MomRN0913 18,523 Views
Joined: Dec 31, '10;
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I have had my fair share of self extubations. It's happens. Some even manage to tongue the tube out!
most of the time my self extubations were ready to come off the vent.
It happens often, don't beat yourself up over it.
No days off in the summer??? Eeeeek. Glad you found another job.
Now that I got laid off from my full-time job, this is something I really need to consider doing. I would feel most comfortable in my ICU. The biggest change since I left is the EMR (we were all paper)
I'm scared, but I need an income, and maybe, just maybe, this was a sign ( I really did love my job I got laid off from, I'm pretty sad)
Before I became a nurse my mom died. I was 21 and she died in a drug rehab facility at 47. I was her next of kin, my parents were divorced. I had to identify her body in the morgue in the hospital( my dad did come with me). I had a nervous breakdown and almost threw up.
I graduated nursing school at 25. Who would have thought I'd become an ICU nurse taking frequent trips to the morgue after THAT?
Not or that I'm not compassionate, but the death of your own loved ones is much more different than the death of a patient. I do feel for the families . But like another poster said, when the patient dies, the last thing that death is about is me.
A, or an " older" nurse ( I will be 34 in 2 weeks) but I have worked in ICU and hospice. The 2 areas where death happens the most.
I see death as a part of life now I guess. Some deaths hve been more difficult ( developing relationships with patients, or ones who were young, or suddenly died when they weren't " supposed" to.
otherwise, yes, it was not unnerving to out a body in the freezer at the morgue. My friends not in the health field couldn't fathom. But it was a part of my occupation .
am I I humane because death of patients doesn't rock me or sometimes even phase me much anymore?
no, I don't think so.
So the first hemoglobin didn't go down significantly enough to transfuse. Ok. Then you get another on and it did. That's why serial hemoglobin are drawn. Nothing is wrong there.
doctora don't always get it right on the first shot. Often they suspect something, and try something, if it doesn't work, they run some more tests, make another educated diagnosis, but that might not be right either.
ever watch house?? Lol.
Honestly, an engineers lines of work and education is very black and white and technical. ( I know many ). As you can see you are passing the very science -minded courses where the answers are either right or wrong.
your key is to switching to using your analytical mind. You need to learn to read between the lines and use out of the box thinking and see the gray area.
honestly, how to do this, I do not know . It comes naturally to me. But I would definitely consult an advisor at the school.
Are you able to place yourself in others shoes and situations ? I think being able to that helps a lot.
best of luck
Yes, even in skilled visits. It's really annoying. They can feel free to go buy it themselves, but if they ask if they can have Tylenol or colace, you technically have to call the do for and ask.
i tell them with a big smile on my face " I'm not a doctor and I can't prescribe" and they usually get it it.
I also got extremely lucky in the preceptor department. Twice. First as a new grad med surg float. She was just awesome and we clicked. Easy going, helpful, never made me feel stupid.
4 month later ( which was 4 months into my nursing career) in the same hospital I switched to float to MICU. I got such a sweet and knowledgable preceptor who, again, never ever belittled me. We actually became good friends.
I also got lucky in the hospital choice. I wish I was still there. Management treated us great, doctors treated is great for the most part, when making an honest error you did not have to worry about your job. You were taught to leArn from it.
when you have these great things, cherish them. I always have
It's bad, but my 6 year old is a sensitive one. Littlest scratch and it's " mommy I'm bleeding, I'm bleeding!" I kiss it and tell her to shake it off
She visits the school nurse about 4 times a week for a band aid or an ice pack, and rarely do I ever get a call that she is sick. The school nurse knows I'm a nurse and only reserves phone calls when she thinks she really is sick. Or DD requests a call, and even then , the nurse will tell me if I really need to come or not.
But yes, when she gets a tiny little scratch, I say " did your arm fall off?" And if she says no, I tell her is ok.
and yup, she probably will throw it in my face when I'm old and she needs to care for me
Honestly....... It goes all sorts of ways. Yes, I've experienced the ER nurses holding their patients they were supposed to bring up hours before until 15 min before the end of the shift as to avoid getting another one. And it's not an assumption. Especially when it's the same repeat offender.
i worked in the ICU who also held onto to tele transfers so they didn't get an admission to fill their bed.
actually, I will be flat out honest. I've been guilty of it myself. But of course I still fully care for that pt I'm holding onto. ( this was not a regular occurrence . Just on particularly bad nights where I'm already swamped)
there re is never an excuse for not assessing a patient. Can't tell you how many we would get up for the ER dead already. Or the pt we got I. Rapid afib who had on his admitting orders SIX hours before I received the pt to start a cardizem drip and lo and behold the reason it wasn't started was because " well, they are the admitting orders, he wasn't considered ER when they were written ". What?!?!?!? I made the MD aware but I didn't write them up( should have, really)
the he truth is it is done all around, holding the pt. But it should be addressed by management
KelRN, don't go into the hospital.. You will be woken to take meds at strange hours, woken for vitals at midnight and 4am not to mention assessments. Hospital nursing is 24/7 so while we try to allow pts to sleep as much as we can, we can not stop treatments etc just because they are sleeping...
Our pts are all scheduled protonix at 6am every morning. I wish we could get it changed to 4am. This way we only have to wake them once. Labs are due at 4am, assessments are due at 4 also. Then I have to wake them again for their 6am meds UGH...
I was just discussing this with a friend. Isn't " dry drowning" essentially aspiration? Depending on the severity they could need ventilators support and antibiotics.
the sad thing is they usually are found is such a state before it's too late
I kind of had the opposite experience. I was an MICU nurse and new mother who's daughter went to the NICU. She was in the NICU as a precautionary measure and when I called the morning after her birth for the update , they spoke to me like a nurse and not a new scared mom telling me my baby " brady'd down and become apenic when feeding" like it was nothing.
I wanted to to spoken to and explained what that means like I'm a new mom! NICU and MICU are very different. Luckily the other nurses treated me that way when I finally could get I to the NICU.
I also had a postpartum nurse come I to my room who was on orientation and is to know I was a nurse. I heard her preceptor come in and do a head to toe assessment and explain what she was doing. I let her do the whole shebang and nodded along. It was a good nursing experience for her.
The he nurse may have not know . All we need to do is say is " I'm a nurse, and I understand you can speak to me in medical terms, I prefer that"
or in my case I basically said " I'm a nurse, but I'm also a new mom and not a NICU nurse, first and foremost , please threat me like a new mom with medical knowledge"
Congrats, that's my clinical dream job!
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