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vadushkas_nurse

vadushkas_nurse

Emergency
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vadushkas_nurse has 4 years experience and specializes in Emergency.

vadushkas_nurse's Latest Activity

  1. Opportunities to practice skills often came in waves with proclaimed "learning opportunity" attached to tasks that others didn't want to do. I was ok with this approach because I really wanted to learn and help out. So the days came where it was my turn PRACTICE and LEARN the skill of SOAP SUD ENEMAS via RECTAL TUBE. This opportunity was bestowed upon me for a patient in much discomfort. I had somehow gotten through nursing school without having to complete this particular task. I had observed a few of these procedures while working in the ER, and felt confident that I knew what was important for this task. I knew providing patient privacy was of the utmost importance as was taking concern to comfort and easing patient's anxiety. I also KNEW that preparing for possible "accidents" was essential. I therefore took very careful measures to cover the bed and floor with extra linens prior to starting the procedure. Once I was set up I felt ready to do my first soap suds enema. I eagerly introduced myself, and explained the procedure to the patient. I then enthusiastically and respectfully guided the patient into the IDEAL position and nervously tried to provide as much comfort as possible. As I cautiously began and slowly progress through the task... I kept ensuring I was doing things RIGHT....things were going smooth, and I felt a sigh of relief. The patient was tolerating the soapy water, tube and procedure and in the meantime my confidence was increasing and nerves settling. "This wasn't so bad," I thought to myself... now only if it is effective...... I began to slowly remove the tube and prompting the patient TO HOLD EVERYTHING in.... when something when wrong.... something was making me panic.... the tube was coming out and out and out.... and I felt resistance..... and the TUBE GOT STUCK?!?!?!.... I tugged lightly, and more aggressively and it wouldn't budge!!! I nervously fidgeted with the tube while straining to picture the anatomy of this area .... I was thinking "where the heck could it get stuck"?!?!. I anxiously tried to assure the patient and encouraged deep breathing -while I started to panic and couldn't think of what to do. I somehow explained to the patient to HOLD ON and that I would be RIGHT BACK. I covered my patient, tiptoed out of the room then ran to the nursing station. Frantically, I explained my embarrassing situation to one of my coworkers and with a smirk she came to my rescue. She assessed the situation, with a barely contained hysterical laughter, directed the patient to take a deep breath and just yanked the tube right out. I cringed at the thought, feeling really confused as to why it GOT STUCK...SHE had DONE the task... just like that?!?! I couldn't believe it. My coworker rushed out of the room barely keeping her laughter in, when she informed me that I had got the RECTAL tube STUCK on a HEMORRHOID. I was MORTIFIED and then couldn't stop laughing at how silly of a situation it was. I learned a lot that day about soap sud enemas and hemorrhoids!!! I frequently remind new people to be ware and also learned to take things a little lighter.
  2. vadushkas_nurse

    The Case of the Missing Dentures

    I attentively and carefully searched everywhere in his room, through his belongings and of course in the bedding for the missing dentures and couldn't find them anywhere. I assured the patient that his dentures must be back at the nursing home as I couldn't find them anywhere. With noted mild dementia, the patient continued to be preoccupied with his teeth for the next couple of hours. I was at a loss for what to do. I vaguely remember calling his nursing home and with little assistance on their behalf, was still unable to track down the dentures. All night the patient continued to call out about how his dentures were missing and if someone could just look for them. I became more and more frustrated about the so-called missing teeth. I was being pulled in many directions that night and felt terrible that I couldn't settle this man. His preoccupation wouldn't allow him to sleep or for others to have a quiet environment. Out of frustration, I went to check on him again and as I approached his room one more last time a flash of white caught my eye. I took a closer look and sure enough, it was the MISSING dentures... sticking out from between the bed frame and the MATTRESS... like a smile staring at me. I started laughing and couldn't stop... all that time I was convinced there were NO DENTURES and sure enough, they were in front of my eyes!!!! What made me recall this funny moment was a similar episode I had during my most recent shift in the same ER department last week. I had an older lady that was formed for her safety, a case of? delirium vs.? dementia. With my initial introduction and assessment, this lady asked me to find her glasses. Aware that her belongings had been locked up for safe keeping, I asked security to go through her belongings and find the MISSING glasses. Sure enough, there were no glasses to be found and PREOCCUPATION began again. For the first five hours of my shift, the patient would call out for us, knock on the wall to get our attention, and begged everyone to find her glasses. I assured her that security had looked, with no avail. After countless explanations to my patient, I frantically called medical units for a magnifying glass or spare pharmacy Rx glasses so that this lady could have some piece of mind. I received a laugh from all the nursing units I called, thinking it was such an odd request. I sadly went to the patient again after 7 hours in my shift and told her the same thing I had told her numerous times earlier "security looked through your belongings and no glasses were found". With red-rimmed tearful eyes, the patient begged me to look again- as the glasses might be in her sweater or her pants. I couldn't take the distraught that this women was feeling and decided to look for her and myself. I went to security and asked them if I could please look through the patient's belongings. I mentioned this is purely for peace of mind and promised not to bother them again. I slowly went through the pockets of the patients pants, jacket, and shirt.... with no glasses to be found. I then rechecked the purse and SURE ENOUGH, there were HER GLASSES. I excitedly went to my patient and said I have a surprise for you... and showed her the GLASSES... she started crying and kissing my hand, then laughing. It was such a heartwarming and happy moment. I and other staff had quite the chuckle about this experience. These examples remind us that despite impaired cognitive function, we really should try to LISTEN to our patients. They deserve the benefit of the doubt. Moments like these are funny and definitely remind us of the importance to look more carefully and take some patient preoccupations seriously!! It's worth going that little extra.
  3. vadushkas_nurse

    "Us" and "Them" ... It Could Mean Trouble

    I also do think that the triage process is important for patients to be somewhat aware of.... sicker people do get in faster... certain things are emergent... and when I have a young adult patient with nausea/ vomitting screaming at me why I would take an older with stroke symptoms in before her... I think it is obvious that some of the public aren't familiar with the purpose of an ER.
  4. vadushkas_nurse

    "Us" and "Them" ... It Could Mean Trouble

    I think what is important about your post is the evident wide gap between patient and health care staff perspectives. I was trying to convey the tension nurses feel when they know people are waiting a long time and some underlying reasons for this. I assure you from my experience... we don't like people waiting that long... nor do we do it intentionally. The moral dilemma of making unwell people wait long hours with very challenging restraints is not something I has a nurse take lightly. I appreceiate hearing the patient view of what they see happening. I think that inorder to close the gap on the issue I am trying to bring up..more discussion and explanation needs to be done. I do think your siutation was unfortunate and didn't mean to mock similar scenarios. Sometimes coping mechanisms of staff are often portrayed negatively to others. I appreciate your willingness to share your story.
  5. vadushkas_nurse

    "Us" and "Them" ... It Could Mean Trouble

    I finished my nursing education in Dec. 2004 and since that time I have noticed a major shift in the health care ideologies. I figure the best way to do something about it is to recognize it, discuss it and find solutions or underlying causes for it. What I have noticed, is an "us" and "them" mentality, growing between healthcare professionals and the public. My background in ER nursing as a beside/ triage / charge nurse has given me ample opportunity to witness various accounts of this change. For instance, people have become WAAYY less tolerant, more demanding and seemingly harder to please. I find that when people present to the emergency there is such a misunderstanding about what the department is for and how it works, people are on edge the second they step in the door. Don't get me wrong, long wait times, a CTAS triage scoring system that people may not understand and our system of expediting things that can be done in the waiting room probably does have a different perspective to those sitting in the waiting room feeling unwell. However, there must be something we can do to remind the patients that we the nurses do our best to make the department run efficiently and smoothly. What they might not be familiar with is that the staff are balancing patient care with the medical wards and need for beds, the constant flow of ambulances into the department, the short staffed areas, the lack of CCU/ ICU or other specialized beds and it goes on and on. Given all the variable factors, I feel that we in our department really do try to make the system work the best it can. I feel that if the "us" vs. "them" mentality continues we are in for an even more chaotic system. From my point of view, we should try and give the best quality care possible, keep the lines of communication open between everyone and never try to annoy someone "just because". I also think not taking the situation personal helps and really listening to people also goes a long way. I know these things take time and can be stressful... BUT... it is us nurses that understand the full depth of what is happening to our health care... it is us that has the power to change and to educate the public about how things are. We are the advocates of the public and it is our responsibility to prevent further deterioration of the relationship we call the nurse patient bond. We the nurses and the public as patients really need to work together and formulate a team that is not a force to be reckoned with I think that destroying this relationship can be detrimental to both nurses and patients. The health care system in any sense doesn't exist without patients or nurses... therefore it is essential that we work together and overcome any unplanned hurdles of the health system.
  6. vadushkas_nurse

    New Mexico/ Eastern Hospital

    Hello Guys, I was wondering if anyone has experience with Eastern ... hosptial in Roswell, New Mexico. I am interested in ER. Any info/ advice would be greatly appreciated. I am planning on going for four weeks with on assignments. Any input would be appreciated. Thank you.
  7. vadushkas_nurse

    new mexico pay

    Has anyone worked at eastern new mexico hospital?? I'm curious about trying it. I am working with On Assignment. Any advice? Thanks
  8. vadushkas_nurse

    Tips for Human Nursing

    Thank you. I also am a fan of quotes for increasing staff morale... for the ER dept. I made 12 laminated landscape posters (one for each month) and each month I would change the pic and the quotes. It went over well!
  9. vadushkas_nurse

    Tips for Human Nursing

    My best advice for doing the NCLEX... is to do questions... do as many as you possible can.... then when you are checking them... take some notes about things you didn't know..... those question books are the most resourceful. If you know how the questions work... then you will have a better idea when you are writing your exam!!:smilecoffeecup:
  10. vadushkas_nurse

    Tips for Human Nursing

    REALLY LISTEN AND REFLECT, THEN YOU WILL LEARN: First of all I was very fortunate to have the opportunity to complete a grad initiative in acute care. This was an experience where I am paired with staff RN's for six months and in a way be mentored by them. At the time, having a new RN with me every shift was somewhat stressful until I opened my eyes and realized that I was actually very fortunate for this change. Each shift the nurse I was with would start out by saying "I start my shift by..." and it was then that I realized these nurses were sharing with me their best practice and their experience. I finally came to the conclusion that I was lucky to be a recipient of so much knowledge. I then developed my own best practice and nature of nursing from these professionals. TREAT PEOPLE HOW YOU WOULD WANT YOUR FAMILY TREATED: As an ER RN you see a variety of patient populations. This can sometimes be very challenging when you are caring for someone that makes poor lifestyle decisions. In nursing they teach you not to be judgmental and treat everyone equal. But this should be taken one step further. Treat people how you would want a health care professional to treat you or your family. With this in mind, it is easier to remove yourself from your judgments and bias. Every person is human and deserves respect, care and dignity. ITS THERE IF YOU WANT IT TO BE THERE, GOSSIP THAT IS: Gossip seems to coincide with the nursing profession. At least from my experience it seems to be there if you are looking for it or starting it. Each nurse makes a conscious decision when contributing or refuting gossip. Everyone you work with deserves the benefit of the doubt. You never know what someone is dealing with outside of the workplace. So next time, before you start contributing to the gossip train, think twice, maybe that energy is better off somewhere else. EMBRACE THE INTRODUCTION: The first few minutes of meeting your patients are crucial. This interaction sets the tone for how the rest of the shift will go. If you can get eye level with your patient, introduce your self by name and find out what their expectations are things will go smoothly. These first few minutes makes a difference. It shows respect and initiation of rapport with people. It wouldn't hurt to try and proof its effectiveness. DON'T SAY IT: "I'll be back in a minute". This phrase can be a real turn off to patients. A minute to you may feel like a minute. But in reality, it's probably been five or ten minutes. In the meantime, you have probably answered call bells, been interrupted, finished off another task you working on or who knows what, while your patient is still waiting. The truth will go a long way. Let them know you will do what they need as soon as you can. Most patients have a pretty insightful idea to how busy you really are. DO THE LITTLE THINGS: Little things go a long way in the clinical setting. Brushing care, giving back care, warm blankets and tea can really have a positive impact on your patients experience. Time is a commodity for everyone, but these things don't take long and make a world of a difference for those needing some human connection and attention. DO THE BEST YOU CAN: Lack of everything is probably a big concern for all departments. Staff, resources, time, room etc. These are system issues and they are long term issues. It is important that you go to work and do the best that you can. There is no point in going home guilty or feeling upset because you couldn't do this or that. Just always keep in mind, that if you do the best you can with what is available, that is all you can do. Patients appreciate you doing what you can, not complaining about what you can't. LEARN AND USE NAMES: Being able to address people by them is a form of respect. It doesn't take much time, especially if people are wearing name tags, but this one will go a long way in the workplace. EVERYONE MATTERS: Treat all those you work with, with respect. If it weren't for the janitor, lab tech, volunteer, unit clerk, or student the setting wouldn't be what it is. Clinical areas are a place for caring, healing, teaching and respect. It takes a large diverse group of people to care for patients. Everyone plays a role and deserves a smile or helping hand. BE CREATIVE: Textbook interventions may not work for everyone. Clinical settings are full of wonderfully creative scenarios. From call bell set ups, to oxygen placement to gown closures. It really can make a big difference if you find a unconventional but effective way to assist with caring for your patient.
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