventricular stretch, thus reducing stroke volume and cardiac output. These two factors of Beck’s Triad are two major determinants of systolic blood pressure.

 2. The rising central venous pressure which is evidenced by distended jugular veins while in a non-supine position. This is caused by reduced diastolic filling of the right ventricle, due to the  pressure being exerted on it by the expanding pericardial sac. This results in a backup of fluid into the veins draining into the heart, most notably, the jugular veins. In severe hypovolemia, the neck veins may not be distended.

 3. The suppressed heart sounds occur due to the muffling effects of the sounds passing through the fluid surrounding the heart.

Although the full triad  of Beck’s is present only in a minority of cases of acute cardiac tamponade the  presence of the triad is considered pathognomonic for the condition.

(Source: emergencymedicalparamedic.com)