Star Employee
How early should you call out for a shift if you are sick?
As soon as you know you won't make it. The limit is 2-hours before start of shift. (Ex: Start shift at 07:00, call out BEFORE 05:00)
-Call both the absence from work line AND staffing
Name 5 things you should assess on a patient with a chest tube?
Work of breathing, crepitus, air leak, dressing, suction vs waterseal, no dependent loop, canister below heart level
What do you check before administering tacrolimus?
If there a lab draw ordered and if not does the team want to order one? Giving it before a lab draw may result in inaccurate titration.
You have questions for the resource team leadership, who should you email?
acfpmgmt@uw.edu
Please do not email leaders individually
You are in ED Boarding and assume care for a patient who just got admission orders and has a non-tunneled CVAD. What steps do you take for their central line verification?
Contact the provider to order a chest X-Ray
Contact VAT team (0700-1900) or STAT RN (1900-0700)
In collaboration with you, document external length, valve or open ended, power-injector compatible or not, for PICCs bilateral forearm circumference, and line properties (lumens, patency, skin integrity)
True/False: I should contact the staffing office with requests or if I don't like the unit I am floating to.
False: The expectation is that you float to all units. Staffing does their best to consider red/green units and current hospital staffing needs. If there are concerns with floating patterns or you wish to update your red/green units, contact resource team leadership.
What are 3 strategies to ensure labs are not contaminated when drawn from a CVAD?
Pause your IV infusions for 5 minutes (including TKOs), Flush the line with at least 10ml, waste 9mls of blood, transfer the sample without delay to prevent clotting.
How long should a Heparin drip be paused prior to collecting an Anti-Xa or PTT if you are drawing from a CVAD or peripherally from arm infusing Heparin?
5 minutes
105
True or false: when drawing a type and screen, 1 specimen is collected and sent with the collector's signature.
FALSE, it requires 2 specimens to be collected at different times, and independently verified by 2 staff. The collector writes collection date, time, initials on label. Second verifier writes initials on label.
You are a staff member that is in school taking part-time classes. You also enjoy playing pickleball on Wednesday evenings. Your birthday is also coming up during this schedule period. What steps should you take to ensure you get an optimal schedule to meet your needs?
1. Put in your schedule requests into UKG by the deadline outlined on the schedule calendar.
2. Input your 4 R days
3. Participate in the draft. Move yourself to better the staffing numbers
4. If the schedule is finalized and you need to switch a shift, email the correct listserv to ask your colleagues for a swap
How often should you document chest tube assessment and output?
Every 4 hours and PRN.
What is required charting when initiating a PCA? How frequently?
SpO2, pain assessment, sedation score and respiratory effort (rate, depth, regularity and effort) every 2 hours for the first 8 hours after initiation of a PCA, then every 4 hours (or per provider orders)
How many PCTs are currently on the Resource Team?
62
You are getting an admission on 4S. The patient is chronically hyponatremic and has kidney failure. They are not giving IV fluids. Patient has sodium tablets ordered Q4 hrs. You are told in report that patient is alert and oriented x4. Their latest sodium level is 120. Should you accept this patient?
Based on the admission and transfer guidelines: Sodium levels should be greater than 120 or less than 160, unless chronic and patient is stable.
Name 3 ways to stay informed about things going on at the hospital, with updated nursing practice and opportunities.
Read your email at least once a week, bulletin boards in boarding areas, Vitals app, read newsletter, ask a manager on rounding, complete LMS, CNO newsletter
How often should you change the dressing on a port or central line?
Q7 days or when visibly soiled
Port gets reaccessed with each dressing change
What else needs to be changed when reaccessing a port?
IV tubing
Fresh new bags of continuous infusions (this means postponing doing a port change until new TPN bag is due at 2100, etc if it's not urgent). If it is urgent, use your judgement and reaccess port, change tubing, and spike infusing bag of TPN)
Your post-op patient is having uncontrolled pain. Their current pain regimen is:
Scheduled PO Acetaminophen 650mg Q6
Scheduled PO Methocarbamol 500mg Q6
PRN PO Dilaudid 2-4mg Q6
PRN PO Oxycodone 2.5-5mg Q4
Is this an appropriate pain regimen?
No. Only one route of administration with one type of opioid should be ordered.
Who has been on the Resource Team the longest? (nurse or PCT)
Saba Solomon started in 1996!
You are working in 2SP boarding and a patient's family member wants to stay the night. After speaking with the patient, you find out that this family member is their primary caregiver. The patient has issues with anxiety and does not want to be away from their support system. What are your next steps?
1. It would be appropriate to reach out to patient flow to see if there is a private room available on another unit so the visitor can stay the night.
2. If that is not possible, let the family know that the visitor will need to stay overnight in the 3rd floor reflection room by the sky bridge once visiting hours are over. You will need to notify security so they do not kick the visitor out overnight.
3. It would be a good idea to make note of the visitor's phone number in the event that you needed to contact them overnight.
4. Meet the patient's needs, explain the plan for your shift, and set them up for success. Try to reduce their anxiety.
True or False: You submitted paperwork for going on leave. You are automatically removed from the schedule.
FALSE: Being "on leave" is a formal process involving submitting paperwork that has been signed by your provider, then it is signed by Karalee. Then it gets submitted to a UW leave specialist, the paperwork takes time to get processed. You must receive a confirmation email stating the leave is approved before we remove you from the schedule. Therefore, if you have shifts before paperwork is approved, you will need to call out following our usual process.
You have a patient who has a sluggish central line with no blood return. You message the provider who places an order for Alteplase (t-PA) in which pharmacy sends to you as soon as the order is verified. What steps do you take when instilling the Alteplase?
Thaw Alteplase by rubbing between the palms of your hands
Without forcing, inject Alteplase into clotted line
Label the line saying "do not use – declotting" with the time and date
Allow solution to dwell for 30 minutes ( then 90 minutes if no blood return for a total of 120 minutes)
What are the only 4 medications allowed to be given per the minimal sedation policy?
Lorazepam, Diazepam, Oxycodone, Fentanyl
Who is the best RN3?
Patrick :) FALSE Lindsey
What are the exceptions for a patient leaving the unit?
1. End of Life
2. Inpatient Rehab (8N only)
3. Perinatal cases where mother and baby are in separate care locations - requires huddle with care team
Patients are not to leave the unit otherwise and if they are gone from the unit for >4 hours it is considered AMA.