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Old 05-18-2012, 05:20 PM
 
Location: North Carolina
102 posts, read 272,655 times
Reputation: 221

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Quote:
Originally Posted by PrinieRN View Post
Hey fellow class of 2013.

I think you have a good strategy and I'll give it a try to see how it fits with my own style of communication.
Thanks! After a year of clinicals I've found that this style of communicating with patients works best for me. I don't come across as condescending, yet I am able to assess their knowledge, correct any misinformation they have, and provide proper teaching.
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Old 05-19-2012, 04:48 PM
 
Location: Love, Epicenter
399 posts, read 494,916 times
Reputation: 385
Wow. It does sound different where I know in the day shift, there's sooo much going on from family to patients, tv, nurses loud and talkative...I don't see a lot of paperwork being done except in the OR (which is why I didn't like the OR...I'm someone who's really into movement). But a lot of this stuff might be overwhelming at first but good for me to experience so I can learn in the end. Hopefully I'll get a chance to experience this before I graduate next year.

Quote:
Originally Posted by Jasper03 View Post
Night has a different pace. During the day pts are leaving the floor for tests and procedures. The bulk of meds are given during day shift and. A lot more docs and bosses are around. At night we do a lot more paperwork and have a lot less resources. You have to be a bit more independent. No unit clerks to answer phones. No IV team when you need to start a saline lock. No resource nurse to help with admits and on my unit we do most admits at night etc. The pts also don't sleep as much as you expect they would at night while they are in the hospital. If I have elderly pts with dementia in my block I will be running all night trying to prevent falls. Psych pts take up a lot of time too.

Sometimes I'm having a peaceful night then the lab results we drew at 12am come back and now I have to pick up orders to repleate the pt lytes. I was almost through my shift the other day and tele called. My pt had brady down to a ridiculous heart rate and had a pause too. From calm to trotting briskly down the hall with the EKG machine. Those are the uneventful nights a rapid response or code ( which happens at least once every 3 shifts.) make life really interesting. It's different at night but still busy.
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Old 05-19-2012, 08:31 PM
 
Location: Lake Station, IN
96 posts, read 271,400 times
Reputation: 301
I agree assessing the patient's knowledge first is a good idea and don't just start automatically trying to educate them.

This is an opinion from a spouse's point of view. My husband has brain damage from high blood pressure and it affects his memory and attention span. Because of this, I stay with him 24/7 whether it's at home, dialysis, the hospital, etc. I know his regular meds, what they do, and how they affect him. When he's at the hospital and a nurse comes in to give meds, I like for them to tell me what they are giving him and ask if I know the med or not. If it's one I know and is a regular one, don't give me a speech about it. If it's a new one, explain what it is for and ask if I have any questions. There was one nurse he had that came in the room with meds and didn't ask. Started getting his meds together and explaining it great detail what each one was for. She didn't stop to ask if I understood. ("This is clonidine and it's for high blood pressure. High blood pressure is...blah blah blah." One med took her 5 minutes and he had 6 to take. First and second meds I didn't say anything even though they were regular ones and the way she was talking was getting on my nerves. Third one was Renegel. She starts in on how it's a phosphorus binder for dialysis patients and I stop her right there. Tell her politely that I know what it is and also that it is supposed to be given right before the patient eats and that dinner was still a couple hours away. She still wanted to give it to him and said it would be fine. We ended up arguing until his nephrologist was called and he told her that I was correct. It wouldn't be as effective 2 hours later. The next day, another nurse comes in and doesn't even say what she's doing. Just starts hooking him up to an IV. I had to ask her what the med was and what it was for since he normally doesn't need anything by IV.

The best nurse was the one who came in, introduced herself to both of us and asked how he was doing and if he needed anything. She started with just asking him the basics such as b-day, age, etc. to judge his mental status. She was polite and asked how much I knew about the medical field. I explained how I take care of him and what I do (meds, BP, stick him at dialysis). She started looking through his information and each medical issue would announce it and ask if we knew what it was and if we had any questions about. When it came time for meds, she said she would say each one out loud and for one of us to tell her what is was basically for just so she could make sure we knew. Such as was it blood pressure, antibiotic, etc. She took note of the ones we knew and then when we saw her the next day, she said she was just going to say what she was giving him so we would know. There was one new one and that was the only one she asked us about. I did have questions about it and she sat down and said to just stop her at any point if I had a question. (I liked the sitting down part because then it didn't seem like she was talking down to me. I was sitting down and when you have someone towering over you, it can be slightly intimidating sometimes.) She then started explaining it and didn't do so as if I was stupid. She would pause slightly when it came to words I might not know to give me a chance to stop her. He had a surgery scheduled for that day and she asked if it was explained to us and if there were any questions. He was scared about it and she took time to calm him down and explain what would happen. Whether the story was true or not, I don't know but she told him a story about when needed surgery and how scared she was. She told him how much better she felt afterward and the story actually worked and made him feel better. She talked to him like she was just a normal person unlike others who had a superior attitude with him.

Sorry for the long post. Point is, don't assume anything. A person may know a lot more than you think. Ask first if the patient knows about the med, procedure, equipment, etc. If you do need to educate, make sure you really do know what you are talking about. If there is a family member there, include them and ask if they have any questions. Especially if the patient has mental issues. They may be that patient's main caregiver and need to know these things too.
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