how to dispose of your patient's ID bracelet.

So. Its a busy shift and you are about to discharge one of your patients home. You cut off their ID bracelet just before they leave. Now what? Do you usually throw it in the general waste bin? There is a potential here for a breach in patient confidentiality if you do. So where should you dispose of it? I asked some of my friends what they would do and here are some of the responses. Heather: I’m naughty and throw it in the nearest Sharps bin Nardine: I chop it up with scissors then chuck in general waste!! Tom: [continue reading this...]

Tips: Blood Culture collection.

The early detection and aggressive management of sepsis is vital in reducing morbidity and mortality, and the gold standard in detecting bacteraemia in our patients is the blood culture. Contamination of blood culture specimens or poor technique may lead to delay in optimum clinical decisions and management with inappropriate or unnecessary antibiotics. Not to mention wasted expenses. Blood culture bottles contain a soup of nutrients that feed a wide range of bacteria/fungi. Some bottles (including the BD BACTEC Plus media) also contain a resin to neutralise any antibiotics present in the patient’s blood in order to promote organism growth. When [continue reading this...]

Securing the Endo-tracheal Tube. One method.

There is more than one way to secure an Endo-tracheal Tube (ETT). These days the safest way will probably involve a commercially available device of which there are quite a few and most intensive care units are probably using one. But what if your units budget does not stretch to such luxuries? Or what if you just need a temporary way to secure the tube? Again there are many ways to do this, and everyone has their own particularity from white tape and a simple bow, to brown tape cut into ‘trouser-legs’ and secured around the lips (the brown tape [continue reading this...]

Tip: how to collect a baby's urine on demand.

One of the most frustrating and time consuming activities that befalls a nurse working in the paediatric area of the emergency department is obtaining a midstream urine collection from a baby. Some units may opt for using sterile stick-on collection bags. But my own experience has been that this method is less than effective often resulting in a contaminated specimen that is not really mid-stream anyways. And collection of a spontaneous pee (often delegated to the parents) although hilarious to watch, is also sub-optimal. A recent paper from Madrid proposes a method to produce a flow of urine on demand [continue reading this...]

The mindful nurse.

Mindfulness is the awareness that emerges through paying attention on purpose, in the present moment, with compassion, and open-hearted curiosity . Through cultivating mindful awareness, we discover how to live in the present moment rather than brooding about the past or worrying about the future. Mindfulness, in my opinion, may just be one of the most important skills that can be taught to nurses (and other caregivers). It is an easily taught skill that can help to strengthen resilience, improve concentration, decrease likelihood of errors, improve clinical performance, nurture empathy and lessen the effects of chronic stress. As well as [continue reading this...]

Tips on delivering IV fluids STAT.

I have written about this before but I still see it a lot. Perhaps you have too. A doctor orders for a fluid bag (or a set bolus of fluid) to be delivered STAT The nurse diligently loads the bag into an infusion pump (or perhaps it was already running via a pump) and maxes up the delivery rate. On many pumps (for example the Imed) this will be 999mls/hr. Our new Bbraun Space pumps max out at 1200mls/hr. Other pumps might allow faster delivery rates 2000 perhaps? Or 3000? Indeed these are big numbers. But they are not STAT. [continue reading this...]

take the trip: an evidence based search engine.

Do you rely on Google to dig up information to help you with your professional development or find information around a particular clinical topic on the fly? Well, there are some other useful alternatives out there. One such search engine is Trip. Trip is a clinical search engine that has actually been around since 1997. It is designed to return search results based on high-quality research evidence. Trip uses an algorithm to rate articles according to the quality of publication resource, the frequency and position of the search term with the text and the publication date. Results are displayed below [continue reading this...]

Kidspeak: Talking the talk.

Amanda Stock, Amber Hill and Franz E Babl (a hospital play therapist and two ED physicians) have published a paper in Emergency Medicine Australasia describing some age-appropriate non-threatening and positive language statements for use by clinicians when describing  procedures to children. The table of descriptors has been developed for use in an emergency department setting where resources such as play therapists may be limited or unavailable and where clinicians may have only a few minutes to develop a rapport with both the child and family, and provide clear explanation of what is about to happen. In stressful environments it is [continue reading this...]

Bedside nursing: OWN the bed.

This weeks reflection: how many times do you find yourself performing an assessment or an intervention on your patient bent over their bed or reaching forward at some sort of uncomfortable back-strangling angle. If you dont think you do this, then instead watch your colleagues bed-to-nurse height alignment activities. So many times I catch myself out hunched over a difficult cannulation or venipuncture with pain in my lower back. I thought it would only take a few seconds and so I was too lazy to adjust the bed height before I started. Now it is going to take a while, [continue reading this...]

The 8 rights of medication administration: a small poster.

I received an email today from Matt: I have just received a copy of our new ‘6 rights of medication’ poster that will apparently be distributed to our appropriate health service sites. To say that it is uninspiring and forgettable is a dramatic understatement. I was hoping with your experience you might have seen something that I may be able to present to our administration for use or inspiration? Now, I had a bit of a poke around and couldn’t find anything very interesting……but as Matt is a cool dude, and gives me a regular fix of comment crack, the [continue reading this...]

  • impactednurse.com will soon be gone. (3)
    • Zeke said: Are you keeping an archive of this site on the nurse path site?

    • jelly said: Just work a few more hundred Sundays!

    • matgrad said: Bye Ian will miss the site but as you say everything has its day. Good luck for the future.

  • Nurses are F*cking C*nts. Verbal abuse in our workplace. (32)
    • Rose said: I have read this article and found it very relevant to me and my own experience.Unfortunately a lot of people think that it is quite OK and acceptable to take out their anger and frustration against a sometimes inadequate health system on nursing staff. I also think that gender is an issue as I often feel that female nurses are...

  • Nominate Now: Social Media Nurse of the Year. (21)
    • Belynda Abbott said: I would like to nominate 3 amazing nurses that contribute to nursing and social media in many different ways: 1. The amazing Philip Darbyshire @PDarbyshire and http://www.philipdarbyshire.co m.au/index.php?option=com_easy blog&view=entry&id=44& amp;Itemid=13&utm_source=b uffer&utm_campaign=Buff...

  • When a patient leaves with cannula in-situ. (17)
    • Andy said: Good thinking! At my hospital the Oncology staff are trained/instructed to bleed CVADs before every use regardless, to remove potential clots, discard, flush, then use. Another excuse if you need it ;)

  • bully nurse. (40)
    • G Boucle said: This is not surprising at all to me! Nurses can and do bully patients, I was on the brunt of this after a surgery with spinal fusion on 5 segments! The pain was blinding, they bickered in front of me over who would change the cath bag on the floor already filled and looking about to burst, I found this extremely upsetting....

  • The art of bleeding. Art, insult…or just plain WTF? (6)
    • Contrarian said: I have seen at least one, maybe two live performances of the Art of Bleeding (they were performing at the periphery of other attention-immersive events). Of course the nurse-slut costume is a standard image, but they turn it on its head and dissect it. So, yes, as they say, while the nurse slut draws in the viewer, the viewer is...