Before the doctor sees the patient
What should the patient be changed into?
What is a hospital gown
Your patient is going for a diagnostic study that requires IV contrast
What is make sure your patient has a working IV prior to the study
You should anticipate setting this up for any female vaginal bleeding complaint
What is a pelvic tray.
** Also make sure your patient is on a pelvic bed
What your patient should be wearing before going up stairs?
What is a hospital gown
Three things that should be in reach of the patient
What is the call light, cell phone, any other personal belongings
The patient with an eye injury
What is a visual acuity
If not removed it will interfere with full view of the x-ray
What is removing jewelry
"Yup that is going to require sutures"
Place the suture cart near the room, be sure to clarify date of last tetanus shot, begin discharge teaching about wound care and assessing for infection
Patient belongings including clothing, cane, walker, dentures, hearing aids
What is make sure it is placed on the bed to go up with the patient OR given to family to take home
Ways we can make our patients comfortable during their visit
Make sure they have a pillow, offer them a warm blanket, make sure they can reach their TV remote and that it works
Do this to prevent false accusations about stealing grandma's diamond earrings
Document what occurred with the patients belongings. Did you take them upstairs with you, did such and such family member take them, was the item not present during ER visit.
Patient has Potassium Chloride ordered but you know they are going for a CTA at any moment
1) Start a second line
2) Delay starting the K until they return to the room
3) Communicate with radiology so they can have you stop/start the infusion
One way that you can be recognized by the providers as being a rock star nurse and awesome team player.
What is be available to the provider and ensure they have all the supplies, equipment and hands on assistance that they need.
I just gave report to Ann and she is going to take really good care of you while you are a patient here.
What is managing up, and showing that the inpatient nurse has been given report
What else can I do for you before I step out? We will be in frequently but at a minimal every hour checking on you and providing you an update.
What is cutting down on call light use and explaining hourly rounding
This is especially important to obtain in the pediatric population
What is a weight in KILOGRAMS
The doctor has ordered an MRI, how do we prepare this patient?
Make sure they are in a MRI safe gown and do not have any metal on their body. Hand the MRI screening form to the patient to have them fill out.
You look over radiology's shoulder at the portable x-ray and observe a "janitor x-ray" confirming what you thought- the patients shoulder is dislocated. What do you need to prepare in anticipation for a moderate sedation
What is place an IV (if they don't already have one), capnography, a bag of NS, suction set up, bag mask in the room, give respiratory a heads up.
In an AMS patient who has been in the ER for six hours and has not ask to void once
What is make sure the patient is soiled. Is the patient wearing a brief that is saturated in urine? Are the bed sheets soaked?
All behavioral health chief complaints
What is placed in paper scrubs, personal belongings removed, checked for any other items that may be used to self harm or harm you. Given a pair of yellow socks
Non-pharmacological interventions for pain
What is ice packs, positioning and propping with pillows, turning on the TV for distraction
Yikes! You are tasked for caring for a really sick patient who is tachycardiac and borderline hypotensive. Who and what should you communicate to?
What is radiology that you will need to go over to the department with that patient because they should stay on the cardiac monitor and continue to be closely monitored.
Pt presents to the ER starting he is concerned he "lost his contact" because it feels like there is something in his eye.
What is anticipate the need for an eye exam and ICPC orders for numbing drops and and they eye carrt
This doesn't always consistently happen but if time allows and you are able to do this it will score you brownie points with your patient
Call the family and let them know what floor and room their beloved patient will be going into.
How do you inform the patient of plan of care
What is using the white board, anticipated labs or x-rays, how long they can anticipate being in the ER. Strive to meet all patient needs prior to testing (pain medication, toileting, wrist band is on)