Instincts

[moonshadeau, ADN, BSN, MSN, RN, APN, NP, CNS]

Have you ever had a voice (no I am not delusional ) in your head tell you that something isn't right, but you can't come up with a better reason that you KNOW that it isn't right? Say a job for instance. You walk in on the first day and think "I really don't know about this place". But tried to suppress it thinking that it was all in your head. It is the same instinct that you have when you look at a patient and know that something is wrong with the patient because he just doesn't look right.

My question to you all is do you follow your instincts to help you or do you supress them. What has your instincts done for you in the past to save your butt? :)

[Stargazer]

moonshadeau, I am highly attuned to my instincts and I let them help me make important decisions in all aspects of my life. Example 1: Was going to a nursing school with toxic instructors, had a horrible sophomore year. All of my instincts told me to get out of there and I switched to a different college that summer--one of the best decisions I ever made, as the new school had a wonderful, nurturing atmosphere and instructors. Example 2: Was doing home visits to an abusive mother (seeking treatment) who also had an abusive, alcoholic boyfriend and lived in a very unsafe neighborhood, for my community health nursing class. He obviously didn't like the fact that I was trying to help her become independent and made vague threats about me. One day I drove to her house at our appointment time and saw a very mean-looking guy sitting in front of the house scanning the street. I had never seen him before, but knew it had to be the boyfriend and that he would hurt or threaten me if I got out of the car. So I drove past the house and returned to the outreach center. They wouldn't let me go back and later that weekend he beat up my client and she became suicidal and threatened to kill herself and her kids. Example 3: Was complaining on the phone to my sis-in-law 7 years ago about my hospital job & she told me I should go work with a friend of hers who had a non-traditional nursing job she was crazy about. Got recruited by the friend, took the non-traditional job, long story short--great job, life-altering experience. Example 4: Was at a commercial carwash one day and noticed a guy in a nondescript car sitting across the street staring at me. I stalled, spent 45 minutes washing my car and he stared at me the whole time. I became convinced he was going to do something and made a plan as I vacuumed out my car. Finally, as I was sitting there fiddling around in the front seat, he came roaring across the street and drove his car through the stall right AT me, but I was ready and cut to the right driving the opposite way through another empty stall and tore rubber getting out of there. Then I drove randomly around for awhile, making sure he wasn't following me. I have no idea what this guy's deal was but I am positive he meant me harm.

I have always listened to my instincts when it came to pts who were subtly sliding downhill or getting ready to crash, and I've been told frequently that I have a good feel for this. One book I can't recommend highly enough is Gavin de Becker's The Gift of Fear--it is all about how to trust our instincts and use them to keep us safe.

[sharann, BSN, RN]

I absolutely use my instincts, and everyday in all walks of my life.An example though pertaining to the job occurred the other night.I had a pt who just struck me immediately as a potential "rail-jumper".The bedside nurses nightmare.Do we really need to waste precious time on another incident report.Well, I just had this "prickly" sensation ( you know like when the hairs stand on the back of your neck),and I hightailed it in there just in time to see her spindly liitle toothpick legs squeeze through the siderails(up x 4 of course).It was one exciting night I tell you!

So, yes I do and will always listen to my little voice.

[night owl]

sharann, I just had to tell you that we used to have those beds with the four siderails on our unit until we had a pt who would have never struck you to be a "rail jumper" get stuck between the top rail and the mattress. He probably, as we figured, placed his skinney little legs between the top rail and the bottom rail(the open area between)and slid down between the rail and the mattress getting stuck at his torso. Thank God the NA heard his little meek voice yelling for help because she was close to his room. She went in and saw him hanging there. She yelled for us to come to his room and sure enough there he was. The supervisor happened to be on the floor when it happened and she helped us put him back into another bed that had the long single siderail. He was ok, but the next day, all of those 4 siderail beds were GONE! One day I was watching CSPAN and the topic was nursing homes and safety issues and this poor woman was telling her story about her frail aunt who died in one of those 4 siderail beds. The aunt did the same thing except she became wedged between the rail and the mattress by her neck and broke her neck. I would suggest to your unit manager to replace those beds with safer ones, or not to place elderly, confused rail jumpers in them. We also had a pt fall thru the open part of the railing. My advice would be to get rid of them altogether before it's too late. We certainly learned our lesson the hard way and I would hate to see it happen to your pts. Luckily there were no lawsuits involved, but there could have been BIG TIME...