CLINICAL NURSE PRACTICE TIP: THE KING OF ALL VITAL SIGNS

If you were to review the vital signs from patients three days before they coded, which vital sign do you think would change more than the others?

I’ve asked that question to hundreds of nurses over the last few years. Most say heart rate or blood pressure. But they are wrong.

NEW NURSE TIP: THE MAGIC OF TRENDING

Caring for patients is getting more complex. One reason is that only the really sick are actually admitted to a hospital – everyone else is being treated as an outpatient. Years ago on a medsurg unit with a 6:1 assignment, you would have one or two really sick patients; the rest were “walkie talkies.”  Now you have the same number of patients but they’re all really sick!

To effectively care for patients requires you to anticipate problems early and intervene quickly. One of the best ways to do this is by understanding the importance of trending.

CLINICAL TIP: CLOSING THE ANION GAP

When I was a student nurse, I prayed that my instructor wouldn’t choose me for her “game show” humiliation during post-conference. She would randomly challenge us with impromptu questions like, “What’s the difference between pre-load and after-load? Tina. Can you answer?”…like she was a game show host but without the fabulous prizes.

Of course the questions in some way related to the lecture content of that week but with the gazillion things to learn, it was impossible to be fully prepared.  If you knew the answer, you were a superstar, however if you didn’t, she made you feel that you were forever unworthy of the RN title.

3 STRESS BUSTERS FOR NEW NURSES

They say that all nurses are control freaks and I’d have to admit that at least in my experience, it’s somewhat true. It’s our unpredictable environment that intermittently sends a rush of adrenaline through our systems, so when we can, we control. This “adrenaline – control dance” can lead to incredible stress. A stressed-out nurse quickly loses his or her ability to keep up with the demands of the work environment, which can lead to errors, dissatisfaction and burnout.

New nurses are particularly vulnerable.

MAKE A GREAT FIRST IMPRESSION IN 7 SECONDS: TIPS FOR NEW NURSES.

Most people will judge you within 7 seconds of meeting you. Successful people know this and engage in specific behaviors to ensure they are making a great first impression, especially in the work environment.

The first time I met Susan was when she was shadowing for an educator position we had open in our department. Immediately I thought, ”No way.” Why? Because Susan didn’t smile at all, didn’t look me in the eye; and appeared to be miserable and way too serious. You see…we injected a lot of humor into our department as a way of coping with the stressful environment (we liked to have fun) and I couldn’t see Susan fitting in.

Susan was hired anyway, despite my (and a few others) opinion NOT to hire her. As it turned out, not only was Susan a brilliant clinician/educator, she was funnier and goofier than everyone in the department combined! Seriously, I used to say that she should have been a comedian.

What happened?

TO HOLD OR NOT TO HOLD: UNDERSTANDING INSULIN

You’re about to walk into your patient’s room with a syringe full of insulin. The unit secretary shouts, “Hey. The physician just made your patient NPO.” Ugh...now what? Do you give the insulin? Do you hold it?

Are you confident that you would know what to do every time?

CLINICAL NURSE TIP: SODIUM – A BIG DEAL FOR YOUR BRAIN!

Sodium is a very common electrolyte. But do we really understand this electrolyte, the role it plays in the body and how it impacts patient outcomes?

What’s the big deal?

GOT A NURSE BULLY PROBLEM? 3 TIPS FOR NEW NURSES

New nurses fear two things when they start their first job: Making a mistake and that the other nurses will eat them alive! Really. I’ve talked with many student and graduate nurses over the years and get asked the same question: “What do I do if the nurses are mean?

Unfortunately, they have every right to be worried.