#Registered nurse

[macgyvermedical]

RN Scope of Practice

I recently learned something that was pretty interesting about the RN scope of practice.

In hospital settings, we tend to think of registered nurses as carrying out the orders of physicians and advanced practice providers. In a hospital just about everything needs an order, including things that in nursing school we were always told were under our scope of practice-like ambulating the patient, dietary plans, positioning, wound care, etc...

So I was wondering- what can a registered nurse do without an order? Do we have our own scope of practice if we were to, say, freelance?

It turns out, yes- I can only speak for the state of Ohio, but outside a facility that requires an order, an RN can actually do a lot in the way of independent practice. The reason everything requires an order in a hospital setting is facility policy, not law.

Here is what the Ohio Revised Code says the RN Scope of Practice is:

"Identifying patterns of human responses to actual or potential health problems amenable to a nursing regimen

Executing a nursing regimen through the selection, performance, management, and evaluation of nursing actions

Assessing health status for the purpose of providing nursing care

Providing health counseling and health teaching

Administering medications, treatments, and executing regimens authorized by an individual who is authorized to practice in this state and is acting within the course of the individual’s professional practice

Teaching, administering, supervising, delegating, and evaluating nursing practice."

"RNs have independent licensed authority to engage in all aspects of practice specified in Section 4723.01(B), ORC, except that, when providing nursing care pursuant to Section 4723.01(B)(5), ORC, the RN must have an order from an individual who is authorized to practice in this state and is acting within the course of the individual's professional practice for administration of medication or treatments or for the regimen that is to be executed."

Basically, if you read down that list, the only thing that actually requires an order is #5. But other than that, RNs are allowed to independently practice without medical direction, as long as we are doing something that is within our scope.

What does that mean? Well, if you look at number 1, we can identify patients who can use nursing care. If you look at number 2, we can independently select, use, and evaluate the effectiveness of nursing interventions such as positioning, diet, oral hydration, non-pharmacological pain, anxiety, and nausea control, run codes if we have ACLS, etc... If you look at number 3, we can do pretty much any physical assessment. If you look at number 4, we can provide health coaching and teach health education to the public. And if you look at number 6, we can teach nursing students, delegate to those lower on the nursing hierarchy, and study nursing practice academically.

So what does that look like? Well, an RN can independently select a patient who could benefit from nursing care, assess that patient, advise nursing interventions that may help them, perform those interventions or delegate them to an LPN, STNA, or CHW, evaluate the effectiveness of those interventions, provide health education to that patient, and pass along that knowledge to a next generation of nurses, STNAs, and CHWs.

So I just want you to know, RNs, future RNs, and writers that write RNs, an RN is an independent license. You do not need a medical provider to practice nursing, only to do things that fall under a medical scope of practice.

[lamentations44]

Hey hey hey- its MELANOMA AWARENESS MONTH!

Put your sunscreen, hat, longsleeve, full coverage bathing suit, etc on!

April 2016 I had a malignant melanoma removed from my back- I still have a significant scar as a reminder. My husband had a melanoma removed a few years after that and we have been vigilant since.

Unfortunately- I had a mole come back after my last visit as a “severely atypical nevi” and had to have a surgical excision( today). These moles or nevi are not ALWAYS cancer or dangerous- but from what I gather, convert easily to melanoma. Given my sordid history with melanoma- the choice was a 2.5cm surgical incision/ removal. I was grateful it was less than the 11cm from the previous melanoma. However- this one is slap dab in the middle of my abdomen. So now, thanks (likely) to my idiotic youth and bikini choices- I will sport- not a cute bikini- but a large surgical incision on my back from 2016 and a medium sized one on my abdomen from today.

Please- be careful. No matter what beautiful skin tone you are- be careful and get SCREENED.

We can PREVENT two cancers- SKIN and COLON. Be smart and screen regularly for both.

(Abdomen from 5/5/23). Back from (4/2016)

[baeway954]

THANK YOU FOR 800 subsssss😍😍😍🥺

[breads-voice]

Nurses are not heroes.

That was a dangerous narrative perpetuated by the government and media at the height of Covid. It prevents them from being seen as human with human needs. Now it’s being used by the same media and government to justify the horrendous working conditions and pressure they are being put under.

Nurses stay unpaid after every shift to help their patients and colleagues. That’s great! Nurses are heroes ❤️

Nurses working through their breaks to help their patients. That’s great! Nurses are heroes. ❤️

Nurses are dealing with unalive and traumatic situations every day. Nurses are heroes ❤️

Nurses get beaten and abused on shift by patients and relatives but it’s ‘part of the job’. Nurses are heroes ❤️

There is nothing heroic about a person not getting adequate rest between shifts. An exhausted nurse should not be looking after anybody other than themselves. They are human.

There’s nothing heroic about a person not being able to provide themselves with adequate nutrition or hydration. They are human.

There is nothing heroic about not receiving proper support or acknowledgment of the trauma they go through every day. Same with assistants and paramedics. They’re still human.

There is nothing heroic about being black and blue by a patient or stalked by a relative and having to see them the next day. Not being able to do anything about it because it’s seen as ‘part of the role’.

There is a massive difference between ‘knowing what you’re getting into’ as a newly qualified nurse and treating them with disrespect, running them into the ground and expecting them to be ok with not having their basic needs met for the needs of the general public.

The nurses wages do not reflect their working conditions or the trauma they experience and have to heal from. They are human and grieve for their patients too. They don’t reflect that this a vocation requiring a degree. That nurses don’t just ‘make beds’, they insert tubes down peoples throats to breathe for them, take chest drains out, keep people alive with complex concoctions of medications they’ve mixed. And so much more.

The NHS has relied on the generosity of its nurses and assistant staff for too long. That generosity is wearing out. What we are being put through isn’t worth our wages anymore.

Stop advertising nurses as heroes and force the public and parliament to see us as the humans we are.

[juniper-moon]

✍️🫀🫁🧠

[whatsyouremergency]

Happy Nurse’s Week, you bad asses.

[rainbow-baby-one]

A pretty sweatshirt for all the amazing registered nurses out there! 

Registered Nurse Sweatshirt

https://www.etsy.com/listing/1364041352/registered-nurse-sweatshirt-registered

[silverstars87]

So I finished all 16 rounds of chemo and now I’m first case on Monday 12/4 for bilateral nipple sparking mastectomies, right port removal, and bilateral expander placement with a cellular dermis.

I Wish this wasn’t happening.

I cry a lot. And my husband won’t even speak to me for the past 5 months.

[scrollsofhumanlife]

Florence Heather Pswakai-Azubuike

Born on August 31 1946 in Zimbabwe

North Little Rock, Arkansas

[monkeymeghan]

Today has been a tough one. I looked into what it would take to reinstate my nursing license in case I get offered that job at the Red Cross. I’d have to take the NCLEX again since my license expired more than five years ago. And it’s expensive to take and you pray you pass. I took my boards 10 years ago, I’m not prepped to do it again. So I texted my sister…

So that made me feel like shit. I didn’t respond. I then talked to my dad about it. He agreed with her feeling, I need to look out for my mental health. I get where they’re coming from, but it hurts. I agree with them though, I’m just not capable of it, even I don’t have confidence in myself that I could be a nurse. (Granted I did pass my boards in 75 questions, which is the minimum, in an hour, the first time I attempted. And I graduated at the top of my class. So I have the smarts.) I cried so much today. Dad and I talked, but I really wished mom was here so that I could talk to her. Dad said she’d agree with him, and I know he’s right, but it’s not the same.

I mean, I haven’t even been offered a job yet, so why am I even stressing about making a decision? I hate big decisions, and this is/will be one. *sigh*

[batmanbeyondrocks]

Fashion by Wole Olosunde

Credit: Blattire@theblattire via Wole Olosunde BSN RN 🇳🇬 (@guacawole)

[baeway954]

THANK YOU FOR 800 subsssss😍😍😍🥺

Im on the road to 1000 😍😍😍

[breads-voice]

Unless you have been the sole nurse on a unit (whilst your one colleague is on break) finding a patient with no heart beat, call the crash team and initiate a CPR/resus attempt alone: you do not get to say the NHS has enough nurses.

At the moment, this is a scenario most NHS nurses worry about whilst going to work every day.

For each extra patient a nurse has outside the safe ratio of care, mortality for those patients raises 7%.

Steve Barclay, the Health Secretary’s, solution is that nurses should work harder. We’re already doing the work of 4 nurses, 2 assistants, the cleaner and cook. We are already exhausted.

Patients do not deserve to be treated by exhausted nurses.

Nurses deserve to be able to treat their patients whilst not compromising on self care.

[ellapastoral]

have y'all ever wondered what it's like in the world of nursing? well here y'all go with this keep dive.

[cariiibaez]

Look at what I am reading in the Bible. “Stand up in the presence of the elderly, and show respect for the aged. Fear your God. I am the Lord.”

‭‭Leviticus‬ ‭19‬:‭32‬

I think I have a good job. I am a certified nurse assistant. I take care of the elderly in a nursing home. It is not easy to take care of the elderly sometimes because some patients have dementia, weakness, and psychological illnesses. They get confused and anxious. In my opinion, you have to have a kind and patient heart with them. You also need to have a humbled heart. As a nurse assistant, we have to clean the patient. Clean them like change their diaper and clean their room because infection control is a thing. Shower them. Feed them. Give them companionship. I also have noticed that taking care of the elderly has helped me respect my parents more. Also think of God more. I like to pray with the patients because some patients love it when I pray for them. So, I like this Bible verse how God says we need to respect the elderly. God knows everything we do. Nothing is hidden from Him.

[beautyinside775]

Always fun to be Free 💌💐🤟🏼