This week. I got asked by my bosses boss to pick up a shift. I used the weakest excuse there is and I stuck to it: my group was just too much, I haven't gotten sleep, and I desperately need my days off.
So now, I bring to you what I learned while sitting in my home ED triage wearing an N95. Yup. It's been that kinda week.
1. I have yet to meet a grumpy person who didn't perk up after giving them a shift of kindness. It feels like the biggest victory, too.
2. It sucks that being required to report abuse and self harm means destroying the trust you'd achieved before that point.
3. Some patients make me hate nursing homes. I'm so sorry to the NH staff we have on here. I understand you function under terrible limitations. However.... When a nursing home gets a patient they are unequipped to handle, they don't realize how horrible the outcome can be. One such patient made me cry. HARD. I found a dark corner of the hospital and just hid. Some things we'll never let go of.
4. We have a patient with us who has been with us three times over 3 months and was not shown to have TB until last week. For some reason only those of us directly exposed seem to be freaking out at all over this. Sputum results would be nice, please.
5. You can do everything in your power on the planet to fight hard to end abuse and make progress for a patient. And then you can find that it did absolutely nothing. Your time was wasted. THIS is where burnout begins.
6. When you FINALLY feel awake enough to get your URI checked out, and you're honest about your TB exposure, you'll get turned away by everyone but the ED. What a waste. Honestly.
7. I don't want to be a psych nurse. I tip my hat to all of you out there. I don't want to be a psych nurse, but you know what? I'm good at it.
8. I don't know what is going to happen if I'm positive for TB. My kids have fevers this morning. Maybe they'll let us room together. [emoji22]
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I've learned the business/recruiting end of home health/PDN is very dirty. Some agencies will slander another just to get patients or nurses. Homie don't play that.
I am not sure it is of some consolation but I have taken care of patients who turned out to be "tb positive" - of course taken care of them without N95 until placed on precaution. My own PPD never turned positive despite ...Hopefully it will be just fine for you!
I learned this week
I really like my laundry dryer to function! After the vent got clogged I had to go to the laundromat for a couple of times to dry and let me tell you - it was an adventure. One time I came in and found several used flu masks on the floor - still wondering about that one...
Dying in a critical care area is just not good. When somebody is made CMO, a quiet room without all the technology would be so much better.
The general public does not seem to be aware of the fact that Medicare does not pay for custodial nursing home care. I have listened a lot to "what do you mean room and board is not covered and we have to pay privately because my father/mother does not qualify for medicaid?" followed by "$12000 - $ 14000 a month?????" followed by " I think in that case we can take my father/mother/loved one home to die".
I also learned that I am still not losing any weight and most likely will get an earful with my upcoming physical ...
It's a general old-timey reference to the abhorrent & abysmal conditions in old psych institutions, like when they were called 'lunatic asylums' and 'madhouses' and 'homes for the insane'. Think old Charles Dickens-type facilities.
But there WAS an old movie (I just googled one - don't know if it is still the one I remember but am thinking it might be) that showed a scene in an old psych ward of a large group of unkempt pts just wandering about and fighting and scratching, etc in an overcrowded, NOISY community day room. And from the aerial? (distant) view it looked just like a pit of snakes just writhing around. Hence the term 'snake pit'.
It was a really really looooong time ago that I last saw that movie - those kind of movies upset me.
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I don't know what is going to happen if I'm positive for TB.
My tuberculin skin tests were all negative when I secured my first licensed nursing position in February 2006. By late 2008/early 2009, all of my tuberculin skin testing results were positive.
The likely culprits were several indigent homeless residents who had been recently admitted to a nursing home where I was working during that time period. All nursing homes in the state where I work are supposed to ensure timely TB testing of new residents upon admission, but this facility dropped the ball.
Anyhow, the nursing home is now closed due to the awful track record. My chest x-ray results are normal, but I always live with the possibility of developing overt TB if I ever become old enough.
1. I learned just how invasive your employer can be into your medical history in the premployment physical. I was not comfortable at all with the process of that and honestly wondered where hipaa fell in. But it's all done and I'm good now.
2. I learned tons in diabetes education. I learned about carb counting, how restrictive the diabetes diet is even with protein, and that the American Association of Endocrinologists is not realistic. The American Diabetes Association is much more realistic.
3. I'm struggling on tests in my Critical Care class. It's making me nervous for NCLEX. I'm not failing any of my tests, but I feel like I should be doing much better for as much as I'm studying.
4. Between the mortgage company and my physical this week, I no longer have any privacy or secrets!!! But my new house is gorgeous guys, just gorgeous!! And I'm getting to spend my life in it with the most wonderful man who is truly my best friend. Life is good, and all the stress will pass.
I learned that women who are essentially guilted into breastfeeding when they previously had no desire of their own to do so rarely succeed at sticking at breastfeeding for very long. This week alone, I talked to 4 different moms who quit nursing very early on and admitted that they never wanted to do it but were guilt tripped into starting. Breastfeeding is great but it's a lot of work and if some women really don't want to do it, they won't.
I learned that some anesthesiologists, when desperate for IV access, will run blood products and certain meds together.
I learned that fighting a cold, getting less than 4 hours of sleep, having a horrible coworker be nasty to me, and walking into a chaotic assignment = crying in the bathroom at work for a brief moment. I haven't cried at work about anything non-patient death related in years!
I learned that I'm really done being a pushover. I'm such a conflict avoider and I try to get along with everyone, but that doesn't work with people who feel the need to bully others to get what they want. (I realize that bully is an abused word so I'm not using it lightly) So basically, I need to stand up for myself more and learn to fight back when I need to.
I learned that my hospital's cafeteria makes a delicious grilled cheese sandwich!
That I got offered a job with awesome pay in a big hospital in one of the cardiac units and I'm thrilled and scared too!!
That some people have severe anxiety to the point they will call the desk, "hi can you ask my nurse to bring a bandaid. I have a bad habit of pulling my whole fingernail off."[emoji32]
That some elderly folks get SEVERE delirium post op. My pt told me she once got so delirious post op that she thought a man was chasing her and to save the treasure, purposefully swallowed her wedding ring so he couldn't steal it. [emoji32]
I also learned that there are places worldwide where IV drug users can exchange needles. At first it took me by surprise. But they're going to get the needle one way or another so you might as well give 'em a clean one.
An ancient (1948) movie about life in a mental hospital. Starred Olivia DeHavilland, who also played Melanie Wilkes in "Gone With the Wind". Sister of Joan Fontaine.
Apparently they had a legendary and life long sibling rivalry.
1. That the hospitals by me ate truly desperate for nurses. They literally hold job fairs and start hiring new grads in January-March, BEFORE graduation
2.that l&d is where I want to be! I impressed my consigned nurse, she said she would hire me!
3.i got bit by the diy bug the last 2 days, and I dusted off my sewing machine I hadn't touched in over a year! I forget how much I enjoy my hobbies and look forward to having another outlet for school.
3. I really need to make a PCP Appt and get a CBC done. Sitting in class learning about iron deficiency anemia (which I've had my whole like). However, readings some of the s/s of moderate and severe anemia TOTALLY explained all the symptoms I was experiencing a few weeks ago.
4. My mother, who is the reason I moved out of her house and into my own apartment last year (family drama) whom I have not spoken with since then, inadvertently moved last week. Right into an apartment complex. That I live in. She didn't know I was there. Time for mending some fences I guess.
That according to my peers in my annual review, I am considered an "agent of change"; I've decided that this was a great complement to my work ethic, although I am still a newbie at Emergency Nursing.
There have been another round of people leaving-people who have shaped me with their wisdom in my first year. although I am happy that they have decided to move on, I am nervous that I have been slowly been included in senior staff, when I still need support in transitioning in my new specialty.
So, update. My chest x-ray looks okay. My heart was going wild, though. My HR was sustaining in the 140s. I had a wonderful, nice PA. 3L NSS later, I came down to 100-120. I have definitely not peed 3L out. It's insane to me that I could be that dehydrated. I mean, how much total volume would be in a skinny 5'2" person anyway? And before anyone asks, no overt S&S of dehydration and all labs WNL.
I'm home now, comfortable, HR 95-105. Glad to be off until Thursday. Gonna kick my feet up, and get lots of rest and fluids.
Thank you for all the well wishes and thoughts! I'll be sure to be medically low maintenance for the coming weeks! Seriously - Disney is coming!
OrganizedChaos, LVN
1 Article; 6,883 Posts
I've learned the business/recruiting end of home health/PDN is very dirty. Some agencies will slander another just to get patients or nurses. Homie don't play that.