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perfectbluebuildings BSN, RN

Pediatrics
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perfectbluebuildings is a BSN, RN and specializes in Pediatrics.

I am a quiet introvert most of the time, but I like Allnurses because it's a place I can open up about work and life and you all just "understand" in a way that it's hard for people outside the medical field to do. And, of course, no one but other nurses "gets" that sense of humor I've developed through the years. 🙂

perfectbluebuildings's Latest Activity

  1. perfectbluebuildings

    My Body Is Not My Resume: Exploring Nursing Dress Codes

    Yes, I do not understand the idea that a ponytail or bun is "unprofessional". I have thick curly hair and that is the best way to keep it "tamed" while at my job. Even then, because it is so curly, little "strands" tend to frizz out at my temples no matter what I use to keep it smooth, and I don't like that it does that at work, but, just can't help it. I have worked with lots of nurses with their hair up in ponytails or buns; it never crossed my mind that some would see it as unprofessional. I guess something to think about for me? I'm not sure what else to do with my hair at work besides a ponytail or bun, any suggestions? Also I do like tattoos when they are well done; they can be so beautiful. I don't think I could pull one off, but I love the look of them, and the kids where I work think they are pretty "cool".
  2. This was a common thing for some patients/families in a pediatric situation where I used to work, most specifically with older teenage boys who had severe delays and resultant incontinence... some of the parents preferred to use an appropriately sized child's diaper to wrap around their child's penis and then a regular brief over that. It was just their usual way of doing things/their preference, and most of the time these children had excellent skin integrity, so it obviously wasn't causing them any problems. I don't know if that is similar to what is done in LTC or not... Of course we would not do this unless the parent wanted to (in this case, the patients could not make their own decisions.)
  3. perfectbluebuildings

    How to trick the one you love into staying alive

    I have similar situation with my partner/boyfriend of five years. He has gained almost 50 lbs in those five years and is now obese; he has been diagnosed with diabetes, high cholesterol, high blood pressure, etc; not to mention drinking too much which I know is bad for all of these conditions. He tries to eat healthy for a while but finds it too difficult after a while and just goes back to what he wants. He tries to cut down on drinking for a little while but then slides back- I have talked to him about getting help for it, but he is embarrassed and ashamed about it and absolutely refuses. He works 8-hr night shifts and is always tired so it's really hard for him to get exercise in. He is not old chronologically, but his health is that of someone much older, and I worry about him all the time. I love him so much and I want him around for a long time, and he is in denial about his health and about the seriousness of his diabetes and his weight. I don't have any idea how to help or do anything and it scares me. I've talked with him about it here and there but it's hard because he is so ashamed about it and I think feels helpless about it all, and cuts these conversations short as quickly as he can. I know he is a grown man and it's his responsibility, but I can't help but want him to improve his health, for his sake too- he would feel so much better. I just don't know what to do. So I sympathize with you. I don't have any good solutions. But I hear you and I empathize very much.
  4. perfectbluebuildings

    What's your best 'Nurse Hack'?

    YES!!!! This is the best "nurse hack" I've read yet!!!!!
  5. perfectbluebuildings

    What's your best 'Nurse Hack'?

    Slushies for patients who don't want to drink (esp good with kids): Microwave two-three popsicles (unwrapped of course) in a styrofoam cup for about 45 seconds (or depending on your microwave- till they're soft enough to scrape off the stick but not liquefied). Pour in a little Sprite, crush up the popsicles in with the Sprite, you have yourself a very refreshing, rehydrating drink that patients may actually be excited to drink (again I work in pediatrics but everyone loves slushies!!!) Also... snack, cold drink, etc can make a big difference to patients (who are not NPO/sedated of course!!) I've found that when I have time to take that minute to ask them about that and bring it to them right at the start of the shift, results in a whole new attitude and positivity of interaction that lasts the rest of the shift... I don't know why it works but it seems to!! Which makes the whole shift easier with said patient/family, usually saving time in the long run, even though takes that extra minute at first. Obviously NOT possible every shift by any means, but it is something that if you have time, makes more difference than you might think. Never run when you can walk... Never stand when you can sit... Conserve your energy!!! :-) Have your patient gulp ice water (if possible) while you're placing an NG tube. Make sure at the START of your shift that all emergency equipment you might possibly even remotely need for that patient, is in their room and functional. Such as: suction open with appropriate suction device for patient attached (and saline bullets available, if applicable), oxygen source on with mask available, bag-valve mask if patient has a trach or unstable airway, a new pulse ox probe if the one the patient has is falling apart/not sticking well. Oh and of course a large basin if the patient has ANY hx nausea; NOT one of those tiny little emesis basins but one of the big ones, you know what I mean! Sometimes taping the med-port shut on a G-tube that is receiving continuous feeds... is a good idea. That sucker can pop open easily on some patients then your formula is all over the bed. Be sure to unclamp appropriate clamps on feeding tubes, IVs, etc after you start a new infusion or change something i.e. hanging an antibiotic, giving a GT or IV push med, etc. If you work night shift: Learning how to be as silent as possible with your assessments if patient is sleeping... always have a good penlight you can use for light to see what you need to see. ALWAYS ALWAYS ALWAYS check your IV sites regularly, and carefully... infiltrations happen fast and you can't completely prevent them, but being very attentive to the site means you catch it earlier. Also making sure the IV site is as stable as possible helps a lot... as much strategically placed tape, Tegaderm, armboards, etc that will help, different ways of positioning the tubing, etc, though ALWAYS MAKING SURE you can see the site itself to assess it!!! If a patient (or their parent/family member) says all of a sudden that, "Something is really wrong... I just don't feel right/he just doesn't look right..." PAY ATTENTION bc more often than not, those feelings turn out to mean something (in my experience). You can never have too many pens in your pockets!!! Those things grow legs. Also, your stethoscope. Keep it with you all of your shift; be VERY wary of "lending" it to someone for "just a minute" you may never get it back haha. :-) Do your best NOT to let people interrupt you while you are preparing your medications. I might add more later. Although this post is extremely too long already haha... I like this thread!!
  6. perfectbluebuildings

    What's your best 'Nurse Hack'?

    Time management; time management, time management!!! Learning to prioritize and delegate and multitask- that is a huge part of nursing that you DON'T learn in clinicals, but it's invaluable- actually, more like absolutely necessary- in real life nursing. The only way you can learn it is by watching some of your more experienced nurses, and seeing how they structure their shifts, and then trying to model it yourself. Be sure to let your preceptor know this is a skill that's important to you and you'd love to see how he/she does it. Maybe even ask for a copy of his/her "brain sheet" (every nurse has one!) And always having some kind of "plan", like the "brain sheet" I mentioned earlier where you have all of your patients written down, along with the hours they get meds, when their treatments are, when their pain meds or blood sugars or whatever other things might be due. Also try to determine which are your "sickest" patients and go assess them first, even though it's scary!! Because if you catch something small with them early in your shift, it will be a LOT easier to deal with than if it blows up later, and even if it DOES blow up later, at least you know their baseline assessment and can provide better emergent care. And don't be afraid to ask your preceptor questions, that is part of what they are there for. Not in the middle of a code or a delicate procedure obviously, but later on out in the hall or in the med room or whatever. Write them down if you need to. Learn where the bathrooms are... sometimes you just NEED a 2-minute or a 30-sec break, and you can go in there and be assured of privacy. YOU ARE GOING TO HAVE BAD DAYS. Probably a LOT of them. Maybe even some TERRIBLE days. You will get through them. You will learn from them. You may cry in your car on the way home, think you're stupid, think you shouldn't be a nurse any more. But not every day will be like that. And then in a year, the new grads will start asking YOU questions, and you'll actually be able to answer them, and you'll realize you're making it. You'll have that difficult patient and be able to handle him/her along with all of your others, and actually feel that you were a good nurse for them that day. One thing to remember though, all through your time as a nurse... you will never stop learning. OK I think I've rambled enough. Good luck to you!!!
  7. perfectbluebuildings

    Is spending $80,000 on a private ABSN school a waste

    YIKES, no, please save your money!!! There are so many wonderful programs out there that cost literally a fraction of that price and are just as good if not better!!! In the end, your first employer after nursing school does NOT care where you went to nursing school, just that you have a decent GPA and you pass the NCLEX!! And any employer after that will pretty much just look at your job experience. It's amazing that you've saved that much up!!! PLEASE save it for the future!!! :-)
  8. perfectbluebuildings

    Not bullying!! But need help to grow a backbone around a certain co-worker.

    I know I quoted/replied to several of you already, but I really, just wanted to thank you all for the new perspectives and the support; you have given me reason for introspection and ideas about how to handle the situation, that I would likely NOT have come up with on my own. And, it feels nice to be validated that I am not just "silly" in seeing her as an unpleasant coworker. I will try to be professional and not try to please her because that is NOT MY JOB, as you all say. Just, thank you a lot. I don't start threads often, and I know my OP was extremely long, so I really appreciate your awesome and well-thought-out responses VERY MUCH.
  9. perfectbluebuildings

    Not bullying!! But need help to grow a backbone around a certain co-worker.

    Wow. If that's how you can write when you're tired, you need to get a side job in writing outside of nursing!!! I really appreciate your perspective. Look at her as a co-worker, not someone who has the same values as me, and just keep things professional and not take personally. Just do what needs to be done and go. As far as the MAR... she won't pull it out of my hands, but if I have it set down on a counter and walk away for just a second she takes the opportunity and grabs it. I will say I need to check that; I need to make sure I signed off everything; and she ignores me... so I just try to catch moments when SHE'S away from the MAR book to be sure everything is signed but she just doesn't respect that. So I need to hang on to that MAR book until I am completely done with it... it's my responsibility to the patients and I need to finish it before she gets started with it. Thank you very much.
  10. perfectbluebuildings

    Not bullying!! But need help to grow a backbone around a certain co-worker.

    Thank you; you make me feel much better :-) I felt a little silly complaining about it bc she's been there longer than me, but it's just not ok and I deserve more consideration/respect. Thank you (Also, a couple of times my DON has actually been there before this nurse gets to work, and seen how late she is, and is filing it away I think... I can definitely tell she's not happy about it.)
  11. perfectbluebuildings

    Not bullying!! But need help to grow a backbone around a certain co-worker.

    Wow, you totally nailed me... this is me!!!! and yes DaveyDo and NurseCard... I do hate confrontation. But I'm going to have to stand up for myself, and maybe think about it first of all as standing up for my patients so they get the best care they deserve... like being sure meds are charted so it is noted they got the correct medication. Different things like that. I can confront someone more easily when it's thinking about advocating for my patients than thinking about advocating for myself. I know that's not ideal way to think, but it is a perspective that will help me!!! And not taking things personally so easily!
  12. Warning: This is a very long post. Avoid if you cannot handle this time of the morning haha) :-) So I am NOT being "bullied". But I need help in concrete ways of "growing a backbone" when it comes to a certain co-worker. I started a new job recently 12-13 hour shifts, where there is only one RN in the facility on each shift, so you end up giving/receiving report to/from the same nurse almost every day, so I need to deal with this. First of all, our shifts start at 6:45. She is rarely there before 7:05. I know that's management's thing and not mine, but it's still very irritating that I can't even start giving report before the last ten minutes of my shift. Then one thing in particular that yesterday irritated me was this: she had told me when I got report from her Wed night "not to set up X's AM meds because he's NPO for labs." So, I didn't set them up. The next morning Thurs when she got report from me, she asked why the meds weren't set up. I said it was because, she had asked/told me not to do so. She acted like I was lazy or had done something wrong, like there was no way she had said that. So I offered to stay and set the meds up for her, which I know I should probably not have done, and she said "whatEVER, it doesn't matter, I mean, but..." so I did stay and set them up bc I "felt bad" about it. I do realize that a lot of this situation is on me for being spineless here and not knowing how to stand up for myself. Then there was another patient's medication that I hadn't been responsible for giving, my preceptor had; and the patient had asked to wait to take one of his medications after eating breakfast, so he wouldn't get sick to his stomach. I had NO interaction with this patient regarding his medications. But when he came back, my preceptor had gone home, letting the day shift nurse know about this situation. But then when he came back to the med pass window, this nurse was looking to me "where was the medication, what happened to it, it was right here, what happened," when I had no idea what she was talking about. When I understood what she was talking about, I went to get another one of the pills from the patient's drawer so he could get his dose in a timely manner, and she was like, "no, no, it's here somewhere, we have to find it!!!" Of course the patient is standing at the med window at this time waiting for his medication. So I go ahead and give him another tablet of the medication, leaving one dose for that evening, and I put in the re-order form for the pharmacy so that it will be refilled that day in preparation for the next morning's early AM med pass.. which is nothing she is responsible for anyway and nothing that she needs to worry about. About ten minutes later, as I am finishing up to leave, the nurse is like, "Look!!! Here it is on the floor!!! It fell on the floor, LOOK!!!" as if it is my fault, that this medication I did not prepare and had no responsibility for administering, somehow ended up on the floor, and this was a horrible negligence on my part. In addition, there is a huge med pass at the end of my shift that goes very quickly. Afterwards, I usually have a few patients whose meds I did not get the chance to sign off on the MAR and that I need to sign off before I leave. She immediately takes over the MAR book as soon as she gets report, and if I mention that I need the book to finish signing things off, she ignores me. I understand that she has meds to get ready... but her first med pass is not until 4 hours after my shift ends. It would take me ten minutes AT MOST to double-check and sign the MAR, but she takes it as an imposition. I know I need to be able to stand up to her and say things like, "I need that MAR book to finish signing off and as soon as I am done I will give it to you right away." Or tell her that, on occasion (maybe once every couple of weeks) I am not able to stay to do first aid/medical treatments that a very few of the residents need first thing in the morning but haven't gotten yet, because they wanted to take a shower first so that the cream/bandage does not immediately get washed off; to me, that is not something I need to stay overtime to complete. I almost always do get these treatments/topical medications done on my shift if at all possible; it's not that I'm routinely leaving these things for her, at all. But she wants me to wait every day until they come down so that I can do those treatments. I need to figure out how to tell her that I need to leave as it is the end of my shift. I mean, these are not complicated things at all; they are small bandages/antibacterial cream, and assessment of healing wounds. I want to say to her "nursing is a 24-hour job and I understand that sometimes there are things left over at the end of your shift that I need to take care of, and that's fine, and I wish you would extend me the same courtesy." I don't know. I have been a nurse for over twelve years, but am new to this specialty and this facility, so I accept that I have things to learn and to become faster at completing. Am I wrong in feeling that she is being kind of unfair? Or is this my issue that I need to work on? For example, I don't feel comfortable, say, signing the MAR before I give the meds, like some of the nurses do. I just can't do that; it grates against everything I've ever done and been taught as a nurse. Even if it would be "quicker" to do that it's just not safe/ethical practice to me. Thanks for any advice, any new perspective, etc. I welcome any and all type of comments, advice, criticism, eye-rolling, etc. I really want to get out on time but still be fair to the oncoming nurse as well. I know this is a long post and it may not make a lot of sense, feel free to ask clarifying questions. Thank you for reading this far!!!
  13. perfectbluebuildings

    What is your Nursing Super Power?

    The biggest I guess is that I'm known as a "baby/toddler whisperer"; I get down on their level (not hard since I'm only 4'11"!!) and just apparently have a touch and a face to make them feel comfortable and make them giggle and calm down... parents will say "he/she hasn't let anyone TOUCH them since we've been here, and look at how they are interacting with you!!!" I can't explain it but it always seemed to happen almost every day at my last job. It made me so happy to make them feel safe.
  14. perfectbluebuildings

    Make It STOP!

    "I made one med error/a patient fell/I said a curse word at work/that patient complained about me/that nurse looked at me funny. Am I going to 'loose' my license?!?!? PLEASE HELP URGENT!!!!"
  15. perfectbluebuildings

    Make It STOP!

    "there's bad weather coming TONIGHT that I've known about for a week!!! Obviously I can't get to work!!! How can my manager/job punish me for this???" (I understand there are extenuating circumstances in some cases, BUT there is also lack of preparation, feeling "special" that they shouldn't have to go to work in bad weather, etc.)
  16. perfectbluebuildings

    Gero-Psych... good resources and essentials

    Thank you!!! I'm going to pay close attention and try to be very objective tomorrow in seeing if this unit seems understaffed or anything like that. I will be shadowing a nurse for four hours. If it seems like it's too much stress or not a good fit, I don't have to take the job, that's what I keep reminding myself. There are other nursing jobs out there, and if this one doesn't work for me/doesn't fit my abilities and limitations, that doesn't mean I'm not going to find something that does work.
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