Friday 18th of May 2012
 Forum :: Issues in Nursing
Board Index Latest Posts Welcome Guest   [Register]  [Login]
Post Reply
 Subject :Re:Mandatory tds observations.. 03 01 2012 14:01 
Guest

Guest
"psychiatric patients" ?? Gee, I remember the days of Clozapine... heart rates of 110 - 120 ( normal ) BP 180 / 115 ( normal ) Temp. 37.6 ( up, but that's expected - monitor ) Patients out chain smoking and drinking several cups of coffee AN HOUR !!! But hey ! the medical profession OKed this drug. Oh, we expect a few cardiac deaths ... but in the long run, it will benefit patients .... yeah !!
Quote
 Subject :Re:Mandatory tds observations.. 03 01 2012 13:56 
Guest

Guest
Did you get down on one knee and say, "oh doctor, please please attend ... WE NEED YOU TO SAVE OUR PATIENTS !! "
Quote
 Subject :Re:Mandatory tds observations.. 03 01 2012 08:02 
Guest

Guest
I like this new process. Working incharge on most shifts, it means it ensures staff bring to my attention immediately an observation outside the flags. I feel it helps cover my butt, all our butts! Of course, many times it is a simple "give antihypertensives early" or "up the o2" or "give him a few glasses of water" or "take it mannually" and the issue is quickly addressed, rather than me finding someone with troublesome obs hours later. It also gives me POWER to get pt reviewed immediately . "Doctor, this patient is in red zone and is really a MET call, however the pt is not comprimised at this stage, and I have doone xyz, but you need to come review immediately please or else I will be required to call a MET" and whammo...doctor arrives.(OF COURSE, ANY PATIENT COMPRIMISED HAS A MET CALL MADE IMMEDIATELY) I believe it gives us power when we are concerned for a patient, and ensures we get immediate review, rather than take our concerns as not important and logged for review by a busy medical officier "whenever"
Quote
 Subject :Re:Mandatory tds observations.. 01 12 2011 19:54 
Guest

Guest
Still a load of bullshit.
Quote
 Subject :Re:Re:Mandatory tds observations.. 14 09 2011 21:29 
juliakathleen
Joined: 06 04 2010 10:19
Posts: 14
Location: 

There are actually five different paediatric obs charts and they're all dreadful.




[Guest 14 07 2011 14:17]:

Apparently they are working on a special Paediatric chart.....
Quote
 Subject :Re:Mandatory tds observations.. 09 09 2011 13:12 
Guest

Guest
I disagree, I think the introduction of the " between the flags" charts are a good idea. I undertand many of your objections to it such as patients whose 'normal' falls outside the parameters and the mandatory charting of tds obs at a minimum however the chart does allow flexibility. The doctors can alter calling criteria or reduce the frequency of observations. For nurses I think it helps, consider this.... have you ever had a patient on the ward whose obs did not meet MET criteria but whom you were still concerned about? you phone the doctor who doesnt seem interested and doesnt come to review the patient.. but now with these charts it allows us the call for a clinical review in which the doctors must attend. In these situations this has to be a good thing...
Quote
 Subject :Re:Mandatory tds observations.. 10 08 2011 10:06 
Guest

Guest
I have detect raining coming up. I want to know who thought up this rubbish. Biggest load of crap I've seen for a long time.
Quote
 Subject :Re:Mandatory tds observations.. 17 07 2011 17:47 
Guest

Guest
I don't agree with your comments bookworm. Many of the elderly patient in my psychiatric ward are often unstable and need to have observation done regularly. They have many complicated conditions. We are constantly having patient clinically review and emergency call which see them being transferred out to medical wards. Actually they usually come from home or emergency with complications.
Quote
 Subject :Re:Mandatory tds observations.. 14 07 2011 17:16 
Guest

Guest
Sorry - no EDIT facility. I meant to say, that the 'office worker' has not adequately considered the training and experience of RNs.
Quote
 Subject :Re:Mandatory tds observations.. 14 07 2011 17:14 
Guest

Guest
Between the flags does not account for fit, young sports people ( usual heart rate less than 60 ). Nor the geriatric with cognitive impairment ( GCS less than 13 ). Or the stable middle aged adult, who is well stabilised with BP and HR outside the so-called 'flags'. I agree, that this is BS. It de-skills RNs who have studied for years to gain a qualification that some non-nursing office worker has accredited as 'life-saving'.
Quote
 Subject :Re:Mandatory tds observations.. 14 07 2011 14:17 
Guest

Guest
Apparently they are working on a special Paediatric chart. While they are at it they should work on one for the elderly. There are many failings with universal parameters. What about the elderly patient with a usual temp of 35.5? Does the chart really help a nurse make a decision about when to call for a clinical review or initiate blood cultures? No, because they'll probably never reach the yellow part of the chart. It would require a spike of three degrees. Recently I read a book on Geriatric Medicine. Every section, no matter what the illness, said for 70 years plus, aim for SpO2 > 92% and recommended the application of nasal cannulae at 2L/min. The use of the SAGO chart would quickly make the elderly dependent on supplemental oxygen, when they don't require it. And, working with elderly end-stage patients, means it is a pain in the ass constantly trying to get altered criteria written up on every single chart. As if we don't have enough to do......
Quote
 Subject :Re:Mandatory tds observations.. 13 07 2011 19:10 
Guest

Guest
Still say its the biggest load of bullshit to hit nursing for a very long time. Most nurses have lots of common sense. I'm fed to the neck of having to wear the extra things like this stupid detect and between the flags rubbish. Jobs for the boys and girls. Love to know which nitwit set the parameters, Because a lot of the time they are way off the mark.
Quote
 Subject :Re:Mandatory tds observations.. 21 10 2010 19:53 
Old Nurse
Joined: 06 04 2010 10:19
Posts: 15
Location: 
Its bullshit, if a patient looks unwell, we have the brains to do obs surely. It's insulting to have this system just to make a job for someone to audit. Just because a set of obs is done doesn't mean a patient can't deteriorate 5 minutes later.
Quote
 Subject :Mandatory tds observations.. 13 08 2010 10:30 
Bookworm
Joined: 13 08 2010 12:15
Posts: 10
Location: 

Since between the flags came in it is mandatory to do obs on patients at least three times a day. This is not required for aged care patients in a designated aged care unit.

Many of our patients are stable and only with us until placement is organised. It seems ridiculous to have to keep doing tds obs on such patients, but no-one has come up with an effective way to allow nursing staff to not have to do this.

Has anyone else come up with a solution to this?
Quote
Post Reply
Page # 


Powered by ccBoard


Back To Top