Content That ixchel Likes

Content That ixchel Likes

ixchel, BSN, RN (30,138 Views)

Joined Jun 3, '11. Posts: 4,588 (74% Liked) Likes: 17,331

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  • Feb 1

    I learned why penicillin is effective. Apparently it attacks the bonding in the cell walls, indirectly causing said bacteria cell to lyse (burst open), and die.

    I also learned that microvilli are effective little ways our body absorbs nutrients. I made the connection with bio 1 that states the greater the volume the smaller the surface to volume area is. So microvilli protrude into the lumen like peninsulas so they don't have to increase their volume to increase their surface area.

    Ah nature, and its efficiency.

  • Jan 29

    Moved to Nursing Humor.

  • Jan 29

    Quote from nurseactivist
    I am not a school nurse but a PHN. This is just a question. If a kid really was hungry, how would they know it is ok to ask for food? Would they be embarrassed, afraid or ashamed?

    I am not defending the stealing children. I saw an interesting documentary on NY School nurse who figured out that a large percentage of kids who present after lunch with a headache are in fact hungry (these were middle and high school kids).
    Oh, you are not wrong about the headaches. Still...

    Getting school lunches to all children is something that now happens in the Boston Public Schools. Every kid gets free lunch to eliminate the stigma and so that no child has to ask for food if they need it; they know they will get it.

    Here's where the "still" comes in. Kids are still sometimes picky eaters. We provide lunch at my school, yet many, many kids tell me "I threw it out because I didn't like it." Lunch is a balanced meal, healthy, but many kids did not like it or are not used to eating that way at home. I have made many "pacts" with 7th graders (!) to try (try being more than just one bite) new foods before they can tell me they did not eat lunch.

    I have also several high school kids that come from homes where food is in good supply tell me that they simply do not want to eat food of any kind at school (no wonder you have that headache, kiddo!).

    And yep, on the flip side, my school does also send several kids home with a a nondescript backpack at the end of the week with food items in it. Because even though we can give them breakfast and lunch at school, sadly, we can't be at their house. We can just try.

    And I still think we should not be encouraging stealing. Again, teach a child to have a voice - in a respectful way. It is not easy and I learn more about what a challenge that can be every day.

    [Whoah, that was long and way more serious than I thought it would be!]

  • Jan 26

    Quote from ixchel
    This week has felt painfully long. And here it is: the end. Just in time for the new one to begin already. I'm so not ready for a new week to begin, especially if it's going to be more of the same.

    In my world, I've learned....

    How fast a 31 year old being treated over the last year for skin cancer can go from okay, to gone.

    How utterly heartbreaking it is to watch her husband fall to pieces.

    How the very first RR code I ever witnessed, EVER, is doing now. It was during my internship in school. After a narcan bolus woke her up, a narcan drip didn't KEEP her awake (or breathing for that matter). It's been years since that day, and I imagine she thinks we're idiots with tiny fish brains. Her "allergy" to narcan with the response "heart stops" really isn't convincing.

    On further reflection, if you ever want to stop someone from giving you narcan, tell them it will stop your heart - the one thing worse than the overdose it is supposed to be stopping.

    I can't decide which hospitalist is worse: the one who totally ignores nurses (leading to malpractice suit-worthy near misses), or the one who thinks nurses are secretaries and puts pointless testing and orders in, and schedules things at times that make absolutely no sense. This one is a fan of q3h vitals (floor protocol is 4, so we thankfully can override that), q8h orthostatics (usually they're q12h), q4h fingersticks on NPO after midnight NONDIABETIC patients... The list goes on. Both these people need to go. Apparently people can't be terminated for simply sucking at their job.

    It is so, so sad to watch a sweet, elderly, a&o, dignified, former doctor become humiliated by his sudden rush of diarrhea, which he did not make it to the toilet to pass. It was kind of beautiful, though, seeing his recognition and deepening respect for all that nurses do. I don't think that he knew. With one doctor ignoring us, one treating us like secretaries, and this guy, I truly wish we could take time with each physician (especially on a hard day) to show them what we do, and share with them what we know, what we see, support and experience in any given shift.

    Kidneys suck. Especially when contrast literally kills them.

    I strained stone fragments out of urine that looked like poppy seeds and sesame seeds. Totally got an everything bagel on the way home. Toasted. Cream cheese. YUM!!!

    Ages ago I started a thread asking for advice regarding good scrubs for a short, tiny person with a big booty. It's probably been a good year since I asked, but I've finally found my answer! Butter Soft Stretch 8-pocket pants (in petite sizes) and 5-pocket v-neck shirt.

    I've decided to hop on a project, choosing frequently seen chronic and acute conditions to gather EBP on for the unit committee I'm on. And suddenly, I'm back on the books and research article libraries like they're crack and I'm hooked.

    The recent dynamics change that we are experiencing on night shift are so not good. We've had a rather dramatic drop in the last quarter's satisfaction scores, and as we went through respondent comments, it was pretty clear that a core group of night shifters are likely the cause of the drop.

    There are some nights when I feel like I'm the only one chasing down the noisy pumps to make them stop beeping and bed alarms when the ninjas come out of the LOLs. They'll all be online, looking up stuff to buy, while I'm all go-go-go all night. Then, shift change comes, and they're all waiting to clock out and leave. I'm still charting and wrapping up my shift.

    Caring for a patient with a horrible looking skin wound might make you slightly freaked out when you get a red spot on your nose that begins to breakdown like 3 days later, then takes days to show progress of healing.

    I was really hoping I would have learned the result of my biopsy by now. I have kept this mostly to myself, because of the passing of the wife mentioned at the top of this list. It hasn't helped, though, to feel the sadness and horror of her sudden loss of life due to skin cancer. Just please let this be negative.

    This week, the drug of choice appears to be heroin. And hookers. And drunken brawls in the ED.

    Deciding to always stay up all night was the best decision I could have made. It's amazing how much more productive I am on my days off when I'm not all jacked up trying to sleep.

    I have a person in my life who is constantly looking for things to be angry about. Seek and ye shall find. Not only is this utterly exhausting, but it's incredibly frustrating.

    So, yeah, long and complicated week. And I'm way behind on this place. Share with me what I should have learned!!! And, of course, I'd love to know - what have you learned this week?

    Eta: I didn't add a video!

    What the heck ISSSS this? DJ Earworm Mashup 2014 1 Hour Long! (United State of Pop) - YouTube
    Good luck with the results. Waiting is awful. It never hurts to call and check on the status of things if it has been a few days.. (Hugs)

  • Jan 26

    Quote from ixchel
    Holy crap!!!!!! That is terrifying!!!!! Thank goodness he's okay and you had an epi pen!

    I have to ask - were you panicked, scared, freaking out? Or were you calm, collected, "it's okay! I came prepared!"

    I do wonder how calm I'll be able to be if something major happens to one of my kids. I imagine myself panicked and hyperventilating and completely useless.

    That, or I'll be the horrible nurse-family member in the ED who hovers and obsesses over every tiny detail. If they don't get the IV the first time I'll be all like, "gimme that, you're done."

    Thank you for good thoughts!!!
    I was calm, cool, and collected while the reaction was occurring, but got really scared once I knew he was ok. I made sure he took the Epi-pen to work with him today.

    Poppy-I hope you're doing ok.

  • Jan 26

    So I did go to the BRN office today (I live like 5 mins away!)...and apparently my expiration date was entered wrong because in California...your first license is good for the first two birthdays! So they're changing it to expire next march!

    Just in case someone else is in the same boat as you know! [emoji4]

  • Jan 26
  • Jan 25

    Yummy, melty, buttery, crumchy grilled cheese.

    Note: Don't share with people on MAOIs just in case you use the wrong kind of aged cheese

  • Jan 24

    Quote from ixchel
    (I'm just now digging in on this thread and apologize for quoting and responding on a page 1 comment when there have been pages since.)

    I have to say that I am actually surprised that this is so far the growing general consensus. And boy am I extremely thankful right now that (for the most part) I work with doctors who are equally as respectful of my time and work as I am of theirs. If I'm in the line waiting to pull meds, I will let them know that I will look up absolutely everything they need, but I need to call them back in a few minutes. That is a reasonable response. The only time I'll get out of that line is the rare instance it's a private practice doctor who can't look it up themselves because they're not near a computer with access.

    Look, if it's not an emergency and you're actually in the middle of something that can't or shouldn't be interrupted, it's okay to say that. And these docs I work with know I don't just blow them off. They also know things I CAN stop doing, I will stop for them and give them whatever info, item, or charting/entering orders they need. This does go both ways.
    Yes. So agree with you, ixchel!

    I guess I picture the OP quoting what the pt told her to the surgeon - we are told to document quotes so it seems repeating a quote shouldn't get a person in trouble. And for the surgeon to throw a hissy fit to the patient -I'd have been more upset if the OP hadn't put a stop to it.

    Next if I am ready to pull medd and the surgeon is *sitting in front of a computer* and wants me to leave and look it up for him, that seems awfully childish. We talk about setting boundaries for patients, why not for a physician?

  • Jan 24

    Thanks to all of you who've posted some really good suggestions. You've expanded my thought horizons with your insights and shared experiences. The more I ponder this decision, the more I feel that it's what I'm really meant to do. Knowing that employers and fellow staff will have my back in tough situations brings peace and comfort. Peace!

  • Jan 24

    Have been in instructor with 5 different models of behavioral de-escalation, crisis intervention, and management of violent behavior. The best advice I give to my students, walk away or excuse yourself away from any situation you are becoming uncomfortable in. Get help, or as it’s now politically correct terminology “Show of Support”. A power struggle or a bad situation can escalate very fast.
    Many years ago, Hawaii State Hospital had a rash of staff injuries. Trying to problem solve the situation, they interviewed injured staff. Asked them, “Did it ever occur to you to leave the situation, and get help”. Almost all of them said no. A classic example of ‘tunnel vision’.
    After encouraging staff to not manage an escalating patient alone, and walking away from a threating situation, their assaults and injuries went to almost zero.
    As psych nurses were reinforced to maintain control of the milieu. Sometimes it clouds our vision of the bigger picture.
    My advice, be sure to always have an escape/egress. Know your patients, be aware of any change in baseline behaviors, and always plan ahead. Usually there is indicator of troubles ahead.
    Utilizing physical presence (or 1:1) to help calm a client in crisis is often the most effective way of helping them thru crisis. Also, builds trust for the next time.

  • Jan 23

    Even though I'm not currently working or in school- I did learn some things this week:

    -- 2-3 doses/day of alka seltzer over 3-4 days can put an 89y/o man in CHF (new onset- but hx of heart disease & CABG)

    --instead of just stressing to nursing staff that pt WILL sundown in hospital & to make sure he gets clonopin so he'll sleep, I need to stay to make sure it gets done properly. (It was found in his bed the next morning)

    -- if an 89 y/o man with dementia doesn't sleep all night, he is a different person the next morning. Not a pleasant one either. Threats were made with a cane, restraints were used, bad things were said.

    This 89 y/o man is my Dad. The meds were finally adjusted & he finally got some sleep. Was more like his slightly confused but joking self when he woke. But dammit, it was really hard.
    I read on here and know many of you take care of parents, spouses, ((((viva))) and I feel a bit of kinship with you all.
    AND I did not go on fb and rant about the mistakes that were made in the hospital! Didn't even go over anyone's head as it could've happened to anyone. The nurses my Dad had were really great with him!

    Hopefully no more lessons like that coming up!!
    I'm ready to go back to work, just don't know what I really want to do.
    Ideally wanted to do inpatient hospice but don't have one around here. Second choice????

  • Jan 22

    Someone needs to leave out some laxative chocolate...Kidding.

  • Jan 21

    There was a mix up at my PCP's office and my appointment for the cyst is now next week. Thankfully the inflammation seems to be decreasing.

    So last night I learned I'm a bully with "mental issues". I'm still too inexperienced to be a COB so not sure where I fit in here...

    I tried PMing Far & Jensmom but I guess it didn't go through - wonder what that's about?

    We had our last appointment with one of my mother's favorite specialists - so sad he's leaving the state for another hospital. He is a good physician.

    I have no idea what I want to do next - get back into nursing? A (big) part of me was awfully relieved when I realized I don't have to...

    But there are areas of nursing I'd like to try - WOC sounds fascinating, ED would be interesting, and I've even considered joining the ranks of the school nurses though I am equally terrified at the thought.

    Thanks for letting me vent, you are great! XOXOXO

  • Jan 20

    Quote from ixchel

    I say this half in jest, but in my defense, it was requested that I use catchy (attention-grabbing?) titles for the WILTW threads. [emoji5]️
    Well your title certainly got attention! LOL

    Seriously, it's fine to talk about things like this as nurses. It's what we deal with. But the public will never understand some of this.

    I know all of you are aware that what you post here on the site can be viewed by anyone on the WWW as our forums are open.....which is a good thing. We don't have anything to hide.

    Posting on FB is another thing. People can be and are offended by things on FB as they are here on the site, because many of them are non-nurses. But we will try to be more watchful of titles, discussions, vents that may put a very negative light on the nursing profession if posted on FB.

    I want you all to feel comfortable to continue to discuss your work experiences. Just watch the titles.