Congrats to our new recruits:
Travis, Emily E., Torrie C., Abby, Ashley Na., Sarah A., Ludwig L., Carleen H., Kristine
Kudos
Vanessa for being so “resourceful”
Courtney for being “flex”ible and moving to flex 1/2 way during her shift
Dave for taking 2 obs admits at the same time
Bailey for handling an intense patient.
Everyone who has taken care of Rm 29, a special case and you all have been so amazing.
Taylor He. for being so interactive with her 1:1.
Shout out to Oct 10 Dx staff
Kyle and Bailee for managing a difficult pt.
Breanna S. for washing up a stinky pt on her 3rd nx
Natalie P. for being an excellent Nx CN for a difficult/chaotic shift
All unit 2 staff for dealing with such a busy/heavy/difficult loads in the last couple of weeks.
Ruth, Jan, and Jenn for running their feet off Oct 10 dx, and Heather B on Oct nx.
For our Oct 11 Unit 1 team who rocked their 4:1 assignments :)
Travis for managing a pretty rough first solo shift. You are the master of repats and complex discharges!!
Tracey and Carolyn for absolutely rocking such a hard week with so many discharges/transfers/admissions.
Staffing Assignments/Sheets
Stop moving yourself and others around on the sheets. Twila does a good job trying to spread the wealth and getting people to take their turns in the units. People are getting burnt out by constantly being in Unit 2. If this doesn't stop we will have to start micro-managing assignments or creating a float pool like system to help mitigate the problem. We have no interest in micro-managing the sheets but if we can't start being more equitable with obs assignments we will have to.
Charges- You are free to move people on the sheets for the safety of the units. You also have the ability to put out more needs if staffing numbers are not safe for the type the patients on the unit at any time, but please do for 24 hours not just the next shift. It is also your responsibility to tighten assignments of units (if safe to do so) to help support a busy/heavy unit. In the end- do what you think is best in the moment. Managers will never judge, we will ask questions so we can understand the decisions to help us with future planning. Charge is a tough job, if you're not comfortable making those decisions reach out to the managers so we can make the tough calls for you or help support your decisions. If you're on nights ask other charges, REMEMBER: too many staff is always a better scenario then too little. Especially as we enter our viral season!!
TEAM WORK MAKES THE DREAM WORK
We are a team. Managers, charges, resource nurse, bedside nurses, educators and support workers are all a team- SAME TEAM. COMMUNICATE. If you're drowning call out for support- Broadcast to peds saying your unit needs help. People will come, and the managers will hear the broadcast that will allow them to help out in the moment. We don't always know as we are off doing our work or supporting patient flow. Unfortunately the layout of the unit doesn't allow others to see what is happening so if you don't call out others may not know where help is needed. Help out whenever you can. Tell the managers when you aren't getting your breaks in the moment. It doesn't help to tell us after the fact bc we can't help support after the fact. We need real time updates, you are not bugging us, we prefer direct communication. That is why we always have 1 manager dedicated to the floor who wears a vocera. We also have cell phones, see the contact sheet on this blog, save the numbers to your phone. Call us, text us, whatever- any communication is better than 0. The floor is the priority, use us so we can work with charge nurse to get support in. Sometimes there is only 1 manager and it can be challenging but we want to help so let us by communicating what you need in the moment.
CODE WHITE
Unfortunately this has becoming more common, specifically in unit 2. We need to start following protocol and calling overhead when we have a code white. Dial 3-2-1 and say code white inpatient peds. They are not allowed to call rooms or units.
This will bring awareness to the entire team and security. It may not help with security coming faster, but it is all about communication. The unit team members need to know when something is happening. This also communicates to the entire hospital, including directors, that something is happening on the unit and we need support. If you are not calling a code white you are bringing enough awareness to the problem.
SECURITY
Physicians cannot order 1:1 security. Security does not answer to physicians. They have their own work standards and protocols to follow. Understanding why a physician wants the 1:1 with security should be discussed by charges so that proper communication and escalation can occur.
For example: Recently we had a FORM- G patient on the unit. This form was created in the ER to ensure they had to do treatment. This meant that security had the right to force them to stay in the hospital as other wise they would have been allowed them to leave against medical advise. FORM-G's expire within 72 hours of admission to the ER. FORM-G's also are only for psych patients and are only meant to be utilized for psychiatric treatment. If a patient is here for medical reasons and not psychiatric treatments (ie: on our unit) FORM-G's technically do not apply. However, as long as psych does not sign off on them we can use the FORM to keep them in hospital. Keep this mind and ensure that bedside nurse and physicians are discussing with psych to keep it up to date if needed. In addition, when a patient who has a FORM -G signed, charges should call security to let them know that you have a FORM G on the unit. They have protocols associated this and it will help gain support from security. If you feel that security is needed for violence or flight risk call security and ask what protocols are needed to be in place to help support in addition to FORM-G. CALL CODE WHITE if they are violent.
ALWAYS CALL 1600 IF SECURITY HAS A POOR RESPONSE.
SCM PHYSICIAN NOTES
Have a consult and can't find the physician notes?! Check on SCM. This has been active for a while and training was provided for this process. If you are rusty or feel like this is new news, PLEASE REACH OUT so we know refresher training is needed.
Mental Health Training
The foundation now has a mental health budget that can be applied for. Managers have been working with psychiatry as well as provincial partners to help create a project to better support staff and patients when they come to the ward. If you have any interest in being apart of this work please reach out :)
TEMPORARY SURGE STAFFING
Some of you already know that we have approval for surge 120 d assignments. These are various FTEs so please email us if you are interested. The lines have just been created and will be emailed out to those who have already expressed interest. If you have any past students who want to work on peds NOW IS THE TIME :)
Accreditation Nov 6-8
Biggest thing thing that they are looking for is that staff know how to access information if they don't know the answers. Asking a friend, educator, resource nurse, or S Drive. They will ask questions regarding medication management, IPC, care plan, fall risk assessment, inpatient oncology patient management as well as some other things but these are the big areas.
New Staff Scheduling Site
Seems to be work ok. Quick dial is gone but hoping to get something similar back, the layout isn't as functional as it was. If you are having problems please email managers so we can submit the concerns.
Entering the correct clean on discharge - For every discharge you must manually enter the type of clean that is required even if the precautions are entered into APF and SCM. Regardless if the patient is in the system as having precautions (contact, airborne etc.) the system defaults the clean to be 'regular'. All rooms with precautions require more detailed terminal cleans when discharged or transferred, and the only way housekeeping knows this is it you entered it into APF.
Master Schedule
We are waiting for the union to get back to us. Hoping to get it back within the next couple of weeks :)
Foreign Objects in the Laundry
There is a target set by Laundry services team to decrease the amount of foreign objects in the laundry. Please do your part and ensure there is nothing in the bedding before tossing it into the laundry bag. There will be more to come on this.
EMPLOYER PAID LICENSE FEES
Get your license renewed before Oct 17th to ensure SHA pays.
Hopefully next week is better for everyone!! It has been really hard and we appreciate you guys so much.
