10/24: What I learned in nursing this week - moral & legal decisions, patient acuity....

Nurses General Nursing

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Specializes in critical care.

After a week of deliberation on the WILTW threads, I can honestly say I'm glad for a new week! I have only worked one day this week so far, so not a very giant list to share.

This week in nursing, I have learned....

There is a very sad line between moral and legal decision-making in healthcare. When a DNR can be revoked by family only to prolong torture and a DNR not granted on an already terminal suicide attempt, we really need to find a way to make moral and legal stop being mutually exclusive.

After a month of horrible patient acuity, I'm realizing that now "normal" days actually feel a bit slow. Amazing how being pushed beyond your limits teaches you to increase those limits.

I've learned what pleurx drains are. Now I want to play with one.

It takes a lot longer to bring up a 2.3 potassium than a 1.1 mag. A lot.

I have a way about me that makes patients confess very, very strange things to me. (Apparently?)

I'm going to learn tomorrow if short hair is easier at work than long in a braid, bun or ponytail. Also, tomorrow I will get to compare my steps at work on my new Fitbit vs. the app in my phone. And..... Tomorrow is my last day in the 18-34 demographic.

I've realized that hospitals would be more mom-nurse-friendly if shifts were 9-9.

Looking at community health job postings has made me realize I have no idea how to figure out government pay scales. I understand the grade, but how does your starting step get determined?

I've included my children in the "daddy's schedule is changing, so mommy's might have to, too," conversation. It was hard to say no when my girl asked if I could "just" not work for awhile.

Crack is a hell of a drug.

Almost 1.5 years since graduation. I think I've decided I know how to nurse now. It's an amazing feeling!

How about you? What have you learned?

The weekly WILTW threads will remain in yellow as long as we remember to keep the majority of posts/comments focused on things nursing related. Students are welcome to share what they learned in their journey to becoming nurses, and of course, CNAs/PCTs/MAs and other unlicensed people who are part of the nursing team are welcome to contribute as well.

As this thread doesn't really have one single topic, it's very nature is to evolve into conversations that are off topic from individual points shared. This is okay, as long as the majority of posts in the conversations remain nursing, nursing school and UAP-related. Questions or comments on this can be shared in the site feedback thread with "WILTW" in its title.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I learned this nugget of wisdom long ago, but I'll post for the heck of it...actually, I posted something similar to another thread, but it bears mentioning once more.

I learned that it's okay to not care about any of our patients to the same degree that we care about certain loved ones or friends. At first this may sound disturbing to people if twisted out of context, but I refer to it as 'compartmentalization.'

I was a patient undergoing surgery back in April of this year. I didn't expect anything out of my nurses other than professionalism, competence and kindness. We can be warm, caring and technically proficient without emotionally attaching to the patient. Our patients are placed in one compartment and the people in our personal lives go into the other compartment.

I learned that a professional nurse knows how to treat the patient with the utmost respect while providing competent care, but compartmentalize for the sake of self-preservation. We would all burn out if we saw every patient as a beloved family member or personal friend. They are not. Learn it and live it.

Specializes in LTC and Pediatrics.

Happy Birthday ixchel!!

What I learned in nursing/my job:

Yesterday we had our monthly nurses meeting after the all facility inservice. During this meeting our group of nurses really collaborated on making some things more efficient. We were also able to discuss a few residents and recommended some possible changes in medications. It was really great that we were all on the same page for these things.

It is a small nursing home and I am really thankful that I have the privilege of working there. I have never worked anywhere with this kind of collaboration and respect for each other. Yes, there are those times, but generally we all get along.

I learned that being forced to cross train to peds, which I thought was going to be my worst nightmare realized, doesn't seem to be as bad as I thought it would be.

Specializes in critical care.

Thank you, quilty!

Happy birthday!

This week I learned:

1. Learning about the terrible twos, and the phases of negativism and autonomy that toddlers go through, makes me have respect for the parents who endure those years.

2. What accels, early/late decels, variable decels, and prolonged decels are. And I actually know why they happen. Guess I'm learning after all.

3. Dental caries in toddlers look disgusting.

4. When working with toddlers, saying statements that don't give them the option of saying "no" works a lot better than asking questions that they'll answer with "no".

Specializes in OR, Nursing Professional Development.

Happy birthday, ixchel!

I've learned that watching my facility's cath lab and EP lab folks' sterile technique will have the OR nurse inside me screaming in agony. They wear rings when they scrub (no! just no!), don't tie the bottom strings of their masks (why even wear one when it's hanging that loose?), and just in general aren't up to the aseptic techniques used in the OR. No, we OR folks aren't perfect either, but it's painful to watch bad technique.

There is no such thing as risk free surgery, even when there are tools to calculate risks and it's as low as 1-3%. We've had a run of patients having strokes post open heart this week. It's hard to know that we went through all of the effort to get their heart back in shape only to see major neuro deficits.

I've learned that the battle between my specialty team (cardiac surgery) and the rest of the OR is worse than thought- we had meetings this week where basically the rest of the staff skewered us.

Specializes in Acute Care Pediatrics.

I learned that no matter what, they only make the all call offering incentive on shifts that I'm already signed up to work. Always.

Specializes in Stepdown, PCCN.

Happy Birthday!!

Mine is Tuesday, though I left the your age demographic several years ago.

I also learned that when patients are as sick as normal, it seems slow because people have been SO sick lately.

My facility doesn't have tele techs they just decided to pull an RN or untrained PCT from the floor to watch the monitors. Ugh!!! So I confirmed my belief that PCTs shouldn't do this task. There was a pt alarming brady in the 40's the PCT notified the nurse, the pt was in a 2nd/3rd degree HB. For a day.

Ixchel you gotta give that Mg super slow if you want to increase the serum levels.

I learned that my ASN precludes me from changing departments within the health system, this is too bad because I was hoping for a less acute unit as I begin grad school. Just because it takes so much out of me mentally when everyone is SOOO sick and needy.

Happy birthday, hope it's a good one.

I learned that clonidine can suck it, hydralazine kicks butt for my pts.

I learned that it is better to turn off the water before turning off the machine that uses said water, else you will get sprayed by said water. TBH, this is not the first time I learned this :bag: TB even more H, it will probably not be the last time I learn this :bag::bag:

I learned that I do not like the sausage egg and cheese toaster from the red button place. But I keep ordering it because it sounds good, but it isn't. Also, at the same place, you can get your choice of a traditional chicken sandwich or a classic chicken sandwich. I really don't get that.

Buying a book to read for pleasure will anger the gods and I'll have to work 90 hours/week for my arrogance. I think ixchel passed her black cloud to me. thanks.

Also (too late to edit), seeing the dramatic improvement after emergent HD is far more satisfying than witnessing the gradual decline of chronic HD. :(

Happy birthday ixchel!! Love you!!

I learned.... I GOT INTO NURSING SCHOOL!!!!

That is all. Bye.

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