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Top advice for nurses in the new year

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Posted 5 months ago

 

 Top advice for nurses in the new year


 

 

Ever had one of those days when you just couldn’t get an IV in? Or you wished there was a great app you could check for clinical info? We feel ya and we’ve got you covered! Below we present a year’s worth of career advice that Scrubs readers have shared and “liked” the most. Ready to streamline your workday? Get “in the know” and read the full list!

 

1.   tips for IV cannulation success

 

Nurses and intravenous catheters (IVs) seem to go hand in hand. Yes, yes, I know nurses are not the only healthcare professionals who place and start IVs, but we do the majority of it. My sincere apologies to all of the out-of-hospital EMS personnel.

 

Oh, and as a side note to all the TV fanatics out there: Physicians RARELY start peripheral IVs. In fact, in my short tenure doing this job, I’ve seen ONE physician start one.

 

Anyway…

 

Even though my IV skills had a pretty rough start, I thought I’d share some tried-and-true tips to help increase your chances of success.

 

Know your anatomy

 This is a simple yet vitally important rule. Don’t go rooting around for that “magic” vein. Know where to look and what you are looking for. Most cephalic forearm veins are overlooked, while the median antecubital vein is usually abused. Remember, the ventral side of the forearm is sometimes a gold mine!

 

 

 

 

2. Do I need to memorize common lab values?

 

Memorizing common lab values used to be a toughie, but thanks to the modern electronic health record (EHR) and full computer access, nurses don’t need to memorize most lab values.

 

The other caveat to lab values is that each institution has its own set of normal value ranges. One “norm” may not be the same as in another neighboring institution or facility. The difference is usually ± 1 to 3 percent.

 

As a nurse, it’s normally your job to notice and address extreme values that do not coincide with your patient assessment, but always keep them in the context of the patient.

 

And to make matters even more complicated, some values will be read and displayed using different methods of measurement. Instead of mmHg, they could use cm of H2O. Just something to pay attention to.

 

Outside of memorizing the values outright, here are a couple of helpful tips to keep in mind:

 

Hemoglobin and Hematocrit (H and H)

 General rule of thumb is a 1:3 ratio

 Hematocrit should be approximately 3x the Hemoglobin

 Norm ~ Hgb 10 / Hct 30 (minimum values)

 Also Hgb 13 / Hct 40 accepted

 

  

 

 

 

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3. How to maintain each patient’s dignity


We often forget there is a human being on the other end of the bedside. While we stand there and spout off the appropriate education and implement the required interventions, we sometimes forget there is an actual human being listening.


Some nurses have an overwhelming knowledge base and the sharpest skills, but fail to treat their fellow humans like people. No matter what kind of nurse you are or aspire to be, please be sure to maintain each patient’s dignity. Here are five tips to help you:


Be careful how you touch them

Whether pressed for time or nervous because it’s a first-time skill, pay attention to how you touch them. Be gentle and be mindful. Gentle pressure goes a long way—not to mention having warm hands.



4. The best and worst states to be an RN in 2012


Good news for RNs! You’re going enjoy an excellent job outlook right through to 2018.



Expect the biggest job rate growth in physician offices. That’s due to an increasing focus on preventive medicine and to advances in medical technologies, which allow for the treatment of more and more medical conditions on an outpatient basis.


Look to home healthcare as the second largest setting for RN job growth. That’s followed by nursing facility care, employment services and, lastly, hospitals. The BLS projects the creation of more than half a million new jobs for RNs from the period 2008 to 2018.


As an RN in the United States, where will you fare the best in terms of salary, job prospects and quality of living during this era of high job growth? Where will you enjoy that winning combination of a high salary and a fulfilling lifestyle?





5. apps for nurses in 2012


If you have an iPhone, iPad or other mobile device, you likely have a ton of apps taking up space. While some of those apps are likely tailored for fun (Angry Birds, Words with Friends), there’s no question that you can use your smartphone to serve your nursing career.


Of course, when you’re in your scrubs and ready to tackle a shift, using mobile apps to get information on drugs, anatomy and conditions is a no-brainer way to treat your patients better and keep reference materials easily accessible. Here’s a look at 20 top clinical apps for nurses in 2012!


Not all of these apps are free, but when you think about the great services they provide—such as keeping you on top of ever-changing medical data—they’re well worth the money.




6. Etiquette tips for bringing fun to your patient’s day


Nurses are the first to tell you that their jobs are stressful. One way to release this stress? Laughter. But how can you have fun with patients while remaining professional? Check out these seven tips for successfully bringing laughter to your patients (and yourself!):

Nurses can keep a patient’s situation and care from becoming mundane. Start by keeping a smile on your face and a song in your heart. The old adage about sharing a smile is true. I also listen to my favorite music on my way to work and try to hum it throughout the day.




7. tips for a great hand-off report


Nurse-to-nurse report (change of shift or transfer of care) is an age-old skill that no one teaches you. It’s the source of concern for many in healthcare these days, but no one seems to take the time to spell out what makes a good report.


I remember reading that one of our certifying organizations is pushing for bedside hand-off reports—a study found that the hand-off report was the source of sentinel events or, at the very least, the place where healthcare professionals are missing important care delivery information.


Still, I do not remember anyone cultivating this skill with me. I remember as a new graduate someone telling me to give report the way I assess the patient, but they never gave me specifics on the what, when, why and why not (not to mention the pertinent and less useful information to include in your report). Let’s be honest here: Some nurses’ reports can be extremely lacking in information, while others are reading you the script from their next movie! Once again, there is no consistency.


I thought I’d give you some tips to make up a good hand-off report:


1. Always be prepared

Be the Boy Scout (sorry, ladies). I approach giving report the same way I approach calling a physician. Have your ducks in a row, have all your information gathered and know what you want to say before you start saying it.




8. guide to tough at-work questions


What do you do when you’re handed a tough task at work? Well, you handle it. As a nurse, juggling difficult, complex tasks that require your full attention (ironically) is pretty much the name of the game from the beginning of your shift to the last minute of the workday.


Every nurse, however (regardless of how seasoned they are!), has that one task that gives them butterflies in the stomach. Here are answers to six at-work questions that nurses—the new as well as the seasoned—frequently ask.




9. the night before an interview


The night before the big nursing job interview is almost like the “pregame” in professional football: Prior preparation is a must in order to perform at your best. If you don’t properly prepare for the big game, you could miss a great opportunity to show them your best.




1. Check your resume/portfolio

I always bring an extra copy of my resume and maybe two copies of my references to have on hand in case the interviewer asks. It also streamlines the hiring process if they choose to proceed with offering you the job.






10. tips to help you console your patient


Therapeutic communication is one of the cornerstones of a nurse’s education. As part of the holistic approach to our care, we treat the patient, not the disease. This means we have to navigate through the murky and sometimes choppy waters of emotional support.


Most nurses understand and know how to use the basic concepts of therapeutic communication—it’s what separates our profession from most others, in my opinion. We have a unique bond on an emotional level with our patients that just cannot be described to a “non-nurse.”


I have a handful of tips that always “work” when I need to console a patient. And as a sidebar—“work” means I have lessened their discomfort (to any degree), or at least have given them the opportunity to feel just a tad bit safer during such a troubling time.


Here’s what I know works:


 





Therapeutic communication is one of the cornerstones of a nurse’s education. As part of the holistic approach to our care, we treat the patient, not the disease. This means we have to navigate through the murky and sometimes choppy waters of emotional support.


Most nurses understand and know how to use the basic concepts of therapeutic communication–it’s what separates our profession from most others, in my opinion. We have a unique bond on an emotional level with our patients that just cannot be described to a “non-nurse.”


I have a handful of tips that always “work” when I need to console a patient. And as a sidebar–“work” means I have lessened their discomfort (to any degree), or at least have given them the opportunity to feel just a tad bit safer during such a troubling time.


Here’s what I know works:


Undivided attention

Close the door, close the curtain and minimize as many distractions as possible. If you can let your coworkers know you need an uninterrupted moment with your patient, do so.


Eye level

Do not hover over them while they are sitting in bed. Sit next to them. Body position matters.


Voice tone and level

Speak softly and maintain a consistent volume with your voice. Find a level halfway between a whisper and normal conversation. And whatever you do, don’t raise your voice.


Tissues

Either come prepared with a box of tissues, or find them in the room. Use the tissues as a compassionate suggestion of empathy and understanding. Whether they use the tissues or not is not the point.


Shut up

Let them talk. Let them express their feelings. Give them the time they need to process the information. It’s okay to sit in silence. In fact, it’s the best thing you can do–just sit and be present.


If all else fails, put yourself in the patient’s position. What would you want from your nurse? What wouldn’t you want from your nurse? If you can remember that this is about the patient and not you, you can’t go wrong