How are nurses surviving when dehydrated? I work inpatient COVID, wear PPE and am sweaty. JHACHO says no water bottles on the unit,the break room only. I’m busy, I average walking 4.1 miles/12 hr shift. Mostly, I feel I’m passing out. Suggestions?
Fuck The Joint Commission
Tell JCAHO to get off their ass and put on that PPE for 12 hrs without water break
Find a new job. I quit mine. I got sick of all the bullshit. Good luck 🍀
Hydrate before work, during and after. Hide your water bottle in the nurses station. Use liquid IV powder in your water. *I prefer the lemon lime. If anyone says anything, tell them to fuck off.
And this is why nurses are leaving the profession. Even farm animals have access to water as needed. Yet nurses are expected to be treated less than farm animals go hours on end with out water or food...
Hospitals do not genuinely care... you are just a number. Inform your charge or resource that you are needing water to continue working. You have rights.
The Joint Commission is a joke. I keep my covered water bottle close by, anyway. If anyone tells me to put it away, I’ll ask them to take care of my patients for 30 minutes so I can go on the lunch that I’m always missing because of understaffing.
I ignore them and keep my water bottle at my desk. So do my coworkers.
EXACTLY…No drinks at nurses station ! My Dr says that nurses are causing havoc on their kidneys! We can’t drink, eat, or go to the bathroom! This is just a rediculous rule!!! Maybe if we all file medical claims against the hospitals…it a proven fact that working nights actually kills a nurse many more years before those who have never worked nights. I’ve been places(travel nurse) where the floor manager does walk throughs to see if we have drinks at the desk while charting..or anything else that she can get someone with a warning! And people wonder why nurses keep leaving …it’s that way everywhere! No help no drink no food no bathroom …but answer that call light within 2 min, turn those patients every 2 hours, give your patients baths, deliver their meals, talk to multiple family members, get they patient to surgery, how you coming on that discharge because there is someone wanting that bed…..on & on & on… don’t stop… jeeezzzz
Just let me drink please!!!
I worked ICU last year. I would go in the break room in between patients to grab a drink. As I learned in EMS, you come first. The patients come second. If you pass out or get sick you can’t help anyone.
When I was in the Army Reserve and we had to be in MOPP Gear (military PPE) it was the commander responsibility to insure all the troops were managed properly and kept in good health (we were not in combat zone mind you)
Buddy aid to make sure breaks were taken, water was consumed and everyone was managed
IF soldiers when down from heat exhaustion, dehydration or getting exposed to the substance it showed on the commander Fittness record. Even to day if too many troops have issue the commander is the first to get relieved.
My suggestion is the Joint should do the assessment the managers and administration as to how well they take care of the staff. IF staff are dropping out , literally or figuratively, the bosses should loose their accreditation, jobs and licenses.!
That is what they say no drinks but look in the cabinets and the black box at the nurse stations. You have to keep yourself healthy or you become a pt.
Bring a water bottle with a lid and go about your day. You have the right to be hydrated. Stick it in a drawer or under the desk. If possible bring bring a small one you can put in a cargo pocket. It's bad enough we don't get lunch half the time. I refuse to walk around weak and dehydrated. Employers usually know when joint commission is coming. You can put it in the break room then if you want.
As a Manager, to solve this problem, I was able to create “hydration stations” in areas nearby each section of the unit. It needs to be a designated area where absolutely no patient care activities occur. It needs to be where no specimens, etc. are placed. It needs to be labeled with a sign that specifies it is for hydration only. It can be a little cubby, table, sink area with shelves, where staff can keep their COVERED water bottles. Try to champion these type of areas with your Manager. It works, believe me.
I am also on the front lines and have learned that NO ONE is going to take care of me but me. The hospital doesn't care if you pass out. So, take your PPE duds off and go in the break room and get a drink of your water. YOU have to take care of you....and, if it means someone has to wait a few minutes (assuming they're not bleeding out their eyes), then they wait. So far, this has worked for me.
Have water bottle holders on the computer carts where the nurse documents. Not having water close by is unacceptable.
Are you kidding me? Screw them. People who writes those policy never work bedside not to mention working on Covid floor. So you need to take care of yourself cause NO ONE WILL!
Keep your bottle handy, refill it as you go, hydrate as much as possible. Those idiots would not survive a minute doing what you do. Don’t get me started. Good luck
Let JHACHO do your job. Keep the water bottle handy.
The 34 bed unit I work in became a dedicated COVID unit for 2 years. It is important to stay hydrated. Our break room was just outside the unit fortunately so I flat out took the time to doff the gear, hand hygiene and take 2 minutes to hydrate. I guarantee that no one is going to check up on you to make sure you’re ok, so it is up to you to take time to hydrate, use the bathroom or just take a minute and reset.
Ask your manager if you can have a hydration station/cabinet in your station where you keep bottled waters to keep hydrated throughout the shift. We did that in our unit. It was very accessible.
Nurses call the shots… whether injections or shots of water! You take care of you the best way possible at all times!
I'll put my water bottle where I please. You have to take care of yourself and your own body in order for you to be able to take care of your patients.
Keep yourself hydrated. If you pass out there will be another nurse to take your place. Let your relief know I’m going to get water. I’ve been a nurse for 20+ years and I’m telling you, you come first, your family comes second, and the job comes third. I absolutely love what I do but if I don’t take care of me those patients won’t get what they need from me and that’s is the best care.
If you work night shift, management isn't around do you can do whatever you need to do. I used a patient pitcher with a lid each shift and left it on my computer station. We only had to follow the no water rules when they knew State or someone was coming to inspect. Now I work in an OR and there really is no water except on breaks so one of my coworkers recommended a camel pak.
Add Liquid IV packets to your water so you get more from your few drinks. Try and grab a drink whenever you pass the break room. Just a sip here and there means a lot!
Ignore The Joint Commissiom - TJC. They no longer have a leg to stand on once they refused to come inside the hospital for 2 years during COVID and silently stood by as we had to re-wear single use PPE, sometimes for weeks on end... and so much more.
Drink your drink. Eat your food. Take that break. You are not a slave and you have rights. If your manager is a jerk and demands you follow the policy, just ask your PCP or any MD you run across to write you an accommodation to have water at your workstation / within reach.
Little trips to the pantry, every time a have a little time or getting water for my patients, I also drank at least one 8 oz cup, that’s what I do 😊 my health is important too.
So, it really originated as an OSHA rule designed to keep our water bottles from being contaminated by blood borne pathogens from patient specimens, etc. One way our facility demonstrates compliance is by having designated drinking stations on each unit. It’s literally a plexiglass box with a door we keep our water bottles in on the units. But it keeps them safe from getting contaminated and so far has passed a few TJC inspections.
Technically JHACHO says not water bottles in patient care areas. I’m not performing any patient care at the nurses station, and patients aren’t allowed at the nurses’ station (behind the counter). I’ll argue that with them until I’m blue in the face. Their verbiage is up to interpretation.
I ignore them and have a closed covered water bottle
Before I retired, my urine actually turned dark from these no drinks rules. I bet those office workers have a drink at their desk all day, plus they can drink eat at the meetings they attend. It’s time that nurses are recognized as human beings, college educated, licensed professionals who should have the same rights as other human beings. Talk to a lawyer now about your rights if you get acute tubular necrosis from the job. Or leave the profession for something that will respect you before you get acute tubular necrosis.
Well, that is unacceptable isn’t it! What about a commercial water drinking station where you take a fresh cup every time? You must stay hydrated. If your superiors don’t care about you, you have to care about yourself and do what you need for your health. If you pass out from dehydration and it goes to court, the lawyers on the other side are going to ask why didn’t you hydrate? It’s your responsibility. You’re a nurse; you’re invaluable! Take charge! Good luck! 🫂
Mine is not a covid unit but the rules are the same because of JHACHO. Staff will take water bottles to non-patient care areas closer than the break room to get water/hydration.
Try a camel back, looks like a small back pack with a straw, no water bottle, no regs on this as far as I know.
Joint commission isn’t there with you every day.
And I’m of the opinion that if there buggiest concern is the danger of water bottles at the nurses station, their priorities are wrong (yes I said it). How can you care for others, if you aren’t making sure you are caring for yourself.
Yes, you must comply with the regulations. Here is where having exceptional management comes into play. Let them know exactly how you are feeling. I know in many areas staffing is tight, but working in some extra 10-15 minute breaks to keep your staff feeling healthy, and maybe more importantly, supported, may be just what you need. Offering this as a solution to your management team is definitely something you can do. They are also swamped right now, and just might be extremely happy to put your solution into practice. Remember, no matter where you are in the chain of command, keeping everyone healthy, safe, and feeling respected, is always a priority.
supportedOOffering this as a solution this as a solution
there's usually a "hydration station" at the nurse station where you can store water bottle/ drinks. with covid, I recommend a covered one.
that being said, TAKE CARE OF YOURSELF!! it took me years as a nurse to realize that we need to take better care of ourselves. we are no good to our patients if we don't take care of ourselves as well. When I was working and pregnant, I made a rule for myself when I needed to stay hydrated. Id sip some water between each patient. it sounds silly but it worked ... seriously, if somebody gets mad cuz you drank some water...time to leave that place
Actually you CAN have waterbottles at the nurses station as long as it's in a closed container. That changed sometime ago. And it is in a discreet area at the nurses station .
We were working under extremely difficult conditions during Covid. We drank, from our covered, cups, or jugs whenever we needed hydration. Finding time to pee was more difficult. I actually have a dr’s notes stating that i need to constantly hydrate, as I suffer from orthostatic tremors and bradycardia. If I don’t stay hydrated, i will, most likely pass out. My managers have not pressed me on this, as I have actually had 3 rapid responses called because I passed out. I was hospitalized each time, with bradycardia and hypotension. We have to take care of our own health if we are expected to care for others. There’s no debating that fact.
Find ingenious ways to hide your water bottle. Fuck them if they say anything about your water bottle.
Just like the flight attendants teach you, put your own O2 mask on first or you will not be able to help another. Your health matters as much as the patient's you care for!
I can relate to this working on the night shift tele/med/surge. We started off w 5 patients and got one, or two, admissions. Couldn't drunk - had No time, Couldn't eat, had No time. I Ran down the hallways to make sure my patients got what they needed on time. Being able to pee? The first time I could was Maybe at 0630, and even Then I received doctor's orders - on the toilet! My shift almost Always ended up at 0900 or 0930. (Because there was so much charting, or receiving a new admission at 0630, that we were Not allowed to pass on to the next shift!) Smh.
We (leadership) actually designated an area at the nursing stations for drinks. An actual, large draw or cabinet depending on the unit. The drink container must have a lid that closes and prevents spills. Encouraged to have name or be very different so staff didn't use someone else's container and must be removed at the end of the shift.
Since all blood and fluids should be labeled in the patient room and bagged and taken to the lab pick up areas, there should be no cross-contamination at the nursing desk.
Here is what TJC actually says.
The Joint Commission is not prescriptive where staff can have food or drink in work areas. The Joint Commission references OSHA's Bloodborne Pathogen Standard (1910.130) applies to occupational exposure to blood or other potentially infectious materials in healthcare settings. All organizations must follow this requirement. Standard LD.04.01.01 requires that health care organizations follow licensure requirements, laws, and regulations, including OSHA's Bloodborne Pathogens Standard.
Specifically, OSHA's regulation prohibits the consumption of food and drink in areas where work involving exposure or potential exposure to blood or other potentially infectious or toxic material exists, or where the potential for contamination of work surfaces exists. In patient care areas such as but not limited to:
Refrigerators
Cabinets
Shelves
Counters
OSHA requires that health care organizations evaluate the workplace to determine locations where potential contamination may occur and prohibit employees from eating or drinking in those areas.
Health care organizations retain the ability to define and establish safe eating areas for staff members. An evaluation will determine what work areas represent the risks for contamination to food and drinks. Based on this assessment, organizations can designate a safe space for staff to eat or drink.
For example, an organization may determine that a nurse or physician station or other location is physically separated from other work areas subject to contamination and therefore reasonable to anticipate that occupational exposure is not likely.
Keep in mind that while OSHA regulations apply to all health care facilities, local health departments may have additional requirements that health care organizations must comply with.
Additional Resources
OSHA 29 CFR 1910.1030 Bloodborne Pathogens
Perspectives Article (March 2019)
Screw JACHO. I am more important than a ding to the hospital. I bring my water with me blatantly. I had to take time off due to kidney stones which were caused by dehydration. No ma’am, won’t happen again!!! If they say anything I just tell them they are not allowed to touch my property and the hospital will just have to deal with my evil water bottle.
Get a Yeti Rambler water bottle with a chug cap. They come in 20-64 ounce sizes. It's totally sealed and keeps your beverage cold. Keep it on the unit in your backpack or a designated place at the nurse's station for beverages.
It’s very important to stay healthy and keep your peace of mine, you can take a 15 minute break after 4 hours. Take off your PPE, wash real fast and hydrate yourself, very important
Definitely go the CAPR/PAPR route. Not only is it safer but also you get cool air blown on your face while wearing a suffocating gown that makes you sweat balls. N95s don't fit my face well as I'm a larger than average human (6'2", 215 lbs) and I haven't been able to pass a fitness test so the hospital I work at has a responsibility to provide CAPR/PAPRs for nurses like me. If not its an OSHA violation. Look into it!
i saw a bottle with long tubbing to be put in the mouth to dring. may be you could conceal under PPE?
Actually, it's 100% acceptable per JC to have a bottle that closes, i.e. one of those bottles that has the mouthpiece that goes up and down. As long as it is 'contained', it's allowed at the nursing station.
JHACHO actually states that all drinks must have lids, and can be kept at the nurse station. Hospitals have brainwashed nurses into thinking they are not allowed to hydrate due to the risk of infection but per the rules and regulations it just needs a lid
https://www.jointcommission.org/standards/standard-faqs/hospi...
Your hospital can designate water or hydration stations closer to your work area. The area just needs to be a safe place, e.g., no specimens, body fluids etc. Saying you have to just hydrate in the break room is a lazy approach from the facility. They are using JCAHO's guidelines incorrectly.
You come first. Take care and drink the fluids or go to bathroom when you needed. You should not let that dictate how to fullfill your basic needs
Screw Jacho. Drink when and where u want to. And if they show up have them put on some PPE to help u out. I am sure u need to eat and pee too. I am so over all the stupid rules laid on us by people who have never or it has been yrs since they touched a pt or worked the floor.
I asked this question to management, my feelings were that know one really care about my needs etc. as long as there was a nurse body on the unit. So, I say take your break or they’ll lose another nurse!
Be prepared to say hello to kidney stones
Make sure to practice self care! If you get sick, pass out or if something happens, they will tell you that you should have asked for help. Take your designated breaks! Make sure to have a nurse buddy or use the charge nurse to get your breaks, you deserve them.
Don’t forget to take care of yourself first!
I always keep a mini bottle of water in my pocket and I take sips whenever I’m available to whether I’m taking a bathroom break or going into the break room quickly. Also on my way out of house a take a bottle of water and drink it on my way to work. That way I can start my day dehydrated.
I believe that is the reason for the nurse shortage. Lack of compassion and empathy from regulatory agencies, government and hospital administrators—- lower wages—-more responsibility—extreme physical and psychological stress—- abuse of power—nasty doctors who treat nurses like servants instead of coworkers..causing gen X nurses to retire in their late 40’s and 50’s or leave the profession 100%.
Doctor’s note saying you need access to constant hydration for a medical reason…?
We were recently informed it’s ok to have water at the nurses station, though it has to covered and not exposed. No straw unless it has a cap.
I believe JCHO allows “Hydration stations” at the nurses’ station. We have them at UCSF. If we had time to pee, hydration would be great.
Drink your water anyway. F them. Write an email so you have a paper trail- cc your bosses boss. Mention these three things 1) I am concerned 2 ) I am uncomfortable 3) This is a safety issue. Get a doctors note. If they say no- F them. Drink your water anyway. Get a black yeti. Hide it in your back pack and keep it in a convenient spot for you- or put in something that looks like it belongs to a patient and write a note- do not move per patient request! Drink water every two hours and make patients, pages and calls wait!!!
Camelback or other hydration backpack.
JCAHO doesnt have that rule it’s actually OSHA. We are allowed water at our stations as long as no lab specimens or contaminants are in the same area. Suggest it to your administrator
Get a doctor’s note that says you need to have access to water while working. I had to do that while pregnant.
Or find a new position that cares about your health and well being.
If your hospital is union, discuss with your union rep.
Or hide it in a cabinet. Lol If we don’t advocate and take care of ourselves, no one else will.
I keep water on the floor whether they like it or not. I did 100-120oz /day to feel optimal and my job isn’t worth my health. I also take supplements for electrolytes. I recommend a brand like Body Health that doesn’t have sugar or added chemicals. I take their reds supplement for a natural energy boost without the crash and their electrolytes because I get lightheaded a lot. Both have all 8essential amino acids as well.
Before wearing the PPE’s grab a couple bottles water to your pockets. Also it will be nice to have wireless vending machines on the road though 🤷🏾♂️🤷🏾♂️🤷🏾♂️
Another unfortunate example of how nurses are treated worst than prisoners, worst than animals. At least animals and prisoners can eat drink and void as nature intends.
There should be a hydration station intended just for nurses.
Where is OSHA who is advocating for the basic human rights for nurses????
Have you tried a sip valve? Is there an occupational health dept at your hospital that can help find a spot on the unit that complies with JCACHO rules? Rhetorical, for your consideration.
I wear a supportive sports bra with a Camelbak water bladder down in the middle between my boobs. You may have to experiment to get it to work for you. I will slap a sexual harassment lawsuit on anyone who dares comment on, or question my boobs so fast their head will be spinning!! Here's link :
https://www.amazon.com/CamelBak-Crux-Reservoir-Set-Blue/dp/B0...
Try drip drop . Its a life saver. Invented by a mayo Dr , 2packets in 16oz of H2O is equal to an IV bag of fluids. Order it online much cheaper on auto ship (Walgreens carries it by the Pedialyte)but it's expensive to get at Walgreens. I always have it on hand. I have 2 kids who have cyclic vomiting syndrome, it has kept them out of er many times
The Joint Commission does not say no water bottles on the unit. TJC surveys you on how you adhere to your own policies. Your leadership and unit counsel need to be addressing that issue so water bottles are closer/more accessible.
Get one those back packs for water and pull the straw out every so often liken when you get meds hide it with light jacket.
The real question is… would the JC Approve of making a patient have to walk as far as 10 feet to get to their drinking water? No. They would not approve. We’d most likely get a RADAR for leaving a patient’s drinking water out of reach.
It’s OSHA that says no water bottles!!!! Advocate for a hydration station!!! This was suggested by JHACO
I work in the OR and our surgeries are long without breaks. I know ORs are cold but with the gown, gloves, and lights I spend the whole time sweating. I’ve experimented with this a bit and the thing that works best for me is a concentrated electrolyte drink before work. I use the LMNT salts but I’m sure you can find other ones. I drink it before I go in and it keeps me feeling alive until I can get a break to drink water again in the afternoon. Maybe something like this could help?
how do we get jhaico to stand in our job and see the realities? they came to my bedside and dinged us for TAPE hanging off the isolate. i mean really… and then we feel bad having a water near by since we don’t have a moment to
run off the unit and take care of ourselves
I work in Arizona and DNV is our accreditation agency. We are allowed a designated "Hydration Station" where all our covered drink containers can be at the nurses' station.
Buy hydration bladder. You can keep it with you all the time. Tie it with waist or hang it in the back like backpack.
Take frequent breaks of about 5 minutes and ask other nurse to watch your patients and you watch their patients while taking breaks.
Keep
Keep your water with you whilst you chart. Plain and simple. JHACHO is out of touch.
I too almost passed out working Covid infusion unit. Had co-workers start an IV on me in the break room. Of course, because of sx, had to test for Covid & was out of work. This happens enough, your employer might think twice about its policy.
Create a “hydration station” this could be anywhere on a desk top/ counter. Tape it’s boarders and label it as such. You can keep a lidded water bottle ect there!!!!
The way I’d do it….. keep it anywhere safe from patients and computers! You’re health is important too!!!!
Rethink the way you eat and drink.
Adding liquids to your food reduces absorbition of very important nutrients since fundamental enzymes get diluted. Eat your water: basically start eating way more fruit too.
May also want to do a check of your hair sample and see what minerals are missing.
The body us basically telling you something is off balance. Mineralization could be the way towards homeostasis.
Good luck
I drink protein shakes like boost and ensure with a ton of ice that’s melts that helps with hydration and protein. It helps me when I feel lightheaded
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That’s OSHA that dictates no food, beverages or cosmetics in patient care areas. There are no options other than being non-compliant and causing a massive fine.
On shift Relieve one another and rehydrate.
Besides telling JHACO to GF themselves, buy a camel back hydration system. Wear it like a back pack, it’s a closed system. That’s what I did during COVID.
You CAN have drinks in a designated area. Even according to JCAHO and DNV. The area must be marked as a designated area for drinks, it must be away from pt care areas and must not ever have pt care items, supplies, or specimens. A sign as simple as “hydration station” makes drinks acceptable. (They must be covered with a lid). I made “hydration stations” at each nursing station, all the nutrition rooms, and in documentation areas throughout the dept. During our JCAHO visit in May the surveyor complimented the fact that we had hydration stations.
Joint commission actually doesn’t say that. OSHA says no food or drinks in the space you work. We have “hydration stations” in our hallways. It’s a cabinet you can place your drinks. Nothing work related can go inside the cabinets. Speak with your infection prevention team about that OSHA standard and see if you can find a solution that will work. Good luck
You can have a drawer with your water bottles in it. It just needs to be labeled properly. They just can’t be on the desk top. TJC has rules and if we follow those rules daily , they become habits and then we don’t scramble when they are in our facility. We may not like the rules but it makes it a lot easier if follow the rules thinking TJC will enter our facility at anytime.
fun fact about joint commission: they are hired by the hospital to make periodic inspections. They inform us if we need to make corrections or clear up documentation etc so, in case anyone complains to the DOH , we will be prepared. The joint commission works as a protective agent for the hospitals, which pay them directly. Can we function without them??? I don't think so
JHACHO does not say no water on unit. You can have water in a covered Non spill container that is placed away from lab, urine and other hazardous items. The goal is to keep you from ingesting lab items. Your work desk is fine for your water bottle. Just don’t bring lab there to fill out, label or store.
My job has the same stupid rule. I have my covered water bottle and stay hydrated. The nurse practice counsel took up the issue and we created a drawer in each desk as a hydration station and keep our water close by.
Designatedde
Designate a cabinet located in the nurses station to store hydration fluids. Then label it “hydration only” It’s ok with regulatory agencies.
I'm not sure if it would be allowed-but if it is covered with PPE-I wonder if you could wear one of those Camelbak water bags that carry 2 to 3 liters of water so that you could drink all shift. It might be hot but if you are sweating already-then at least you would solve the thirst problem.
Prioritize yourself. You CAN'T take care of someone else when you're compromised. I'm sure your coworkers are feeling it too.
When my unit was Covid, I communicated with my coworkers. The goal was to cover eachother so everyone got five minute breaks every 2 hours. It didn't always happen when there were back to back rapids/codes... but we tried. Everyone wanted everyone else there to stay healthy, partially for selfish reasons as well as the good ones.
Carry hydration tabs in ur pockets And or a pocket size container of water. Go into the restroom for 30 sec to drink or do it inconspicuously where pts can not see.
On your unit have a hydration station designated in your work area. Covered drinks with lids. The only reason that TJC says this is so Urine or other bodily fluids won't come in contact with the fluids you are drinking.
Yeah I To
Hi I suggest wearing the full PAPAR. I may feel a bit much at times but it has the air to blow into you mask so it keeps you cooler than just the n-95, plus you more protected. Give it a try :)
Wow! Fortunately I was off of work during these pandemic days!!. You must stay hydrated no matter what!. You must find time to drink water! Don’t have to take a break to drink water!. 12hour shifts are really busy but to provide good nursing care you have to be well taken care of too!!. Quit if you must!!.
I also am dehydrated and hungry no water and no lunch. I try to keep a bag of nuts for energy
This is an OSHA requirement. The Joint Commission has no standard on this. In Leadership, it says you must comply with law and regulations. OSHA has regulations that must be followed
