A Nurse's Christmas Poem
T'was the week before Christmas,
and all through the floor,
The Lasix was filling
the Foleys galore.

Stockings were worn

to prevent emboli.

They came in two styles:

knee- and thigh-high.

The patients were nestled

half-assed in their beds,

While visions of stool softeners

danced in their heads.

We in our scrubs,

and they in their gowns

- Fashions created

to hide extra pounds.

When down in the E.R.

it became such a zoo.

They called for admissions

for me and for you.

They're coming, they're going,

they're looking the same.

My patience for patients

is starting to wane.

Now call lights are ringing, the patient expounds

"I have not had my peri-care, please send someone down."

So now delegation seems like a good plan.

We pass on to others the needs of this man.

When, what to my wondering eyes should appear

But Santa himself and 8 tiny reindeer.

He states that he came in from Central Supply

To bring us LR, NS, and D5.

The doctors then scribbled what no one could read.

Orders for patients, to measure their pee.

We try to decipher illegible words.

Orders for patients, to soften their turds.

The new shift arriving, our day is now through.

How'd the stool and the emesis get in my shoe?

We give them report and pass on the facts,

And tell them of Duoderm lining the cracks.

And the Nurses exclaimed as they drove out of sight,

"Ativan to all! And to all a good night!"

Which mask?

Hello Everyone,
There has been much confusion regarding which masks are to be worn for MRSA patients. I have contacted Barb Catt and the following is her response:

"In SB mask policy, all HCWs when required to wear a mask are to wear the PCM 2000 mask.
The exceptions include:
OR, surgical procedures the surgical mask is required (tied) and
then with those patients requiring airborne precautions which would be for example TB, then the N95 fit tested respirator is be worn by the HCW.
The only time that an ear loop mask is to be worn is with symptomatic patients who perhaps can be infectious with respiratory organisms and they need to go for a test and/or the visitors."
Barb

The Sunnybrook mask policy can be found HERE

Corporate Nursing Council Meeting

Have you ever wondered what is being discussed at the monthly Nursing Council Meetings held at the McLaughlin Auditorium? Here are the minutes. Sandi and Betty will be taking turns attending, but anyone who is interested in becoming involved, please step forward.

NURSING COUNCIL MEETING
MINUTES
DATE: - November 26, 2008

Location: Sunnybrook, McLaughlin Auditorium EG 18a
Co-Chair: Julie Diemert, RN, BScN, SB Site
Co-chair: Anita Long, RN, BSN, SB Site
Recorder: Aaron Dumanat, RPN, Holland Site



Agenda Item
Issue/Discussion
Decision/Action
Gathering of Community & Call to Order
Called to order at 0740

Review Agenda & Approval of Minutes
Read over, and a few grammatical/spelling corrections made
Sophie Baranik, Bridget Jackman
Announcements & Comments
Obstetrics Rounds – Friday Nov 28
4th Annual Oncology Education day on Feb 12
Recertification Schedule: (WHMIS, Fire safety etc)
Organizational Workshops
RNAO- E-health workshop
Quality Improvement workshop on December 10 & 11
A Culture of Inclusion Sessions
Advisory meeting held for the future goals of Nursing
Brief report on NAC retreat. New Grad Initiative- Unfortunately a decrease in funding in the next year.

Welcome New Members
K1C, C2, C6

Professional Practice Updates
Frances Flint & Cathy O’Neil
Developing a policy for hand over protocol for the tri-campus to increase patient safety. Template given to members to review. Protocol to help decrease workload for nurses.
Add neurological status to the form, pain management, nutrition status, and family contact number. Travel Pass for a patient from diagnostic imaging. Include RPN, HFN/Armband check, special treatment, language spoken, lab/diagnostics pending, main service contact, include documentation of when patient has left the floor as well as when nurse gave report to the receiving nurse & list of units. Accountability in the policy.
Pilot: Holland Centre(3E), C3, and P & G.
Bladder Scanner
Due to the weather conditions, deferred to next month.

Nursing Rounds: Continence Care
Sue Sebastian
Becoming 21st Century Nightingale. Time spent in China. BNCC = Beijing Nightingale Consultation Corporation Limited. To share with our continence program with China’s Nursing Body. Goal: To promote bladder/bowel function to eligible patients.
Presentation to be sent out.
Open Session with EVP, Programs/Chief Health Professions and Nursing Executive
Confirmation for the New Grad Initiative for 2009/10 funding.
December 5th, a big meeting with the directors, PCM for how to recruit new grads for next year and to confirm going forward with the externs next year.
The Resource Pools are growing, still need to develop more.
No new money expected after 2009/10 for the corporate budgets.
We have 10 CCAC managers. There is increased funding to help with the patients who need ALC (funding for patients to have increased CCAC services so they can remain at home while waiting for placement).
New Nursing Clinic set up at CNIB for IV antibiotic treatment, dressing changes etc.
Christian (PCM) is looking at developing a plan for helping with the orientation of Internationally Educated Nurses.
Communicating with Care Program will have Internationally Educated Nurses be buddied with a staff nurse to observe the staff nurse interacting with the different groups.
ABC program: with the University of Toronto to have the nursing students who have a degree and are now going for their nursing degree to pre-select the hospital where they will do all their clinical placements.
NAC Retreat: missing representatives from the NC. Set goals and objects for the next two years.
Input to be given to Sue for where we would see Nursing in the next 18 months.
Follow up to develop strategies to improve participation.
Reports from Workgroups
Best Practice: Presented the results from the survey that was done by the nursing council members
Nursing Voice/Nursing Rounds: Reviewed the Terms of Reference
Nursing Research: Went to the Library and spoke with Henry and had help to use the online resources and have been able to tighten up the question.
Information & Technology: RNAO eHealth champions workshops (fill out the application to attend with a letter of recommendation from management), RNAO education day happening at Sunnybrook in February
New Member Orientation: Three new members

Adjournment
Next Meeting – December 17, 2008, Sunnybrook, McLaughlin Auditorium (EG18a)

Survey Monkey

Hello Everybody!
SPANC is trying hard to collect as much information as possible for the PeriAnesthesia Handover tool to make it as user-friendly as possible. Your input from Survery Monkey would be very much appreciated. Click Here to take survey It's quick! It's easy! Your opinion is valued!

Quiz of the Month

Laurie Mahoney has been so kind as to forward a Neuro Quiz from The Foothills Hospital in Calgary. Thought I'd pass it on to you (though I tweaked it a bit)


1. The internal reference point, when levelling intracranial EVD’s is called:____________
2. The external reference point, when levelling intracranial EVD’s, is located: ____________
3. Lumbar EVDs are “typically” levelled to the area of insertion site or area of injury.
True or False
4. Flushing of the EVD transducer may only be performed when the waveform is dampened or is absent and other, less invasive, troubleshooting methods have been tried. List 5 less invasive, troubleshooting methods that must be tried prior to flushing the transducer.
5. Is it possible for a Richmond Screw to have a drainage system attached? Y or N
6. Is it possible to monitor ICP with a Richmond Screw? Y or N

7. You are setting the ICP alarm limits on the monitor but the physician has given you no guidelines. What should you set your high ICP alarm at?

8. List 3 common nursing interventions that are employed in PACU for control/maintenance/management of ICP.

9. What does CPP tell us?
10.What is considered to be an acceptable CPP?
11. What are the 4 major components of a neurological assessment?

12. The Glasgow Coma Scale is:
a. is always a 15 point scale
b. measures level of conscious sedation
c. less valid when used by inexperienced users
d. only scale where you can be dead and still score a 3

13. When assessing pupil size, it is most appropriate to measure and document AFTER testing reactivity to light. True or False



ANSWERS:
1. Foramen of Monroe
2. Between the outer aspect of the eye and top of the ear
3. True
4. http://sunnynet.ca/Default.aspx?cid=100244-100445-100446-100675
5. http://sunnynet.ca/Default.aspx?cid=100676&lang=1
6. http://sunnynet.ca/Default.aspx?cid=100749&lang=1
7. http://sunnynet.ca/Default.aspx?cid=100749&lang=1
8.
Adequate oxygenation, maintaining normal C02 levels
Control of N+V
HOB 30 or as ordered
Head and neck properly aligned
Normothermia
Accurate I+O
Adequate pain control
Seizure prophylaxis
Quiet environment
9. The adequacy of the perfusion to the brain
10. 60-70, 70 being more ideal for adequate perfusion
11. pupil response, GCS, VS, sensory and motor power
12. c
13. False