1/30 This week I learned: you suck, EMTALA.

Nurses General Nursing

Published

  • by ixchel
    Specializes in critical care.

From loony tunes, to total inadequacies, this week was ... unusual. Certainly plenty to learn. I actually had a much bigger list and realized I was a bit *too* specific with some details. Don't want to anger the HIPAA gods!

That aside, I got my fair share of unstable people and psych consult-worthy (and maybe law enforcement worthy) people. Good times....

Flipping back to days this coming week, and only this week. I hate days. Expect Grumpy ixchel for the next several days. You've been warned! [emoji5]️

This past week, I have learned:

Biopsy was negative! And I'm surprised, because two different providers told me to expect something abnormal. Trust me - it's a happy surprise!

Esme is back!

Being on dayshift this week makes me want to cry. Also, there is no night shift jetlag/hangover when you stay up all night every night. Apparently I do better without all the sunshine.

Using a little creativity to bring a patient a small bit of joy after a week in the hospital from sepsis can really fill the heart. All it took was brewing some fresh iced tea.

"Roadkill", in rural poor slang, means cigarettes in public ashtrays that have enough left you can pull them out and finish smoking the rest.

I have met the creepiest man on the planet. I swear to God he killed his mom the night before he was admitted, and I'm pretty sure every single morning he dosed himself with different meds to have different legit symptoms to keep him in the hospital. By the way, being hospitalized is probably a great alibi.

There is a certain look that a terminally ill total dependent care patient gets on their face when you can tell they're only full code because their family insists. I wish I never noticed that exists. When you get them care that clearly makes them uncomfortable they get that look and all I want to do is apologize and promise I'll never cause them pain or discomfort again.

Expecting short term rehab because your driveway is snowed in is totes legit, yo.

If you are wondering why a medication that you get has increased in price, perhaps it's because their promotional brochure has started to include videos that can be played in English and in Spanish and is in full-color stuck in the middle of an actual pamphlet. God bless the pharmaceutical industry. (As much as I hate to link Vanity Fair, some of this is alarming. Deadly Medicine | Vanity Fair)

Lantus still smells as bad as it did the last time I broke a bottle of it.

If you feel your heart heavy after a shift because a patient situation was handled so horribly wrong, your hospital's patient advocate will enjoy hearing from you. You will also be able to go home and sleep knowing its in the hands of the person who is paid to solely make things better for the patient. If, as an RN, I opt for a 9-5, that's a job I could absolutely love.

I have once again witnessed how hard a body will fight to live. I'm sad for the circumstances with everything that went wrong, but honestly remain enamored by how impressive bodies really are. Newbies, remember this - the body wants to live. Let that truth steady your hand.

I actually found myself incredibly angry at EMTALA. It had good intentions, but now it can justify the non-emergent people pulling vitally needed staff away from the critically ill, leading to malpractice and negligence from severe lack of resources to handle the sudden influx of overflow.

So, what have you learned?

Duran Duran - Hungry Like The Wolf - YouTube

(But those lips, though. [emoji15])

I learned that there are a lot of two-faced people in the world.

I FINALLY know how to set up a primary and secondary IV, and how to prime the secondary tubing with the primary solution. I never thought that I would be so proud to nail this skill.

I now know what cardiac tamponade. And I actually understand cardiac-related issues.

My mom asked me to diagnose her. When I told her I didn't know what she had and I can't diagnose her, she asked me if I learn anything in school. :rolleyes:

Oh, and I started watching Brooklyn Nine-Nine. It is hilarious.

springchick1, ADN, RN

1 Article; 1,769 Posts

I learned that since I share my opinion on an Internet forum and people don't like it, that clearly I have no compassion and am terrible with my patients.

Some people are so much easier to precept than others and it is such a nice change!

My new guilty pleasure is cheesy Hallmark Channel movies.

Specializes in Pediatrics, Emergency, Trauma.

I learned that there are educated professionals out there that have no idea what legal rights they have as employees...it can be extremely frustrating to watch TPTB provide misinformation to continue to entertain the status quo; it's nice to enlighten the misinformed while TPTB have to be forced to admit the important info they conveniently left out. :cool:

Wrench Party

823 Posts

Specializes in Cardiology, Cardiothoracic Surgical.

1) What you hear in report is not always what you get. Got a supposedly stable patient back, instantly desatted to 80s on full non-rebreather and we had to call an RRT on him. I'm on to you, cath lab.:sniff:

2) How to do a 12-lead EKG.

3) How to make annoying family members useful. Yes, Mom, open that gauze pack, hold that piece of tape, as you're freaking out about a routine dressing change and literally about to drip sweat into my sterile field.

4) I'm becoming more comfortable in codes and rapids. I was able to give a coherent report to the team, as well as gopher efficiently on another. I think I'm starting to find a role in such things.

5) Doing PICC line dressing changes while a patient's on a bedpan isn't ideal, but you gotta do what you gotta do. (Pt about pulled out his PICC running heparin, was a horrible stick, and had no other access. Managed to save it for awhile).

6) I am the Queen of Bladder Scans and I/O caths. Had 3 pts that all needed them and was a pro by the end of the day.

7) I can work 6 days in a row and survive. Not ideal, but it can be done.

VXD4722

46 Posts

Specializes in Pediatrics.

1) It's a lot harder to keep a nebulizer mask on a 30 day old baby than I anticipated!

2) I want to quit my part time retail job sooooo bad. It is getting to be too much with school and clinical and work that I feel like I have no time for ME. Too bad I don't think I'll be able to afford to quit yet.

3) I found out that my grandmother is deteriorating really quickly at her assisted-living facility, it is likely that she will pass soon (next few weeks). And my grandfather's dementia is getting worse and worse. It breaks my heart to see them going through that. I knew it was going to happen eventually, but you can't really prepare yourself for it.

Editorial Team / Admin

Rose_Queen, BSN, MSN, RN

6 Articles; 11,658 Posts

Specializes in OR, Nursing Professional Development.
Biopsy was negative! And I'm surprised, because two different providers told me to expect something abnormal. Trust me - it's a happy surprise!
:w00t: Glad that's a worry you can let go of!

Esme is back!
Another :w00t: Glad to have you back, Esme!

I've learned how much easier and enjoyable it is to help out in another department when they are appreciative and actually say thank you. I'll happily go to that department at any time over helping out other specialties in the OR that don't say thank you and then turn around and say we don't do enough. Which goes to show how just a little appreciation goes a long way.

I've learned just how long I can be in pain after shoveling an entire winter's worth of snow in one day. Still need the heating pad in the evening.

Farawyn

12,646 Posts

I've learned I'm the world's worst bowler.

I wasn't sure, but Yep, I am.

Editorial Team / Admin

Rose_Queen, BSN, MSN, RN

6 Articles; 11,658 Posts

Specializes in OR, Nursing Professional Development.
I've learned I'm the world's worst bowler.

I wasn't sure, but Yep, I am.

I might be able to give you a run for your money. My lowest score is in the 20s and my best is in the 80s.

Farawyn

12,646 Posts

I might be able to give you a run for your money. My lowest score is in the 20s and my best is in the 80s.

Highest score broke 100. Barely.

Lowest score was a 1. :bag:

Editorial Team / Admin

Rose_Queen, BSN, MSN, RN

6 Articles; 11,658 Posts

Specializes in OR, Nursing Professional Development.
Highest score broke 100. Barely.

Lowest score was a 1. :bag:

Sounds like you might be in the running with me for the title "Queen of the Gutter Ball"

NICUNurseEliz

110 Posts

Specializes in Pediatrics, NICU.

1) That staycations in the winter are awesome! My apartment is spotless and I'm about to start on my 3rd book in a week. I could live like this!

2) That you start forming meconium (your first poop) at 16 weeks gestation! (I feel like this won't be on my CCRN exam but that I will remember this fact forever)

3) I learned that my Fitbit is really motivating me to walk more but my feet hurt!

4) I started watching American Horror Story this week and I learned that I will never walk into a basement again. Nothing good happens there! :nailbiting:

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