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spotangel MSN, RN

ED,Tele,Med surg, ADN,outpatient,homecare,LTC,Peds

Content by spotangel

  1. spotangel

    Nursing Supervisor - Walk In My Shoes For A Day!

    Thank you! What is amazing is that everyday you come across a new problem to fix. Gets your mind working constantly!
  2. Was it the new construction or the" pulsating" Zumba class upstairs for staff?!!
  3. spotangel

    CPEN advice

    Hi OP! I did my ACLS , TNCC,PALS before doing the CEN and CPEN. I gave myself 3 months to study for each and did 60 practice questions everyday and timed them! Went to the ENA website and checked on their recommended books. Checked out Amazon for cheaper prices! I wrote my name and wrote CEN next to it and posted them all over the house! Once I got that, I wrote my name and wrote CEN,CPEN and did it again! My kids asked me about it and we all studied during homework time! Best of luck!
  4. spotangel

    I Lost My Baby And My Phone!

    The night Nursing Supervisor was giving me report. I was taking over half the hospital including ICU, CCU, ER, LR, NICU, Postpartum and a bunch of other units. The supervisor told me about a patient who was on one to one observation and security watch. During my rounds I went to her unit. I spoke to the nurses who were all having a rough time with her for the last few days. I could hear her yelling at the top of her lungs demanding her phone and her speech reminded me of the Jerry Springer show! Every second word was a curse word! She recently had a fetal demise and had multiple psy hospitalizations in the past. I was told that a situation developed the day before and security watch was initiated along with one to one observation. The father of the baby was barred from coming in and as he stirred up the patient and set her off every time he was at the bedside or on the phone with her. Finally the situation became so hostile that he was barred from coming into the hospital.She was refusing medications and was very labile. The doctors wanted her to sign a behavioral contract before the phone was returned and she refused. The nurses went in and offered medications for agitation and she refused. I walked in quietly into the room and introduced myself and shook her hand. She looked me up and down. I softly told her, " I am so sorry for your loss." I asked her if that made her sad and angry. She nodded her eyes never leaving my face.I asked her did it feel like a hole in her heart? She nodded again, her face crumpling. I then looked her straight in the eye and asked, " May I give you a hug?" She nodded. I took out my ID from my white coat, laid it at the bedside table along with my report and stepped closer to her bed. I opened my arms and she fell into them sobbing. I held her murmuring reassurances and acknowledging her loss. I told her that she was a brave and strong woman and would get through each day, one day at a time. I told her that it was ok to get sad and mad after losing her baby but it was not ok to hurt herself or others in the process. I requested her not to hurt herself or others. I looked behind me at the staff and the security guard and told her, " All these people you see are here to help you not hurt you. You have to remember that every day they get up from their warm beds and come out in this cold weather to the hospital to help patients like you. They have families that want them safe home and the end of the day. So please don't hurt my staff or yourself". She nodded and smiled through her tears. I was struck at how that smile transformed her face and commented, " How pretty you look when you smile!" One of the staff commented that she also had a beautiful voice and could sing! Now that she was calmer, I asked her if she would sing for us. After the initial bout of shyness, she started singing, "Amazing Grace how sweet the sound". She sounded like an angel! I joined her in the second stanza and so did half the staff there and the security guard in his baritone! It was a beautiful moment and there were a lot of smiles and tears! I thanked the lord in my heart that he choose to change an ugly situation into something beautiful that we could all relate to. I went back to the nurses station and asked security to bring up her phone.We convinced her to sign a behavioral contract. Although she was upset that she could not keep the phone for long periods of time, we reassured her that it was all dependent on her behavior. The charge RN convinced the doctor to leave her phone with her for the time being as she was calm playing on the phone and reaching out to family. She also wanted to see pictures of her daughter who had died who she had named Lilly, that she had on the phone. The last I saw her, she was quietly playing on the phone. I left the unit satisfied that she was in safe caring hands.
  5. spotangel

    I Lost My Baby And My Phone!

    Thanks Kooky Korky!
  6. Beautiful! Bringing peace and closure! Rockstar nurse!
  7. spotangel

    The Blue Angel

    It had been a rough day and it was only 10 a.m.I worked as a telemetry nurse on the day shift. I had started out my 7 am to 7 pm shift, with a shocker. John one of my regular patients was scheduled for a cardiac catheterization at 10 am. John was admitted as he had cocaine induced chest pain and was also relapsing into his drug habit despite attempting to stay clean. I had seen him have visitors the day before that had given me an uneasy feeling. I had spoken to him after they left and he swore that they did not bring him any "presents" that would hurt him. He called me his "angel nurse" and told me that I always treated him with respect and not like a junkie. I walked into his room after getting report that he was sleeping, to find him dead on the floor. He was 46 years old. I called a code, we worked on him for quite some time with no luck. I then had to be with his mom as she viewed her only son, and comfort her. I then took him down to the morgue. I now was in the next room with Ms. Gonzales, another one of my patients. She was having chest pain. I wondered what kind of day this would turn out to be as I hooked her up to the E.K.G. monitor, took vital signs, gave her nitroglycerin tabs and an aspirin and then called a doctor for further instructions. As I was working on her, her roommate kept calling for me. "Nurse! Nurse," the old woman was confused, "I need to pee". She had a foley catheter in. "Go ahead and pee Mrs. X. I'll be right with you". "No! No! I'll get wet. Come and help me". She did not understand that the catheter would take care of the pee. "I'll be right over," I called out as I turned from Mrs. Gonzalez, my chest pain patient. As I turned, my foot tangled in the cable wires of the E.K.G. machine and vital signs machine. I started falling. There was nothing to hold on to. As I fell, I heard Ms. Gonzalez say, "It's okay. He is holding you. You will not fall". All of a sudden I was upright with no reason. I went over and took care of the old lady who wanted to pee. When I came back, Ms. Gonzales was smiling. She said, "Child, you are protected!". When I pressed her for details, she told me that she had seen a blue angel hold on to me and prevent me from falling. She described him as a Cherub and told me that those angels are very powerful. I asked her if this was the first time that she saw an angel. She told me that when she was younger, one of her daughters was dying. She was at the bedside crying when she saw a host of angels come and take her daughter's soul to heaven. Her daughter looked happy and this sight gave her a lot of peace. Ever since then, she has been seeing angels. I joked that my angel may be "blue from worrying trying to protect me". Later, I went home and sat mulling over all the events of the day. I absently looked at the shelf over the T.V. set. There was a blue angel candle holder that my sister had bought for me over 2 years ago from New Zealand. It was my very first angel. I later on learned how to ask your guardian angel his/her name and found out that this angel's name was Providence. Providence has been with me through thick and thin and I keep him perpetually blue! Now, I collect angels!
  8. spotangel

    I Lost My Baby And My Phone!

    Thank you! We are in a blessed profession as we touch hearts and not just heal bodies!
  9. spotangel

    The Blue Angel

    Sit in a quiet place and relax. Then just ask and tell your angel you want to talk to him/her using their name. Then don't focus but stay relaxed. Names will start coming.Sometimes one, sometimes more than one. Write them down. Don't overthink or be anxious. Ask and let go. It will come. I asked and got the name providence. I got up in the middle of the night and morning and asked again and the same name came up.I do this activity with children especially around the holidays. Kids are amazing. You just need to trust like a child that you WILL get your answer! All luck and happy conversations!
  10. spotangel

    Mary's Gift

    It was Christmas Eve and I was in the ER working a 11am-11.30pm shift. I eyeballed her across the ER. She walked in with her son, an old frail lady. I looked at her pallor and shaky steps and knew in my gut that she was deathly ill. "She's not going to make it out of here alive," an unbidden thought sprang to my mind as I walked towards her. Cindy was the charge nurse and as she looked to see who was on next to take a patient, I reached her. "I'll take her Cindy," I said smiling easily at mother and son and taking the paper chart from Cindy. "Hi, I'm Annie. I will be your nurse today," I said as I deftly got her on a stretcher and closed the curtains of cubicle #4. I helped her change into a hospital gown, hooked up to the cardiac monitor and got my first set of vitals. Her name was Mary. She had been feeling more tired, fatigued and had lost her appetite for over a week. She was a little short of breath. Her vitals were normal. Her BP was border-line. I listened to her lungs and abdomen while my mind raced. I suspected that she was septic and so drew 2 sets of blood culture along with other labs and got a urine sample that was a tad cloudy. Probably a UTI that turned into sepsis, I thought. By the time the doctor came in to see her 15 minutes later, and EKG and CXR was done and I had normal saline running. The doctor agreed that she could be septic and I monitored her vitals carefully. The lab called back half an hour later with her blood count. Her WBC was 37. Bingo! I thought. Right on the money! I had antibiotics running and we kept pushing fluids. Her pressure began to drop and she started becoming tachycardic. I knew that she would crash pretty soon and wanted to make sure I was prepared. So I gently broached the subject with her son James who had no clue how sick his mother was or what her wishes were in case of an emergency. I talked to Mary in her son's presence and asked her. She looked at me, with wise knowing eyes and told me, "If you can save me, go ahead and do what you need to do, but at any point if you see it not going to help me, then let me go. I do not want to be hooked up to machine and it is futile." I told her, we would follow her wishes. I took James aside and talked to him. I asked him if he had any other family. He said he was the sole caretaker of this 87-year-old mother. His dad had died many years ago. He had a sister, who he had not talked to or seen for 20 years. She lived in the same city but they had a fight and stopped talking. I told him gently that it would be a good idea to call her as his mom was very sick. It would only be a matter of time before her systems collapsed due to the overwhelming infection in her blood. He was bewildered and said, "But she walked in! She can't be that sick". I told him that UTI and sepsis signs in the elderly were very subtle and that she might take a rapid turn for the worse very suddenly. I encouraged him to call his sister Ella. "After all, wouldn't you want to know if your mom was very sick and you were not with her?" I asked. He readily agreed to that and dialed her number (I got it from the patient) as I held my breath. They talked and Ella asked to speak to me. She told me that she was an RN and so I was able to give her an update on her mom's clinical status. She had just picked up her husband from another hospital after discharge and promised to be there in half an hour. "Try and keep her alive for me, Annie" she begged. I stayed by Mary's bedside but she was rapidly going downhill. I looked at her and marveled at how her dying was bringing her two children together one last time. I now had her on multi drips. She crashed. We intubated her. Five minutes later her daughter rushed through the ED doors. I took her and her brother to our tiny family room where they talked for the first time in 20 years and hugged each other. Tears and laughter rang as they reconnected. Later Ella came to me and told me that her sick husband was sitting in the car and she had to take him home. She gave me her number and left. James came to me and told me that he could not watch his mother die. By now she was made a DNR after they talked to the doctor. He gave me his number and left. Another nurse relieved me for break but I stayed at the nurse's station drinking my coffee and writing my notes playing catch up. A few minutes later I heard a voice in my ear, "It is time". Probably my guardian angel Providence, I thought to myself. I quietly got up and went to her cubicle. I sat down near her and held her hand. I spoke to her softly, "Mary, you did it. You got them back together one last time. Now it is up to them. Go in peace." As I recited the Lord's Prayer, she flat lined and was gone peacefully. I sat at the nurse's station and made the calls to her children. Mary had gone leaving her final gift behind; the gift of peace to her two children. I walked out of the ER at 12 midnight on Christmas day marveling at a mother's final act of love where she used her dying to bring her children together. Merry Christmas and God bless us all!
  11. spotangel

    Mary's Gift

    3ringnursing, I am sorry about your loss. Remember, you have to love to grieve and what a privilege to love! A book that changed my life as a nurse and as a person is Embraced by the light by Betty J Eadie . It is worth reading and may bring you comfort. Death is a graduation and going back to our natural home.Honor their memory by celebrating their life and doing good for others in their memory.
  12. spotangel

    The Blue Angel

    Thanks!
  13. spotangel

    I Lost My Baby And My Phone!

    The contract was written by the MD team and pretty much said that she had to comply with the treatment protocol (meds,tests etc) and not cause safety issues for herself and others and the phone would be given initially for an hour and based on her compliance for more hours. She blew a gasket but I went back in hearing the ruckus, calmed her down and said,"Look, this is an initial step. You are in charge here. If you comply, we nurses will advocate for you to keep your phone. We have to start somewhere so that I can get your phone back to you. The rest depends on you." That put the control back in her hands and surprise surprise she complied as now "she was in charge!"
  14. spotangel

    I Lost My Baby And My Phone!

    Thanks Chris!
  15. spotangel

    I Lost My Baby And My Phone!

    That's the beauty of being a nurse.You can cut through the medical issues and get to the real issue which is grief, anger and an inability to cope.Many adults struggle to cope especially when they are in crisis mode. Nursing is an art of balancing physical and emotional issues,not getting sucked in the drama and leading a patient towards a positive outcome. I always go in thinking this person was not born this way and somewhere there is a kernel of goodness inside each person.My job is to find it and help it blossom in a very short amount of time!
  16. spotangel

    I Lost My Baby And My Phone!

    Thank you! The nurses were postpartum nurses. Pt was not stable to be transferred out.
  17. The ER was dead on Christmas day and we decided to pull a fast one on our transporter James! His best friend Mark who was another transporter lay on a stretcher.I tied a toe tag on him with a fake name and ID and covered him with a sheet!I then closed the curtains around the cubicle and called James with a serious face. I told him to take the body to the morgue and that security was waiting by the morgue to open the door for him. James hated dead bodies and morgues, so I told him that I would come with him. Relieved, James pulled the curtain with me right behind him to see the big toe of the patient moving! He shot out of that cubicle like a cannon ball while the entire ER staff erupted laughing! The "body" called out, " Stop James, Take me with you!"Thankfully he did not have a heart attack and we still laugh about it when we see each other!
  18. spotangel

    Ridiculous medical mistakes on TV

    Laughing hard! You made my day!
  19. spotangel

    I Lost My Baby And My Phone!

    Always! Thank you!
  20. spotangel

    I Lost My Baby And My Phone!

    There was good team there but she was not easy to handle.This was ongoing for over a week and the staff was very frustrated. Documentation in this case was important and since we have an EMR it takes less time than paper. The patient was young, with psy issues,no family support,multiple hospitalizations and a weird boyfriend that made the situation worse.She was grieving, angry and felt she had no control over her situation and lashed out! When she felt that she was heard and was comforted,she calmed down. The nurses advocated for her and helped her keep her phone once we set clear boundaries and kept everyone safe!
  21. spotangel

    I Lost My Baby And My Phone!

    Thank you! I am humbled! I love being a nurse!
  22. Nurse Angela, why is Billy Smith yelling in cubicle #20 ?" "Billy wants you to fix his gout, constipation,diabetes,hypertension and pneumonia in the next hour Dr Hotshot just like in the ER show that he watches! After all you are the ER Medical Director!"
  23. "Just tell him we will have a bed soon. He keeps calling me!" "Really,doc, after 2 days in the ER and no beds upstairs? Did your nose just fall off?"
  24. spotangel

    I hate nursing

    Hey Neezy! Thank you for being honest about your feelings! Do not ignore them but listen to what your body is telling you. Couple of things you can do. 1-Be honest with yourself. What do you want to do to make a difference in this world? Is it nursing or is it something else? 2- Take the litmus test.If I had a year to live and wanted a career what would it be? Is it nursing? 3-If it is nursing, look at your present job? Do you feel you are making a difference? Is the thought of going to work putting you in a heightened sense of anxiety? If so you may have to change jobs. Been there, done that and am still alive! 4- Get your RN ASAP. More options including school,community,homecare, longterm,hospitals,management---the list is endless! 5- I go in everyday and promise God that I will make a difference in at least one life by my actions and words.Every day is not all roses. I have learned that I cannot change circumstances but am in charge of my reaction. I learn lessons meant to be learned and try and stay positive and celebrate small victories. 6- Nursing is a beautiful profession but has a mix of kind and cruel co workers. Learn to speak up when needed and always be professional no matter what. 7-Good luck! Stay happy and true to yourself! You have been sent to this world to make a difference that ONLY YOU can make! All the best! Spot Angel
  25. 1-Pick the topic and a place where you want to study. 2-Get your study aides-pen,paper,computer,flash card,highlighter. 2-Skim through the topic and get an idea of the topic. 3-Read up questions and answers on the topic. 4- Write,type main points on the topic. 5-Read, Read, Read. Practice makes perfect. 6-Test yourself.Read and understand where you went wrong. Test again and get it right. 7-Pat yourself cause now you are spot on right!
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