Content That ixchel Likes

Content That ixchel Likes

ixchel, BSN, RN 37,066 Views

Joined Jun 3, '11. Posts: 4,940 (74% Liked) Likes: 18,914

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  • 12:14 pm

    Quote from ixchel
    We had someone sent us who had been hyperventilating for hours. Came to the floor, no intubation, not one but two doctors didn't question this. No ABGs, no intubation... Real head scratcher. First thing we did was get ABGs. CO2 was 5. Off to the unit he went. Some things just leave you wondering - what the Samwise Gamgee were these people smoking?!
    Yes! I now have a go to request of an ABG whenever the doc wants to say "let's just see how they tolerate....." ... nah... "how about we check a blood gas doc, and then decide?"

  • 7:18 am

    Quote from nursemcsleepy
    And then comes your career choice. 'You're a male nurse? You must want to go into cardiac, or psych, or the OR, or trauma' - where the excitement is. God forbid you're a man drawn to NICU, or medicine, or oncology, or pediatrics... because those are soft specialties, where the delicate, fragile women belong.
    When I started nursing school wanting to go into one of the stereotypical male nurse specialties (ER, trauma, ICU). It wasn't until I did a rotation in the NICU that I found the ideal specialty for me. You have the Adult ICU environment without the 300 pound adult in the bed. We deal with the same types of patients as adult ICUs (Cardiac, Respiratory, Gastro, Neuro). Try maintaining an airway on an intubated micro-preemie with an ETT tube smaller than a straw or starting an IV in a preemie.

    It may be thought of as a "soft" specialty, but the nurses are not delicate, fragile women. They are highly skilled ICU nurses. ER nurses dread pediatric codes. They are far more emotionally taxing than an adult code. NICUs deal with them far more frequently. I would rather code a 95 yr old patient that has had a long life than a 24 week preemie with first time parents crying and praying for a miracle in the hallway.

    Unfortunately, it seems that more and more of the public have known of relatives/friends that have had babies in the NICU and witnessed first hand NICU nurses jobs. I have yet to get the "dealing with babies is a female's job". It has been the "I could never deal with taking care of those tiny babies"

    To paraphrase the Marine motto: "The few, the proud, the male NICU Nurse"

  • May 4

    Quote from ixchel
    If you tap a post that you like once, you'll get a few choices pop up, including liking a post. To like, tap "thank".

  • May 4

    Quote from ixchel
    If I'm "ixchty" (which, lets face it, probably is pronounced "itchy"), does that make you "Farty"? (With a capital F)
    I second this.

  • May 4

    Quote from Farawyn
    By whom?
    I'm working on the details.

  • May 4

    Quote from ixchel
    Boo! When did that word get censored?!

    (It wasn't what you probably think it was.)

  • May 4

    Quote from ixchel
    We have one newer MD, came to us off residency maybe 4 years ago, who sits down and truly TALKS to the patients. He knows I like to be in there for rounds, so he finds me to go in. He gets eye to eye with the patients and doesn't have any vibe whatsoever of being rushed. And yes, always, "I have time for that," followed with, "what can we do for you?" The conversation always ends with, "if you need to reach me, ixchel has my number and can call any time."

    The patients usually love him. (We nurses always love him because he listens better than anyone when we call.) The patients who dislike him are the ones who are so accustomed to paternalistic care, they feel disease when a person is that nice, that helpful, and includes them so actively in the discussion of their care. Its rare, but I do get patients like that. Its like somewhere they learned GOOD doctors are A holes.

    To the nurses who handled this guy before sending him to us, thank you! L.o.l..

  • May 4

    I've learned I missed you guys. A lot. Busy. Lots of life changes and adjustments going on. Mostly good... Just... Big.

    I don't need ice for my bitten tongue. I wish I did because I responded less than graciously to a nurse from a preceding shift over some really ridiculous shenanigans. And then I just.couldnt.stop. Oh well. I may hear something about that one. Strangely, I wasn't actually the instigator a la the shift nit picking wars... It was more like I should have backed down when I saw where the conversation was headed.

    I didn't.

    I second the comment several pages back that sometimes, no matter how hard I try, I do care what people think to a degree. Especially when I know I could have improved on my performance.

    Really enjoyed the esophageal varices story. *notes taken*

    Congrats to all the new grads. I'm super excited to read all the stories.

    I learned that I may be in the running for a position I didn't willfully seek out but that had always been my goal. I'm hoping the stars are aligned and that it's the right time. I appreciate positive energy.

    Morale is at an all-time low at our normally plucky hospital that sports some pretty good leadership. By far better than some of the stories I've heard from others. It's really a rocky time and that takes a toll all around.

    For those with a strict upbringing: my family decided long ago I was heading for the hot zone. Strangely, (sarcasm) it works for me. I love the family I've built from the friends I cherish and who never let me down.

    I've learned I'm a vegetarian with a serious craving for steak and Cadillac margaritas. eace:

  • May 4

    I read these every week (and love them!) and finally decided to join the conversations

    I learned that when Medicaid insurance changes in your state it wreaks havoc for patients and staff alike. I have argued more with insurance companies in the last month than in three years combined. They denied an injectable anti-psychotic for a patient that has been stable on it for years. I argued for hours with them, only to continue to have them deny it. Thankfully, with the help of an amazing drug rep, who used to be a nurse, we were able to get her several months of free injectables and she can remain stable while I continue to advocate for her. Apparently the insurance company thinks it would be cheaper to hospitalize her when she lights herself on fire or drinks bleach, both of which she has done when not on her medication.

    The psychiatrist I work with is correct - "the hardest part isn't connecting the dots, it is collecting the dots".

    Getting a "thank you" from a patient who went from being acutely psychotic to much more level means a lot. She remembered that even though she had to be restrained for injections due to some violent episodes, that we were all "nice and didn't judge". wish I had more patients like that.

  • May 4

    Quote from Purple_roses
    Good luck on your transfer!
    Thanks! It's a career move I've been wanting to make, but I'm nervous all the same. What if the unit politics suck? What if my new co-workers aren't as awesome as my current ones?

    All will be well, I know. I really really dislike the whole being-the-newbie-going-through-orientation-asking-questions-constantly thing.

  • May 4

    I looked on my Facebook today while kick starting my birthday month and saw a "memory" post where I stated I was hoping to do well on a final-it was my next to last semester of nursing school.

    I'm glad I did well after all that worrying 5 years ago!

    I learned:

    Trauma season is alive and well...having triple traumas occur within ten minutes is so much..."fun"

    That I still have a "no" list in terms of doing favors for people, even co-workers; I haven't done it in a while because I work with a good crew of people (even though we are short staffed) and this one coworker I will not do a favor for ever AGAIN.

    I also learned that there is tremendous physician support for my staff; I have ideas on what to do to turn morale around, and if may have to involve the physicians as well; it's going to be a LONG process, however, I'm committed to making it happen, even if it means circumventing management for it to be successful...I am still unsure how to circumvent management, or rather how to diplomatically say that they are HUGE reason that morale is down.

    I learned that I can have enough days off to string a spring vacation together, even if it's a staycation, I will be catching up with friends, family, and get to enjoy my days off!

  • May 4

    I learned that I am not important in the big scale of things, but I am everything to my dogs.

    I learned that telling the obviously manic new nurse that she isn't safe around patients right now is freaking hard.

    I learned that a drug addict who is undertreated for pain will call her boyfriend to bring her some meth in to the hospital. Just give her the GD dilaudid, already!! She has skin pop scars -- 2mg of morphine isn't doing anything for her!! She's already addicted to drugs, stop trying to force her into your own moral mold.

    I learned that a scary number of people on AN really believe men are better than women. At everything. Let's just see one have a baby. Hmmph. (No offense, dudes. You are awesome. Just not "better than.") As a woman who escaped socialized misogyny, this REALLY irks me.

    I also learned, or had reinforced, that therapeutic communication and limit setting works well with sundowners and manipulative patients.

    Far, I'm the opposite. If I think something is going to be easy, I knock it out. If I think it's going to be hard, I'll put it off as long as I can. Then I'm mad at myself when I find out it isn't that hard, after all, and I wasted all that worry over nothing.

  • May 4

    Finished my last week of nursing school, and here's some of the things I've learned:

    I've had no trouble hearing back from MI hospitals, but personal situations required me to turn down a few, unfortunately.

    I love that I can PM some random AN members with questions and get more answers than I initially hoped for.

    Cholinergics aren't administered to pts with urinary strictures or obstructions.

    Administer fluoroquinolones with a glass of water and maintain pt's urinary output to 1200-1500 mL to prevent crystalluria.

    Sulfonamides can cause several blood disorders (e.g. hemolytic anemia, leukopenia) - notify the physician if signs of infection are observed. Also, use with caution in pts with renal insufficiency.

  • May 4

    Purple-Roses . . . I learned that the young woman taking care of my son while he was hospitalized was not a seasoned nurse yet but a nursing student and she ROCKED. My son was very impressed by his care at this hospital.

    I learned that it is very hard to sit across the room and just "be the mom" and watch someone who looks 16 years old care for your son. I also learned that the stereotype about cocky surgeons held true for the man who did my son's surgery. And I already knew that I can exchange a good bedside manner for superior surgical skills.

    I learned that pathology departments (in some places) are closed on the weekend. That can change the plan for surgery.

    I learned just now from Farawyn's mom about how to read while out in the sun and needing to keep your sunglasses on! Eureka! I've always put my reading glasses OVER my sunglasses, which my kids tease me about. Now I can put my sunglasses OVER my reading glasses!

    I learned that many of the friends I've made here on AN are real, true friends.

  • May 2

    I hate them. Stealing all the good jobs. Getting into nursing school easier. And those dashing good looks.