4/16 What I learned this week: POD2 and I want my button back

CVICU-Nurse1.5 · Apr 17, 2016

You shock for SVT

It's nice to be offered a position on a unit when you feel the need for a change

I am an excellent test taker when it comes to the final but horrible on the practice tests

I am told by higher ups that I'd do good in administration but am wondering how I'd feel about stepping into that kind of role

Patients friends and family will have millions of questions and its alright not to know all of them, but to find out and get back to them

People are all asking if I am ok or get sleep because of redness and darkness around the eyes. I just tell them I work and go to nursing school full time lol!

I only go to the movies for the popcorn even though it's darned expensive its good!

Really love ice cream about now

LadyFree28, BSN, LPN, RN · Apr 17, 2016

I :laugh: about the smartphone smack when one sleeps...I do this regularly, especially when I'm posting on my phone, reading from my phone-you're in great company ixchel!

I learned:

When people have previously worked to facilitate change and have been retaliated against for doing so, it becomes very difficult for those habits to die hard, despite having protection against retaliation; although the best things about advocacy is that change happens, and there's enough new blood to continue to put pressure-it helps balance out the ones who are still fearful-and rightfully so.

Even though it's was only in the 60s this week, the sun was 80 degrees and made it a great trauma day in the bay; it was possible for me to have an arterial bleed pt. The best part of the situation was promoting hemodynamic stability-the exhausting part was dealing with a needy surgeon and an unexperienced resident that needed to learn the ropes-giving them a verbal smackdown worthy of them posting on a WILTW thread-but can't was the highlight of the week. :yes: What was more of a highlight was having my art bleed kid be well informed of the process and relaxed prior to induction; then come down and have a kid that was hit by a car while (most likely) moving in and out of traffic on a dirt bike (with no dirt around) and the police show up-dirt bikes are illegal to ride in my area, and to put it in the best context possible-no dirt=no ride. :no:

My life is a huge plate right now-I'm getting emails to facilitate meetings for a local PTSD group; a lot from people who want to help, which is a great thing; my career has certainly accelerated in term of being a leader by the bedside while being a healthcare worker activist while learning a new specialty has its excitement, but having a few days off to recharge is refreshing!

Lauraingalls, BSN, RN · Apr 17, 2016

Sending prayers and good luck your way Ixchel!

I learned this week that an Intrathecal pain pump is not designed to hold two strong medications like Fentanyl and Bupivacaine. These two medications can and did cause the motor to stall in my husband's pain pump on a Sunday night. It had been running like a champ and then it wasnt...

THe time it takes to begin withdrawal symptoms is about 8 hours (or it was for my hubby).

Thankfully the pain doctor gave oral pain meds to cover the pain pump not working. Pain doc called surgeon and surgery was scheduled on this past Wednesday.

With lots of morphine and Oxy to cover the pain and the process of surgery.....my dh became backed up....Lots of senna, biscodyl, colace and two enemas later, things are moving.

I learned that I am way less patient with my hubby when he is the patient. Not to mention I had a huge deadline due tomorrow for school (my last big project- yay!)

And I learned that I suck at trying to saran wrap a bandage so that it doesnt get wet in the shower- Epic Fail and I had to change the dressing (OOOPS)

Tenebrae, BSN, RN · Apr 17, 2016

Ixchel, gentle hugs and get better soon.

I learned that sometimes one is simply in the right place at times. I had the opportunity to get one of my patients into see their wife (at an across time hospital) one more time before the wife died from advanced CA that reoccured right after being given the all clear. The wifes wish was to see her husband one more time and I got to help make that happen

Autolytic debridement on pressure injuries (for when surgery is not an option) can work really well. I have a patient with a pressure injury who I thought we wouldnt heal, however after changing yesterday, its almost healed

Supportive management makes a huge difference. In the LTC facilities we have to be signed off on clinical competencies and in my previous facility had been asking my clinical manager for 14 months to make this happen and get signed off on male catherisation. Nada

4 weeks at a new facility and boom, its done

Debilpn23 · Apr 17, 2016

Hello, my lovelies...
I will avoid rambly as I am in pain and rambly left ages ago. I've popped a fever today, and let me tell you.... I really don't know if I have ever felt so bad. Im in a clear patch at the moment, able to think clearly and communicate.
I made a pre-op and post op list through this week. So this week, I have learned...
Being that it isn't remotely close to summertime, I am feeling a large degree of resistance to all of the grooming I have to do in the name of pride and humility peri-op.
I'm going to have a piece of a dead guy in me.
Why is the end of a straight cath ribbed? It certainly is NOT for her pleasure!
I wish I started looking for "mommy is with you" trinkets for the kids sooner. The idea only struck me this past weekend. I found cute things they'll like. I just know I could have done better.
No NSAIDs for seven days does become horrible.
I've withheld every impulse in me to make a request list for post op orders. There are just SO.MANY.THINGS. Like, please do motrin instead of tylenol.
I'd like to apologize in advance to all my nurses just in case I'm "that nurse patient". I promise I don't mean to be. This has been a long, horrible journey and reaching where I am now is scary.
(I have trust issues.)
There aren't any tiny womens cut fun hospital gowns that I can find in my quick 7-minute search.
I hope my hardware in entirely titanium.
Being pediatrically sized is complicated.
Post op:
I am very thankful for the functional differences between morphine and dilaudid.
I might actually be taller now.
No, really! I think I am!
Falling asleep with a phone in your hand will result in one of two things happening: 1. getting smacked the face by a phone, or 2. getting the **** scared right out of you when you get a text.
It's still annoying as a patient when a patient has their 49 closest friends and family packed into their room and the hallway.
It's still annoying when patient family members stare in a room. MY ROOM.
It really sucks when the floor starts sundowning early and your PCA is empty and your stomach is jacked up and you have an idiot CNA who freaks out because your 12 respirations are LOW!OMG! "Can you silence your PCA's alarm?" for the 18th time is making me very cranky.
Flipping lights on and shouting as loud as you deem necessary does not actually mean the sleeping person in front of you heard a single word you said.
Alaris PC Guardrails is a really crappy PCA.
It's 5:30 in the morning. Do you know where your sundowner went?
You guys learn anything good?

Hi ixchel

Just want you to know I'm thinking of you. And sending hugs .

sleepycat7 · Apr 17, 2016

[quote=Lauraingalls;

And I learned that I suck at trying to saran wrap a bandage so that it doesnt get wet in the shower- Epic Fail and I had to change the dressing (OOOPS)

- Lauraingalls-

Helpful tip: One layer of Saran Wrap followed by one layer of Coban; wrap completely and press slightly to seal. Works like magic.

greenerpastures · Apr 17, 2016

Sometimes, you give cardizem IV push for SVT. We had a wide stable QRS SVT that I thought - wow, we are going to give adenosine and/or cardiovert this pt. NOPE - that "expert consultation" part of ACLS decided to try the cardizem first. Stole the thunder right out from under us when it worked!

smartassmommy · Apr 17, 2016

WILTW; I start RN prerequisites next month. I can do them online so it reduces the impact on the family that made me shy away from going straight for it.

I am losing some great coworkers to transfers

The hospital I work at is bringing back LPNs, so I am now hoping that doesn't mean phasing out PCAs.

The computer based learning we are required to do at work assumes that everyone has gone to nursing school, therefore Google definitions is my new work buddy.

I need to get a notebook and write down all the stuff I have learned at work, if I had done it from the beginning of this job I would probably have a full book already.

allnurses Guide · Apr 17, 2016

Why is the end of a straight cath ribbed? It certainly is NOT for her pleasure!

I learned recently that regular caths are this way as well. :eek: Ouch.

I learned that I haven't been on these threads for awhile and didn't know about ixchel. Hugs and good wishes sent to you.

meanmaryjean, DNP, RN · Apr 17, 2016

{{ hugs }} Ixchel (unless it hurts- in that case a gentle high five)

I learned that my fears about missing bedside care are unfounded. I am digging my academia job- and I found exactly the right place to be on faculty.

I learned that it is worth spending money on making my home office the way I want it to be.

I learned that my four siblings kinda suck. Not one congratulated me on my doctorate completion- but boy howdy- when they need advice about their grandkids' health- guess who's on speed dial?

Kitiger, RN · Apr 17, 2016

Hello, my lovelies...
I made a pre-op and post op list through this week. So this week, I have learned...
Falling asleep with a phone in your hand will result in one of two things happening: 1. getting smacked the face by a phone, or 2. getting the **** scared right out of you when you get a text.

I laughed out loud. Yes, I do know about phones rising up!

I hope these first few days go by quickly. May you heal soon!

la_chica_suerte85, BSN, RN · Apr 17, 2016

Why is the end of a straight cath ribbed? It certainly is NOT for her pleasure!

:woot: OMG, I need to stop being on here at work because you guys keep cracking me up!!!!! I am really tempted to steal this add it into my speech for my graduating class but I must remember how square some classmates (and, of course, their families) are. But, seriously, this is freakin hilarious!!!!!! :roflmao:

I hope you are feeling better (and taller!!) and I wish you a speedy recovery.

What did I learn this week? I learned that I have a dark side that rears its head when I have family members who are either completely disengaged with our little patients and don't help out at all and why.Did.You.Even.Bother.To.Show.Up.At.All?!?!?!?! It bums me out and makes me want to sit in the room watching play-doh toy reviews on YouTube all day just so the patient knows someone gives a damn.

It makes a person want to start mass adopting little ones.