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mi_dreamin has <1 years experience.

mi_dreamin's Latest Activity

  1. mi_dreamin

    What is night shift actually like?

    Where I work nightshift can definitely be steady but tends to be much less busy and demanding. I am primarily dayshift but like to pick up nights because it is more money and less work There are actually several open day shift positions on my unit but none of the nightshift RNs will come to days because it is so much more busy and a lot more work (their words). You have to realize, on day shift you are doing 2, 3, sometimes 4 or more med passes as the docs add orders, coordinating procedures/therapy/meals, talking to family members, planning care with social work/docs, discharge planning/teaching/coordination, in addition to the things that all shifts do - call lights, admissions, patient care, charting, etc. Night shift can be hectic, emergencies harder to deal with, and 04:00 can feel like a nightmare, but overall it is less demanding than dayshift (on my unit anyway). It seems to me that the worst part of nightshift is the toll it takes on your body/circadian rhythm/ social-emotional health. My aunt worked nightshift for 5(?) years and always talked about how it was still busy even though it was night and people don't sleep. Then she came to days and realized what a HUGE difference it is. Just my 0.02¢.
  2. mi_dreamin

    New kid on the block

    I interviewed for a position on my hospital's MIU/peds unit last week with the intention of eventually transitioning to L&D once a position became available. I received a call today from the manager and I was offered a position on the L&D part of the unit!!! I accepted the position and am so very excited/nervous but sad to leave my old unit. I am sure that I will love L&D but I love my coworkers and patients on my current unit and will miss the comraderie and culture of the unit that made me a nurse. I am re-reading parts of my OB textbook but looking for resources experienced L&D nurses would recommend for a newbie. I remember reading a similar thread awhile back but couldn't find it when I searched. Recommendations, advice, links to old threads are all appreciated!!
  3. mi_dreamin

    Having Fun with Documentation

    Among my favorites: Pt grabbed scissors, held them up and loudly stated, " I want to see the son-of-a-***** who put those orders in!" Dr. Do-Nothing made aware. Pt pushed sitter and ran into hallway, stated loudly, "I'm not ashamed, do you wanna see em!? Do you wanna see my *****!?I'll show you!" Security present. Pt educated that SpO2 was too low to remove BiPAP and eat. Pt stated, "there has to be some compromise, it can't be all **** me, **** me **** me!" Pt then turned to face the window and refused to engage in further communication at this time. Will continue to monitor. (Sorry for the * bomb, I couldn't leave this one out and that's what he said) Staff responded to pt's bed alarm. Pt stated she wanted to know who stole her whole vagina. Genitalia intact upon assessment, will continue to monitor. Pts heparin gtt turned off and left off by nightshift RN. Dr. Know-it-All made aware, states, "what do you want me to do about it? Ask the pharmacy, just follow the policy." Heparin gtt resumed. And 3 of my favorite admitting diagnoses ever: "Fell ill" "Probably sick" "I got pergernant" (That's not a typo)
  4. mi_dreamin

    RRT on Patient for Hospice

    In this specific circumstance I would have educated the family regarding the dying process and asked the provider for comfort meds; roxanol, oxycodone SL, atropine SL, scopalamine patch, ativan, haldol, etc. A rapid response is for patient's whose plan of care is not strictly comfort care. That is why communicating with the family first is so important. Maybe they feel something else should be done besides strictly comfort care, maybe they need the provider to come and educate them that the patient is imminent and nothing will change that. We have called a rapid on a patient whose plan of care was hospice but that was only because when the patient was suddenly declining very rapidly (not unexpected) the family panicked and wanted everything done. That patient went to ICU only to come back to our floor and pass the next day. Communicating with and educating the family is one of the most important parts of hospice care.
  5. mi_dreamin

    I'm better at dying

    Oh my! I wouldn't want that!
  6. mi_dreamin

    I'm better at dying

    I certainly didn't see your post that way, regardless of which title they were referring to. Also, I realized recently that I am very good at disassociating with death until I find myself crying over the cancer diagnosis in a sappy movie. It's not that I don't care for and about my patients and their families very deeply, I just seem to have an emotional "off switch" that makes it seem as though I am a sociopath, especially when I am not face-to-face. A weird coping mechanism I guess. Rest assured though, I am not a sociopath. I have sat (at home) and cried over my patients' obituaries on more than one occassion
  7. mi_dreamin

    2 full-time jobs?

    My entire 4-year degree was just under $30k for an in-state university. Have you considered going back to your home state and getting your adn? Even with having to retake courses you've previously taken that would ve much more financially prudent and probably less time as well. Maybe try looking into the schools near your home town...if you can love with your parents during school you'll save even more money, just my $0.02
  8. mi_dreamin

    I'm better at dying

    Thanks for the feedback. In daylight with sleep, food, and rational thought onboard I agree.
  9. mi_dreamin

    I'm better at dying

    I should have clarified - this wasn't a hospice patient and she did have a sitter. We do palliative care in addition to tele/renal/dialysis on our floor (some ICU stepdown as well). Honestly it wasn't so bad except the not knowing what to do nobody doing anything part. Probably the worst of it was sitting down at 1700 to enter the meds of my 80-year old admission whose only request all day had been to get his home meds and whose BP was now 184/85. For some reason sitting down in that moment I felt defeated, exacerbated of course by the (different doc) who I couldn't get to put orders in on him but apparently had had time to wait on hold for 30 minutes earlier in the day....I never did mind the little things
  10. mi_dreamin

    I'm better at dying

    Exactly! Lol
  11. mi_dreamin

    I'm better at dying

    Thanks @Davey Do. And to clarify, I wasn't angry, or really even upset by any of this, I simply didn't feel I had the skill set to manage it. I knew I was not strong enough to hold her down myself and useless security guards stood there for an hour before we finally brought her bed out. I just like it better when I know ehat to do and feel capable of doing it
  12. mi_dreamin

    I'm better at dying

    I've posted a few times before, not often, but it's apparent from my posts that part of my job includes inpatient hospice. I am really good at this part of my job. The palliative care providers like me (the way I do my job), the families like me, and I keep my patients comfortable (they usually aren't alert enough to know whether or not they like me). That being said I am NOT a psych nurse. A little agitation here or there, depression, your run-of-the-mill anxiety, all this I can handle. What I cannot (or don't want) to handle is acute psychosis, especially when it involves pulling scissors out of my pocket and asking for the "son-of-a-***** who put these orders in" and pushing the sitter, and punching the staff who came to see what all the screaming was about. I especially don't like it when the acutely psychotic screaming patient comes out to the nurses station and rips her IV tubing in half and threatens to bite anyone who tries to take her back to her room but strokes Mr. Security 1/3 and says that she wants to take him home. I do, however, find some amusement when the doctor opens the door to the dictation room, quietly says, "I'll put some orders in" and then gently closes it back, remaining there for the duration of the excitement. I do not, however find it amusing when security guards 1-2 stand there uselessly while the patient calls me a sneaky ***** and insists that they keep me away from her. I also don't like it when we have to bring her bed into the front of the unit and prompt security guards 2-3 to lift her onto it and hold her down while we restrain her and give her a magical injection that I'm pretty sure is made out of the same dust that's on those poppies in The Wizard of Oz. I espcially don't like documenting on 4-point restraints every hour while also trying to get the med rec done for my admission that came in hours ago while keeping"high fall risk and I just learned I can stand today" from falling and also making sure Mr. CallLight doesn't purposefully set his bed alarm off again because he's been waiting "too long" and also contacting the surgeon so I can give Mr. Vascular surgery today his meds. I don't mind not taking a lunch though, it's not that bad when you don't have time to think about it
  13. mi_dreamin

    Things Patients Have Taught Me NOT To Do.

    If you are going to procure someone else's urine for a UDS 1.) Ensure it is not so cold it will not register on the themometer 2.) Ensure it is not positive for meth 3.) If you fail to do both of the above, do not stand and stare dumbfounded and say, "but I don't do meth!" Also, if you tell your nurse you can't breathe, do not yell at her when she comes to put your bipap on, it does NOT make her feel helpful, at all.
  14. mi_dreamin

    Anyone every work 24 hours a week? (2 12s) is it doable?

    I work 3, sometimes 4 12s/week. One of the nurses I work with will sometimes do 5 or 6 12s in a row. 2 is definitely doable
  15. mi_dreamin

    Doctors Say the Darnedest Things Nurses Week Contest

    Hospice patient died, time of death called by two nurses, Dr. F notified. Dr. F arrives on the unit: Dr. F: does anybody have a penlight? Nurses: Dr. F, why do you need a penlight? Dr. F: you know, to look...professional...you know.... *holds up hands, mimes using a penlight* Nurses: Dr. F, how will that make you look professional? Dr. F: you know, check pupils to declare death...you know, to look professional... Nurses: .... Dr. F: ....okay I guess I'll just go do the discharge....
  16. mi_dreamin

    Any facilities actually using an AccuVein? Any thoughts?

    I think so, we call it a veinfinder. IME, those who are "good sticks" don't care for it. Others love it. I'm somewhere in the middle. The reality is that I still have to be able to feel the vein (most of the time) in order to hit it so it is a nice tool but I don't grab it every (or even most) times I place an IV.