February 26, 2025 • 60 mins
Discover the key to mastering respectful relationships in nursing teams and revolutionize your healthcare environment! Promise yourself a shift towards better collaboration as we explore the invaluable roles of Patient Care Technicians (PCTs), Certified Nursing Assistants (CNAs), and nurses. Learn how establishing rapport at the beginning of shifts and maintaining fair workloads can transform the working atmosphere into one of mutual support and efficiency, benefiting both staff and patients alike.
Find out how effective communication and delegation can make or break a nursing team. We highlight the often-overlooked training gaps in nursing schools and stress the need for practical skills in communication and delegation. Through real-life examples, we illustrate the importance of respectful dialogue and shared plans for patient care, ensuring that every team member feels valued and capable of providing the best care possible.
Reflecting on personal experiences and the journey from CNA to nurse, we delve into the challenges and triumphs of building a cohesive team. Highlighting the critical role of familiar colleagues and the difference they make, especially during unpredictable emergencies, we emphasize the power of teamwork. By setting a positive tone and embracing the support of techs as the backbone of hospital operations, we uncover strategies for cultivating a work environment where humor and camaraderie thrive, elevating both patient care and job satisfaction.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Christopher (00:00):
Welcome to Nursing Lyfe 101, the most important
nursing class you never got totake in nursing school.
We will be traversing differentobjectives, like interviewing
what to do in nursing school,boundaries burnout and so much
more, if this interests you.
I hope you are taking goodnotes because class is now in
session.
Colby (00:46):
Hello and welcome to Nursing Lyfe 101.
We're so excited to have youhere with us as we dive into the
world of nursing, sharing ourexperiences, insights and a
little bit of fun along the way.
I'm Colby, but I couldn't behappier to introduce my co-host.
Christopher (00:59):
What's up, guys?
My name's Christopher.
Together, we'll be bringing youreal stories, practical tips
and discussions about all thingsnursing, whether you're a
fellow nurse or just curiousabout the life behind the scrubs
, we're thrilled to have youjoin us.
Colby (01:13):
All right, so today's topic.
Christopher (01:16):
Today's topic is an interesting one relationships
between PCTs, CNAs and nurses.
Colby (01:29):
And nurses.
Yeah, so to start a PCT or aCNA are basically the same thing
with a few nuances.
Christopher (01:39):
Right.
Colby (01:39):
But what you could summarize, it is like your
nursing assistant.
Christopher (01:44):
Yeah, yeah, yeah.
Colby (01:45):
So, depending on the hospital or certification, they
have a range of skills that arewithin their scope of practice,
but generally they're there asthe nurse's assistant to the
patient.
Christopher (02:07):
And really and truly.
They probably see a patient alot more than a nurse does,
because they're the ones that doa lot of the bathing, a lot of
the toileting, the feeding allthose various things that nurses
tend to not have as much timeto be able to do because we have
other things that we have toprioritize.
Colby (02:28):
Yes, um.
So basically anything thatnurses can delegate um to below
them not below them isn't reallya good term, but um as far as
like degree.
I guess um is what a nurse'said or assistant tech will do.
Christopher (02:53):
Yep, what would you say?
Or what do you think PCTs sayabout you?
Colby (03:01):
Oh, I think
Christopher (03:01):
To your face and then, I guess, behind your back.
Colby (03:03):
Okay, I think generally I have really good relationships
with my techs, nurses, aides,whatever, what have you but I
also feel like that's becausethey respect me in the sense of
like, if I need help, I'm goingto ask them to help me, but if
(03:27):
I'm not busy, I'm going to dothe things that technically are
like in the scope of theirpractice.
Christopher (03:33):
Right.
Colby (03:34):
Like, for instance, like if a patient rings and they want
a cup of ice and I'm not doinganything, I'm going to bring
them a cup of ice.
I'm not gonna say, okay, we'llsend your tech in and then go
look for the tech and say, canyou bring them a cup of ice?
And then continue on liketalking or whatever.
Christopher (03:51):
yeah, and that's interesting because that leads
on to various things.
On like how do you think interms of like, gaining that
respect, for example, like youas a nurse, you can't when
(04:12):
you're new, you can't just sayyes to all of it.
You can't.
Colby (04:16):
Yeah, you've got to find a balance.
Christopher (04:18):
Right.
But like, how do you gain thatrespect?
Because you do.
You want to say, yes, I'm thereand available.
Colby (04:23):
Yeah.
Christopher (04:23):
But like you can't just.
Colby (04:27):
I think it's really important to establish like a
good report in the beginning ofyour shift.
I mean, generally, unlessyou're in like a float pool
situation, you're gonna beworking with these staff members
pretty consistently, true, andyou want to, you want to grow
healthy and good workingrelationships with all of your
(04:47):
co-workers.
I like to get report and then Igo find my tech and say like
hey, here's what I've got forthese patients today.
Like I'm going to do this andthis or, and at this time I'm
going to need like help withthis point.
Or, like you know, try to comeup with a game plan together.
I think you know that's gonnabuild a trusting working
(05:08):
relationship.
Um, you've established, likefrom the beginning of your shift
, like this is the help that Iknow I'm gonna need right now,
like what this patient's gonnaneed today from both of us.
Or like maybe you could takethis for me and blah, blah, blah
, I think probably behind myback.
No, I think it's probably muchof the same.
(05:31):
I think you, you know youcultivate these relationships.
I think I don't know.
I feel like my my as a chargenurse, like my nurses and my
techs know that.
I try to make everything veryas fair as possible and I am
(05:52):
very equitable when it comes tolike assignment making.
So, like when I'm on the floorand I'm taking care of patients,
I'm very equitable and, likethe amount of work that I'm
asking for them to do, I'mtaking on, you know, an equal
responsibility as well, right,so I hope that, like, even
behind my back, that that's myreputation, um is, you know it
might not be fun, but it's fair.
You know I want to, I want youknow, I want them to feel like I
(06:15):
check in and be like hey, howare you doing?
Can I help you with anything?
Um, I want to make sure thatthey get their break.
You know, like that sort ofthing, um, even with like I, I
mean, we're talking about techs,but like, sometimes our techs
end up like sitting with apatient who's confused and needs
a companion and our staff cant,our staffing office, can't
provide one.
Like, right, I have gone andsat and like covered their lunch
(06:40):
break and sat with the patientand even, and then also
traditionally, if we do get acompanion, a lot of times the
techs are asked to break thecompanion or like the one-to-one
sitter and instead of askingthe tech to do that, I, as the
nurse, is like hey, I have 30minutes, my other patients are
all tucked away.
I can cover this person's breakso that you can continue
(07:01):
helping the rest of the floor.
Christopher (07:02):
Right Now.
So what, in those situationswhere you do kind of alleviate
some of that pressure in termsof like workload and that PCT
just like sits and does nothing,how do you feel?
Colby (07:21):
oh, obviously that's frustrating.
Christopher (07:23):
Oh, I am.
Colby (07:24):
Yeah,
Christopher (07:24):
Yeah
Colby (07:25):
But I also don't let people get away with that like.
I just don't like if I'm busyand I'm busting my, my tail end
to get things done and I noticesomeone sitting on their phone
at the nurse's station.
Like I'll delegate, like I'lllike.
The thing about me is that,like I like, as a new grad, you
have to figure out the balanceof, like, what you should
(07:47):
delegate and what you shouldn't.
Um, and I do think there's alearning curve there for a lot
of people, um, myself included.
I like I like to be in chargeof everything and do as much as
I can.
So that's probably anotherreason why my techs like me is
because I do do a lot of stuffand they're like and that's why,
Christopher (08:04):
Colby's got it.
Colby (08:05):
Yeah, well but that.
But like you said, that couldbecome dangerous because then
they just expect you to dothings.
Christopher (08:11):
Right and and then they get upset if you don't.
Colby (08:14):
Yeah, yeah, but that's like a precedence that you've
set.
So, like for me, if I this is alearning curve that I had to
figure out is like when Irealize I can't do everything,
as to when you can delegate thethings that are delegatable to
the people who can do them, andif I see someone sitting in the
nurse's station on their phoneor chit-chatting and I have like
(08:36):
three sets of vitals I need toget and someone needs to go to
the bathroom, I'm going todelegate something.
I'm going to be like, hey, Ineed you to go and do blah, blah
, blah, please, thank you.
Oh, here's a question for youand I would love to know how you
feel about this.
There was conversation at somepoint about our health system,
(09:00):
somebody in I don't know whereit was, but the conversation
came about where it's like youdon't have to say please and
thank you, it's their job, and Iwas like you don't have to be
rude either.
I was like I don't think that'sa teamwork environment, but okay
(09:24):
.
Christopher (09:25):
Yes, it is our job to do certain things, nurses
included, but you, I've beenreading Nine and a Half Things
Disney, or Nine and a HalfThings Disney Does Different
Than the Hospital, or somethinglike that.
I can't think of the actualtitle at the very moment, but it
(09:48):
it's.
It talks about building aculture of teamwork and
camaraderie, and that is not howyou do it.
Colby (09:57):
No.
Christopher (09:57):
That is not how you do it.
Colby (09:58):
It's a quick way to set a fire.
Christopher (10:01):
Torch the place down.
Colby (10:02):
Yeah, well, that's what I said when someone came back
from one of those things andsaid that.
I said, ooh, don't use thatlanguage here, they're gonna
burn you, they're gonna burn thewhole place.
Yeah, I mean, I'll say thisI've seen nurses do it the wrong
(10:23):
way.
Christopher (10:24):
Yeah.
Colby (10:28):
And I've seen people do it the right way, and you will
too.
And if you think and here'sanother sign If the techs aren't
nice to you,
Christopher (10:35):
oh, you probably aren't doing it the right way.
Colby (10:38):
You probably are not doing it the right way.
Christopher (10:40):
It's true.
Colby (10:40):
That's a surefire sign
Christopher (10:42):
100%.
Colby (10:42):
But yeah, I mean someone's listening to this and
they're like hate listening andthey're like I hate Colby and
she's the worst.
She's the worst nurse she gives.
She gives me a ton of justgarbage to do
Christopher (10:55):
Go ahead and write it down in the comments.
Colby (10:56):
We yeah, call me out.
I'm really not terrible,honestly.
I truly, I truly do still do somuch when I'm on the floor and
I won't ask for help unless Ireally need it.
And if there was something thatwe as far as our techs in
(11:19):
nursing assistants, they do havespecific tasks that are that
they're supposed to do.
Like on our unit we geteveryone gets a morning vital
signs at 8 am and then either Q4or Q8 from that point on.
So, like our techs do that.
Our techs know that Our techsget blood sugars before
mealtimes.
That's something that they do.
And then what is something elsethat they like automatically do
(11:43):
?
I mean they'll help settle thepatient for an admission.
So they'll get the vital signs,EKG, like in assistant with as
an assistance to the nurse, likethey're both in there doing it.
Our our techs will run the QCson our blood glucose machines,
like.
So there are some things thatare just like automatically
delegated and a part of theirdaily routine.
(12:06):
Now there are other things that,like, they do throughout the
day that it's like aconversation with the nurse,
like I said at the beginning ofthe shift, like here's what I'm
gonna need help from you at thispoint.
Like this is what we're gonnado together, this is what I'm
gonna need.
I'll do that kind of thing.
Um, for example, like whenwe're giving certain medications
(12:29):
, um, like Ticasin or Sodalol,and it's a loading dose,
someone's come to the hospitalhave this medication.
Yeah, when someone comes to thehospital to do that, um, we
give the medication, and twohours after that medication is
given, we need to get an EKG.
And so usually I'll have aconversation with my tech, like
(12:49):
immediately in the morning, andsay hey, this patient is on
Ticasin, I'm planning on givingthe dose at nine.
They'll be due for an EKG at 11.
I'll let you know after I givethe dose to confirm what time
the ekg is done right if, forwhatever reason, if you're tied
up around, then just let me know.
I'll go get the EKG.
But like, if not, like, can youplease?
And so, like that's aconversation, I like like, let's
(13:12):
plan our day together, you know.
Christopher (13:14):
It really and truly you know.
So something that nursing schooldoes not teach you is that, yes
, they kind of give you a decentlittle break of what the
non-licensed professional, Ithink, nlp non-licensed
(13:34):
professional, I think that'swhat they usually refer to them
as in terms of NCLEX world.
They give you kind of like abreakdown of what they can do,
right, but they don't teach youhow to actually communicate to
someone and delegate.
That is something that, atleast in my nursing school, was
never actually taught.
I mean, you know, they say youshould delegate, you should do
(13:57):
this, but they never actuallysay what you should do.
Colby (14:00):
Yeah.
Christopher (14:01):
And it really does.
It starts out, you know, assomeone who was a CNA before
becoming a nurse.
I absolutely hated my nurses,hated them because they didn't
do anything.
They just sat at the computerand charted.
(14:25):
Take that for what you will,but there were and you know, in
terms of CNAs in the nursinghome that I used to work for,
there were only really and trulytwo really good ones that would
be helpful to me.
Like I was, I graduated highschool and immediately started
working as a CNA.
(14:45):
Yes, I had a whole semester oflike actual work and I was
working for that, that actualhealth system or that rehab
facility, and I got to know theresidents and the people.
But when you, I mean this waslike a big boy job for myself
(15:05):
and I mean I didn't know what Iwas doing.
So, like it was those two likepillars of CNAs, those two
people.
There was two older ladies,they had been there for years,
they knew what they were doing,they could, they could tell you
a resident back forward sideways.
Colby (15:23):
Yeah.
Christopher (15:24):
You know all kinds of different ways, but it was
those people that really droveme into because, like honestly,
legitimately, this just in I waslike I'm not going into health
care.
Colby (15:37):
Yeah.
Christopher (15:38):
Like even in I knew I was gonna be a doctor and I
was like I don't even want to dothat.
Colby (15:42):
Yeah.
Christopher (15:43):
I'm like if it's anything like this.
Yeah.
If it's anything like this.
Colby (15:46):
Yeah, I'm out.
Yeah.
Christopher (15:48):
I'm out.
Colby (15:49):
Yeah.
Christopher (15:49):
And it wasn't until I really kind of honed in onto
those two that I was like, okay,there is saving grace and
you're going to have to be thatfor other people yeah Right.
Colby (16:06):
You have to set the tone.
Christopher (16:07):
You do, yeah, and so bringing all that story back
together.
So just one thing is that I onething that I absolutely noticed
in terms of just thecommunication between the two
CNAs.
It was, it was solid yeah andthey they could talk to each
other and they could say thingsand it would they.
They got it.
But then they could also justdo things and just know that it
would be done.
You know, like it was just kindof a that weird look.
(16:28):
You know you've given peoplethat like yo don't talk to them,
look, and you know it would, itwould be done.
They did that, except with likeactual tasks that CNAs did and
it was.
It was insane.
They worked like a machine.
I've never seen um but
Colby (16:44):
that's amazing.
Christopher (16:45):
Yeah, it was really cool.
But going back to, I'm makingmy way back, I promise, is that
what Colby's saying in terms ofdelegating?
It's all about communicationand it starts at 7.01.
Colby (16:59):
Yeah.
Christopher (17:00):
It really does.
And we're in a health systemwhere both I know our techs
stagger our start time.
Y'all don't.
Colby (17:12):
Yeah, our techs come in a half hour before our nurses.
Christopher (17:15):
Right.
So that's a vital and also thisalso shows your commitment to
the tech work as well.
Your license covers everythingthe tech does, so don't ever
think that you are not allowedto do any of that stuff, because
you are trained to wipe butts,you are trained to feed, you are
trained to walk people, you aretrained to make sure they go to
(17:37):
the bathroom.
You are trained to do that, andso that 30 minute, like
staggered time, is your abilityto show the tech that you will
do the work.
Colby (17:49):
Yeah, for sure, I think.
Well, yes, I think that's sotrue of our techs.
While they're in report, likeour, if the call bell goes off,
like our, we call them hospitalunit coordinators, but they're
like the secretary, um, theyknow that like the techs are in
(18:10):
report and the nurse, like, willhave to respond to this call
balance, so they'll go to thenurse and say like hey, this
person needs this.
So then, like it's on thenurses to find a partner, if
it's a two-person job, likeanother nurse to go in and do it
.
Like those techs are gettingreports, so that way, when the
nurse is going to report half anhour later, the techs are, you
know, are there?
(18:31):
Yeah, yeah yeah, exactly.
Christopher (18:34):
And really and truly that, like last 30 minutes
, is a good time for you to makesure that pain medicines are
addressed, making sure any othertype of medicine is addressed
any.
I'd like to call them mybleeding and not or excuse me,
not bleeding and shoot.
(18:55):
What do I actually call itbreathing and not bleeding
rounds.
Colby (18:59):
Breathing and not bleeding rounds.
I like that.
Yeah, um, because the last halfhour.
Christopher (19:03):
Yeah like
Colby (19:04):
Because how many times have you finished a shift and
it's like 6.30, you go in to doyour last round and it's
automatically like we call themMET calls but like a medical
emergency team.
Like all the time at the end ofshift because you haven't seen
the patient.
It's been busy the last twohours.
You go in and you're like doingyour final check and you're
(19:25):
like something's wrong yeah,something's wrong.
Oh stroke alert, oh like bloodpressure suddenly tanked.
There's always it's just theluck of your end of shift that
everything goes down the drain.
It always hits the fan.
Yeah.
Christopher (19:39):
Always.
Just be prepared.
Colby (19:41):
Just be prepared.
But yeah, I think it goes back,like you said, to communication
.
If you're not talking about whatyour plans are and sharing that
with each other, like you know,and also they're not your
personal tech, that tech mighthave four other nurses that
they're helping out that day,like you may think, like, oh,
(20:02):
I'm gonna sit down and I'm gonnamake this plan with them, and
they're like I can't do thatbecause I've got this going on
with this patient.
Like to have that conversation,that two way street, like then
you understand, like what theyhave on their task list, and
then you can see like, oh, ok,well, I can do this one.
But if you can do that, likeyou can trade off it's like it's
just so vital the communication, because otherwise, if you
(20:22):
don't, then you're making anassumption that they're doing
something, and then they made anassumption that you're doing it
and then it doesn't get done.
And at whose expense is that the?
patient's.
Well, that's a patient'sexpense but also yours.
Christopher (20:36):
because but it's your license that falls on them.
Yes, yes, Like this is yourlicense.
Yes, they do not have a license.
That's why they're non-licensedprofessionals.
You delegate those things andyou assume that they or you,
they have gone through the listof getting checked off, so you
know that they're able to do it.
So then you, you've got tocircle back and ensure that it's
(20:59):
got.
It gets done, yeah, but to sonursing?
Nursing is like you've got tocommunicate techs and, excuse me
, nurses, you also know thatthey have they could have,
depending on the health systembetween 9 and 12 patients.
Colby (21:18):
Or even more.
I've worked on units wherethere's one tech and like 20
patients.
Technically they're all.
They're all they know.
They're the tech for all thosepatients, which is obviously,
obviously on those.
I won't say obviously, becausehospital, every hospital is
different.
I'm sure there's some hospitalsthat just are not well not
(21:39):
splitting up workload very well,but I mean we would.
That's what that's an exampleof, like how nurses took on
workload.
Uh, you know, like you know, notthat it's extra, but like
obviously, if we don't haveenough techs, then there there
will be more on our plates to doand when we had one tech at a
hospital that was a traveler atlike, nurses would get the end
(22:02):
ofshift vitals and thestart-of-shift vitals, and that
was because that was when themost common labs were due, and
these techs also werephlebotomists.
They didn't have a phlebotomyteam.
Christopher (22:12):
Yeah, yeah, yeah.
Colby (22:12):
So they got the middle-of-the-night vital signs
and then were there to helpanswer all the call bells and
toiling and everything with thenurses.
But the vital signs in themorning and in the night of,
like the two other, ones weredone by the nurses and the
weights were done by the nurses.
That way the tech couldn't goaround and get all the labs.
Christopher (22:32):
And see, that's the thing.
That's the thing our healthsystem is very cush.
Colby (22:43):
Yeah, oh, it's a very cushy place to work.
Christopher (22:46):
And you know you might be listening and you're
like man, they have, they alwayshave two techs, or at least
have two techs, and you knowplenty of nurses Like that
happens.
Colby (23:00):
But to the we often have one tech on my unit at least but
we have a floor rule or aspecialty rule that they don't
take more than 10 patients.
So you could have one tech, butthey're only taking 10 patients
.
So then that means the rest ofthem are technically
(23:20):
quote-unquote nurse-covered.
As far as tech responsibility,
Christopher (23:24):
Right, and we do.
We try our best to respect that,and that's just something that
I think, overall, is somethingthat should be done.
Yeah, but, techs, when you hearthat nurses only have three or
four patients or five, who knowsit doesn't mean that we have
(23:45):
more time.
Yeah it doesn't I.
I know it sounds like it.
You're like there's the, buttake it from me, who has been a
CNA and who had done 13, 14, 15patients at a time.
I get it, I it makes.
It makes no sense in your mind,but when I became a nurse, I
was like it makes no sense inyour mind.
(24:05):
But when I became a nurse, Iwas like I feel like I'm taking
care of 15, 16, 17 patients.
Yeah.
And it didn't change, though Iactually did decrease in natural
patient load.
Yeah.
And I would love to tell youthat it's because I don't know,
I can't even really start tokind of quantify what is the
(24:29):
real reason behind why it's soheavy.
It's a different, I think it'sjust different.
Colby (24:36):
It's just like fully different tasks.
It is.
The reason why a non-licensedperson can do the things that a
tech can is because like not tolike discriminate against a tech
or a nurse's assistant but likeanybody can do those things
right what the responsibility ofa nurse with each patient is.
(24:57):
It takes the degrees that wehave to do it and it's just like
task.
Christopher (25:03):
The tasks that we do are way more involved yeah,
there's, and it's not justphysical, it's a lot more mental
, yeah, than what a tech does.
And there's there's a lot ofthinking and and not theorizing.
Colby (25:18):
But just it's like critical thinking, like you know
, like they're like, oh, you'rejust giving meds.
It's like, oh, I'm not just likescanning and handing them meds
like I have to think like whatthis med is, what it's gonna do,
how is it gonna affect thepatient, what is their vital
signs?
Right now, if I give this med,how is it gonna affect their
vital signs?
Like you have to think aboutthat for each individual patient
(25:40):
, for each individual medication.
You have to look at lab worklike we're.
We're as nurses.
We have way more like criticalthinking involved than we do in
a tech role.
Christopher (25:52):
Yeah.
Colby (25:53):
Yeah, not to say that what the techs do is not vital.
I mean, like you said earlier, alot of times they may be
spending more one-on-one timewith the patient than the nurse
gets to, and they might be thefirst person to recognize, like
hey, their blood pressure ateight o'clock this morning was
140 over 70.
And now it's 80 over like 40.
(26:16):
Like that's a big change.
Like they're the first one tosee that they're getting the
vital signs.
They're coming to the nurse andsaying, hey, something's up,
that's important.
Like important work too.
Christopher (26:27):
It is, and and that's why you are so important
as a CNA, PCT, PCA, NA, all theacronyms.
Acronyms is because you do haveso much information that you
can give a nurse that sometimeswe as nurses are thinking about
(26:47):
another patient and we justdon't know.
So, like when you see that ablood pressure has changed that
drastically, you're probablygoing to be the one to see it
and you've got to let us know.
Colby (26:59):
Yeah.
Christopher (27:00):
If a patient doesn't pee within like four
hours of the shift, like we wantto know, like these are.
These are important things.
Colby (27:09):
Yeah, if you're getting a blood sugar before a meal and
someone's 50, like it's soimportant, like for them to like
let you know so that you canact fast.
And you know some techs thathave been around long enough
know that 50 is critical.
And they'll go get an orangejuice and tell you on the way,
like I'm grabbing an orangejuice, 12 sugars, 50, and then
(27:32):
like you're like, all right, I'mright behind you like it is
that having that assist, havingthat second pair of eyes, having
that second pair of hands, isso important and it's so
important for you to cultivate,like good working relationships
with your PCAs, PCTs, with yournursing assistants, so that,
like it again, it all comes backto the patient.
(27:52):
Like you want to provide thebest patient care and working
with this individual in a team,in sync, like having a plan, is
what is how the best care isgoing to be delivered to the
patient.
Christopher (28:04):
Yeah, and so like all of that involves all types
of communication.
But let's kind of bridge alittle bit further into the
delegation part, like we brieflykind of touched on it.
But like how can you tell whenis it too much and when when is
it not enough?
Colby (28:21):
When is it too much and when is it not enough.
We kind of talked about it alittle bit when we said, like
you know too, when you're notdelegating enough, when you're
feeling frazzled and you'renoticing like the tech is
chilling, that is like a verylike baseline, like very easy
way to tell.
(28:42):
When you're delegating too much, like if you're not doing
anything, there's no reason foryou to not do a task.
Christopher (28:51):
Right.
Colby (28:52):
That like if you were let otherwise, if you were busy,
you would delegate.
Like that gets under my skin sobad.
Like, okay, how about when I'veseen this happen so many times
and I've called people out on ityou walk out of a room.
Christopher (29:06):
And I believe that one.
Colby (29:09):
I've seen a nurse walk out of a room that she was they
I'll just say they, because itcould be a she or he but I've
seen nurses walk out of a roomthat they were in for maybe 30
minutes and then they go up tothe tech and they're like can
you get their vital signs?
Why didn't you get the vitalsigns while you were in there?
You were there for 30 minutes.
Why would you leave the roomand then go ask them to get the
(29:32):
vital signs?
If you didn't have the Dynamapor the B450 or whatever kind of
monitor you have with the tocheck the blood pressure?
Then you left the room anyways,you might as well just went and
got it and go right back andget them real quick, like,
unless there's something that'slike so crazy that you have to
go to the next patient.
You're like, hey, this is goingon.
Like, can you, can you go backin there and get those vital
signs for me real quick?
(29:53):
I need to go check on thispatient.
Like, unless there's like anextenuating circumstance, just
get them while you're in there,and it's very rare that that
extenuating circumstance isactually happening.
Yeah, no, exactly that's why I'msaying that's when it's too
much delegation.
Yeah.
Christopher (30:14):
And I mean I think there's a very fine line in that
, because there are times whereyou're like I see the PCT there,
like they could easily do it.
When I have, you know, timelymeds that I still have to give,
like I get it.
But like you you said you werein there for 30 minutes you
could.
The blood, the blood pressurecuff is automatic, so it runs by
(30:36):
itself.
Colby (30:36):
Yeah, it's not like you're doing a lot of heavy
lifting.
Christopher (30:39):
So like you know.
and then you, your pulse ox isautomatic, so you don't have to
do much, for I mean you can't doanything manual for the O2, but
you don't have to count thepulse.
Colby (30:51):
Yeah, the only thing you have to count is respirations.
Christopher (30:54):
Respirations.
Colby (30:54):
Everything else is digital.
Christopher (30:55):
I'll tell you so like five minutes at most.
Colby (30:59):
Yeah, it really shouldn't be that long.
Christopher (31:01):
It takes me a little longer, but you know it's
been a while.
Colby (31:04):
It does not take you more than five minutes to get a set
of vital signs.
Um, I think that's anotherthing, like why techs can take
on more than a nurse, becausethe tasks that they do have can
be done quickly.
Yeah, like generally, it shouldnot take more than five minutes
to do vital signs.
No, maybe if you're having alot of conversation, the patient
asks you to go get a water inthe middle of it, like that kind
of thing.
(31:24):
Sure, but they don't take theirtests, don't take as long.
But
Christopher (31:29):
Well, if if you know anything about patient
satisfaction scores and one ofthe like major patient
satisfaction companies forhospitals is Press Ganey and one
of the questions that is PressGaney and then another one is
Gallop g-a-l-l-o-p?
Um the one of the other, one ofthe questions actually both of
(31:52):
them ask, is anticipating yourpatient's needs yeah as nurses.
I just remembered I alwaysbrought a cup of water.
Colby (32:01):
Yeah, you pull your meds, you get a cup of water.
Christopher (32:03):
You got a cup of water.
Colby (32:04):
I think, and some of our techs that I've experienced,
some of my techs are also likethat, like when they come
through in the morning.
Well, it's tricky on my floorbecause we have heavy heart
failure.
So you have to make sure, likeand that sort of thing.
But like, if there isn't afluid restriction on a patient,
like a lot of my texts arereally good about.
Just like getting a water goingand getting vital signs getting
(32:25):
a water going and getting vitalsigns, like it's just, it just
becomes like secondhand practice, like you just got to
anticipate it.
And also like toileting inadvance, being like, hey, while
I'm here, do you need to go tothe bathroom?
Like that's another thing.
Like, if you're I hate that.
Like you're as a nurse, hatethat, like you're as a nurse
(32:46):
they walk out and they're likehey, this patient needs to go to
the bathroom oh okay, you werejust there, just there welcome
to the bathroom please like Ijust can't, like, I can't wrap
my head around that one and I'veseen people do it and I'm
always like shocked every time.
Like what?
And I again I think like it isin the, in the scope of
responsibility for Charge Nurseto I don't want to say call out,
(33:12):
but like call out behaviorslike that.
And on both sides
Christopher (33:16):
Right
Colby (33:16):
A lot of times.
Christopher (33:18):
You're maintaining a culture.
You're not calling it out,you're just maintaining the
culture.
Colby (33:22):
Maintaining a positive yeah, a positive work
environment.
And.
To let nurses get away withthat kind of behavior is not
like going to provide you with a, with a patient positive
experience like that's.
Christopher (33:37):
A patient positive experience or a employee or
teammate positive experience.
Colby (33:44):
Yeah, either one.
Christopher (33:45):
I mean I don't want .
I have to catch myself at timesbecause I'm like, hey, can you
do this?
Because I need to go back tothe office.
I mean I have an RN behind myname, I have not lost my license
, I just renewed it this pastyear.
Like, I still am able to dothose things and I have to
(34:06):
remember that.
You know, sometimes I should doit.
I mean it's just.
Colby (34:10):
Yeah, I think, and, like I said, it goes both ways too.
Like, if you notice like theremight be some beef between a
tech and a nurse and you're inthat charge nurse role, you have
to a lot of times, like try toresolve that between the two.
Like I hear you need to listento both sides, you need to, you
(34:30):
know, say like hey, I hear whatyou're saying this is, and then
like try to get them to get onthe same page and then remind
everybody that ultimately, it'snot about it's not about one or
the other, it's about again I'mgonna say, it's about the
patient making sure that theyget the care that they need.
And I think a lot of timespeople take situations like this
(34:52):
.
Again it becomes, if it's a badsituation with, like, a nurse
and a tech, or beefing, it's apersonal thing.
Yeah, and we need to rememberto leave, like like we can
handle personal things, butright now we have to get this
work done for the patient.
We need to put that to the side,Like when we walk through this
door threshold into the patientroom.
It's about the patient.
(35:13):
It is.
And that should be our firstpriority.
Christopher (35:17):
What do you do when a PCT like shows favoritism?
Colby (35:23):
This is completely off script.
Yeah, this is off script.
Yeah, what do you mean likeshows favoritism?
Christopher (35:27):
So I I remember a particular tech on my floor when
I was an actual nurse on thefloor, um, I mean, it was kind
of like ensure that all thethings were done for me, but I
mean like to a T but, but it waskind of like whatever yeah.
(35:48):
For everybody else.
Colby (35:50):
I mean again.
Christopher (35:51):
I appreciated it.
Colby (35:54):
Thank you.
I mean I think that goes backto like your.
You have a working relationshipwith that, with that tech.
You know like you and not tosay that that's the right thing,
but it kind of just shows thatlike you're a better example of
a nurse and what everyone elseshould strive to be, if that
tech likes you so much that theydid everything to a T and then
(36:16):
they were just kind of blaséabout everyone else.
What's going on there?
There's a bigger question andthat's more for management.
But also in the moment.
Are you asking me, I'm a chargenurse or I'm one of the nurses
that's getting neglected?
Christopher (36:30):
I'm saying charge
Colby (36:31):
okay, well, I mean either way, I mean personally, but as
charge.
I mean, if I see it and it'sblatant, I don't know.
I feel like here's the thing.
I feel like a lot of times it'scharged.
I might not notice somethinglike that it's like, as long as
they're working and they're notjust, like you know I'm not
going to notice that they dideverything like you know, and
then like left some things tothe side unless it gets brought
(36:53):
to my attention, um, but let'ssay it does get brought to my
attention.
I mean I have to address it andthat's like a critical and
awkward conversation, but it hasto be done.
I mean you want to just likesay, hey, like what's going on,
like it's been brought to myattention that like you're not
(37:14):
doing x, y and z for these threenurses, like did something
happen?
Like what's, like was there aconversation?
Like you need to get to thebottom of it and figure it out,
I mean, and then just go fromthere.
Christopher (37:27):
No, that's fair.
Colby (37:28):
It's not a comfortable conversation but when you're,
when you're in a leadership role, you have to have uncomfortable
conversations quite frequently,unfortunately.
Christopher (37:36):
Yeah, I'm learning that very quickly actually.
Yeah, it's not fun at all.
But I mean and it another likeexcerpt very much to your point.
You can't just make a blanketstatement at huddle, you have to
target that person.
(37:56):
And it's not targeting in termsof like aggressive or mean or
malicious.
It's targeting to understand youknow it's like hey, I.
.
.
Colby (38:06):
I mean it's just getting to the source.
Like, if you know that it's nota blanket issue, why would you
give a blanket statement.
Like, if it's not all of thetechs doing something or all of
the nurses doing something, whywould you just say like, hey,
everyone, because one that'sgoing to create more animosity.
Because I will say personally,when that does get done, because
(38:27):
for some reason, there is aleadership style like that where
, like, something bad happenedwell.
Christopher (38:33):
It's because it's easier to do.
Colby (38:34):
And there's it it is, but it doesn't make you a good
leader and I'll say that unlessit's a consistent I would say
this unless it's a consistentissue, unless it's a blanket
problem, right it like.
If it's a blanket problem, thenit warrants a blanket response
yeah if you know who's doingsomething, it needs to be
(38:58):
directly like intervened rightyeah, like otherwise, what's the
point?
because, as someone who knowslike, I don't know why they're
saying this right now I did allthe a, b, c, a, one, two, three
tasks and I do it every shift.
Yeah, and I do it every shift.
Why are they saying this?
(39:18):
There's like probably six otherpeople that have that same
thought and then they get angry.
They're like you know I getupset At least I'm like I always
do that.
Why are they saying that?
But really they're talking tolike one or two people and
(39:41):
you're like, just talk to thosetwo people.
So they said that's gone offtrack a little bit.
But I just think like, yeah, ifyou know specifically that it's
one or two people, you need totalk to those one or two people
to figure out what's going on.
Sometimes somebody just needsto be heard, or you, you hear
what's going on.
You're like oh, you'refrustrated because of this, this
and this.
Okay, let's see what we can doto mitigate and like fix the
problem so that we can all getback on track.
Christopher (39:59):
Yeah, all right, it's time for Pop Quiz.
In this segment, we're divinginto one or two NCLEX style
questions to test our knowledgeand see how we stack up.
Colby and I will each take ashot at answering the question
and then I'll break it down withthe correct answer.
We'll also chat about howrealistic, or sometimes
unrealistic, these questions canbe in the real world.
(40:20):
Let's see how we do.
Colby (40:22):
Okay, I'll read the first question to you because, this
is kind of like in my wheelhouse, so I already knew the answer
earlier.
Christopher (40:27):
Well, you say that I do deal with kidneys.
Colby (40:30):
You do, but like come on.
Christopher (40:36):
Oh wow, okay.
Colby (40:36):
This question was made for me.
Christopher (40:37):
Yeah it was, so I'm gonna read it.
Colby (40:38):
Oh, accident, it was really by happenstance.
All right.
Question number one a nurse iscaring for a client.
I hate that they use client nowby the way sidebar.
Yeah, I hate that.
They're patients, come on.
Christopher (40:50):
So so okay'm going to continue on this sidebar.
Interestingly enough, thereason why Walt Disney calls
their.
.
.
Colby (41:00):
Patreons.
Christopher (41:02):
Yeah, the people that come to the, they call them
guests, yeah because they'reguests in their amusement park.
Yeah, yeah, yeah, but like it's, it's all about patient
satisfaction.
Colby (41:16):
I know and that I feel like I get it.
But also there needs to be aline of like patient
satisfaction, but also likelet's remind you that you're
sick and we're providinglife-saving care.
Christopher (41:26):
Okay, that's okay.
Colby (41:27):
There's like I feel like there's a fine line.
Christopher (41:30):
Client, doesn't work like that?
Colby (41:32):
No, because they need to be reminded that they're a
patient.
I'm not working for them.
Like it's a different mindset.
You know what I mean.
Yeah, like if I have a clientlike I'm working for them, I'm
investing their money.
I'm doing blah, blah, blah.
I'm saving your life, and it's alittle bit more.
Christopher (41:46):
It's a little bit different than working for you.
Colby (41:48):
I'm working for you, I'm to keep you alive.
Yeah, sorry this is way offtopic, but I would love for you
to keep this actually in thepodcast, okay, okay, anyway,
don't edit that out.
Christopher (42:00):
I won't.
Colby (42:00):
Back to the segment break .
Question number one a nurse iscaring for a client with heart
failure who has been prescribedFurosemide, also known as Lasix.
Which of the followingassessment findings should the
nurse report to the healthcareprovider immediately?
A.
A blood pressure of 102 over 68.
(42:21):
B.
Potassium level of 2.8.
C.
Urine output of 250 millilitersover eight hours or D.
Heart rate of 82 beats perminute.
Christopher (42:38):
So I mean blood pressure, it's okay.
Colby (42:40):
Yeah, you know, it's fine For a heart failure patient.
Sounds about right.
Christopher (42:43):
Yeah, luckily I have delved into your world
before.
Yeah, urine output is fine.
Yeah, and then the heart rateis good, super soft.
I'm not worried about Lasixdropping any type of heart rate
anytime soon, right?
So I mean, I think I'm going togo with B potassium level of
2.8 because of it being low andLasix lowers potassium.
Colby (43:10):
Yes, yep.
Christopher (43:11):
Look at me.
Colby (43:12):
So B potassium level of 2.8 is the correct answer.
Um.
So for anyone that's notfamiliar with diuretics, um,
there's a few different kindsbut furosemide or lasix.
That's actually a loop diureticand that causes the body to
lose potassium.
Um, a potassium level of 2.8 iscritically low.
Um, normal range is 3.5 to 5.
(43:35):
But in our world we really liketo see our potassium Like in
cardiology we really love to seepotassium at least 4.
So whenever it drops below 4,our providers are ordering
potassium repletion.
When the potassium does get low, it has a higher chance of
causing lethal rhythms, lethalcardiac arrhythmia.
(43:58):
So we want to keep thosepotassium within a good normal
range.
Christopher (44:03):
You be dead.
Colby (44:03):
Because we don't want to have to save your life
Christopher (44:07):
We want to stop you before.
Colby (44:09):
Right.
And then when Christopher wentthrough all the other options
and why they weren't the rightanswer, those are all legitimate
.
Blood pressure's fine, theurine output was fine and the
heart rate was absolutely normal.
Christopher (44:23):
And so, interestingly enough, when I
learned in nursing school,potassium is a wimp.
It is a wimp of an electrolyteit moves the fastest away yeah.
It does all kinds of stuffweird to the body.
Colby (44:41):
Yeah.
Christopher (44:41):
It's just a wimp.
Colby (44:43):
Yeah, potassium sucks.
Christopher (44:44):
It does, and it's the biggest dang pill to
actually use.
Colby (44:48):
Oh my God, they're like horse pills.
Yeah, they're massive.
Patients hate them and then likeou can't cut them because
they're like enteric coated youcan't smoosh them up, the big
white ones.
You can't squish them.
Yeah, that's what I'm gonnasquish them up, yeah.
And then the powders tastedisgusting and then the iv
version burns the shit out ofyour veins.
(45:09):
So potassium's not fun toreplete, it's not fun to lose,
it's not fun to mess with it.
It's not fun to lose, it's notfun to mess with.
It's also not fun when it'selevated, like if you're above
five, we have to do likehyperkalemia protocols to get it
back down.
It's just.
Potassium is a rascal.
Christopher (45:28):
It's a rascal.
It's the one that's easilyhemolyzed.
It's just a rascal.
Yeah.
So a nurse is caring for aclient with type 1 diabetes who
reports nausea and abdominalpain.
The client's blood glucoselevel is 350 mg per deciliter
(45:52):
and ketones are present in theurine.
Which of the followinginterventions should the nurse
perform first A.
Administer regular insulinintravenously.
B Start an IV infusion ofnormal saline.
C Administer an anti-emetic asprescribed, or.
D Notify the healthcareprovider.
Colby (46:15):
Okay, so this is a classic NCLEX question situation
where you're like there'smultiple right answers here.
Yes, and the first time that wewent through this question I
said D notify the healthcareprovider, because I was like,
yeah, I think we're going to dothat first, but unfortunately
(46:37):
that's not the right, that isnot the right answer.
Christopher (46:39):
It's actually starting an iv infusion of
normal saline and here's why theclient is exhibiting signs of
diabetic ketoacidosis, alsoknown as dka, a life-threatening
condition characterized byhyperglycemia, ketonuria and
dehydration.
So rehydration with normalsaline is a priority
intervention to restorecirculating blood volume and
(47:02):
improve perfusion.
Once rehydration has begun,other interventions can follow.
With a wonderful key NCLEX tipin DKA always prioritize your
ABCs, your airway, breathing andcirculation.
I'm sure you've heard it manytimes in nursing school.
So those principles.
Rehydration addresses thecritical issue of circulation
(47:26):
and takes precedence over otherinterventions.
Colby (47:30):
Yes, so that is, like I said, a classic NCLEX question,
where it's like very easy to getcaught up and I fell in the
trap because my I go straight tolike my, my actual practice
brain where I'm like, well, Iwouldn't.
Just while I know startingnormal saline makes sense and I
can anticipate that the doctorwould do that.
(47:52):
If I'm suspicious of DKA, I'mgoing to page the doctor first.
What I thought that the answerwas going to be.
My second guess was likeadminister the anti-emetic as
prescribed, because they saidthat they were nauseous and
there's already an order for it.
So, with the answer actuallybeing the saline, I was kind of
surprised because it didn't saythat there was already a
(48:14):
standing order for it orsomething.
So it's just a tricky NCLEXquestion, classic, exactly what
you'll see in the actual boardtest.
You're going to run into thoseones where you're like there's
multiple things right here.
You have to figure out whichone's the most right.
So while I knew instantly theanswer to the first one, without
even having to take a a secondto think about it, the second
one, even after 10 yearsexperience NCLEX style question,
(48:36):
got me tripped up
Christopher (48:37):
Well and that's the thing right, like in in nursing
world and you're in nursingschool, you're taught the s-bar
right situation.
So here's the situation.
The situation is there's type 1diabetes patient who reports
nausea and abdominal pain, has aglucose of 350, ketones are
(48:57):
present in the urine.
Background is probably the type1 diabetes part.
Assessment is the ketones inthe urine part and the
recommendation is starting the.
Iv of normal saline.
So you're notifying thehealthcare provider.
That's what we do in the actualhealth system.
Is the starting the IV ofnormal saline?
(49:19):
So you're notifying thehealthcare provider.
That's what we do in the actualhealth system.
And it's so unfortunate becauseI mean I somewhat guessed my
answer.
I mean I did, I was like oh
Colby (49:26):
yeah, christopher got it right immediately and I was like
oh, that's probably right, Iwas like I was.
Like I was like it's DKA.
Christopher (49:31):
But yeah, but you know and that's the thing you
kind of have to think about whatthe patient is actually going
through.
But you do this on a dailybasis.
Yeah, you do it, and you wouldnot start IV fluids before
notifying the provider.
You won't.
The only time you'll do itmaybe is if you're in the ICU
(49:52):
Excuse me Sorry, maybe, and eventhen it's yeah.
Colby (49:58):
I mean, usually when you're in the ICU, your
providers are right there soyou're just kind of being like
working together we're doing.
Christopher (50:05):
I'm moving my, I'm moving my face away from the mic
.
I don't know if y'all heard mepop your head in.
It was like, hey, I'm justdoing this, is that okay?
Colby (50:13):
yeah yeah, yeah, yeah.
And they're like oh, yeah, yeah, yeah, I'm putting the order in
right now.
So, like you're workingsimultaneously in the ICUs Cool.
Christopher (50:21):
Well, great job.
If you feel like you would wantto hear more NCLEX questions,
just let us know.
And also, if you thought thesewere pretty tough and are
terrified NCLEX now it's okay.
Yeah, you have time and youmight not ever get this question
(50:42):
.
Colby (50:42):
Yeah, or maybe you just passed your boards and you're
like, oh, listen to thisquestion that I got.
That is going to haunt me.
For the rest, of my life, yeah.
And then I looked it up after Iwalked out of the test.
Christopher (50:52):
Do you have one?
Colby (50:53):
No, I don't, honestly, that was such a traumatic
experience, I literally blackedout.
So I passed, but I blacked out.
Christopher (51:00):
That's good, I'm glad.
Colby (51:02):
But if there are any that haunted you, send anyone else
to like.
If you want to share, let usknow.
Do you have any that haunt you?
Christopher (51:09):
No, I don't remember.
Colby (51:09):
Yeah, I feel like a lot of people's shared experience
would be like.
I don't remember, but if thereis one, share it with us.
Christopher (51:17):
I remember the drive home.
Colby (51:20):
I don't Wow, it was such a long time, good, so I want to
go back to journaling.
So I don't have a good memoryfor small things like that.
I remember afterwards I waswalking around a mall and I was
on the phone with my mom and Iwas like I don't know what just
happened.
I was like I'm shocked, I'm inshock
oh god
Christopher (51:41):
Do you feel a good relationship can drastically
change your shift?
Colby (51:45):
Oh for sure.
yeah, I mean I definitely thinklike the difference between
working with a tech thatnormally works on my floor and
working with a tech who gotfloated to my floor Definitely
two different experiences.
Like when I'm working withpeople that I have known for a
while and I have a goodrelationship with, like someone
(52:05):
you can like not that you can'tshare a laugh or joke around
with someone you don't know,aLike you can, but some people
are very serious um, a nd youknow it's the difference between
like making it through yourshift and being like all right,
it was fine, it was a good shift, I survived, we all survived.
and then like having a good timeand like right cutting it up
with your friends and like yeahlike getting the work done, but
(52:27):
also being like I'm wiping poopfrom this person while they're
holding the leg and like we'rejust like making eyes, like
sometimes you can like do thatsilent giggle like I cannot
believe that just happened.
Like you know, it's likedifferent when you're working
with your friends versus workingwith, like, someone you don't
know, but they're a colleague,whatever
Christopher (52:45):
Yeah, no for sure, and you know you talked about
how there are times where nursesdo not have text covered.
Tech coverage do you?
What does it make you feel interms of having techs when you
(53:06):
don't have tech coverage?
Um it's kind of a differentquestion than what's actually
written down yeah, so you're.
Colby (53:15):
My brain kind of like skipped, though.
So, like you're asking, likewhen we have techs but they're
not covered for all yourpatients, right, how does it
feel?
Like when you're I mean, listen, I think, if you're working
well as a team, even if the techisn't assigned to your patient,
and you have a goodrelationship and like everyone's
(53:35):
tied up and the tech happens tobe sitting there, like you have
a good relationship, like hey,can you just help me turn this
patient real quick?
Yeah.
Like it's not going to be a bigdeal or a big ask.
You can.
I mean you can ask anybody thatyou know.
It doesn't.
You don't have to ask like thetech.
Obviously, if they're notassigned, you don't have to ask
them.
You can.
It shouldn't be a big deal tohave a turn.
(53:56):
But everybody that works on thefloor, it should like.
We used to have this saying onour unit.
We don't use it quite often,but it's just kind of like a
culture of like it's all, it'sall 28, and 28 was the amount of
patients that we had on ourfloor.
So all 28, like it's not.
Oh, I have four patients andI'm not going to help you.
Or.
I have like or I'm a tech.
I have these 10 and I'm nothelping you with the rest.
(54:18):
Like we're here for all of themand like if I'm free, I'm going
to help you.
So it's like never fun whenyou're short-staffed, it's never
going to be like the best dayyou've ever had.
But that's just not going tohappen.
Like there's going to be apoint in the shift where you're
like you're like Jesus, I can'tbe in six places at once.
(54:40):
Like give me a break.
But if you're working with,with good people and everybody
has that teamwork mindset, likeit's not, it's not going to be
the worst shift, either You'llget through it.
Yeah.
Christopher (54:53):
Yeah, yeah, yeah.
I think and I'm really justkind of coming back from when I
was on the floor I know that Ireally appreciated the days that
we were fully staffed.
Colby (55:06):
Oh yeah.
Christopher (55:06):
It was like oh wow.
But then it was like when thetech was like hey, I'm busy, I'm
like you know what I get it.
Yeah.
You know, like, okay, like.
Colby (55:17):
Yeah, no problem.
Christopher (55:19):
No problem, no big deal.
Colby (55:19):
That happened today.
I mean today we had if we havethree techs, technically that I
mean I think technically ourunit, when our unit's full, we
qualify for four techs, which isthat hasn't happened in years,
I'd say.
Christopher (55:32):
Because if we have four techs, that is a unicorn
I've yet to see.
Colby (55:36):
Yeah, I was like if we have four techs that are
scheduled in the same day,they're pulling them to help,
like, cover other units.
So we never have more thanthree on the floor in the last
few years.
But when we have three, thatmeans all of our patients are
covered by a tech with, as wellas, obviously, our nurses.
The day goes by so much easierwith, as well as, obviously, our
nurses.
The day goes by so much easierand like literally today I had a
(55:56):
LIP reach out to me and saidhey, I went to go message the
nurse, but they're on, do notdisturb.
I didn't want to bother them.
If they were on lunch, do youmind going to recheck a blood
pressure?
I was in the charge role so Iwas like no problem, we'll get
it done.
So I reached out to the techbecause the NP didn't know who
the tech was.
So I was like I reached out tothe tech.
I said, hey, can you recheckthis patient's blood pressure?
(56:18):
And she, the tech, replied backto me she's like I'm on lunch
but I'll do it afterwards.
And I said, oh poo, don't worryabout it, I'll go down there
and get it, no problem.
Like I was, like I let her haveher lunch, like it's not a big
deal, like I can go get it.
I have a second.
Like no NBD, but like NBD NBD nobig deal, like I will go and
(56:38):
get that.
Like it's just like you justappreciate having having them.
When you actually get them,it's just a different vibe for
your whole shift, like you justless worries, less stress, like
they're probably they're thebackbone of the hospital, truly
so.
When you actually have like afully staff ship, it's like oh
(56:59):
amazing it's so great yeah, likethe angels are like
Christopher (57:05):
um, and we talked about this, uh, in, actually I
think was it the first or secondepisode?
It was earlier.
But being a CNA before being anurse, was it the first episode?
I really we definitely.
Colby (57:23):
Yeah, we talked about this before.
Yeah, definitely gives you anadvantage.
Christopher (57:27):
Yeah, 100%.
Colby (57:28):
Yeah, we were going to.
And again, I'm sure otherpeople would agree that it
definitely gives you anadvantage of being a CNA, makes
you better nurse and you canspeak to that because you did
that as well.
Christopher (57:43):
Yeah, but I mean I can't tell if I'm a better nurse
or not.
I can't say that.
That would be very conceited ofme.
I think it does, though I thinkit does, though oh no, I mean,
I have seen other people and Ido.
I think it does make them abetter nurse.
They're just more aware andthey're easier to delegate
(58:05):
things, but they are also easierto be overwhelmed by not
delegating things.
Colby (58:10):
True, yeah, I could see that as well, because they know
how it feels to be like.
They know what feels to feellike they've been over delegated
, being like why don't you lazynurses do something?
So then they want to like tryand do more than what they
probably should.
Yeah, yeah, I can.
I've seen it both ways.
I've seen them.
(58:30):
I've also seen a former CNAthat's become a nurse be like
now you can do all my stuff andjust like be kicking back.
And I've been like okay, that'snot remember how you felt when
that was done to you, like comeon redirect.
Christopher (58:46):
I can't imagine.
Yeah, it's like uh.
Colby (58:49):
but I think for the majority, though, I would say
yes, it definitely makes adifference on the positive side
of things, to come in with thatexperience before nursing.
Fair.
Does that wrap it up?
I think so.
I think that wraps it up.
Christopher (59:10):
Class dismissed.
That's a wrap for today'ssession of Nursing Lyfe 101.
We hope you found some usefultakeaways to bring back to the
floor.
Remember, nursing is a lifelonglearning journey and we're here
with you.
Colby (59:23):
If you want to connect, find us on Twitter at
NurseLyfe101, or on Facebook atNursingLyfe101.
And don't forget to subscribeand share with fellow nurses.
Until next time, take care ofyourselves, which is what I need
to do.
Clearly, I have a cold.
Christopher (59:37):
100%.
Colby (59:39):
And keep making a difference out there.
Welcome to Nursing Lyfe 101, the most important
nursing class you never got totake in nursing school.
We will be traversing differentobjectives, like interviewing
what to do in nursing school,boundaries burnout and so much
more, if this interests you.
I hope you are taking goodnotes because class is now in
session.
Colby (00:46):
Hello and welcome to Nursing Lyfe 101.
We're so excited to have youhere with us as we dive into the
world of nursing, sharing ourexperiences, insights and a
little bit of fun along the way.
I'm Colby, but I couldn't behappier to introduce my co-host.
Christopher (00:59):
What's up, guys?
My name's Christopher.
Together, we'll be bringing youreal stories, practical tips
and discussions about all thingsnursing, whether you're a
fellow nurse or just curiousabout the life behind the scrubs
, we're thrilled to have youjoin us.
Colby (01:13):
All right, so today's topic.
Christopher (01:16):
Today's topic is an interesting one relationships
between PCTs, CNAs and nurses.
Colby (01:29):
And nurses.
Yeah, so to start a PCT or aCNA are basically the same thing
with a few nuances.
Christopher (01:39):
Right.
Colby (01:39):
But what you could summarize, it is like your
nursing assistant.
Christopher (01:44):
Yeah, yeah, yeah.
Colby (01:45):
So, depending on the hospital or certification, they
have a range of skills that arewithin their scope of practice,
but generally they're there asthe nurse's assistant to the
patient.
Christopher (02:07):
And really and truly.
They probably see a patient alot more than a nurse does,
because they're the ones that doa lot of the bathing, a lot of
the toileting, the feeding allthose various things that nurses
tend to not have as much timeto be able to do because we have
other things that we have toprioritize.
Colby (02:28):
Yes, um.
So basically anything thatnurses can delegate um to below
them not below them isn't reallya good term, but um as far as
like degree.
I guess um is what a nurse'said or assistant tech will do.
Christopher (02:53):
Yep, what would you say?
Or what do you think PCTs sayabout you?
Colby (03:01):
Oh, I think
Christopher (03:01):
To your face and then, I guess, behind your back.
Colby (03:03):
Okay, I think generally I have really good relationships
with my techs, nurses, aides,whatever, what have you but I
also feel like that's becausethey respect me in the sense of
like, if I need help, I'm goingto ask them to help me, but if
(03:27):
I'm not busy, I'm going to dothe things that technically are
like in the scope of theirpractice.
Christopher (03:33):
Right.
Colby (03:34):
Like, for instance, like if a patient rings and they want
a cup of ice and I'm not doinganything, I'm going to bring
them a cup of ice.
I'm not gonna say, okay, we'llsend your tech in and then go
look for the tech and say, canyou bring them a cup of ice?
And then continue on liketalking or whatever.
Christopher (03:51):
yeah, and that's interesting because that leads
on to various things.
On like how do you think interms of like, gaining that
respect, for example, like youas a nurse, you can't when
(04:12):
you're new, you can't just sayyes to all of it.
You can't.
Colby (04:16):
Yeah, you've got to find a balance.
Christopher (04:18):
Right.
But like, how do you gain thatrespect?
Because you do.
You want to say, yes, I'm thereand available.
Colby (04:23):
Yeah.
Christopher (04:23):
But like you can't just.
Colby (04:27):
I think it's really important to establish like a
good report in the beginning ofyour shift.
I mean, generally, unlessyou're in like a float pool
situation, you're gonna beworking with these staff members
pretty consistently, true, andyou want to, you want to grow
healthy and good workingrelationships with all of your
(04:47):
co-workers.
I like to get report and then Igo find my tech and say like
hey, here's what I've got forthese patients today.
Like I'm going to do this andthis or, and at this time I'm
going to need like help withthis point.
Or, like you know, try to comeup with a game plan together.
I think you know that's gonnabuild a trusting working
(05:08):
relationship.
Um, you've established, likefrom the beginning of your shift
, like this is the help that Iknow I'm gonna need right now,
like what this patient's gonnaneed today from both of us.
Or like maybe you could takethis for me and blah, blah, blah
, I think probably behind myback.
No, I think it's probably muchof the same.
(05:31):
I think you, you know youcultivate these relationships.
I think I don't know.
I feel like my my as a chargenurse, like my nurses and my
techs know that.
I try to make everything veryas fair as possible and I am
(05:52):
very equitable when it comes tolike assignment making.
So, like when I'm on the floorand I'm taking care of patients,
I'm very equitable and, likethe amount of work that I'm
asking for them to do, I'mtaking on, you know, an equal
responsibility as well, right,so I hope that, like, even
behind my back, that that's myreputation, um is, you know it
might not be fun, but it's fair.
You know I want to, I want youknow, I want them to feel like I
(06:15):
check in and be like hey, howare you doing?
Can I help you with anything?
Um, I want to make sure thatthey get their break.
You know, like that sort ofthing, um, even with like I, I
mean, we're talking about techs,but like, sometimes our techs
end up like sitting with apatient who's confused and needs
a companion and our staff cant,our staffing office, can't
provide one.
Like, right, I have gone andsat and like covered their lunch
(06:40):
break and sat with the patientand even, and then also
traditionally, if we do get acompanion, a lot of times the
techs are asked to break thecompanion or like the one-to-one
sitter and instead of askingthe tech to do that, I, as the
nurse, is like hey, I have 30minutes, my other patients are
all tucked away.
I can cover this person's breakso that you can continue
(07:01):
helping the rest of the floor.
Christopher (07:02):
Right Now.
So what, in those situationswhere you do kind of alleviate
some of that pressure in termsof like workload and that PCT
just like sits and does nothing,how do you feel?
Colby (07:21):
oh, obviously that's frustrating.
Christopher (07:23):
Oh, I am.
Colby (07:24):
Yeah,
Christopher (07:24):
Yeah
Colby (07:25):
But I also don't let people get away with that like.
I just don't like if I'm busyand I'm busting my, my tail end
to get things done and I noticesomeone sitting on their phone
at the nurse's station.
Like I'll delegate, like I'lllike.
The thing about me is that,like I like, as a new grad, you
have to figure out the balanceof, like, what you should
(07:47):
delegate and what you shouldn't.
Um, and I do think there's alearning curve there for a lot
of people, um, myself included.
I like I like to be in chargeof everything and do as much as
I can.
So that's probably anotherreason why my techs like me is
because I do do a lot of stuffand they're like and that's why,
Christopher (08:04):
Colby's got it.
Colby (08:05):
Yeah, well but that.
But like you said, that couldbecome dangerous because then
they just expect you to dothings.
Christopher (08:11):
Right and and then they get upset if you don't.
Colby (08:14):
Yeah, yeah, but that's like a precedence that you've
set.
So, like for me, if I this is alearning curve that I had to
figure out is like when Irealize I can't do everything,
as to when you can delegate thethings that are delegatable to
the people who can do them, andif I see someone sitting in the
nurse's station on their phoneor chit-chatting and I have like
(08:36):
three sets of vitals I need toget and someone needs to go to
the bathroom, I'm going todelegate something.
I'm going to be like, hey, Ineed you to go and do blah, blah
, blah, please, thank you.
Oh, here's a question for youand I would love to know how you
feel about this.
There was conversation at somepoint about our health system,
(09:00):
somebody in I don't know whereit was, but the conversation
came about where it's like youdon't have to say please and
thank you, it's their job, and Iwas like you don't have to be
rude either.
I was like I don't think that'sa teamwork environment, but okay
(09:24):
.
Christopher (09:25):
Yes, it is our job to do certain things, nurses
included, but you, I've beenreading Nine and a Half Things
Disney, or Nine and a HalfThings Disney Does Different
Than the Hospital, or somethinglike that.
I can't think of the actualtitle at the very moment, but it
(09:48):
it's.
It talks about building aculture of teamwork and
camaraderie, and that is not howyou do it.
Colby (09:57):
No.
Christopher (09:57):
That is not how you do it.
Colby (09:58):
It's a quick way to set a fire.
Christopher (10:01):
Torch the place down.
Colby (10:02):
Yeah, well, that's what I said when someone came back
from one of those things andsaid that.
I said, ooh, don't use thatlanguage here, they're gonna
burn you, they're gonna burn thewhole place.
Yeah, I mean, I'll say thisI've seen nurses do it the wrong
(10:23):
way.
Christopher (10:24):
Yeah.
Colby (10:28):
And I've seen people do it the right way, and you will
too.
And if you think and here'sanother sign If the techs aren't
nice to you,
Christopher (10:35):
oh, you probably aren't doing it the right way.
Colby (10:38):
You probably are not doing it the right way.
Christopher (10:40):
It's true.
Colby (10:40):
That's a surefire sign
Christopher (10:42):
100%.
Colby (10:42):
But yeah, I mean someone's listening to this and
they're like hate listening andthey're like I hate Colby and
she's the worst.
She's the worst nurse she gives.
She gives me a ton of justgarbage to do
Christopher (10:55):
Go ahead and write it down in the comments.
Colby (10:56):
We yeah, call me out.
I'm really not terrible,honestly.
I truly, I truly do still do somuch when I'm on the floor and
I won't ask for help unless Ireally need it.
And if there was something thatwe as far as our techs in
(11:19):
nursing assistants, they do havespecific tasks that are that
they're supposed to do.
Like on our unit we geteveryone gets a morning vital
signs at 8 am and then either Q4or Q8 from that point on.
So, like our techs do that.
Our techs know that Our techsget blood sugars before
mealtimes.
That's something that they do.
And then what is something elsethat they like automatically do
(11:43):
?
I mean they'll help settle thepatient for an admission.
So they'll get the vital signs,EKG, like in assistant with as
an assistance to the nurse, likethey're both in there doing it.
Our our techs will run the QCson our blood glucose machines,
like.
So there are some things thatare just like automatically
delegated and a part of theirdaily routine.
(12:06):
Now there are other things that,like, they do throughout the
day that it's like aconversation with the nurse,
like I said at the beginning ofthe shift, like here's what I'm
gonna need help from you at thispoint.
Like this is what we're gonnado together, this is what I'm
gonna need.
I'll do that kind of thing.
Um, for example, like whenwe're giving certain medications
(12:29):
, um, like Ticasin or Sodalol,and it's a loading dose,
someone's come to the hospitalhave this medication.
Yeah, when someone comes to thehospital to do that, um, we
give the medication, and twohours after that medication is
given, we need to get an EKG.
And so usually I'll have aconversation with my tech, like
(12:49):
immediately in the morning, andsay hey, this patient is on
Ticasin, I'm planning on givingthe dose at nine.
They'll be due for an EKG at 11.
I'll let you know after I givethe dose to confirm what time
the ekg is done right if, forwhatever reason, if you're tied
up around, then just let me know.
I'll go get the EKG.
But like, if not, like, can youplease?
And so, like that's aconversation, I like like, let's
(13:12):
plan our day together, you know.
Christopher (13:14):
It really and truly you know.
So something that nursing schooldoes not teach you is that, yes
, they kind of give you a decentlittle break of what the
non-licensed professional, Ithink, nlp non-licensed
(13:34):
professional, I think that'swhat they usually refer to them
as in terms of NCLEX world.
They give you kind of like abreakdown of what they can do,
right, but they don't teach youhow to actually communicate to
someone and delegate.
That is something that, atleast in my nursing school, was
never actually taught.
I mean, you know, they say youshould delegate, you should do
(13:57):
this, but they never actuallysay what you should do.
Colby (14:00):
Yeah.
Christopher (14:01):
And it really does.
It starts out, you know, assomeone who was a CNA before
becoming a nurse.
I absolutely hated my nurses,hated them because they didn't
do anything.
They just sat at the computerand charted.
(14:25):
Take that for what you will,but there were and you know, in
terms of CNAs in the nursinghome that I used to work for,
there were only really and trulytwo really good ones that would
be helpful to me.
Like I was, I graduated highschool and immediately started
working as a CNA.
(14:45):
Yes, I had a whole semester oflike actual work and I was
working for that, that actualhealth system or that rehab
facility, and I got to know theresidents and the people.
But when you, I mean this waslike a big boy job for myself
(15:05):
and I mean I didn't know what Iwas doing.
So, like it was those two likepillars of CNAs, those two
people.
There was two older ladies,they had been there for years,
they knew what they were doing,they could, they could tell you
a resident back forward sideways.
Colby (15:23):
Yeah.
Christopher (15:24):
You know all kinds of different ways, but it was
those people that really droveme into because, like honestly,
legitimately, this just in I waslike I'm not going into health
care.
Colby (15:37):
Yeah.
Christopher (15:38):
Like even in I knew I was gonna be a doctor and I
was like I don't even want to dothat.
Colby (15:42):
Yeah.
Christopher (15:43):
I'm like if it's anything like this.
Yeah.
If it's anything like this.
Colby (15:46):
Yeah, I'm out.
Yeah.
Christopher (15:48):
I'm out.
Colby (15:49):
Yeah.
Christopher (15:49):
And it wasn't until I really kind of honed in onto
those two that I was like, okay,there is saving grace and
you're going to have to be thatfor other people yeah Right.
Colby (16:06):
You have to set the tone.
Christopher (16:07):
You do, yeah, and so bringing all that story back
together.
So just one thing is that I onething that I absolutely noticed
in terms of just thecommunication between the two
CNAs.
It was, it was solid yeah andthey they could talk to each
other and they could say thingsand it would they.
They got it.
But then they could also justdo things and just know that it
would be done.
You know, like it was just kindof a that weird look.
(16:28):
You know you've given peoplethat like yo don't talk to them,
look, and you know it would, itwould be done.
They did that, except with likeactual tasks that CNAs did and
it was.
It was insane.
They worked like a machine.
I've never seen um but
Colby (16:44):
that's amazing.
Christopher (16:45):
Yeah, it was really cool.
But going back to, I'm makingmy way back, I promise, is that
what Colby's saying in terms ofdelegating?
It's all about communicationand it starts at 7.01.
Colby (16:59):
Yeah.
Christopher (17:00):
It really does.
And we're in a health systemwhere both I know our techs
stagger our start time.
Y'all don't.
Colby (17:12):
Yeah, our techs come in a half hour before our nurses.
Christopher (17:15):
Right.
So that's a vital and also thisalso shows your commitment to
the tech work as well.
Your license covers everythingthe tech does, so don't ever
think that you are not allowedto do any of that stuff, because
you are trained to wipe butts,you are trained to feed, you are
trained to walk people, you aretrained to make sure they go to
(17:37):
the bathroom.
You are trained to do that, andso that 30 minute, like
staggered time, is your abilityto show the tech that you will
do the work.
Colby (17:49):
Yeah, for sure, I think.
Well, yes, I think that's sotrue of our techs.
While they're in report, likeour, if the call bell goes off,
like our, we call them hospitalunit coordinators, but they're
like the secretary, um, theyknow that like the techs are in
(18:10):
report and the nurse, like, willhave to respond to this call
balance, so they'll go to thenurse and say like hey, this
person needs this.
So then, like it's on thenurses to find a partner, if
it's a two-person job, likeanother nurse to go in and do it
.
Like those techs are gettingreports, so that way, when the
nurse is going to report half anhour later, the techs are, you
know, are there?
(18:31):
Yeah, yeah yeah, exactly.
Christopher (18:34):
And really and truly that, like last 30 minutes
, is a good time for you to makesure that pain medicines are
addressed, making sure any othertype of medicine is addressed
any.
I'd like to call them mybleeding and not or excuse me,
not bleeding and shoot.
(18:55):
What do I actually call itbreathing and not bleeding
rounds.
Colby (18:59):
Breathing and not bleeding rounds.
I like that.
Yeah, um, because the last halfhour.
Christopher (19:03):
Yeah like
Colby (19:04):
Because how many times have you finished a shift and
it's like 6.30, you go in to doyour last round and it's
automatically like we call themMET calls but like a medical
emergency team.
Like all the time at the end ofshift because you haven't seen
the patient.
It's been busy the last twohours.
You go in and you're like doingyour final check and you're
(19:25):
like something's wrong yeah,something's wrong.
Oh stroke alert, oh like bloodpressure suddenly tanked.
There's always it's just theluck of your end of shift that
everything goes down the drain.
It always hits the fan.
Yeah.
Christopher (19:39):
Always.
Just be prepared.
Colby (19:41):
Just be prepared.
But yeah, I think it goes back,like you said, to communication
.
If you're not talking about whatyour plans are and sharing that
with each other, like you know,and also they're not your
personal tech, that tech mighthave four other nurses that
they're helping out that day,like you may think, like, oh,
(20:02):
I'm gonna sit down and I'm gonnamake this plan with them, and
they're like I can't do thatbecause I've got this going on
with this patient.
Like to have that conversation,that two way street, like then
you understand, like what theyhave on their task list, and
then you can see like, oh, ok,well, I can do this one.
But if you can do that, likeyou can trade off it's like it's
just so vital the communication, because otherwise, if you
(20:22):
don't, then you're making anassumption that they're doing
something, and then they made anassumption that you're doing it
and then it doesn't get done.
And at whose expense is that the?
patient's.
Well, that's a patient'sexpense but also yours.
Christopher (20:36):
because but it's your license that falls on them.
Yes, yes, Like this is yourlicense.
Yes, they do not have a license.
That's why they're non-licensedprofessionals.
You delegate those things andyou assume that they or you,
they have gone through the listof getting checked off, so you
know that they're able to do it.
So then you, you've got tocircle back and ensure that it's
(20:59):
got.
It gets done, yeah, but to sonursing?
Nursing is like you've got tocommunicate techs and, excuse me
, nurses, you also know thatthey have they could have,
depending on the health systembetween 9 and 12 patients.
Colby (21:18):
Or even more.
I've worked on units wherethere's one tech and like 20
patients.
Technically they're all.
They're all they know.
They're the tech for all thosepatients, which is obviously,
obviously on those.
I won't say obviously, becausehospital, every hospital is
different.
I'm sure there's some hospitalsthat just are not well not
(21:39):
splitting up workload very well,but I mean we would.
That's what that's an exampleof, like how nurses took on
workload.
Uh, you know, like you know, notthat it's extra, but like
obviously, if we don't haveenough techs, then there there
will be more on our plates to doand when we had one tech at a
hospital that was a traveler atlike, nurses would get the end
(22:02):
ofshift vitals and thestart-of-shift vitals, and that
was because that was when themost common labs were due, and
these techs also werephlebotomists.
They didn't have a phlebotomyteam.
Christopher (22:12):
Yeah, yeah, yeah.
Colby (22:12):
So they got the middle-of-the-night vital signs
and then were there to helpanswer all the call bells and
toiling and everything with thenurses.
But the vital signs in themorning and in the night of,
like the two other, ones weredone by the nurses and the
weights were done by the nurses.
That way the tech couldn't goaround and get all the labs.
Christopher (22:32):
And see, that's the thing.
That's the thing our healthsystem is very cush.
Colby (22:43):
Yeah, oh, it's a very cushy place to work.
Christopher (22:46):
And you know you might be listening and you're
like man, they have, they alwayshave two techs, or at least
have two techs, and you knowplenty of nurses Like that
happens.
Colby (23:00):
But to the we often have one tech on my unit at least but
we have a floor rule or aspecialty rule that they don't
take more than 10 patients.
So you could have one tech, butthey're only taking 10 patients
.
So then that means the rest ofthem are technically
(23:20):
quote-unquote nurse-covered.
As far as tech responsibility,
Christopher (23:24):
Right, and we do.
We try our best to respect that,and that's just something that
I think, overall, is somethingthat should be done.
Yeah, but, techs, when you hearthat nurses only have three or
four patients or five, who knowsit doesn't mean that we have
(23:45):
more time.
Yeah it doesn't I.
I know it sounds like it.
You're like there's the, buttake it from me, who has been a
CNA and who had done 13, 14, 15patients at a time.
I get it, I it makes.
It makes no sense in your mind,but when I became a nurse, I
was like it makes no sense inyour mind.
(24:05):
But when I became a nurse, Iwas like I feel like I'm taking
care of 15, 16, 17 patients.
Yeah.
And it didn't change, though Iactually did decrease in natural
patient load.
Yeah.
And I would love to tell youthat it's because I don't know,
I can't even really start tokind of quantify what is the
(24:29):
real reason behind why it's soheavy.
It's a different, I think it'sjust different.
Colby (24:36):
It's just like fully different tasks.
It is.
The reason why a non-licensedperson can do the things that a
tech can is because like not tolike discriminate against a tech
or a nurse's assistant but likeanybody can do those things
right what the responsibility ofa nurse with each patient is.
(24:57):
It takes the degrees that wehave to do it and it's just like
task.
Christopher (25:03):
The tasks that we do are way more involved yeah,
there's, and it's not justphysical, it's a lot more mental
, yeah, than what a tech does.
And there's there's a lot ofthinking and and not theorizing.
Colby (25:18):
But just it's like critical thinking, like you know
, like they're like, oh, you'rejust giving meds.
It's like, oh, I'm not just likescanning and handing them meds
like I have to think like whatthis med is, what it's gonna do,
how is it gonna affect thepatient, what is their vital
signs?
Right now, if I give this med,how is it gonna affect their
vital signs?
Like you have to think aboutthat for each individual patient
(25:40):
, for each individual medication.
You have to look at lab worklike we're.
We're as nurses.
We have way more like criticalthinking involved than we do in
a tech role.
Christopher (25:52):
Yeah.
Colby (25:53):
Yeah, not to say that what the techs do is not vital.
I mean, like you said earlier, alot of times they may be
spending more one-on-one timewith the patient than the nurse
gets to, and they might be thefirst person to recognize, like
hey, their blood pressure ateight o'clock this morning was
140 over 70.
And now it's 80 over like 40.
(26:16):
Like that's a big change.
Like they're the first one tosee that they're getting the
vital signs.
They're coming to the nurse andsaying, hey, something's up,
that's important.
Like important work too.
Christopher (26:27):
It is, and and that's why you are so important
as a CNA, PCT, PCA, NA, all theacronyms.
Acronyms is because you do haveso much information that you
can give a nurse that sometimeswe as nurses are thinking about
(26:47):
another patient and we justdon't know.
So, like when you see that ablood pressure has changed that
drastically, you're probablygoing to be the one to see it
and you've got to let us know.
Colby (26:59):
Yeah.
Christopher (27:00):
If a patient doesn't pee within like four
hours of the shift, like we wantto know, like these are.
These are important things.
Colby (27:09):
Yeah, if you're getting a blood sugar before a meal and
someone's 50, like it's soimportant, like for them to like
let you know so that you canact fast.
And you know some techs thathave been around long enough
know that 50 is critical.
And they'll go get an orangejuice and tell you on the way,
like I'm grabbing an orangejuice, 12 sugars, 50, and then
(27:32):
like you're like, all right, I'mright behind you like it is
that having that assist, havingthat second pair of eyes, having
that second pair of hands, isso important and it's so
important for you to cultivate,like good working relationships
with your PCAs, PCTs, with yournursing assistants, so that,
like it again, it all comes backto the patient.
(27:52):
Like you want to provide thebest patient care and working
with this individual in a team,in sync, like having a plan, is
what is how the best care isgoing to be delivered to the
patient.
Christopher (28:04):
Yeah, and so like all of that involves all types
of communication.
But let's kind of bridge alittle bit further into the
delegation part, like we brieflykind of touched on it.
But like how can you tell whenis it too much and when when is
it not enough?
Colby (28:21):
When is it too much and when is it not enough.
We kind of talked about it alittle bit when we said, like
you know too, when you're notdelegating enough, when you're
feeling frazzled and you'renoticing like the tech is
chilling, that is like a verylike baseline, like very easy
way to tell.
(28:42):
When you're delegating too much, like if you're not doing
anything, there's no reason foryou to not do a task.
Christopher (28:51):
Right.
Colby (28:52):
That like if you were let otherwise, if you were busy,
you would delegate.
Like that gets under my skin sobad.
Like, okay, how about when I'veseen this happen so many times
and I've called people out on ityou walk out of a room.
Christopher (29:06):
And I believe that one.
Colby (29:09):
I've seen a nurse walk out of a room that she was they
I'll just say they, because itcould be a she or he but I've
seen nurses walk out of a roomthat they were in for maybe 30
minutes and then they go up tothe tech and they're like can
you get their vital signs?
Why didn't you get the vitalsigns while you were in there?
You were there for 30 minutes.
Why would you leave the roomand then go ask them to get the
(29:32):
vital signs?
If you didn't have the Dynamapor the B450 or whatever kind of
monitor you have with the tocheck the blood pressure?
Then you left the room anyways,you might as well just went and
got it and go right back andget them real quick, like,
unless there's something that'slike so crazy that you have to
go to the next patient.
You're like, hey, this is goingon.
Like, can you, can you go backin there and get those vital
signs for me real quick?
(29:53):
I need to go check on thispatient.
Like, unless there's like anextenuating circumstance, just
get them while you're in there,and it's very rare that that
extenuating circumstance isactually happening.
Yeah, no, exactly that's why I'msaying that's when it's too
much delegation.
Yeah.
Christopher (30:14):
And I mean I think there's a very fine line in that
, because there are times whereyou're like I see the PCT there,
like they could easily do it.
When I have, you know, timelymeds that I still have to give,
like I get it.
But like you you said you werein there for 30 minutes you
could.
The blood, the blood pressurecuff is automatic, so it runs by
(30:36):
itself.
Colby (30:36):
Yeah, it's not like you're doing a lot of heavy
lifting.
Christopher (30:39):
So like you know.
and then you, your pulse ox isautomatic, so you don't have to
do much, for I mean you can't doanything manual for the O2, but
you don't have to count thepulse.
Colby (30:51):
Yeah, the only thing you have to count is respirations.
Christopher (30:54):
Respirations.
Colby (30:54):
Everything else is digital.
Christopher (30:55):
I'll tell you so like five minutes at most.
Colby (30:59):
Yeah, it really shouldn't be that long.
Christopher (31:01):
It takes me a little longer, but you know it's
been a while.
Colby (31:04):
It does not take you more than five minutes to get a set
of vital signs.
Um, I think that's anotherthing, like why techs can take
on more than a nurse, becausethe tasks that they do have can
be done quickly.
Yeah, like generally, it shouldnot take more than five minutes
to do vital signs.
No, maybe if you're having alot of conversation, the patient
asks you to go get a water inthe middle of it, like that kind
of thing.
(31:24):
Sure, but they don't take theirtests, don't take as long.
But
Christopher (31:29):
Well, if if you know anything about patient
satisfaction scores and one ofthe like major patient
satisfaction companies forhospitals is Press Ganey and one
of the questions that is PressGaney and then another one is
Gallop g-a-l-l-o-p?
Um the one of the other, one ofthe questions actually both of
(31:52):
them ask, is anticipating yourpatient's needs yeah as nurses.
I just remembered I alwaysbrought a cup of water.
Colby (32:01):
Yeah, you pull your meds, you get a cup of water.
Christopher (32:03):
You got a cup of water.
Colby (32:04):
I think, and some of our techs that I've experienced,
some of my techs are also likethat, like when they come
through in the morning.
Well, it's tricky on my floorbecause we have heavy heart
failure.
So you have to make sure, likeand that sort of thing.
But like, if there isn't afluid restriction on a patient,
like a lot of my texts arereally good about.
Just like getting a water goingand getting vital signs getting
(32:25):
a water going and getting vitalsigns, like it's just, it just
becomes like secondhand practice, like you just got to
anticipate it.
And also like toileting inadvance, being like, hey, while
I'm here, do you need to go tothe bathroom?
Like that's another thing.
Like, if you're I hate that.
Like you're as a nurse, hatethat, like you're as a nurse
(32:46):
they walk out and they're likehey, this patient needs to go to
the bathroom oh okay, you werejust there, just there welcome
to the bathroom please like Ijust can't, like, I can't wrap
my head around that one and I'veseen people do it and I'm
always like shocked every time.
Like what?
And I again I think like it isin the, in the scope of
responsibility for Charge Nurseto I don't want to say call out,
(33:12):
but like call out behaviorslike that.
And on both sides
Christopher (33:16):
Right
Colby (33:16):
A lot of times.
Christopher (33:18):
You're maintaining a culture.
You're not calling it out,you're just maintaining the
culture.
Colby (33:22):
Maintaining a positive yeah, a positive work
environment.
And.
To let nurses get away withthat kind of behavior is not
like going to provide you with a, with a patient positive
experience like that's.
Christopher (33:37):
A patient positive experience or a employee or
teammate positive experience.
Colby (33:44):
Yeah, either one.
Christopher (33:45):
I mean I don't want .
I have to catch myself at timesbecause I'm like, hey, can you
do this?
Because I need to go back tothe office.
I mean I have an RN behind myname, I have not lost my license
, I just renewed it this pastyear.
Like, I still am able to dothose things and I have to
(34:06):
remember that.
You know, sometimes I should doit.
I mean it's just.
Colby (34:10):
Yeah, I think, and, like I said, it goes both ways too.
Like, if you notice like theremight be some beef between a
tech and a nurse and you're inthat charge nurse role, you have
to a lot of times, like try toresolve that between the two.
Like I hear you need to listento both sides, you need to, you
(34:30):
know, say like hey, I hear whatyou're saying this is, and then
like try to get them to get onthe same page and then remind
everybody that ultimately, it'snot about it's not about one or
the other, it's about again I'mgonna say, it's about the
patient making sure that theyget the care that they need.
And I think a lot of timespeople take situations like this
(34:52):
.
Again it becomes, if it's a badsituation with, like, a nurse
and a tech, or beefing, it's apersonal thing.
Yeah, and we need to rememberto leave, like like we can
handle personal things, butright now we have to get this
work done for the patient.
We need to put that to the side,Like when we walk through this
door threshold into the patientroom.
It's about the patient.
(35:13):
It is.
And that should be our firstpriority.
Christopher (35:17):
What do you do when a PCT like shows favoritism?
Colby (35:23):
This is completely off script.
Yeah, this is off script.
Yeah, what do you mean likeshows favoritism?
Christopher (35:27):
So I I remember a particular tech on my floor when
I was an actual nurse on thefloor, um, I mean, it was kind
of like ensure that all thethings were done for me, but I
mean like to a T but, but it waskind of like whatever yeah.
(35:48):
For everybody else.
Colby (35:50):
I mean again.
Christopher (35:51):
I appreciated it.
Colby (35:54):
Thank you.
I mean I think that goes backto like your.
You have a working relationshipwith that, with that tech.
You know like you and not tosay that that's the right thing,
but it kind of just shows thatlike you're a better example of
a nurse and what everyone elseshould strive to be, if that
tech likes you so much that theydid everything to a T and then
(36:16):
they were just kind of blaséabout everyone else.
What's going on there?
There's a bigger question andthat's more for management.
But also in the moment.
Are you asking me, I'm a chargenurse or I'm one of the nurses
that's getting neglected?
Christopher (36:30):
I'm saying charge
Colby (36:31):
okay, well, I mean either way, I mean personally, but as
charge.
I mean, if I see it and it'sblatant, I don't know.
I feel like here's the thing.
I feel like a lot of times it'scharged.
I might not notice somethinglike that it's like, as long as
they're working and they're notjust, like you know I'm not
going to notice that they dideverything like you know, and
then like left some things tothe side unless it gets brought
(36:53):
to my attention, um, but let'ssay it does get brought to my
attention.
I mean I have to address it andthat's like a critical and
awkward conversation, but it hasto be done.
I mean you want to just likesay, hey, like what's going on,
like it's been brought to myattention that like you're not
(37:14):
doing x, y and z for these threenurses, like did something
happen?
Like what's, like was there aconversation?
Like you need to get to thebottom of it and figure it out,
I mean, and then just go fromthere.
Christopher (37:27):
No, that's fair.
Colby (37:28):
It's not a comfortable conversation but when you're,
when you're in a leadership role, you have to have uncomfortable
conversations quite frequently,unfortunately.
Christopher (37:36):
Yeah, I'm learning that very quickly actually.
Yeah, it's not fun at all.
But I mean and it another likeexcerpt very much to your point.
You can't just make a blanketstatement at huddle, you have to
target that person.
(37:56):
And it's not targeting in termsof like aggressive or mean or
malicious.
It's targeting to understand youknow it's like hey, I.
.
.
Colby (38:06):
I mean it's just getting to the source.
Like, if you know that it's nota blanket issue, why would you
give a blanket statement.
Like, if it's not all of thetechs doing something or all of
the nurses doing something, whywould you just say like, hey,
everyone, because one that'sgoing to create more animosity.
Because I will say personally,when that does get done, because
(38:27):
for some reason, there is aleadership style like that where
, like, something bad happenedwell.
Christopher (38:33):
It's because it's easier to do.
Colby (38:34):
And there's it it is, but it doesn't make you a good
leader and I'll say that unlessit's a consistent I would say
this unless it's a consistentissue, unless it's a blanket
problem, right it like.
If it's a blanket problem, thenit warrants a blanket response
yeah if you know who's doingsomething, it needs to be
(38:58):
directly like intervened rightyeah, like otherwise, what's the
point?
because, as someone who knowslike, I don't know why they're
saying this right now I did allthe a, b, c, a, one, two, three
tasks and I do it every shift.
Yeah, and I do it every shift.
Why are they saying this?
(39:18):
There's like probably six otherpeople that have that same
thought and then they get angry.
They're like you know I getupset At least I'm like I always
do that.
Why are they saying that?
But really they're talking tolike one or two people and
(39:41):
you're like, just talk to thosetwo people.
So they said that's gone offtrack a little bit.
But I just think like, yeah, ifyou know specifically that it's
one or two people, you need totalk to those one or two people
to figure out what's going on.
Sometimes somebody just needsto be heard, or you, you hear
what's going on.
You're like oh, you'refrustrated because of this, this
and this.
Okay, let's see what we can doto mitigate and like fix the
problem so that we can all getback on track.
Christopher (39:59):
Yeah, all right, it's time for Pop Quiz.
In this segment, we're divinginto one or two NCLEX style
questions to test our knowledgeand see how we stack up.
Colby and I will each take ashot at answering the question
and then I'll break it down withthe correct answer.
We'll also chat about howrealistic, or sometimes
unrealistic, these questions canbe in the real world.
(40:20):
Let's see how we do.
Colby (40:22):
Okay, I'll read the first question to you because, this
is kind of like in my wheelhouse, so I already knew the answer
earlier.
Christopher (40:27):
Well, you say that I do deal with kidneys.
Colby (40:30):
You do, but like come on.
Christopher (40:36):
Oh wow, okay.
Colby (40:36):
This question was made for me.
Christopher (40:37):
Yeah it was, so I'm gonna read it.
Colby (40:38):
Oh, accident, it was really by happenstance.
All right.
Question number one a nurse iscaring for a client.
I hate that they use client nowby the way sidebar.
Yeah, I hate that.
They're patients, come on.
Christopher (40:50):
So so okay'm going to continue on this sidebar.
Interestingly enough, thereason why Walt Disney calls
their.
.
.
Colby (41:00):
Patreons.
Christopher (41:02):
Yeah, the people that come to the, they call them
guests, yeah because they'reguests in their amusement park.
Yeah, yeah, yeah, but like it's, it's all about patient
satisfaction.
Colby (41:16):
I know and that I feel like I get it.
But also there needs to be aline of like patient
satisfaction, but also likelet's remind you that you're
sick and we're providinglife-saving care.
Christopher (41:26):
Okay, that's okay.
Colby (41:27):
There's like I feel like there's a fine line.
Christopher (41:30):
Client, doesn't work like that?
Colby (41:32):
No, because they need to be reminded that they're a
patient.
I'm not working for them.
Like it's a different mindset.
You know what I mean.
Yeah, like if I have a clientlike I'm working for them, I'm
investing their money.
I'm doing blah, blah, blah.
I'm saving your life, and it's alittle bit more.
Christopher (41:46):
It's a little bit different than working for you.
Colby (41:48):
I'm working for you, I'm to keep you alive.
Yeah, sorry this is way offtopic, but I would love for you
to keep this actually in thepodcast, okay, okay, anyway,
don't edit that out.
Christopher (42:00):
I won't.
Colby (42:00):
Back to the segment break .
Question number one a nurse iscaring for a client with heart
failure who has been prescribedFurosemide, also known as Lasix.
Which of the followingassessment findings should the
nurse report to the healthcareprovider immediately?
A.
A blood pressure of 102 over 68.
(42:21):
B.
Potassium level of 2.8.
C.
Urine output of 250 millilitersover eight hours or D.
Heart rate of 82 beats perminute.
Christopher (42:38):
So I mean blood pressure, it's okay.
Colby (42:40):
Yeah, you know, it's fine For a heart failure patient.
Sounds about right.
Christopher (42:43):
Yeah, luckily I have delved into your world
before.
Yeah, urine output is fine.
Yeah, and then the heart rateis good, super soft.
I'm not worried about Lasixdropping any type of heart rate
anytime soon, right?
So I mean, I think I'm going togo with B potassium level of
2.8 because of it being low andLasix lowers potassium.
Colby (43:10):
Yes, yep.
Christopher (43:11):
Look at me.
Colby (43:12):
So B potassium level of 2.8 is the correct answer.
Um.
So for anyone that's notfamiliar with diuretics, um,
there's a few different kindsbut furosemide or lasix.
That's actually a loop diureticand that causes the body to
lose potassium.
Um, a potassium level of 2.8 iscritically low.
Um, normal range is 3.5 to 5.
(43:35):
But in our world we really liketo see our potassium Like in
cardiology we really love to seepotassium at least 4.
So whenever it drops below 4,our providers are ordering
potassium repletion.
When the potassium does get low, it has a higher chance of
causing lethal rhythms, lethalcardiac arrhythmia.
(43:58):
So we want to keep thosepotassium within a good normal
range.
Christopher (44:03):
You be dead.
Colby (44:03):
Because we don't want to have to save your life
Christopher (44:07):
We want to stop you before.
Colby (44:09):
Right.
And then when Christopher wentthrough all the other options
and why they weren't the rightanswer, those are all legitimate
.
Blood pressure's fine, theurine output was fine and the
heart rate was absolutely normal.
Christopher (44:23):
And so, interestingly enough, when I
learned in nursing school,potassium is a wimp.
It is a wimp of an electrolyteit moves the fastest away yeah.
It does all kinds of stuffweird to the body.
Colby (44:41):
Yeah.
Christopher (44:41):
It's just a wimp.
Colby (44:43):
Yeah, potassium sucks.
Christopher (44:44):
It does, and it's the biggest dang pill to
actually use.
Colby (44:48):
Oh my God, they're like horse pills.
Yeah, they're massive.
Patients hate them and then likeou can't cut them because
they're like enteric coated youcan't smoosh them up, the big
white ones.
You can't squish them.
Yeah, that's what I'm gonnasquish them up, yeah.
And then the powders tastedisgusting and then the iv
version burns the shit out ofyour veins.
(45:09):
So potassium's not fun toreplete, it's not fun to lose,
it's not fun to mess with it.
It's not fun to lose, it's notfun to mess with.
It's also not fun when it'selevated, like if you're above
five, we have to do likehyperkalemia protocols to get it
back down.
It's just.
Potassium is a rascal.
Christopher (45:28):
It's a rascal.
It's the one that's easilyhemolyzed.
It's just a rascal.
Yeah.
So a nurse is caring for aclient with type 1 diabetes who
reports nausea and abdominalpain.
The client's blood glucoselevel is 350 mg per deciliter
(45:52):
and ketones are present in theurine.
Which of the followinginterventions should the nurse
perform first A.
Administer regular insulinintravenously.
B Start an IV infusion ofnormal saline.
C Administer an anti-emetic asprescribed, or.
D Notify the healthcareprovider.
Colby (46:15):
Okay, so this is a classic NCLEX question situation
where you're like there'smultiple right answers here.
Yes, and the first time that wewent through this question I
said D notify the healthcareprovider, because I was like,
yeah, I think we're going to dothat first, but unfortunately
(46:37):
that's not the right, that isnot the right answer.
Christopher (46:39):
It's actually starting an iv infusion of
normal saline and here's why theclient is exhibiting signs of
diabetic ketoacidosis, alsoknown as dka, a life-threatening
condition characterized byhyperglycemia, ketonuria and
dehydration.
So rehydration with normalsaline is a priority
intervention to restorecirculating blood volume and
(47:02):
improve perfusion.
Once rehydration has begun,other interventions can follow.
With a wonderful key NCLEX tipin DKA always prioritize your
ABCs, your airway, breathing andcirculation.
I'm sure you've heard it manytimes in nursing school.
So those principles.
Rehydration addresses thecritical issue of circulation
(47:26):
and takes precedence over otherinterventions.
Colby (47:30):
Yes, so that is, like I said, a classic NCLEX question,
where it's like very easy to getcaught up and I fell in the
trap because my I go straight tolike my, my actual practice
brain where I'm like, well, Iwouldn't.
Just while I know startingnormal saline makes sense and I
can anticipate that the doctorwould do that.
(47:52):
If I'm suspicious of DKA, I'mgoing to page the doctor first.
What I thought that the answerwas going to be.
My second guess was likeadminister the anti-emetic as
prescribed, because they saidthat they were nauseous and
there's already an order for it.
So, with the answer actuallybeing the saline, I was kind of
surprised because it didn't saythat there was already a
(48:14):
standing order for it orsomething.
So it's just a tricky NCLEXquestion, classic, exactly what
you'll see in the actual boardtest.
You're going to run into thoseones where you're like there's
multiple things right here.
You have to figure out whichone's the most right.
So while I knew instantly theanswer to the first one, without
even having to take a a secondto think about it, the second
one, even after 10 yearsexperience NCLEX style question,
(48:36):
got me tripped up
Christopher (48:37):
Well and that's the thing right, like in in nursing
world and you're in nursingschool, you're taught the s-bar
right situation.
So here's the situation.
The situation is there's type 1diabetes patient who reports
nausea and abdominal pain, has aglucose of 350, ketones are
(48:57):
present in the urine.
Background is probably the type1 diabetes part.
Assessment is the ketones inthe urine part and the
recommendation is starting the.
Iv of normal saline.
So you're notifying thehealthcare provider.
That's what we do in the actualhealth system.
Is the starting the IV ofnormal saline?
(49:19):
So you're notifying thehealthcare provider.
That's what we do in the actualhealth system.
And it's so unfortunate becauseI mean I somewhat guessed my
answer.
I mean I did, I was like oh
Colby (49:26):
yeah, christopher got it right immediately and I was like
oh, that's probably right, Iwas like I was.
Like I was like it's DKA.
Christopher (49:31):
But yeah, but you know and that's the thing you
kind of have to think about whatthe patient is actually going
through.
But you do this on a dailybasis.
Yeah, you do it, and you wouldnot start IV fluids before
notifying the provider.
You won't.
The only time you'll do itmaybe is if you're in the ICU
(49:52):
Excuse me Sorry, maybe, and eventhen it's yeah.
Colby (49:58):
I mean, usually when you're in the ICU, your
providers are right there soyou're just kind of being like
working together we're doing.
Christopher (50:05):
I'm moving my, I'm moving my face away from the mic
.
I don't know if y'all heard mepop your head in.
It was like, hey, I'm justdoing this, is that okay?
Colby (50:13):
yeah yeah, yeah, yeah.
And they're like oh, yeah, yeah, yeah, I'm putting the order in
right now.
So, like you're workingsimultaneously in the ICUs Cool.
Christopher (50:21):
Well, great job.
If you feel like you would wantto hear more NCLEX questions,
just let us know.
And also, if you thought thesewere pretty tough and are
terrified NCLEX now it's okay.
Yeah, you have time and youmight not ever get this question
(50:42):
.
Colby (50:42):
Yeah, or maybe you just passed your boards and you're
like, oh, listen to thisquestion that I got.
That is going to haunt me.
For the rest, of my life, yeah.
And then I looked it up after Iwalked out of the test.
Christopher (50:52):
Do you have one?
Colby (50:53):
No, I don't, honestly, that was such a traumatic
experience, I literally blackedout.
So I passed, but I blacked out.
Christopher (51:00):
That's good, I'm glad.
Colby (51:02):
But if there are any that haunted you, send anyone else
to like.
If you want to share, let usknow.
Do you have any that haunt you?
Christopher (51:09):
No, I don't remember.
Colby (51:09):
Yeah, I feel like a lot of people's shared experience
would be like.
I don't remember, but if thereis one, share it with us.
Christopher (51:17):
I remember the drive home.
Colby (51:20):
I don't Wow, it was such a long time, good, so I want to
go back to journaling.
So I don't have a good memoryfor small things like that.
I remember afterwards I waswalking around a mall and I was
on the phone with my mom and Iwas like I don't know what just
happened.
I was like I'm shocked, I'm inshock
oh god
Christopher (51:41):
Do you feel a good relationship can drastically
change your shift?
Colby (51:45):
Oh for sure.
yeah, I mean I definitely thinklike the difference between
working with a tech thatnormally works on my floor and
working with a tech who gotfloated to my floor Definitely
two different experiences.
Like when I'm working withpeople that I have known for a
while and I have a goodrelationship with, like someone
(52:05):
you can like not that you can'tshare a laugh or joke around
with someone you don't know,aLike you can, but some people
are very serious um, a nd youknow it's the difference between
like making it through yourshift and being like all right,
it was fine, it was a good shift, I survived, we all survived.
and then like having a good timeand like right cutting it up
with your friends and like yeahlike getting the work done, but
(52:27):
also being like I'm wiping poopfrom this person while they're
holding the leg and like we'rejust like making eyes, like
sometimes you can like do thatsilent giggle like I cannot
believe that just happened.
Like you know, it's likedifferent when you're working
with your friends versus workingwith, like, someone you don't
know, but they're a colleague,whatever
Christopher (52:45):
Yeah, no for sure, and you know you talked about
how there are times where nursesdo not have text covered.
Tech coverage do you?
What does it make you feel interms of having techs when you
(53:06):
don't have tech coverage?
Um it's kind of a differentquestion than what's actually
written down yeah, so you're.
Colby (53:15):
My brain kind of like skipped, though.
So, like you're asking, likewhen we have techs but they're
not covered for all yourpatients, right, how does it
feel?
Like when you're I mean, listen, I think, if you're working
well as a team, even if the techisn't assigned to your patient,
and you have a goodrelationship and like everyone's
(53:35):
tied up and the tech happens tobe sitting there, like you have
a good relationship, like hey,can you just help me turn this
patient real quick?
Yeah.
Like it's not going to be a bigdeal or a big ask.
You can.
I mean you can ask anybody thatyou know.
It doesn't.
You don't have to ask like thetech.
Obviously, if they're notassigned, you don't have to ask
them.
You can.
It shouldn't be a big deal tohave a turn.
(53:56):
But everybody that works on thefloor, it should like.
We used to have this saying onour unit.
We don't use it quite often,but it's just kind of like a
culture of like it's all, it'sall 28, and 28 was the amount of
patients that we had on ourfloor.
So all 28, like it's not.
Oh, I have four patients andI'm not going to help you.
Or.
I have like or I'm a tech.
I have these 10 and I'm nothelping you with the rest.
(54:18):
Like we're here for all of themand like if I'm free, I'm going
to help you.
So it's like never fun whenyou're short-staffed, it's never
going to be like the best dayyou've ever had.
But that's just not going tohappen.
Like there's going to be apoint in the shift where you're
like you're like Jesus, I can'tbe in six places at once.
(54:40):
Like give me a break.
But if you're working with,with good people and everybody
has that teamwork mindset, likeit's not, it's not going to be
the worst shift, either You'llget through it.
Yeah.
Christopher (54:53):
Yeah, yeah, yeah.
I think and I'm really justkind of coming back from when I
was on the floor I know that Ireally appreciated the days that
we were fully staffed.
Colby (55:06):
Oh yeah.
Christopher (55:06):
It was like oh wow.
But then it was like when thetech was like hey, I'm busy, I'm
like you know what I get it.
Yeah.
You know, like, okay, like.
Colby (55:17):
Yeah, no problem.
Christopher (55:19):
No problem, no big deal.
Colby (55:19):
That happened today.
I mean today we had if we havethree techs, technically that I
mean I think technically ourunit, when our unit's full, we
qualify for four techs, which isthat hasn't happened in years,
I'd say.
Christopher (55:32):
Because if we have four techs, that is a unicorn
I've yet to see.
Colby (55:36):
Yeah, I was like if we have four techs that are
scheduled in the same day,they're pulling them to help,
like, cover other units.
So we never have more thanthree on the floor in the last
few years.
But when we have three, thatmeans all of our patients are
covered by a tech with, as wellas, obviously, our nurses.
The day goes by so much easierwith, as well as, obviously, our
nurses.
The day goes by so much easierand like literally today I had a
(55:56):
LIP reach out to me and saidhey, I went to go message the
nurse, but they're on, do notdisturb.
I didn't want to bother them.
If they were on lunch, do youmind going to recheck a blood
pressure?
I was in the charge role so Iwas like no problem, we'll get
it done.
So I reached out to the techbecause the NP didn't know who
the tech was.
So I was like I reached out tothe tech.
I said, hey, can you recheckthis patient's blood pressure?
(56:18):
And she, the tech, replied backto me she's like I'm on lunch
but I'll do it afterwards.
And I said, oh poo, don't worryabout it, I'll go down there
and get it, no problem.
Like I was, like I let her haveher lunch, like it's not a big
deal, like I can go get it.
I have a second.
Like no NBD, but like NBD NBD nobig deal, like I will go and
(56:38):
get that.
Like it's just like you justappreciate having having them.
When you actually get them,it's just a different vibe for
your whole shift, like you justless worries, less stress, like
they're probably they're thebackbone of the hospital, truly
so.
When you actually have like afully staff ship, it's like oh
(56:59):
amazing it's so great yeah, likethe angels are like
Christopher (57:05):
um, and we talked about this, uh, in, actually I
think was it the first or secondepisode?
It was earlier.
But being a CNA before being anurse, was it the first episode?
I really we definitely.
Colby (57:23):
Yeah, we talked about this before.
Yeah, definitely gives you anadvantage.
Christopher (57:27):
Yeah, 100%.
Colby (57:28):
Yeah, we were going to.
And again, I'm sure otherpeople would agree that it
definitely gives you anadvantage of being a CNA, makes
you better nurse and you canspeak to that because you did
that as well.
Christopher (57:43):
Yeah, but I mean I can't tell if I'm a better nurse
or not.
I can't say that.
That would be very conceited ofme.
I think it does, though I thinkit does, though oh no, I mean,
I have seen other people and Ido.
I think it does make them abetter nurse.
They're just more aware andthey're easier to delegate
(58:05):
things, but they are also easierto be overwhelmed by not
delegating things.
Colby (58:10):
True, yeah, I could see that as well, because they know
how it feels to be like.
They know what feels to feellike they've been over delegated
, being like why don't you lazynurses do something?
So then they want to like tryand do more than what they
probably should.
Yeah, yeah, I can.
I've seen it both ways.
I've seen them.
(58:30):
I've also seen a former CNAthat's become a nurse be like
now you can do all my stuff andjust like be kicking back.
And I've been like okay, that'snot remember how you felt when
that was done to you, like comeon redirect.
Christopher (58:46):
I can't imagine.
Yeah, it's like uh.
Colby (58:49):
but I think for the majority, though, I would say
yes, it definitely makes adifference on the positive side
of things, to come in with thatexperience before nursing.
Fair.
Does that wrap it up?
I think so.
I think that wraps it up.
Christopher (59:10):
Class dismissed.
That's a wrap for today'ssession of Nursing Lyfe 101.
We hope you found some usefultakeaways to bring back to the
floor.
Remember, nursing is a lifelonglearning journey and we're here
with you.
Colby (59:23):
If you want to connect, find us on Twitter at
NurseLyfe101, or on Facebook atNursingLyfe101.
And don't forget to subscribeand share with fellow nurses.
Until next time, take care ofyourselves, which is what I need
to do.
Clearly, I have a cold.
Christopher (59:37):
100%.
Colby (59:39):
And keep making a difference out there.
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