Hope you have a good night Nel and win some money at those card games. Our docs in med-surg intervene when they are greater than 160 or 170 depending on the doc. We have one doc that leaves a standing order for above 150. Sheesh. I understand a patient not being symptomatic, most people with high blood pressure aren't, but I don't understand not treating it.
I wound up having a decent day. We were well staffed that I assigned the nurses one admission each and when the fourth one came, it was shift change, so I didn't do that one. I did help a lot of nurses get things done. I was assigned one difficult patient that fired her nurse last night because and called the house supervisor because she refused to give her Klonopin, Ambien together while she was on a PCA. Personally, I might have staggered them, but gave myself a good night by giving her the meds. I had ZERO issues with her, we talked about her losing her mother last year and she was quite pleasant. But I also can understand not wanting to overstate a patient and cause problems, but you have to take in it on a person by person basis. If someone has been doing this for years, to me it's a non-issue. If she sleeps she's not hitting the PCA anyway. But each nurse makes their own decisions.
Ted, I've been thinking about your teeny tiny "critical access" hospital and I get that sometimes there is very low census and downtime. But that crazy state senator didn't need to be such a witch about saying nurses sit around playing cards. Also, what she doesn't seem to get is the small amount of resources, that the nurse has to birth the babies, do the EKGs, draw the blood, do critical care, float around to med-surg, be house supervisor on and on. Personally, give me a large busy hospital any day. OK, off my soapbox.