6/4 WILTW: Oui jete' du Nursing???

Nurses General Nursing

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Specializes in Pediatrics, Emergency, Trauma.

Hi Everyone!

Ixchel asked me to guest host WILT for the second time.

I will say-my French is not that great...the best I can do is relegated to ballet terms at best; one of my nieces is heading into the direction of becoming a principal ballerina; she is heading to New York for a Summer intensive in one month, and goes to a world renowned school in my area-she has been dancing for 11 years; her youngest sister is in her same shoes; this week I was able to see them both perform on stage at their dance school's end of year performance-it goes beyond the average recital...and they both know French :D

So, jete' simply means "thrown", rather a leap in which one leg appears to be thrown in the direction of the movement in ballet. I always felt I have "thrown" myself into nursing; meaning, I never had a specialty I had my heart set on, when I was a LPN, and even as I progressed to an RN; I had goals, yes, but most of those actions meant to transcend specialties, which I think I have accomplished nicely.

I have come come to a point in my career where I found a specialty that is a fit; I have focused on one position, however, I see a per diem position where it's working with adults, in the same specialty as opposed to children; it would give me additional experience; also a few people that I network with and a few recruiters have been asking for my resume.

The jete' in me wants to apply and see if I can juggle both (the per diem is truly per diem) but the practical side of me wants to wait another year before applying.

Ah, decisions, decisions.

So, what I also learned this week:

I have passed my "black cloud" onto one of my coworkers due to my long hiatuses from work, which got longer when I ended up with a cold this week; I helped her out as much as possible because I understood the struggle of constant work ups, bizarre pts and families.

I still need practice with accessing ports; I have an idea how to achieve this, and know who to ask in terms of having more practice during a low season; before I probably would've gotten a no, but now that a new regime is in place, I have renewed hope. :yes:

I also started a hand IV on my first chunky baby...one of my other banes of existence to conquer!

I'm a de-facto resource person post orientation and newbies are feeling very comfortable talking to me about their new life in the world of a Level 1 PediED.

After talking about my other two nieces, their sister, the middle one who is 14 and destined to be a veternarian, placed second in her FIRST horse show! I'm hoping she can go for gold someday...:coollook:

So, what have you learned this week?

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Since I'm not working any more I don't have any nursing WILTW. My husband is starting the prison academy at the end of this month. The black cloud is finally moving off from over us! Whew!

Specializes in LTC, assisted living, med-surg, psych.

I'm so glad to hear that, OC. You've struggled for so long, it's time you got a break.

I learned that I really like doing free CEs online. I don't have to have them to keep my license, I just enjoy doing the modules for my own edification. My most recent CEUs came from a course on bipolar depression, and case studies on the topic of type 2 diabetes. I also have certificates of completion in geriatric psych, infection control, and a few others I can't recall at this moment. It doesn't matter that I'll probably never use this knowledge, because education is never wasted. :)

Specializes in OB.

I learned this week that I love the lecture audio from Mark Klimek. His content and tips for the Nclex are amazing! Here is what I learned

In congenital heart deformities, if it begins with a T like Tetralogy of Fallot then it means trouble. If it doesn't begin with T, then no trouble and not a priority.

With V fib, you Defib

With atrial arrhythmias you use ABCDs for treatment. Adenosine, Beta blockers, CA channel blockers and Digoxin.

And lots more. I am hooked listening to his audio files.

Between that and Uworld, I am getting set for testing. Hopefully next week, I can schedule my test.

Specializes in Family Nurse Practitioner.

I learned that I have to start standing up for myself more when they want to send me a new patient after 10. (I work 1030-11 - and give report at 1030). After a couple late nights at work I am ready to fight because I can't keep doing this. The person who sent me that patient at 1020 who also sent me a patient who was a really hard stick with a fistula in one arm and also had a colostomy (bag falling off of course), urostomy, and nephrostomy who was actively vomiting right before. She had called me to send me a patient and I told her I was still trying to get blood from patient #1 so could she please send me a lighter patient who could sit in the room. Well instead she calls me and sends me this unresponsive seizure patient on a nonrebreather at 1020 (10 minutes before I'm supposed to give report). I stayed late catching up and then I was told that the nurse who sent me the patient has been writing down the names of people who refuse to take patients.

Specializes in ICU.
With atrial arrhythmias you use ABCDs for treatment. Adenosine, Beta blockers, CA channel blockers and Digoxin.

Technically, a lot of places teach that amiodarone is for ventricular arrythmias, but it is also the drug of choice for a-fib with RVR on my unit, so you might see that, too. Cardizem is a close second, but what I have seen is that the cardizem bolus/drip is way more likely to significantly drop the patient's blood pressure. Amiodarone bolus/drip is gentler, so it's a good way to get the patient rate controlled without also having to fix the blood pressure, but amiodarone has a lot of dangerous side effects with long term use. I have a love/hate relationship with the stuff. It is so nice to not have to chase your tail fixing the patient's blood pressure, but seeing patients come in with end-stage pulmonary fibrosis from amiodarone use sucks, especially if they were otherwise pretty healthy and end up not being candidates for a lung transplant.

I learned that I really like doing free CEs online.

I love doing CEs, too. I'm such a nerd.

I got called off from my PRN job last night, so I learned how nice it was to get called off. I have been working so much overtime and I am already signed up for five shifts this coming week. It's nice to have three days off instead of two. I haven't had more than two days off in a row in at least a month, I think. It's been a while since I've worked under 60 hours per week.

I also have learned that if you work all the time, you can forget how to entertain yourself on your days off. What do you all do at home? I grilled out with my SO earlier, but he has gone home and gone to bed. I have run out of new posts on allnurses, there are no new posts on facebook, I read a book earlier, and I'm sick of watching TV. I played video games for three hours already and I have done my laundry and cleaned my kitchen.

I don't know what people do to make the time go by. I get so bored here, and then being bored makes me feel lonely, and then being lonely makes me feel sad. Sometimes I pick up overtime just to have something to do. I think I am a happier person at work than I am at home, and a lot of the time I'm not very happy at work.

This week I learned that my school/program has yet again messed up something and are placing blame everywhere but where it belongs, on themselves.

My transcript had not been sent to the BON, 3 weeks after graduation. At this rate it will be August before I can finally test. [emoji35]

So here is some of the things I have been exploring this week:

Vein illumination is one of the most important newer technologies. The hospital bought one for each floor - not the hand held ones but the ones that come on a stand so you can actually illuminate the vein and stick right away. Not all hospitals have an IV team or phlebotomy staff - this is great technology that will help as our pat population is increasingly older and fragile. The link is to a specific company but there are other products out there as well. I have seen this product in action and think it will help a lot. There are gifted nurses out there who can put an iv into anything but not everybody is that gifted and secondly time also matters and we do not want to stick a couple of times before we can get an access. I do not put in ivs anymore but think it is great technology:

Vein Illumination Leader Announces AccuVein AV4

I'm so glad to hear that, OC. You've struggled for so long, it's time you got a break.

I learned that I really like doing free CEs online. I don't have to have them to keep my license, I just enjoy doing the modules for my own edification. My most recent CEUs came from a course on bipolar depression, and case studies on the topic of type 2 diabetes. I also have certificates of completion in geriatric psych, infection control, and a few others I can't recall at this moment. It doesn't matter that I'll probably never use this knowledge, because education is never wasted. :)

This week I learned that my state must not be the only one without CE requirements!

I just re-opened an account with NCSBN's learning extension. I have loved reading about the clinical knowledge in WILTW's threads and it's made me realize how stagnant I am. I figured the best refresher, since it's cheap, would be to re-do the NCLEX prep because it provides a massive overview of nursing knowledge. Even if I don't get a lot out of it (though I'm sure I will) it will help me get my brain primed for learning again.

For NCLEX preppers out there, NCSBN starts at $50 for 3 weeks of unlimited access to their prep and practice questions. It's good stuff. You pay more for longer access periods.

I feel like I don't have a lot of new clinical things to offer here, which makes me sad, and is another reason for my self-kick-in-the-pants to be an active learner again.

I was floated off my unit for staff balancing and I learned that I don't really miss having all the "Why can't I have a full cup of coffee with my meal?/I feel so puffy. I can't breathe./Can I have another glass of water?" type patients, but I DO miss having up ad lib patients.

I learned that a functional capacity evaluation (FCE) isn't over when it's over. The test provider takes days to put together a report, and even then, apparently, the doctor has to create his own final report on it, and can take his sweet time turning that in. In the meantime, I've heard from more than one person "It looks like you can do MOST of your job requirements," and they follow with anything from "If it says you're permanently disabled, they'll give you a settlement," to "They can't let you go because the FCE says you can't do your job, because they already sent you back to work and you're currently doing that job." (really, dude?)

For the record, I am NOT permanently disabled and I will fight anyone who claims that I am. Urgh. In the meantime, I'm trying not to go crazy with the uncertainty and trying to make contingency plans for every possible outcome.

Specializes in Pediatrics, Emergency, Trauma.

I don't know what people do to make the time go by. I get so bored here, and then being bored makes me feel lonely, and then being lonely makes me feel sad. Sometimes I pick up overtime just to have something to do. I think I am a happier person at work than I am at home, and a lot of the time I'm not very happy at work.

I used to be like that early in my career; I had two jobs for the point of learning. About nursing, trying to be the best nurse, and one of my goals was to specialize in two specialties (a goal long achieved)

Since my nieces have gotten older ( I have much more btw, I'm just closer to these three because this sibling-my sister-and I are close), and my brother and I have gotten closer, my fiancé and his nieces are now my nieces and being a step mom have left that particular "emptiness" out of my life, along with getting involved in healthcare activism, I find I sometimes need more "me" time; I fill that with being a foodie, knitting, and I would paint, but the logistics aren't there in the house I live in, so I engage in adult coloring books by hand and on my iPad-very soothing. :yes:

Specializes in Pediatrics, Emergency, Trauma.
Since I'm not working any more I don't have any nursing WILTW. My husband is starting the prison academy at the end of this month. The black cloud is finally moving off from over us! Whew!

Great to hear!

Sending positive vibes for your health as well!

Specializes in Pediatrics, Emergency, Trauma.
This week I learned that my school/program has yet again messed up something and are placing blame everywhere but where it belongs, on themselves.

My transcript had not been sent to the BON, 3 weeks after graduation. At this rate it will be August before I can finally test. [emoji35]

Oh no!

It may not take that long...study now, then when you get the word, you will be ready to test.

Look up my posts on how to study for the NCLEX; you may or may not need 2 months to study-it's only the max time that NCSBN wants you to study.

You may end up getting your ATT this month and be ready in July.

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