What's wrong with that?
Family in room and talking to patient. CNA brings in dinner tray and sets on bedside table and walks out.
What is - no communication, no offering to help, no repositioning the meal or the patient to eat.
BP 186/92, HR 86, Temp 100.9
What is - notify the nurse of BP and temp. Why temp?
"I asked you for help 45 minutes ago."
What is - I am sorry, I'm here now to help you.
Is there anything else I can do for you?
Pt starts crying while the CNA is checking her VS.
What is - with compassion, active listening, address any needs.
Are you ok, Mrs. Smith? I'm sorry to hear you are going through that, that must be very difficult. Would you like me to let your nurse know? Is there anything I can do to help?
Change linens
What is - every other day and when dirty/soiled
Call light answered at the desk - 460 needs to use the bathroom. Clerk says "someone will be right there". Clerk waits 25 minutes until this patient's CNA or nurse shows up at the desk.
What is - poor communication, lack of setting expectations for the patient, potential for incontinence in some if waiting too long. How can we do better?
Patient on hourly outputs. You emptied 11mL of amber colored urine from the foley bag.
What is - notify the nurse. Why?
Should be notifying at 25ml/hr or less
"This meal is ice cold and tastes like rubber."
What is - Apologize, offer solution.
"I am sorry for that. I would be happy to reheat it for you if you'd like or I can check and see if there is something else we can prepare for you?"
Note: Don't heat up the grey FNS containers or grey coffee cups!
Mr. Bill is confused and keeps trying to get out of bed. He's a x1 assist. You take him for a walk around the hall and are now putting him back in his bed.
What is - turn on the bed alarm.
What else can we do?
Fresh water/ice
What is - at least twice a day or more if the patient's just is emptying or missing ice when you go in the room
Preferred times 5am and 5pm when changing trashes. Don't forget this BIG little thing!
4am. Patient sleeping after being in pain all night. Lab goes in to draw. Pt falls back asleep. CNA goes in to change trash and clean up items left over from the night before. Pt falls back asleep. RN goes in to perform rounding.
What is - frequent interruptions, can we cluster care? How do we do our jobs yet still be compassionate about the patient's needs?
BP 115/72, HR 68, RR 18
What is - no need, just document.
"I had an accident because you didn't answer my call light when I needed you."
What is - I am very sorry that I didn't make it in here in time. Can I help you get cleaned up?
Ms. Nana said she had her dentures in this morning but now she can't find them. You remember helping her put them on but can't find them anywhere in the room.
What is - check laundry, trash...
Give/offer baths and showers
What is - MS and ICU - Every day a bath or shower should be offered!
SNU - odd days odd rooms, even days even rooms
Oh oh - they refused a bath, now what?
PITS and PERI care
CNA goes into room and tells pt she needs to give her a bath. Sets up cloths and water basin and starts removing patient's blanket and exposing the patient's body.
What is - no Nodd, no asking for permission before touching
Non-blanchable redness to coccyx that wasn't there yesterday when you bathed them.
What is - Notify the nurse! Why? What does non blanchable mean? Do we notify of redness that blanches?
"My nurse was awful last night."
What is - I am sorry to hear that. Would you like to speak with someone about it?
You are going into the patient's room for the first time this shift to check vitals.
What is - NODD, set expectations of how often you'll be in, make sure CL is near and they know how to use it, address any needs.
Oral Care?
Peri Care?
What is - at least BID
Do we offer warm wet wash cloths for face and hands? When?
Each morning and night. Why?
Staff talking loudly at nurses station about patient in room 220. "Bruh, 220 STINKS and he won't stop calling complaining about his pain. Maybe if he would have taken better care of himself and made better life choices he wouldn't have been diagnosed with HIV today."
What is - HIPAA.
There are literal ears EVERYWHERE. People here what you talk about in that open nurses station. Aside from HIPAA, compassion, dignity and respect for another person's life.
Patient complains of pain to injured extremity at 6/10.
What is - notify the nurse!
What if pain is 2/10?
CNA Timmy comes to you and says "Are you planning on doing your job today? I've had to get 206 up to the bathroom 7 times already."
What is - explain if you've been busy. Thanks for helping me out with him while I've been helping 212.
Is he joking? Do you need to QTIP? Do you need to address the behavior?
Have you been lazy? Own up to it, apologize and do better.
You have 450-460, Bob has 461-470. You are busy in 452 giving a bath. 460 is on the call light. You leave 452 to go to 458 and check VS. You see Bob sitting at the desk on his phone.
What is - Bob can you please get the call light in 460? I am tied up for a bit longer.
Get patients up and out of bed
What is - every meal if able