Evidence-Based Practice by Nurses for Nurses

This article describes an evidence-based patient-centered campaign and clinical resources that were developed by nurses, for nurses. Evidence includes an older AHRQ systematic review combined with current and emerging evidence. The topic (early induction of labor) is a high priority across many disciplines and is a strong example of how evidence can stimulate and inform changes in practice that are entrenched routines (you know the refrain -- "because we've always done it that way."). We hope you enjoy this new posting and explore the embedded links to the evidence-based materials. Read More

Challenging Relationships with Doctors

Can anyone elaborate on the circumstances of challenging relationships you may have with medical doctors in the workplace and how you deal with it? Read More

[Toon] Wallpaper or scrubs?

Lots of colorful scrubs nowadays. However, sometimes I think we've gone too far. Wallpaper or scrubs? Hmmm....what do you think? Read More

Should ICU get more pay than floor nursing?!?

I am pretty confused as to how my facility can pay medsurg nurses an extra $3/hr over what they pay me! I know they work very hard but I work in a large level one ICU and I make critical life altering decisions on a daily bases. I have far more autonomy and with that comes more risk to my license. Don't get me wrong I LOVE my job and LOVE my facility but how can a nurse get paid more to pass meds on the floor than I do in the ICU? Read More

[Poll] How long is the wait to get to day shift in your NICU?

Just curious as to how long the wait for night shifters to come to day shift is on your unit? My unit used to be 5-7 years, but a back log of long termers on day shift not retiring has pushed that out to 8-10 years. Read More

25 Years and Counting

When did I become the old timer?

In 1989, I was a young fresh-faced nurse ready to start the first steps to becoming a nurse. I was so excited to begin the rest of my life.

We were all young in my group 18-27 years old - 2 male nurses and 18 female nurses. We wore dresses in blue check, not the men of course, and we wore hats with one single strip, this indicated we were first year student nurses.

Roll on to 2014, 25 years after that day and I am older, wiser and fatter! What happened to the fresh-faced young nurse? Read More

Cause of uneven pulse/ox wave form

I took care of a child recently who did not have any invasive monitoring. Just standard EKG and pulse/ox. I noticed that the waveform on the pulse/ox would show one high, strong wave, followed by one slightly lower, and then one lower than that. Then it would start all over again in groups of three from tall to medium to low. I was unable to determine why and the RN's I asked were also unsure why it was happening. Other VS were stable in the child. Any thoughts? Read More

Advanced Nursing Lacking "Medical Science"

Advanced Nursing is often considered less rigorous than Medicine even though Nursing is it's own profession. Of course there's overlap. Do you think it's because nursing doesn't require the same rigorous premed perquisites? Osteopathic medicine use to be regarded the same, but now it is equivalent to allopathic medicine. Do you think requiring the premed prerequisite curriculum (eg: PA, DO, MD prereqs) to gain entry to advanced practice will better prepare advanced practice nursing clinicians? Read More

What constitutes "comfort care" at your hospital?

I recently changed jobs from one hospital to another. I am baffled by many differences and one of them is "comfort care".

At my old hospital, patient who were on comfort care were kept comfortable. No vital signs, no neuro checks, usually only pain and anxiety medications were given. At my new hospital, a patient is deemed "comfort care" but its obviously in name only. Vitals are done, regular medications are given. There is virtually NOTHING different from the care we would give any other patient. So, how is it done where you work? Read More

Bar Code Medication Administration NICU Style

My institution (teritiary care, Level IIIc NICU) is moving to scanning for med administration soon. I know ideally you are to affix a barcoded ID band directly on the patient and scan that. However, we also know that reaching scanner wands into incubators isn't the easiest thing to do. Additionally you don't want to unwrap a sleeping infant to get to their ID band on their ankle. So what do you really do? Read More

What if a patient is too sick to manage their own healthcare?

I was wondering how many clients become helpless victims when they have to manage their own healthcare and have no PCP to manage this for them. The amount of work that must go into this makes me sick just thinking about it. What would be a patient's options when they're managing their own healthcare, and when they're too sick to handle all this work? Read More