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Adam D. RN2005

Adam D. RN2005

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  1. Adam D. RN2005

    ACLS Certified!!

    It really wasn't that tough. There is a lot that you have to know, but they teach it to you. But they teach you how to run a code, and it really helps you anticepate what the MD is going to order depending on what the situation is. Adam, RN.
  2. Adam D. RN2005

    Death of a favorite Patient...

    :bluecry1:I guess stunned, shocked and grief stricken is the best way to describe my feelings right now. That also is the best way to describe my unit feelings. The patient was a favorite of the units, a frequent flier. They had been on the unit multiple times and for months at a time. The pt had wounds all over their body and constantly septic. Spent all their time in a clinitron. They were admited several weeks ago, and on a weekly basis undergo surgury for I & D of the wounds and wound vac. They had been getting better. This morning they were sent down for surgery, the pt is good spirits. (Not my pt this time around) I saw them and just said goodbye. Not my customary see you later. I don't like saying goodbye because there is finality to it. About an hour later I was in the nurses station sitting next to the OR PAC when a general page came up on their blackberry and it just said "Why is **** coding in OR?" For the next fifteen minutes we didn't here anything, then we got the god awful news. Not one Nurse or Tech who had taken care of the pt had a dry eye. Our patients could just see a difference in our body language. We later got news that they had a PE on the table. We had a brief memorial service for the pt this afternoon among the staff. I remember the first time I had the pt about a year ago. My preceptor had assigned me this pt and all she said was I was going to get signed off on my wound care today. I looked at my preceptor and said no pt has that many wounds. Preceptor just said you never met ****. When I walked into the pt's room, they looked at me and said newbie nurse. I nodded. They just said that'll change today with a wry smile. That started a relationship that was both professional and personal nature. And that was the way this pt was with everyone who took care of them. One time many months later, when I was just doing wound care all day for different RN's pt's, came to them and they said I want to get to know you. I said you already know all about me. Their response was, no, let down your hair, I want to know the person underneith that you hide, the one in emotional pain. No one expect for my therapists and family knew about my deep routed emotional pain. That pt saw what I refer to as my sorrow. While I was doing their wound care,(their wound care commonly took 2 to 4 hours, just the sheer number of them) I told them about it, my adoption. Turns out, we both were adoptees, and it became a common bond between us. That day was one of the most therapeutic days for me. They understood my grief. That pt had considered me to be one of their favorite nurses. Their family was the units family. One nurse today said it perfectly, they were our baby, the units baby. They were family. When the family came up to get the pts stuff, it was hard on all of us. They just thanked us and just said they considered us all to be family and had positive things to say about the core group of RN's and techs who took care of them. The pt will be missed. They will no longer be in pain. But our baby is gone. I plan on going to the wake, and if I am not working to the funeral. It is the right this to do. They will be missed very much. Adam, RN
  3. Adam D. RN2005

    ACLS Certified!!

    Past two days, I have been taking an ACLS class, today took the certification exam and can now start adding the proverbial alphabet soup after my name. The new way for BLS CPR is completely different. No longer the 2:15 ratio, but now the 2:30 ratio. Getting past confusion, and learning how to run a code, made what I refered to as organized chaos a little bit more organized, and I now see the method to the madness. I also gave me a heads up as to what meds are going to be pushed during a code. Work has been keeping me busy. My manager has contantly been giving me positive feedback, and it has been noted by many of my co-workers, that now with 11 months of experience under my belt, that I am now calm, cool and collected when a situation arises. I have really kept my sense of humor and don't let things get to me. When the nutty (whether they are an almond, cashew, or peanut) family member approaches me, I just take it in stride and keep my cool. No use getting myself angry, or upset. I just take what they say with a grain of salt. I am also not afraid to question a MD's order without hesitation. If I feel something is not right, I will question it. Two weeks ago, I had a patient in for alcoholic pancreatitis. They had been NPO for 5 days. New resident who was in their 3rd day of practice comes up to me and promptly tells me that they are going to D/C the patient. I looked at the resident as if they were crazy. (I did not know the attending was standing behind me.) I told them that the pt has been NPO, we don't know if they can tolerate a diet. And their lipase levels on the lab went up. Resident then says to me it only went up a little bit. I then said it went up 50 points from a normal number. We don't know if it is trending upward. His responce was "I'm the doctor and your the nurse, (saying it as if I am lowly and uneducated.) and I am going to d/c the patient." I simply responded with, "and how long have you been out of schoo?" 1.5 months, "And how many days have you been practicing?" 3 day. "Do you know what the purpose of an RN is?" To carry out what the MD orders. "Wrong, it is to cover your gluteous Maximus." At this point the attending stepped in, and just said to the resident, follow me, went into the stair well where they were chewed out. Resident came out with a dejected look, said sorry followed by lets keep the patient atleast 24 more hours. Fortunately the pt tolerated their meal and the numbers were just an abnomally. And the resident last time I saw them was trying to get on my good side now on the last pt that I had. They asked me what did I think was the best course of action. I guess they learned their lesson, never insult the nurse. The latest class is going to be so much fun. Got to head to sleep for tomorrows shift. Can't wait!!! Adam, RN, ACLS
  4. Adam D. RN2005

    Eight months in and loving it...

    I have been a practicing nurse now nearly eight months. What I can't believe is how well I am doing. I love getting up (okay I don't enjoy the getting up part) in the mornings to go to work. The second I put the uniform on, I become one with it and transform. My supervisor has been coming to me left and right (too the point I am started to go 'Oh no, not again...' each time.) a pin award because of compliments from my patients. More then a handfull of patients have writen it. And even recently one letter made it up on the unit bullitin board, that a patient's daughter stated that I exemplified the art of nursing. That I changed her position on how she felt about the unit. And how ontop of everything I was. Another patient dropped a card in the "Been caught fishing being the best" boxes that are all around the hospital saying that I was able to comfort and give a scared patient a peace of mind. And that they looked forward to when I was their nurse. I must have 30 pin awards now. They are all in my locker. Honestly, I choose not to wear them. Reason, while I know that I am a good nurse, I don't want to flaunt it. And also, all of these awards are extremely humbelling to me. I am just trying to be the best nurse that I can be. Making sure that my patients get the care they need and desearve. For me, I have found that nursing is the perfect profession for me. I go in there and do my job, and when the patient destabilizes, I am in there doing everything in my power, using all of my knowledge to get that patient stabile. I found that I am catching my patients constantly when something is not right. And I get on top of it. My supervisor has told me that she sees me in the crises situations very calm and very aware of what is going on. And she also feels that I am extremely thourogh and organized. And I feel it. I love my job and it shows. Tomorrow (3/27), I celebrate my 33rd birthday. I am taking the day off to celebrate. But if I see an accident, or someone collapses, I will go into Nurse mode and will calm that person down and make sure that they are stable and will stay with them untill help arrives. Like I said, I love my job, as well as my profession. Later, Adam D., RN
  5. Adam D. RN2005

    You know the family is nuts when...

    Your charting reflects more of the antics of the family then the patient. As the family is going balistic, you sit there smiling to yourself knowing that you are going to chart this.
  6. Adam D. RN2005

    Fun Day...

    You know you have a problem family member when your charting reflects more about the antects and harassement of the family member then the actual condition of the patient. Add that in to two RN's that called in with the flu, and the RN on availability was fired on friday, and you get 9 to 11 patients per RN. The good news, they held admits for our unit. And other than the fact that my patient's daughter was completely nuts, I had a pretty good day. The interesting thing, was when I saw the board, I didn't even blink. I just knew today was going to be a day that I would need to stay on task and continuely keep an eye on my patients. Charting would come later in the shift. I don't feel I compromised my patients care. I just prioritized them. And fortunately, I had most of them the day before, so I knew what to look for, and I was not flying blind. Now to my patient's daughter. Oh my god. Now I know why everyone has been complaining about her. She was the proxy for the patient who had dementia. Pt was pretty much non-responsive. Not once did I lose my cool with the daughter. Just kept on calling the nursing AD to the floor. And this person was well documented. Not only by me but by the rest of my unit as well. When I asked her to step out of the room so I could transfer the pt from the bed to the stretcher (which I normally do), she went balistic. She accused me of going to hurt the patient and that she was going to sue. (Never say that to a nurse on duty, because I will document it. And if you do sue, it shows alteriative motive and will 99.9% of the time get thrown out by the judge. I have a family full of lawyers, some medical malpractice,and they gave me plenty of advice on how to cover my backside.) Next she started following me around the unit, and at one point when I went to the pharmacy, she followed me most of the way there until I turned around and saw her, she turned around and ran back to the unit. Interesting. I documented that as well. I also documented every bit of care that I provided to the patient from the diaper changes all the way done to the how I put the pillows on the patient. I walked into the room at one point about 15 to 30 minutes after I had walked into the room earlier, I noted that the pillows that I had placed under the pt back, between the knees and under the heels were piled neatly on the garbage pail. I know I didn't and the tech didn't move them which just leaves one person. I just documented it. Then the daughter has the gall to accuse me of not turning the patient every two hours. Interestingly enough, the daughter was there the entire time, saw me several times go in and turn the patient. And then becomes obsessed with saying that I did not provide any care for the patient. The daughter was abusive towards me and my tech. And harrassed me. I just documented every bit of it. From 9 am till 1855. It took me two hours to document that one patient. Insane. The amazing thing, not once did I get angry. Not once did I talk back to the daughter. Not once did I raise my voice. I just kept the smile on my face and reminded myself that I love my job and that I am not going to let onc nut case change that for me. And that I was going to have a field day documenting all of this. I got commended from the Nursing AD on my professionalism today, and she told me that this was pretty much the same old from this person and that tomorrow, risk management is going to be taking a look at this person and also getting SW involved as well as a judge to remove the bi-proxy and transfer the care of this person to the state. I love my job. And I did not once allow this person to get to me. Yes she gave me heartburn. (Took mylanta, god that is the worst tasting stuff.) and took everything that she said with a grain of salt. Because, there is so much documentation from patients that states completely the opposite of what this patient said. Now I am going to go to sleep and enjoy the next 3 days off that I have. Adam, RN
  7. Adam D. RN2005

    What Is Your Most Gross, Yucky, Disgusting Nursing Horror Story?

    I've got one that happened this past weekend, I was interviewing a pt that was just transfered when my aid asked, "Adam, is the pt in the room accross the hall allowed out of bed, (Yes the demented one accross the hall.) I suddenly hear a crash followed by a splat. A rather loud splat to say the least. It seems my pt got ouf of bed, pulled out the foley, and then stood straight up, fell backwards onto a fully loaded diaper, full of a very rather large bowel movement. Sending the BM all over the place. Splattered on the walls, curtins, bed, and of coarse the patient. Interestingly enough, the pt was uninjured in this. We credit the BM for it crash absorbing properties from saving the pt from a THR.
  8. Adam D. RN2005

    What Is Your Most Gross, Yucky, Disgusting Nursing Horror Story?

    I love it!! I have got to try this one. Adam, RN
  9. Adam D. RN2005

    Fear Factor, Nurse Style, Five Stunts... lol

    Compaired with the mouthwash, it tasted a hell of a lot better and would have rather have had the taste of urine in my mouth than that mouthwash. I am shuddering just thinking about it. (The mouthwash that is.)
  10. Adam D. RN2005

    Fear Factor, Nurse Style, Five Stunts... lol

    Been there, see it, and done that as a tech when I worked as on a resperatory unit. And during my peds rotation in school, had a baby pee in my mouth. It was a good vintage. The mouthwash I used afterwards tasted worse. ANd I am not kidding about the taste.
  11. Adam D. RN2005

    Fear Factor, Nurse Style, Five Stunts... lol

    I remember my instructors as well as some older nurses tell me of a day when they cleaned poop without gloves. I was told they did this as late as the 1980's and that gloves are a really recent thing as a result of universal precautions.
  12. Adam D. RN2005

    Add to the story....

    the RoadRunner with a little man who resembles Marvin the Martian who...
  13. Adam D. RN2005

    Hurricane Katrina Relief

    I actually feel helpless watching the situation in New Orleans with respects to the nursing profession. I actually want to head down there as an RN and help out. The only problem is, I have been working as an RN for only 1 month now. Does anyone else have similar feelings of wanting to head down there to help out? Adam, RN
  14. Adam D. RN2005

    I'm scared of physical exam....

    I live in cronic pain from a nerve injury in my left hip 4.5 years ago. At times the pain can reach 50, on a modified pain scale where kidney stones = 10. (I have had kidney stones and this is worse.) When I was being interviewed, they were fully aware of the problem, and were more worried about making sure I don't reinjure the nerve than not hiring me. And they wanted to make sure that the unit I went to did not inflame it from the constant lifting and moving of pts. Relax, many nurses out there have different disabilites that maybe worse, and they are working out there on the floor. You will be fine. As long as it does not interfer with your duties, it will not affect you. Adam, RN. Adam, RN
  15. Adam D. RN2005

    Night from #@**

    The fact that while cracks showed up on the surface, you were able to prioritize, keep your wits, and give the best care your could give considering the circumstances is commendable to say the least. No one ever said that nursing was easy. And it isn't. And there are shifts that are going to go like that. What is important is that you kept your priorities straight and did the best job that you could. In my mind, you defined yourself that night as one to count on when the going gets tough. Give yourself a pat on the back because by all means, you deserve it. Adam, RN.
  16. Adam D. RN2005

    Did I fail the NCLEX?

    Congratulations Randie, RN!!!! Welcome to the RN club. You did it and you should be proud!!!! Adam, RN