The Basic Roles of Student Nurses

The Basic Roles of Student Nurses

The Basic Roles of Student Nurses

The roles of student nurses are essential in the healthcare system. Don’t feel like you cannot do much because you are still a student. And if you want to know what student nurses do, this post can help clear this up! 

What is a Student Nurse?

Student nurses are individuals who study nursing. They also work to maintain, restore, and promote patients’ health while following the policies and procedures laid out by the hospital or healthcare facility. 

The duties of a student nurse are limited. Often, approval is needed before you can administer care to patients. They must also follow the instructions given to them by their clinical instructor. 

Working at a health care facility gives student nurses a chance to practice what they have learned in school. They are also given a specific time frame to complete these duties. 

Roles and Responsibilities

As student nurses, you will also have roles and responsibilities to do. Take it as your “warm-up exercises” in the nursing world as you prepare yourself for your future role. 

Getting your patient assignment

Clinicals are exciting for many student nurses. This experience will give them a feel of what it is like to be actually on the job. As a student nurse, one of your roles is to acquire a patient assignment. It will consist of the names of patients you have to take care of during the day. 

Your instructor will expect you to understand the diagnosis of the patients under your care. It means that you must understand their medical condition to execute the treatment they need. Whether it be a bed bath or a simple change of bedding, knowing your patient’s condition will also help you determine the right kind of treatment to give. 

In addition to that, it is also vital that student nurses are well-versed in modern technologies. It will be helpful when it comes to giving patient care. 

Giving medications

As part of your clinical rotation, student nurses must experience administering medications to patients. However, this is not done of their own accord but with the instructions and supervision of a clinical instructor and physicians’ approval. 

Administering medication involves preparing them in the appropriate dosage, specified time, and correct procedures. They must also ensure that they give the right drugs by asking their names. To avoid confusion, student nurses must also check the patient IDs to confirm the right person. 

Nursing Care

One of the primary roles of student nurses is to provide patients with the proper care they need. It could be eating, bathing, or changing bed linens; student nurses assist these patients. 

Student nurses must also provide nursing care to bedridden patients. One of their duties is to bathe them. It could be laborious, but they must ensure to execute the procedures correctly and provide bedridden patients with blankets to keep them warm. 

Before doing these nursing care procedures, student nurses must first ask for the patient’s consent. It is best to remember this as some patients are uncomfortable with student nurses. 

Charting

A patient’s chart is essential in learning about the patient’s health history. It provides the involved healthcare professionals with the information they need to administer the correct patient’s treatment. This chart is also a good opportunity for student nurses to learn more about their patients. 

A chart includes the details of the patient’s condition, treatment plan, symptoms, and medication list. It also contains the treatment done to the patient or the medications/drugs given to them as part of the plan. 

As part of your duties as a student nurse, you must record these details by writing them down on the chart or recording them on the computer. 

Your Takeaway

Knowing what to expect during your clinical will help you understand the roles of student nurses better. These will help you get the experience you need, and you will be more confident in taking on the part of a future nurse. 

 

7 Tips on How to Handle Difficult Patients

7 Tips on How to Handle Difficult Patients

7 Tips on How to Handle Difficult Patients

Working as a nurse means dealing with different kinds of patients, even the rude ones. You must know how to handle difficult patients to become an extraordinary nurse. 

Why are some patients rude?

Several factors make a patient hard to handle. It could be due to the stress of the illness or the tensions they feel from being inside a hospital. Sometimes, patients can be distressed, angry, scared, demanding, or have unrealistic treatment expectations for their needs. However, some of these behaviors may also be due to their past experiences in terms of medical treatment. 

How to Deal with Difficult Patients

As a nurse, you cannot avoid patients that can test your nerves. However, you can also find ways to deal with them. Here’s how:

Tip 1. Don’t fight fire with fire.

One of the first things you must understand is that patients are sick and need your help, not the other way around. As a healthcare professional, you must try not to respond in anger or reactive behavior; keep your professional face on. A patient’s offense may not originate from when they were at the hospital but perhaps triggered by something that might have happened in their life. Try to be as patient and understanding as you can. Showing respect is still the right thing to do. 

Tip 2. Listen to them.

Sometimes, an angry patient will tell their story once they have calmed down. Showing concern for a patient is one of the best ways to calm someone who is being difficult. When they do, give them undivided attention and listen to what they are talking about. Be sure to collect your thoughts before speaking to them too. Address them by their first name, acknowledge their concern, talk slowly and maintain eye contact when talking to them. Avoid mirroring their words; this could trigger them and may even turn defensive again. 

Tip 3. Take note of your body language.

Sometimes, actions speak louder than words. That said, be mindful of your body language when dealing with a difficult patient. When a patient is angry, they will also find a way to push your buttons. In return, you become mad yourself. It will be easier to deal with a difficult patient if you do your best to remember not to take it personally.  Being mindful about how you react is crucial. It will also help you choose the right words to say, use the tone of your voice, body language, and overall response. 

Tip 4. Acknowledge the situation at hand. 

Learn to acknowledge the situation. Most importantly, recognize how your patient feels. You can start by saying, “I understand how you feel” or “I feel like we have a misunderstanding.” As you do, keep your feelings aside and stay calm. Avoid using negative words that could escalate the situation. 

Tip 5. Setting the boundaries. 

Patients go to the hospital because they need attention, no doubt about that. However, if you keep giving in to their demands, how can you give attention to your other patients? Be clear with your boundaries. Let them know that their abuse is unacceptable. Make sure to set a time limit, say 15 minutes, then tell them you will see them in the next 30. As you continue to practice this with them, they will soon realize that you have a busy schedule and empathize with your situation. 

Tip 6. Provide a Patient’s Satisfaction Survey.

This survey will allow your patients to share any of their concerns. Tell them that you value their feedback seriously. It also prevents them from leaving bad reviews online. 

Tip 7. Stay proactive.

There is no use ignoring the problem. Avoiding a problematic patient won’t work either. So stay proactive, acknowledge your patient’s situation, identify the source of their anger, and be sure to implement steps to de-escalate the problem. The more you understand the case, the better it is for you to handle difficult patients. 

Your Takeaway

There will always be unruly patients wherever you go. They will come to you with various ailments, mood disorders, fears, and other complications. You must also understand that they come from diverse backgrounds and live different lifestyles that you may disagree with. But it is part of the job, after all. As a nurse, stay professional; you were trained in this field, so use your nursing knowledge and abilities to provide them with the quality care they deserve. 

 

 

EP 173: Determining Fluid Status in Patients

EP 173: Determining Fluid Status in Patients

Determining Fluid Status in Patients

Maintaining the correct fluid balance in the body is crucial to the health of our patients. Knowing how to check for fluid status in patients will help determine if they are overhydrated or dehydrated. That said, learning how to determine fluid status in your patients is essential, and you will learn all about it in this post. Assessing a patient’s fluid status is a critical skill you will regularly do as a nurse. It involves evaluating if a patient is hypovolaemic, euvolemic, or hypervolaemic.

Hypovolaemia vs Hypervolaemia 

Hypovolaemia refers to a deficit of fluid in the body. Causes include:

  • Poor fluid intake.
  • Excessive fluid loss (e.g., vomiting, diarrhea, hemorrhage, excessive diuretic therapy).
  • Third, space loss of fluid.

Hypervolaemia refers to an excess of fluid in the body. It is also known as fluid overload. Hypervolaemia is expected in the elderly and those with renal or cardiac failure. It can be caused by excessive fluid intake or inappropriate fluid retention (e.g., heart failure, renal failure). It is also why checking patients’ fluid status is crucial. 

Assessment Findings Determining Fluid Status in Patients

  • Bleeding from any source
  • Vomiting: frequency, volume, presence of blood
  • Stools: frequency, volume, presence of blood
  • Fever and diaphoresis
  • Urine output: color and volume
  • Heart rate
  • Lung sounds
  • Pre-syncope/syncope
  • Mucous membrane – Wet or dry?
  • Skin tugor – skin tenting 
  • Capillary refills <3 seconds
  • Oral intake
  • Daily weight 
  • Fluid restrictions
  • Fluid overloaded symptoms:
    • shortness of breath
    • Orthopnoea
    • paroxysmal nocturnal dyspnea
    • leg swelling

Labs of Fluid Status in Patients

  • Full blood count – May reveal raised hematocrit in hypovolaemia  
  • Urea and Electrolytes – Urea/creatinine will be raised in hypovolaemic patients and those with acute or chronic renal disease. Electrolytes such as sodium may be low in hypervolaemic patients (e.g., dilutional hyponatremia).
  • Urine and Serum osmolality – consider if suspected SIADH or DI. 
  • BNP is a marker of cardiac stretch under the effect of fluid overload.

Passive leg raise

If a patient has a blood pressure cuff, and you want to see if the patient will be fluid responsive, a passive leg raise is easy to check. Passively raise the patient’s legs to at least 45 degrees and check a patient’s blood pressure before and after the leg raise.

You can also lift the foot of the bed and see if there are changes in the blood pressure. This motion acts as a mini fluid bolus because you are forcing the blood to go from the legs into the core. 

Orthostatic 

Orthostatic hypotension, also called postural hypotension, is a form of low blood pressure that happens when standing after sitting or lying down. To check orthostatic:

  1. Have the patient lie down for 5 minutes.
  2. Measure blood pressure and pulse rate.
  3. Have the patient stand.
  4. Repeat blood pressure and pulse rate measurements after standing for 1 and 3 minutes.

A drop of 20 mmHg in the systolic is supportive of hypotension.  

Jugular venous pressure (JVP)

JVP provides an indirect measure of central venous pressure. The Internal jugular vein runs between the medial end of the clavicle and the ear lobe. 

To check this position, see that the patient is in a 45-degree place, turn their head slightly to the left, and assess the vein. 

A raised JVP indicates the presence of venous hypertension/hypervolemia. It can also be indicative of Right-sided heart failure. 

Patients with a Central Venous Pressure (CVP) 

These patients have access to the central venous system and peripheral arterial line. When you have a Central Venous Pressure (CVP), you can measure the patient’s preload. That will directly correlate with the patient’s fluid status. 

A CVP is good for checking where your patient’s fluid level is moving. A normal CVP is between 8 to 12 mmHg. 

Systemic Vascular Resistance (SVR)

If you don’t have a Swan, you can still check and SVR by Non-Invasive Continuous Measurement. SVR is the afterload, the pressure the heart is working against to push blood across the body. A normal SVR is between 900 and 1440 dyn/s. If your SVR is below 900, you will be more dilated vascularly; if above 1500, you will be more clamped down. 

So if you have a patient that needs fluids, you will have someone with a high SVR because the body is clamping down to increase volume to help maintain blood pressure. Maybe your patient is low BP, but the SVR is down, well, that can be a sepsis issue, and we can fix the SVR with vasopressors. 

Swan-Ganz catheterization

Swan-Ganz catheterization is also known as right heart catheterization. The tiny catheter is placed into the right side of the heart and the arteries leading to the lungs. This catheter monitors the heart’s function, blood flow, and pressures in and around the heart. 

One way to check fluid status on a Swan is by looking at the cardiac index. The index relies on cardiac output and turns cardiac output into a normalized value that accounts for the patient’s body size. A normal Cardiac Index is 2.5 – 4.0L/min/m2

Here’s how you can determine fluid status in your patients correctly. Click here for the full episode 👇

TIMESTAMP:

00:00 Introduction
01:21 Hypovolaemia vs Hypervolaemia
03:36 Assessment findings to determine fluid status
13:28 Passive leg raise
15:13 Orthostatic
17:02 Jugular Venous Pressure
18:06 Central Venous Pressure
24:55 Systemic Vascular Resistance
28:24 Swan-Ganz catheterization
33:07 Wrapping up the episode

EP. 172: 5 Skills for Better Nursing Communication

EP. 172: 5 Skills for Better Nursing Communication

5 Skills for Better Nursing Communication

Better nursing communication is essential in patient care, but it is also as important when communicating with colleagues and other healthcare professionals. What makes an effective way of communication? And what can you improve to be better at communicating? Here are five skills that you must learn. 

Better Nursing Communication is a Must

Communication with friends, family, and coworkers is crucial for success. It gets your message across to others and allows you to understand what others need and want. Without proper communication, personal progression is impossible. It’s just as necessary for the speaker to get the message across as it is for the listener to understand. 

1. Non-Verbal Communication

Communication begins with nonverbal cues. How often have you looked at someone and known they were open to a conversation, or even that time someone seemed that they didn’t want to be bothered. The nonverbal cues are the first things we notice. 

Nonverbal communication is used throughout a conversation; think about:

  • Eye contact
  • Tone
  • Posture
  • Body language
  • Facial expression 

 

2. Active Listening

Listen to understand, not just to respond. Really think about that because often, when someone is talking, we are already thinking of a way to respond. This leads to missing the whole picture or the other person not feeling understood.

It’s good to repeat a portion of what the person is saying to ensure that the intent is clear and that there are no misunderstandings.

Not everyone is coming to you for a solution sometimes, people just want to be heard and understood, not told what to do in response. 

3. Inspire Trust

Keep your word. Don’t make promises you can’t keep, no matter how small. People tend to remember you for your best actions and for how you didn’t follow through with what you said. 

Be honest; don’t say you can if you can’t do something.

An excellent way to build honest trust is to be open with your flaws. Share your mistakes and show your vulnerability. We are all human.

This is important when speaking with management. You might not see them every day, but it is essential not to sugarcoat things and really talk about how you feel about the unit environment.

4. Cultural awareness makes better nursing communication 

People come from all walks of life, even your coworkers and managers. Don’t judge them on what they do. Don’t be ignorant, be open. Instead of judging, ask to learn about the things you don’t understand. 

5. Verbal Communication 

Verbal communication is the most important. It’s the primary way we get our message across. 

Know what you are going to say and why. Is it going to be a serious conversation with a manager, or are you just catching up with a friend? 

The most important thing to remember is to just talk to people. Talk to your coworkers and make them more than just a body to help you with turns. Share with them things about you and your stories, and ask them questions.

Do you want to learn how to communicate better as a nurse? Click on the full episode here 👇

TIME STAMPS:

00:00 Intro
01:12 Episode Introduction
02:43 I. Non-Verbal Communication
07:13 II. Active Listening
12:37 III. Inspire Trust
16:51 IV. Cultural Awareness
27:03 V. Verbal Communication
33:49 Wrapping up the episode

How Nurses Cope with the Death of a Patient: 7 Ways to Do it

How Nurses Cope with the Death of a Patient: 7 Ways to Do it

How Nurses Cope with the Death of a Patient: 7 Ways to Do it

We all die in the end. It sounds morbid, but this is the reality and commonality for us all. For nurses, dealing with a patient’s death can be traumatic in some ways. How do nurses cope with the death of a patient anyway? 

How to Cope with the Death of a Patient

If you are a new nurse and have just experienced the death of a patient, it can be overwhelming. It is not always easy to deal with it. And just because you are a nurse, that does not mean you are immune to grieving. Truth is, it is part of the challenges nurses face. We do grieve for our patients, and we do these seven steps to help us cope with the loss. 

1. Understand that Death is Inevitable.

When you understand that life is a cycle, it is easier to cope with all the stress. We all are bound to die at some point, and while death can’t be avoided, you should accept that this is part of life. Of course, accepting it does not mean you are someone who doesn’t feel anything. You do, but you understand better, and as a nurse, it is part of your understanding that all life comes to an end. 

2. It is part of your job. 

As a nurse, dealing with loss is a daily part of your life. Showing empathy toward your patients is what makes you an excellent nurse, but it can also be painful when you lose a patient. You also mourn the loss whenever you lose a patient, and sometimes, longer than you thought you could. Death becomes personal for nurses with empathy, but they must also remember that it is part of their chosen profession. And as a nurse yourself, you must realize that your profession deals with caring for people, and grieving for your patients means you have done your job. 

3. Talking about it helps.

Being in the healthcare field means you are often surrounded by the sick and dying. Fortunately, you have coworkers and colleagues who have dealt with the same situation before. Whatever you are feeling, they have experienced it too. Processing your emotions out loud to another empathetic nurse can help you with that. Colleagues who have dealt with patient death can often relate to how you feel and may even advise you on what to do.

4. It’s OK to feel how you feel.

Sometimes, as healthcare providers, we often rationalize how we feel about the death of a patient. While this can sometimes help, this is not realistic. Of course, you have to remain as professional as you can be after losing a patient, but you can also feel sad about it. Understand that death is a tricky thing, but you are also entitled to feel how you feel. You can grieve for your patients in your way as long as it doesn’t affect your work. 

5. Take care of yourself.

As nurses, we often form a close bond with our patients. And when we lose that patient, we often find ourselves grieving for them like family. How nurses cope with the death of a patient can sometimes be more personal than anything. However, in the aftermath of this, you need to take care of yourself. Remember, your job as a nurse means taking care of patients. That said, you must also take care of yourself by getting enough sleep, eating well, and exercising regularly. 

6. Remember, you are making a big difference.

Part of a nurse’s job is to not only care for patients but their families as well. The loss of a patient can affect family members the most, and as a nurse, you have the opportunity to be there for them too. How you treat family members who suffer and talk to them can make a huge difference in their lives. It can also help them cope with the loss. So, in your little way, you helped them. 

7. Find an outlet to destress. 

Dealing with patient loss is no doubt stressful. How nurses cope with the death of a patient can sometimes be done creatively. If you are a creative nurse, finding an outlet to express your emotions can help you in a big way. You can try crafting, arts or painting, joining an art club, or anything creative. Nurses need a break, too, significantly when they are affected deeply by the death of a patient. Pent-up emotions can be deadly, so finding an outlet to destress helps. 

Your Takeaway

We all deal with death and dying differently. Choosing the path of being a professional nurse means you will be exposed to death more often than you think, so be ready for such cases. Remember that death does not mean you failed as a nurse, nor does it signify the end of patient care. 

Your life and job as a nurse are bittersweet – there will always be ups and downs. Always remember that the way you cared for and loved your patients will be remembered by those around them, so keep doing your best!