11/21: What I've Learned, Thankful Thanksgiving Edition

[sailornurse]

With Ixchel's gracious guidance, Here is this weeks What I Learned This Week. Since Thanksgiving is this week, I want to focus on being thankful for being nurses.

I am thankful that there was a nursing program in my hometown. This is what launched my nursing career. Amazingly, it was the only program I applied to, it never occurred to me to apply any where else. I am thankful that I was even accepted.

Also Thankful that my hometown had a hospital that hired me as a teenage LPN in Labor & Delivery working every Sat & Sun. That job allowed me to continue on for ADN, which led me to a much bigger city, Phoenix AZ. I am glad that although I was a new grad RN, I had a couple of years experience.I am very grateful that I was able to complete my BSN back when there really weren't any RN to BSN programs. I was fortunate to have served in the Navy Nurse Corps. And thankful that so far, have not had student loans. I am thankful to have 2 local universities that have DNP programs.

For those that will be away from your families on Thanksgiving Thursday, myself included, it really is an honor as nurses to be there for patients and patient's families.

What I learned this week: I learned that people of Asian heritage can have Alcohol Induced Red Man Syndrome.

I learned that all the fuss about ICD10 was just that, fuss. It really is making more sense every day.

What are you thankful for this week?

[WKShadowNP, DNP, APRN]

I learned that a person who drank enough pure vanilla extract to have a blood alcohol of over 200 will vomit and the room will smell like sick cookies.

The tele monitor will call to question documentation of a sinus rhythm if they are seeing a fib and of course no p waves. Also, I will feel like a punch to the gut when I have no EKG and the guy who complained of belly pain but has a PE is sent without one being done.

[LadyFree28, BSN, LPN, RN]

I learned that I can articulately explain F&E balance and gluconeogenesis in layman's terms, in relation to Diabetes and DKA and actually be excited about it; I've two DKAs today and three in a matter of a two day span; they've worn me out as much as worrying about alteration in mentation and metabolic acidosis-one whose ph became worse after worse and I tried pushing for a CT Scan for one-thinking about fluid shift and possible ICP as well.

F&E was the bane of my nursing education for some reason; however learning gluconeogenesis in BioChem was the highlight; and understanding ABGs in the dark is my forte-I've had some a-ha moments while managing sick pts.

[Davey Do]

I learned that a person who drank enough pure vanilla extract to have a blood alcohol of over 200 will vomit and the room will smell like sick cookies.

Kind of throws a New Light on the old synonym of "Tossing One's Cookies", eh WKShadow?

[Farawyn]

Hey sailor! :)

(*following*)

[cracklingkraken, ASN, RN]

I learned that high bilirubin levels in newborns can ultimately progress to kernictus.

I learned that pnematosis is air in the intestines and can result in bowel necrosis.

I learned that the aggressive pulling to rip the abdominal wall apart during a C-section can make you never want to have a C-section, if possible. And when they pull the baby out, it's difficult to tell what part is coming out. Especially when it's all covered in white stuff that you're completely okay without knowing what it is.

[Farawyn]

I learned that high bilirubin levels in newborns can ultimately progress to kernictus.

I learned that pnematosis is air in the intestines and can result in bowel necrosis.

I learned that the aggressive pulling to rip the abdominal wall apart during a C-section can make you never want to have a C-section, if possible. And when they pull the baby out, it's difficult to tell what part is coming out. Especially when it's all covered in white stuff that you're completely okay without knowing what it is.

Yea, they yank those suckers.

I've had 2 c sections. My core will never be the same.

[whichone'spink, BSN, RN]

This week I learnt I do have the capability for leadership, and that maybe I do know what I am doing after all. I just did a presentation in front of the Minnesota Department of Health as part of a project for one of my classes (currently working on a DNP in nursing informatics), and it went well. I was co-leader of a group of DNP students, and we all worked remotely, with students from as far away as Virginia and Georgia! It felt like at times it was difficult to manage a group of students working remotely, like herding cats, but it came together well.

This week I learnt Level 2 trauma criteria is much more stringent that what I've seen at my so-called Level 2 hospital. There are a lot of things lacking.

[NICUNurseEliz]

I learned that some chronic babies in the NICU will develop such tolerance to meds that they are a huge pain to sedate/paralyze when they are older. Three doses of morphine, two versed doses, one Ativan, and two vecs later...and the child was still kicking!

I learned that I have less and less patience for apathetic providers, especially when they don't want to take time to update our patients' parents!

I learned that I need to put lotion on more regularly so that I don't wince every time I use Purell!

[Spidey's mom, ADN, BSN, RN]

Yea, they yank those suckers.

I've had 2 c sections. My core will never be the same.

The light just went on! I just learned THAT'S why my tummy isn't flat! It has nothing to do with bad eating habits or lack of sit-ups!

Although I only had one cesarean, to get Spidey out emergently.

Speaking of which, Spidey and dad went to the grocery store and brought home chicken strips and potato salad from the deli and I learned I have no willpower today to refuse carbs.

As for work, this week I learned that members of my team finally realize that drug addicts really do lie to you.

[~PedsRN~, BSN, RN]

I had three C-sections... really wish they had just installed a zipper after the first one, would have been easier on my body.

[ixchel]

Things I am thankful for:

1. I am thankful it took a year and a half to learn what people have warned me about since day one on my unit: two of the day shift CNs have no qualms about screwing nurses over.

2. I'm thankful my unit was finally given the official okay to never, ever have more than 4 patients, and the 24 hours they stuck with that declaration before ignoring it.

3. I'm thankful I know how to handle the multiple crashing patients ED keeps dumping into my patient group, with no warning, and no ICU bed available to get them to since we don't have the resources.

4. I'm thankful for when I got pulled to med/surg last week. The other nurses on that unit had 2-4 patients, but I got 5. This left my unit with 4 each, and 4 open rooms that were filled. So thankful for that 4:1 ratio we've been guaranteed.

5. I'm thankful for the many posted positions throughout my hospital, and the hospital 20 minutes closer to me.

I've been a terribly grumpy person the last couple of weeks. Very thankful for guest OPs for these threads. [emoji5]️

On a personal note, I'm thankful my kids and their sitter are okay after being in a car accident today. My littles are going to wake up sore tomorrow, but all in one piece. And my sitter thinks I hate her, but I don't.