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

Boomer MS, RN · 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?

Oh, wow. Keep moving forward and healing....a journey. I am so sorry you needed surgery. Best wishes coming your way.

calivianya, BSN, RN · Apr 17, 2016

I need to have more confidence in myself. I had a pt who was acting strange, and the nurse seemed unconcerned. After taking VS, the pt's Biox had dropped from 98% and hour before to
Good catch! :)
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.
That just made me laugh. I am going to do that for real if I'm ever in the hospital. Tylenol doesn't do a thing for me. I honestly even feel guilty when I give one to my patients for pain, because I feel like I'm wasting my time and theirs both.
I hope POD3 is feeling better than POD2!
I learned even our orientees are getting burned out, which is scary because it makes me think we're never going to be fully staffed again. I was giving report to one of the orientees this morning who had a three patient assignment, and she commented about how this was her fourth day in a row with a three patient assignment and she feels like she isn't learning anything anymore because she doesn't have time. It's only her fifth week of orientation so she still has seven left, but we'll see how she does. It's a little sad that her excitement is already gone.
In all fairness, though, it was going to be a really easy three patient assignment. I am curious what her attitude is going to be like when I come back tonight.

MedicFireRN · Apr 17, 2016

I learned even our orientees are getting burned out, which is scary because it makes me think we're never going to be fully staffed again. I was giving report to one of the orientees this morning who had a three patient assignment, and she commented about how this was her fourth day in a row with a three patient assignment and she feels like she isn't learning anything anymore because she doesn't have time. It's only her fifth week of orientation so she still has seven left, but we'll see how she does. It's a little sad that her excitement is already gone.
In all fairness, though, it was going to be a really easy three patient assignment. I am curious what her attitude is going to be like when I come back tonight.

What kind of unit do you work on? I'm still orienting and I am still learning new things even taking a full pt assignment in the ED (4:1). I think a lot of it at a certain point becomes self-initiated. There's always something to learn if you look for it :)

quiltynurse56, LPN, LVN · Apr 17, 2016

Hugs ixchel, you have been in my thoughts. Praying for a fast recovery for you.

WILTW

That when you report a CNA for the way she does her job (she thinks she is the one in charge on night shift) and she shows her true colors to the Admin, DON and ADON, that she doest get fired. They have gone out of their way to be supportive of her due to personal issues, but when not one, but two nurses report her, stuff happens. They tried her in a different position and she refused to do the work and then was a no call, no show two days. Bye bye CNA. Will I suffer repercussions from the nurse she gets along with? Time will tell.

Monday, I take my first shift through the staffing agency. Shall see how that goes.

OCNRN63, RN · Apr 17, 2016

I learned that I really need to start opening my medical insurance statements before my mother files them. Today she said to me, "You really need to open your statements. You got a substantial check."

Now, to my mother and I, "substantial" would be much less than what most people would think. A check for $50 is substantial to us. Anyway, I looked at the check, and yes, it was substantial...almost $600!

ixchel · Apr 17, 2016

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.

That is part of what inspired this thread to be created. Unfortunately, I missed out on the weeks in my first year, but it is okay. [emoji5]ï¸

I actually make lists throughout the week. I have them in my phone. Helps me remember the little things!

margin261 · Apr 18, 2016

Many 'Get Well Soon' wishes to you Ixchel!!

Can I just add... I was really surprised to read you are pediatric sized- just by reading your posts, I've always imagined you to be more Amazonian! Funny how you get a picture of people in your head...

Ok, WILTW - (this is not human related, but kinda medical)

Baby chicks get 'pasty butt'. Poop builds up on their butt & blocks their vent (orifice), more poop can't come out & builds up in them (impaction?) and they can die. Soooo you have to clean the poop off their butts. Who knew??

The husband has been sorta been forced into retirement (oil business bad) and has decided he wants to raise chickens & pygmy goats. At least the goats are cute...

allnurses Guide · Apr 18, 2016

Wishing you a speedy recovery, Ixchel!!!!

Wrench Party · Apr 18, 2016

1) Learned a nice little diddly for the purposes of understanding dopamine and BIPAP on a patient (PPP). Push the heart, push the lungs, push the fluid out.

2) Had my first serious clash with a resident this week over a (what else) trainwreck of an admission from an OSH. Pt was in severe CHF, severe AS, not mentating well, the lab people couldn't get anything but serous fluid from their sticks. No one could start IVs on her. Only had one crappy IV we were probably going to blow soon from IV abx. 80 mg Lasix is NOT going to singlehandedly solve this lady's problems; the last facility did that and she was still swollen like a balloon. I had to go to the fellow and push for a central line and better interventions. :banghead:

3) This week re-iterated how much I HATE patients in their 20s. The amount of rudeness and entitlement is mind-boggling. I can't quite capture the joy I experienced in my soul when I got to send one of these patients to the ICU for a very before-my-shift preventable reason (refused dialysis for like 4 days when she goes 3x/week). I could really, seriously care less about your hunger when your K is approaching 8 and you're starting to show rhythm changes on the monitor, we have to re-organize what feels like half the stepdown and the ICU to accommodate you, and I'm also trying to keep my other patient from going down the hill.

4) (not nursing related) I definitely still possess the power to scare people. A guy friend's wife is insecure, jealous, and took away her husband's phone because she thought her husband was constantly cheating on her. She proceeds to call MY husband repeatedly to figure out where her missing husband was and woke ME up after a horrible night shift. Your problems are becoming my problems? Sorry honey, that don't fly in my household. :no:

I couldn't get a hold of that phone fast enough to give her a piece of my mind and tell her off. No more calls after that! :yes:

bell1962 · Apr 18, 2016

Feel better soon Ixchel

whichone'spink, BSN, RN · Apr 18, 2016

-This week I learnt helping the ICU nurse I handed a trainwreck to can count as a workout of sorts. Yesterday, I didn't workout and my Fitbit recorded 26 active minutes. Those 26 minutes covered the time I was helping stabilize this sick, sick patient. Now, if the patient had coded and I had to do compressions, boy, talk about a workout there!

-This week I learnt maybe I should work my forearms a bit more. That way I can hand pump blood in way faster than I did.

-This week I learnt I guess I do get some satisfaction in taking care of really sick patients. But I don't see myself doing this day in and day out. I did try to get a job in the ICU some time ago, but in hindsight, I'm glad I didn't. I like my patients stable, awake, and going somewhere else without any issues.

-This week I learnt, or rather it was reinforced, that Joint Commission is not worth taking seriously. I am very surprised my place of employment did not have major citations, but only minor ones. How can we get away with stashing patients in rooms that don't have a private bathroom, and only one shower on a floor with 28 beds? Plus, this overflow area is staffed with random people, who were floated or got mandatoried to staff this floor.

SeattleJess · Apr 18, 2016

:sorry: It all sounds very exhausting and challenging! I think the "mommy misses you" gifts are an amazing idea. Please give yourself credit instead of beating yourself up about "could have done better". We all could always do better.

Prayers for a speedy and complete recovery!