6/11 WILTW Unsupervised Chalk Use

Nurses General Nursing

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I apologize for starting this thread late! Ixchel asked me to host this week's thread for the first time , and I put a reminder on my phone, for the wrong date!

This week has been filled with ups and downs, but then again that feels like my life in general the past few years.

First I learned that I officially won a scholarship through NAHN (National Association of Hispanic Nurses)! I'm still surprised I won it, seeing as to how I sent in my completed application, paid for it to be overnighted, on the *day* it was due. Talk about procrastinating. It's for $1500, and considering I'm at a community college, that's great. I have to go to Chicago to accept it. Which will require an overnight trip and traveling & hotel costs. Fine, we were going to make a family trip out of it.

My husband also go offered a promotion at his job! Most people go through a few rounds of interviews before finally getting promoted and he got his on the first try. However, he was offered a really bad shift for us, and he was going to turn it down, but, they worked it out to having him start on a different shift, not the ideal one, but a shift we can work with.

And then, the chalk happened. I've been trying to not be a helicopter mom, and have been letting my daughter play outside of our apartment complex on her own, with me checking on her every 15 minutes or so. Well yesterday, her and her sister decided to chalk/draw on a few of my neighbors cars. And scratched them. My neighbor was nice about it, but it's a new car and he rightfully wants us to pay to fix the scratches. Thankfully the other car was a hoopty/clunker and he didn't care. But it is likely going to cost us $400. There goes my traveling and hotel money for the scholarship.

But I also won a full scholarship through school! So no loans for my final year of nursing school. But I'm still sad about not being able to accept the other scholarship, I put a decent amount of work into it. And I was also looking forward to getting all dressed up and visiting Chicago.

So far my summer Pharmacology class has been refreshingly easy. Almost too easy, because I space out alot in class, until the end when he stops to tell us the questions for the next quiz. Now I almost wish I had taken it during the regular semester, as I usually pride myself in understanding the information, not just getting good grades. It's alot for 4 weeks.

Oh and I lost some weight! Maybe 8 lbs in total over the last 5 to 6 weeks. This is with just healthier eating, no dieting, and exercising 3 to 5 times a week. The goal is to fit BACK into my scrubs before I'm back at clinicals.

So, fine, more ups than downs. So what have you learned this week?

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Specializes in Pediatrics, Emergency, Trauma.

I learned that I could go up my clinical ladder for a project I have enthusiastically :sarcastic: volunteered for.

My enthusiasm for volunteering for projects have positioned for positive change, so I think that having one where it is something I want to do well in and will help the unit as a whole while positioning myself professionally is a great step; my new boss wants to help me with going up the clinical ladder as well. Nervous and excited! :D

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Specializes in Hospice.

I've learned that a radio ad for a for profit nursing school gives me the jeebies.

Part of the copy goes; "Isn't it better to have a program that keeps students IN, rather than weed some OUT?" [emoji33][emoji33]

Coming from a school that churns out students 2-3 times a year and costs a metric butt-ton to attend, yeah I can imagine they want to keep everyone until graduation.

I've renewed my vow to stay as healthy as I can and avoid being a hospital or facility patient as long as I can. I've seen some of the product this place churns out, and it ain't pretty.

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Specializes in ICU.

I learned I passed NCLEX!!!!! OH my gosh, I get to put RN behind my dang name now!!!

I learned I really like working on my unit. I love the supportive environment. I got to do a couple of things last week that I deemed really scary that I had never done before. I've learned to maybe not be so scared, it's going to be fine.

I hope, that in some small way, I can start living a normal life again. You know, go to work, go home, spend time with the fam.... All the stuff I have missed out on for three years because there was always a test somewhere. A care plan that needed done, sleep needed.

I learned today that I finally made it. Insert, tears rolling down my face right now.:cry:

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I learned I passed NCLEX!!!!! OH my gosh, I get to put RN behind my dang name now!!!

I learned I really like working on my unit. I love the supportive environment. I got to do a couple of things last week that I deemed really scary that I had never done before. I've learned to maybe not be so scared, it's going to be fine.

I hope, that in some small way, I can start living a normal life again. You know, go to work, go home, spend time with the fam.... All the stuff I have missed out on for three years because there was always a test somewhere. A care plan that needed done, sleep needed.

I learned today that I finally made it. Insert, tears rolling down my face right now.:cry:

Congratulations!

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Specializes in LTC, assisted living, med-surg, psych.

I learned that my son, the LPN student, is really beginning to think critically, instead of just writing care plan after care plan. I'm so proud of him. :)

I also learned that scrivener's constipation (my term for writer's block) is a PITA. I can't seem to get unstuck, and I've got a blog to keep up with as well as several ideas for articles here. They're in there...I just can't get them out. GAAAH!

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I learned that I hate being Bipolar. I feel like I'm missing out on important things in my son's life because of my depression. I hate it.

Also, we aren't out of the clear quite yet. My husband starts working on June 24th but doesn't get paid until the end of July so we need to find a way to pay July's bills. Uh oh.

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This week was busy like always...

Here is something "scary" I read for my graduate studies:

http://www.jcrinc.com/assets/1/14/VNM10_Sample_Pages.pdf

Also, I was able to actually make a great flowchart with another program. It costs money if you subscribe but they have a 7 day trial for free, which literally saved me when I had to make a complicated flowchart:

Flowchart Maker & Online Diagram Software

The chronic care model :

Preventing Chronic Disease | The Chronic Care Model and Diabetes Management in US Primary Care Settings: A Systematic Review - CDC

I need to say that I learned some interesting facts about chronic care models and how to change clinical microsystems so the clients get the care they need.

And apparently "mental status" is the 6. Vital Sign as the educational webpage dedicated to "delirium" proclaims. They do have some good information though:

Home

And here is the dilemma of the week from palliative care:

A very elderly patient with extensive disease comes to the hospital and gets admitted. Within a couple of days the patient status deteriorates. Since there is terminal illness that is extensive (cancer), the physician talks to the family about changing the code status from "full code" to something more appropriate. The family has a hard time to cope and understand but after several discussion and continued decline decides to agree to "do not resuscitate" (no chest compressions) but elects "intubate". Patients receives treatment but clearly approaches end-of-life and a rapid response is called because the respiratory status has now deteriorated. The intensivist comes to evaluate the patient and consults with other physicians - all of them state that intubating this patient would be futile given that there is extensive disease and the patient is made comfortable. The family was not available to discuss. The patient was made comfortable and passed shortly after. For days several physicians had written what constitutes futile medicine and futile care. Despite this, there was some upset from some staff over the fact that the family had elected "intubate" and in their opinion the physician has to do "what the family wants".

This is not how it really works. After all, CPR and intubation is a medical treatment so to speak and physicians have the right not to perform certain treatments when it is futile or risk outweighs the benefit clearly. We all have heard about patients not getting the surgery they had elected or hoped for because when the surgeon opened the patient they found extensive disease. Here are some links that pertain to this topic futility:

Do Not Resuscitate Orders: Ethical Topic in Medicine

http://circ.ahajournals.org/content/102/suppl_1/I-12.full

http://www.kevinmd.com/blog/2012/06/burdening-families-cpr-decisions-face-futility-cruel.html

http://community.the-hospitalist.org/2008/03/11/absurd-resuscitating-90-year-olds-with-dementia-or-metastatic-cancer/

http://www.lifemattersmedia.org/wp-content/uploads/2014/05/futility-article.pdf

I also learned that my younger child who just got her permit is a great driver and does not give me motion sickness. And I like the X-Men movie.

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Specializes in critical care.

My, oh, my, another fun week, people!

First, AMW, thank you so much for your OP! And I'm sorry I left you high and dry!

CONGRATULATIONS!!!!! What a huge couple of victories! (We'll leave the chalk out of it. lol UGH!!!!!)

This week, I have been reminded that...

The most mundane stretches and core exercises suck. (I'm trying to stay focused on the end result - that they don't suck for long.)

Girl Child is missing a tooth. This isn't a, "she just lost it, so now we wait," thing. She lost this chunk of teeth years ago, the teeth she got back lined up perfectly with no space for more. There is no evidence that I can see that this tooth has any desire to ever return. 6 front teeth on top. 5 on the bottom. 6 up top are crazy crooked. 5 on the bottom are beautifully aligned.

I really suck at dance momming.

This week I have learned...

It is terrifying to see my son's eyes roll upward, as he goes down and his head goes through the wall. Watching his whole body twitch as he wakes up. Then his pupils change sizes and his orientation declines over the day.

How much it sucks to realize a pediatric hospitalist happens to be a huge idiot, by mom and nurse standards.

That I am so incredibly thankful that nurse brain has become somewhat instinctual for me. Thank God, because if it weren't for that, I would have been useless.

That my husband does not realize that when I say I have to be at the hospital with my son, it is in no way a reflection on his lack of medical knowledge. I need to hold my child's hand. The child has two hands, come hold the other one.

It sucks to be the nurse, telling the family of the patients that we don't know what caused the syncopal episode. Do you know how much it sucks even more to be the family member?

As a person with a very odd presentation of epilepsy, I was 17 different shades of red when the hospitalist told me all about what seizures look like.

It is so hard to stay more than arms' length away after something like this.

I've never been so thankful for my cardiology and neurology experience in my life.

Except for that one time I learned I can trust my son's doctor so deeply that I want him as my own. Damn him and his decision to go peds only.

It's two days later and I don't know how to stop being afraid. :( I certainly won't get the image of his eyes and the sound of his head making impact out of my head.

Oh, I guess I was also reminded how much my husband can freak out and how HORRIBLY irrational he can get. I wont even go there.

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My, oh, my, another fun week, people!

First, AMW, thank you so much for your OP! And I'm sorry I left you high and dry!

CONGRATULATIONS!!!!! What a huge couple of victories! (We'll leave the chalk out of it. lol UGH!!!!!)

This week, I have been reminded that...

The most mundane stretches and core exercises suck. (I'm trying to stay focused on the end result - that they don't suck for long.)

Girl Child is missing a tooth. This isn't a, "she just lost it, so now we wait," thing. She lost this chunk of teeth years ago, the teeth she got back lined up perfectly with no space for more. There is no evidence that I can see that this tooth has any desire to ever return. 6 front teeth on top. 5 on the bottom. 6 up top are crazy crooked. 5 on the bottom are beautifully aligned.

I really suck at dance momming.

This week I have learned...

It is terrifying to see my son's eyes roll upward, as he goes down and his head goes through the wall. Watching his whole body twitch as he wakes up. Then his pupils change sizes and his orientation declines over the day.

How much it sucks to realize a pediatric hospitalist happens to be a huge idiot, by mom and nurse standards.

That I am so incredibly thankful that nurse brain has become somewhat instinctual for me. Thank God, because if it weren't for that, I would have been useless.

That my husband does not realize that when I say I have to be at the hospital with my son, it is in no way a reflection on his lack of medical knowledge. I need to hold my child's hand. The child has two hands, come hold the other one.

It sucks to be the nurse, telling the family of the patients that we don't know what caused the syncopal episode. Do you know how much it sucks even more to be the family member?

As a person with a very odd presentation of epilepsy, I was 17 different shades of red when the hospitalist told me all about what seizures look like.

It is so hard to stay more than arms' length away after something like this.

I've never been so thankful for my cardiology and neurology experience in my life.

Except for that one time I learned I can trust my son's doctor so deeply that I want him as my own. Damn him and his decision to go peds only.

It's two days later and I don't know how to stop being afraid. :( I certainly won't get the image of his eyes and the sound of his head making impact out of my head.

Oh, I guess I was also reminded how much my husband can freak out and how HORRIBLY irrational he can get. I wont even go there.

Ixchel, I am so sorry. I know how it is to have a chronically sick child and all the worries, dealing with physicians that are failing to be "specialists" and so on and forth. My daughter had febrile seizures as a baby and that was bad enough - I can only imagine how anxiety provoking it must be when the child is older. I did work neuro at some point and that floor had a seizure monitoring unit. Seizures can present in such a weird way at times...

Of course you want to be with your child when it is sick!

I hope things calm down and get better for you soon.

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Specializes in Cardiology, Cardiothoracic Surgical.

1) Friday night confirmed I can never be a float nurse, unless I stick to heart/pulmonary floors. I got floated to uro/gyn/onc for a shift and was like :no::yawn::scrying: when it came to my patients and other nurses. Typical post-surg nursing, but I really don't care to check pads and lady partsl packing like whoa on 4 different patients. I did women's health for a year, and that was enough! I'd rather they put me on call then deal with the dinosaur of a floor that was.

2) Being nocturnal is seriously beneficial in these hotter'n-hades temps. I've been sleeping between 12-6 pm, even on my days off.

3)

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Specializes in OB.
I learned I passed NCLEX!!!!! OH my gosh, I get to put RN behind my dang name now!!!

I learned I really like working on my unit. I love the supportive environment. I got to do a couple of things last week that I deemed really scary that I had never done before. I've learned to maybe not be so scared, it's going to be fine.

I hope, that in some small way, I can start living a normal life again. You know, go to work, go home, spend time with the fam.... All the stuff I have missed out on for three years because there was always a test somewhere. A care plan that needed done, sleep needed.

I learned today that I finally made it. Insert, tears rolling down my face right now.:cry:

Congrats!

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