Working for a “rural” hospital

And that was not the plane I flew home in.. nooo… however I did learn that for a very reasonable fee a plane like this will take newbies up and give them an aerial tour of the area. The great thing about hospital orientations is that you get to meet other newbies, some are from here and some have traveled from southern Ontario, like me. One newly graduated RN is from the Conestoga program and the another has been nursing only a few years from Windsor.

So this is for the few of you who messaged me this week, missing my face. Yep, its true I received that message more than once.

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This is will be one of the last posts of green’age. The leaves are a-changin.

Speaking of hospital orientation, I have spent most days this week in nursing orientation. New nurses hired by the organization receive 2 days corporate orientation, that was where I received the tour of the facility (priceless). 1 day cultural sensitivity, 1 day Non-violent crisis Intervention training, 2 days Anisinaabe Cultural training (next week for me) and 4 days of nursing orientation. I also am cramming in 24 hours in the ER (now you can see why I’ve been so distant…) So a few things I’ve learned and want to share about this unique hospital.

I am working with that illusive Meditech system we all have heard about, you know the myth.. everyone knows someone who had a placement somewhere that used the check box Meditech system, it’s here. With (drum roll please…) computer generated MARs. 7 day computer generated MARs. What this means to my non nursing readers, is that all of the charting is done online, and it appears as thought we just click boxes and type notes at the end (bye bye F5) and instead of me trying to read my sloppy collegues hand-writing to figure out what medication I need to give you, I just read the computer print out, complete with contraindications and safe handling. Now with every pro there is a con. Pharmacy does not come up and give us a newly stocked cart with each patient and their medications in their drawer. It seems the nurses pull the individual meds from their version of an accudose. Now I’m thinking this is going to be bad – but they do it. Also BID med times are 1000 & 2200, so I guess more time to get in and pull em out… we shall see… I’ll keep ya posted on that one.

So this facility has an actual kitchen, I mean a real one, like in a hotel. But not only that, because of the cultural preferences of some patients here there is a second work station that on Thursdays will cook un’inspected game for those who are interested. Yep so hunters will bring in moose, beaver, fish.. and cook it up as a traditional offering. With recipes, and on a stove. Shocking I know! The tray delivery carts look like they were designed from NASA – I mean one side keeps trays hot, and the other things cold. So no frozen solid soup. The RD explained how important it is for nursing to input the correct diet orders into the system, because each tray is tailored depending on the diet. And no cakes or sweets for anyone – even if you diet is regular. This idea tries to teach everyone how to eat healthy, using small portions of fruit instead. The food the patients are receiving are the same as served in the subsidized cafeteria, today for lunch I had a philly-cheese steak sandwich with sweet potato fries… for $5.50. This is awesome for staff and families, especially those away from home staying in the hostel. Learning all this I spoke to the RD after her presentation, did you know there is a Canadian Malnutrition Task Force? Me either, these professionals use research to create strategies to prevent malnutrition in hospitals! Interestingly enough next week is Canadian Malnutrition Week! Needless to say, she and I will be speaking more over the next few months.

Lastly for today; we had an education session by a chemotherapy RN who discussed nursing management of CVAD. So, your peripheral IV sites, PICC lines, and ports. I may have zoned out slightly while she talked about PICCs however it is a big thing up here for sick patients receiving long term therapy to have a central venous access port. This woke me right up. I’ve seen (a few) implanted ports and am pretty sure “We are not allowed to access them”. Well I guess now I will.

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Now speaking of PICCS, this facility does not draw blood from them, why you ask.. well using suction either from a syringe or vacutainer pulls the cells down that long catheter, potential breaking the blood cells in the process (Potassium out of wack..hmmm…) Makes sense right. So there is little to no bleeding back of any site here, now we do of course also have a 24 hour lab team who comes to draw all the blood, even in ER. When we spoke about this I heard that there were so many false positives, and nurses who couldn’t keep straight which tube to draw when (they got a kick out of my fancy beads), so errors that it cost less to have the lab do it. The lab team here feels the same about butterflies for blood draws.. blood cells get damaged in transit ( So I was correct to practice with the straight needles, but I’ll have lost it by the time I return in Dec)

I may be honeymooning a bit still, but after 3 weeks.. how will I ever come back to work in the big city…?!?

So to all my nursing buddies– let me know in the comments what ya think!

Make sure you’re all caught up on my posts Click HERE

 

 

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2 thoughts on “Working for a “rural” hospital

  1. Reminds me of my time in the Petrolia hospital just outside Sarnia. They cooked everything in a real kitchen and the patients actually ate it! Do they have less rates of malnutrition or less use of supplements since the food is better quality? Am loving reading your blog Rhiannon!

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  2. Lov’n hearing all that your experiencing Rhiannon .. And this blog is truly informative !! Keep up the good work !! And keep the blogs coming !!

    Like

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