ixchel, BSN, RN 41,694 Views
Joined Jun 3, '11.
Posts: 5,154 (75% Liked)
Two of my medical conditions (a neurological condition that is exasperated by sleeplessness, and now my spinal fusion) have been a bit of a nuisance and could be an issue in the future. Mostly it's the epilepsy that I'm concerned about. Twice EVER it has impaired me, changing my mental status.
(before responses get icky - I've been tightly supervised and plans are in place to keep things safe and seizure free. It was a 2 week run of insomnia that caused the second episode. First episode was from a medication.)
So, I have noticed the ones who recognize the atypical presentation of left temporal lobe epilepsy is those who work in the medical field. If I can't speak for myself, I need to communicate that it may be epilepsy causing the problem. Plus, it could be a good thing to mention the titanium.
I'm thinking inner forearm. One saying "left temporal lobe epilepsy" and one saying "fusion L5/S1 spondylolisthesis". I could find some compression sleeves (or those adorable scrub sleeves) to ensure patients don't get weirded out by it. (Amazing how terrifying the work 'epilepsy' is to most people.)
I want to prevent a disaster like something that happened months ago. I was in desperate need of a doctor but was sent home instead. No repeats of that, please!!! THIS is the situation I have not discussed here due to still pending litigation being possible.
Anyway, you've heard my "pros" and we know the professional cons. My facility does require cover up. I think I'm allowed one inch visible.
What are your thoughts? I need help deciding on this.
Have you thought about hanging up this nursing thing.. and writing romance novels?
My only problem with this whole resume/cover letter thing is I have zero work experience that any HR or DON would care about when looking at me as a potential nurse. Working at Walmart and even being in the Navy with several large gaps in work history do NOTHING for me...which is probably why I have yet to get an interview. So now what? I can't just make stuff up to fill a resume and I don't have anything to say in a resume or cover letter without lying so none of the usual advice works...even career services at my school advised I fudge my information.
Glad you found it because when I searched for it again, it was not where I left it!
I am having the hardest time tapping "quote" and getting a response to post. This is really glitchy today.
OP, I do not regret asking if you are a nurse. It is not childish, damaging, or whatever the other word is. Your OP and first comment read to me like an early-ish nursing student with enough med/surg experience/knowledge (or perhaps you are an inpatient CNA in school) to start gaining strong opinions on something you haven't put into practice.
I stand by my question and every part of my comment.
Katie, thank you for your comment on CI. The only CI coming to my brain was Clinical Instructor. Or Clinical Investigator.
One reason I quit ICU work and went to floor nursing with a passion is I got sick of watching machines. For me they seemed to interfere with my communication with the patient. That was MY own feeling. Of course then the floors got all the things that bing and bong and we wound up running after the alarms. You really get alarm fatigue quicker than you realize. I took care of full code vent patients on the floor, those who were medically stable enough to come out of the ICU. Take a vent, a few IV lines, etc and there you are right back taking care of alarms. The alarms are also distressing to the patients and families. May be there is a way to have the alarms go to a pager that the RN carries? I don't know the answer but I know what drove me crazy. Alarms on new machines that continued to beep regardless of what you did, so we went back to what we knew, manually timing drips until we could get a different machine. Sometimes we went through 3-4 machines until we got one that worked. They were so over used that pieces of them broke off after a few months. Who knows, maybe in a fit of pique some nurse tore the machine up so they would not have to listen to it. Fluid and electrolytes, drips, antibiotics, all need close monitoring but if you can't rely on the machine they give you then what do you do? I learned timing drug and drips by drops/min. I calculated the H---l out of those things and watched the patient like a hawk. Anyone remember the chambered IV lines used in pediatrics?
You had a measuring chamber that you put fluid in, then added your meds and stood there and watched it while it dripped. Not a perfect system but so many times I hung out in the baby's room and played, changed, bathed while the meds went in so I knew the rate and was sure that they got the right dose at the right rate, over the right amount of time and made sure there was not infiltration. Seeing as how we gave stuff like micro doses of Gentamycin which is oto-toxic it was important. Plus we were giving minute doses of the stuff. I much preferred staying with the patient over answering a machine. Maybe I am too old and need to shut up. I don't know. I just know alarm fatigue is a real problem and it does not help patients. Their anxiety goes through the roof and then you have more problems to deal with.
There is nothing so good as the "gut" feeling of an RN. Regardless of what a monitor says, trust your gut. If you know the patient then your gut tells you how to go. I know that many docs do not understand that "nurse gut " thing but some do and if you can back up that feeling with any clinical sign at all you can usually get an order for labs, x-rays or something to help diagnose. I have had many "gut" discussions with residents and after you are correct once and they don't see you as a threat(presentation is everything) well, BAM, you have a believer. I have had more than one resident thank me for the heads up. Let the resident know you are on their side and just advocating for your patient and I have found it usually wins them over. It has certainly improved my subsequent conversations with them. After all we are a team. OK now I shut up.
Or if you're on the mobile site, it's in the dark grey menu at the bottom of the page
I found this thread!!!! Omg I can't believe I just found it. It was on, like, page 4 of search results.
Guys.... There is a new thread up now. I didn't expect to actually find this thread, so I didn't save the link. I'll try to come back with it. If you happen to be better at this and you don't see I've come back here yet, please post the link!
Seriously. I'm just diving in right now.
As an AN member...
1. I absolutely, positively can NOT figure out a damn thing on desktop via mobile AN. Somebody, for the love of god, I've been finding my posts by clicking on notifications, going to likes, and following them to stuff I've bookmarked. I'm on safari on iphone. I found something that MIGHT be bookmarks, but crazy old threads are mixed with new ones. I am wondering how the heck I managed to stay active before the app. Maybe it was regular desktop pre-mobile desktop in those days. I can't remember, but I was never morefrustrated than I've been this week. Speaking of... Anyone able to link me to last week's thread? I hadn't posted in it before I lost app access. So now it's missing. Not really missing, just impatiently missing. YOU GUYS. I seriously can't get into this site anymore when it's this much more of a hassle.
As a patient...
2. Another hassle - STD's clinician feels that my claim is not extendable. Obviously my job as a bedside nurse is not relevant. Nothing was done on their end to review this until a few days before my claim ended. Two weeks now waiting on their decision and they're now requesting old records prior to my claim beginning. I'm pretty sure, if we keep this simple, if my surgeon feels my body is not capable of being at the bedside, and my hospital wont take me back as a result, then the insurance I have paid for without using for years now should continue my claim until I can fulfill the duties of my job.
As a hospital employee:
3. AND ANOTHER HASSLE! HR. I'm not going there. I just wont. It's been bad enough.
As a patient's mom:
4. Turns out my kid probably wasn't on abx long enough. Pretty sure Rocky Mountain Spotted Fever is back. No new ticks, no new exposures. I just think he wasn't treated long enough. New labs drawn. 21 days of doxy ordered. Waiting on lab results. So very thankful for the docs at my kids' pediatrics practice. I wish I could find adult doctors this wonderful.
As a person who napped in an empty house today, after several days of feeling a sinus-y thing looming over me:
5. My brain has managed to combine:
(1)a David Bowie and a John Lennon (adult) kid documentary (pre-Bowie death, late 80s-ish) (spoiler: there was sex but after Lennon was gone)
(2)filming a Lannister scene with the Lannister boys (the grown ones, not the kings) (spoiler: Brienne ends up with Tyrion. I did NOT see that coming.)
(3)filming with a realistic Stark direwolf model trying to bite my leg off (I was actually afraid) (spoiler: it was Aryas)
(4)and it was all with the dark undercurrent of TWD, where a shadowy Negan-esque character kills off a GOT character, but you wont know who until next season
All of this in one dream. I skipped the part where a person I haven't seen in 18 years was there with his new husband. Flew in from Oregon. Or was it Washinton? I honestly cannot remember now. I'm still confused about the elbowy sex.
I really don't actually have anything else to add. I didn't expect to be starting this this week. If there is another one out there done by the person I'd already talked to, I never heard back - I'm sorry! (Please see lesson number 1.)
I also got fired once after 2 weeks of orientation for "not smiling enough".
This bears repeating! YOU DID NOTHING WRONG, legally or ethically speaking. Your manager is spinning it so that you are the one at fault for all this. If pay was fair and equitable at your facility, this would be a non-issue. Now, they're exposed and are scrambling. Again, YOU DID NOTHING WRONG.
Transparency is never a bad thing. But it should come from management/leadership!
"Look at the patient, not the monitor" doesn't work for me either. I've seen plenty of patients that look fine chatting away with a CI of 1.8 or an SBP around 200. So...as long as my equipment is calibrated correctly and not being assessed by someone who doesn't know how to properly use the devices, more often than not, I believe what my monitor tells me 100%.
Your story is interesting and it sounds like it made for a terribly stressful day. Seems to me there may have been a failure in protocols. Did anyone check a pulse or responsiveness?
Even if a monitor shows a shockable rhythm you still follow the BLS survey first. It also seems odd that the monitor in room A (which was presumably hooked directly up to the patient in room A) would show data from a different room. I'm no IT guy for sure, just seems very odd.
I'd say my point of view only works if you know what you are doing. It doesn't work if you put the wrong size BP cuff on a patient, or if you have bubbles in your pressure lines, or if you don't check your patient's pulse and responsiveness when you have some strange artifact that often does look fib-ish.
I just find this old expression to be only mildly useful. Of course you use your intuition and assessment skills, but the notion that you should treat based on what you see over data drawn from high-tech equipment seems a little over the top.
Oh, dear lord, someone please tell me how to get a list on desktop that used to be the bookmarks list on app?
I realized the link never posted.
No one will ever convince me desktop is better.
Here is the 8/5 WILTW -
I learned that just because a patient is a nurse does not mean they will be nice and understanding when the team refuses to order IV Benadryl. Being a new grad has been one of the toughest things I've ever done
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