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NightNerd

NightNerd BSN, RN

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NightNerd has 5 years experience as a BSN, RN.

BSNRN with experience in hospice, psych, and med-surg/telemetry. Still doing the bedside thing for now, interested in some kind of community/public health work down the line. My true passions are sleeping and eating, but I also like music, books, and hanging out with my boyfriend. I run and do yoga to counteract my cupcake worship.

NightNerd's Latest Activity

  1. NightNerd

    Needle Stick injury

    I have had way too many needlesticks. My first was awful: de-accessing a port from a deceased patient after aged been gone for a few hours (family was VERY bereaved and wouldn't let anyone into the room for a while). It was very challenging to remove that port, and when I finally got it out it went right into my thumb. It wasn't a fun night, but after a few follow ups with employee health, I felt pretty safe. This was five years ago and I'm just fine. I have had two since and they were in situations where I was stressed and moving too fast, thereby not making sure the safety was all the way engaged. Thus, my best advice to you is to simply take your time and be mindful of where your hands are in relation to the needle. Getting a needlestick is honestly more of a pain than anything else, and your risk of contracting any communicable illness (especially if the needle goes through your glove first before sticking you) is extremely low.
  2. NightNerd

    Med-Surg IV Meds

    In addition to the above, methylprednisolone, dexamethasone, etc. are some that I've come across recently. Like Hoshio said, it's hard to anticipate all the possible IV meds you may push. Know your resources and always look up meds you're unfamiliar with before giving them. Look up how fast or slow to push, compatibility with IVF, side effects, and how irritating they are to vessels should the IV infiltrate. Also, if you're going to a med-surg floor, there are likely some meds or doses you aren't allowed to give per policy. There should be a resource where you can see whether a certain med or dose can be given on your floor. I learned the hard way soon after going from palliative nursing to a med-surg unit that I couldn't give the same doses of pain medication I was used to. 😑 (The patient was fine, but I hadn't checked our policy, and the dosage I gave of this narcotic was such that the patient was supposed to be monitored at a higher level of care due to risk of respiratory depression.) Usually providers have a sense of what meds can be given where, but if you're unsure, better to be safe and double check before giving the med.
  3. So my boyfriend and I have been having a fun-filled debate since we met about whether water beds could help prevent pressure ulcers. (Long story, but we discuss this every now and again for kicks and giggles. I'm a nurse, we met through work but he is not clinical, if that's somehow relevant.) Anyway, I think it wouldn't do much, but there is no argument I've made so far that will convince him to abandon his theory! Does anyone here know of any research into this matter? Or can anyone articulate an argument for why it wouldn't make a difference? (Or heck, if I'm wrong, tell me that!) For all I know, this is already a thing, but last time I googled it, I didn't find much weighing in on either side. We were just wondering if anyone here had any thoughts we hadn't considered!
  4. I second this wholeheartedly. Please talk about these feelings with someone, and pursue a session with a mental health counselor if possible. Being a new nurse is extremely challenging and many of us have also gone through the awful cycle of eat-sleep-work-repeat; however, it definitely should not be allowed to take your desire to live your life. It's easier said than done, but try to remember that it's not your problem if people are critical of you for asking for the help you need. You are new and need to ask questions! Also, is it possible that these two nurses were simply discussing a private matter because they are close, one that had nothing to do with you? Sometimes in the heat of the moment it feels like we are being judged more harshly than is actually the case. As for the situations where you are asked to be three places at once and can't be, please try to be more patient with yourself, because that is an obviously unrealistic expectation. You will learn with time to prioritize and consolidate tasks and it will feel easier, but sometimes the to-do list doesn't end and some people have to wait. It sucks if they get annoyed with you, but just remember that you are doing everything you can. The size of your workload is not a verdict on how good of a nurse you are. One thing that is helping me through a stressful time at work is determining what I expect of myself and what my limits are before I even get to work. A similar exercise may help you define what you need to strike a more ideal work/life balance. For example, I expect myself to: keep my patients safe, try to meet their priorities, and advance their care help my coworkers whenever possible and learn from them ask for help and wait for it, rather than do anything I'm not properly trained to do (I'm in a new specialty area, so this has come up a couple times) In exchange, I honor myself by prioritizing my tasks, taking a real lunch break (not always the full time, but enough to eat an actual meal), and not staying late. This is what I find I need to give my best to my patients and team, while still having energy to give myself on days off. I would suggest reflecting on the kind of care you want to give your patients, and what you need in order to do that consistently. All the best to you! This is very hard work, especially in Peds (I would think), but it sounds like you are very conscientious and thoughtful - in other words, great nursing material. Hang in there.
  5. NightNerd

    Too strong of a personality?

    If your manager, preceptor, etc. all give you positive feedback and this is coming primarily from coworkers, it most likely will have no bearing on your job, so that's good. Have they given you any examples of what it means to have too strong of a personality? I can't imagine in what world that phrase alone counts as helpful feedback, LOL, but I'm very curious! Maybe there's some useful feedback hiding behind this very murky criticism, or there very well may not be. If you care to ask for an example, cool, but otherwise it sounds like you are doing a great job and don't need to pay attention to other people's reactions to you.
  6. NightNerd

    New protocol - No report from ER to floor...

    We get a written SBAR as a note in the computer. No official time limit before they can transfer the patient up, but it's usually at least half an hour. I actually like reading the SBAR; it's a good summary and I can quickly look up anything else I'm interested in while I'm in the EMR. Talking on the phone is annoying and distracting, LOL, so I have learned to prefer this. It does sound like your hospital is making a pretty sudden change without a clear presentation of the new practice to the people it will affect, which isn't okay. Whether written, verbal on the phone, or bedside, I think it's important to somehow hear from the ER nurse what the patient came in for and what's been done for them so far; anything else is something we can probably figure out on the fly, even if it's not ideal.
  7. NightNerd

    Hazard Pay

    No hazard pay, and just learned no performance emails evals and raises for the fiscal year. Supposedly there I'd a small one-time recognition payment in the works for later this year, which I guess is something.
  8. NightNerd

    I'm so ashamed of myself

    Honestly, this is totally relatable - except for the huge increase in updates I need to give over the phone. Depending on the family, restricted visitors can be a lifesaver. That said, outside of the pandemic, I am totally cool with my patients having one or two visitors. It makes them feel safer, they have someone to help advocate for them, and their social needs are being met so I can better deal with the nursing stuff. (I feel like I spend an increased amount of time entertaining my patients now because they can't have company, and I am unfortunately not that nurse who can small talk with you all day, even if it's not crazy busy.) As long as the visitors aren't being rowdy, are bringing forward legitimate questions and concerns, and the patient feels better with them there, I think that's a good thing.
  9. NightNerd

    Nursing for Intimate care for men

    Agreed that this was unprofessional and rude. This is unfortunate, as my experience is that most providers wish to keep their patients comfortable. I would argue that more training, feedback, and constructive criticism to staff who are observed acting this way is a more realistic solution than male-only clinics. There is is frequently not enough staff to be able to tailor care in this manner - for either men or women.
  10. NightNerd

    Nursing for Intimate care for men

    While I can empathize with the modesty thing, please remember that many women are treated by male OBGYN and other specialists who often need to conduct some awkward exams. It's not a given that we're seen by someone of our own gender either. I appreciate the gender imbalance in healthcare, but women cannot control how many men pursue healthcare careers or work in particular specialties or locations. If you are struggling to get medical care because even the front desk staff are female, it might be of benefit to reconsider how you see them. These are professionals whose work is literally to help you with treatment of a medical condition. They are not random women who are laughing at you or judging you for seeking needed medical intervention. They will certainly do anything possible to make you feel comfortable, especially if you're able to confide that you're uneasy. No one wants you to have an unpleasant experience, but there's only so much that the employees of this office can do about who works there. Like CharleeFoxtrot, I would be interested in reading some of the research and source materials you have found relating to this issue.
  11. NightNerd

    New grad nurse, can’t stop thinking about work

    Lol, five years later and I still have work dreams sometimes. If you're like me and a little anxious, this might be something that happens time and again, BUT, it will get less frequent. You're new, you're learning all this stuff, and it's starting to stick! That's great! Just be a little patient with yourself when you notice you're zoning out. If your mental dialogue is more, "I'm doing it again jfdggdy CV jvgs," that's not as helpful as, say, "Whoops, that's fine, now let's get back to this conversation/this delicious meal/doing my taxes/what have you." I think what you're experiencing isn't uncommon, and it'll probably get better with time as parts of this work start to automate for you a bit. Hang in there!
  12. This was common practice on my former unit, so I rolled with it until we were told not to clock in that early. Nope, nope, nope. This nurse is not working for free. At the unit where I work now, we're honestly lucky if the assignment is even done by 645. 😂 I found it useful to take those extra 10 minutes when I was brand new to the hospital, but it was more a way to assuage my own anxiety by developing a plan before my shift. Now I feel like I am more comfortable getting report, doing my own assessment, and putting together the rest of the details from the EMR. That said, if it's helpful to you to get a headstart on looking up your patients, there's nothing wrong with that. I don't think you should expect yourself to be there 40 minutes early, though; I'm sure there's stuff you'd rather be doing before spending 12-13 hours at work.
  13. NightNerd

    Do nurses make a difference?

    Yes!! Thinking of this career as a whole, it sometimes feels hard to think of it as a success, because so many outside factors affect how we do our jobs. But when you consider each individual shift and each individual patient, chances are that you have done something important for them - even if it's a simple thing! There are days when I have to shift my focus from, "Did I save someone's life?" to, "Did I keep that person safe while they were confused and aggressive? Did I educate them well enough that they'll really be ready for discharge? Did I push hard enough to manage their pain?" Some of these things feel small to us, but from the other side they do make a huge difference. It feels better to judge myself based on that than on the idealistic, sometimes unrealistic standards I had before actually working as a nurse.
  14. NightNerd

    Are boundaries ok?

    Boundaries are the best! Don't feel obligated to pick up extra time unless you want to.
  15. NightNerd

    Tired and burnt out from the abuse

    I've totally been there. Sometimes you do feel yourself losing patience and motivation, and it sucks! It's really sad to watch yourself change like this because of work-related stress. That's why it's so important to look out for yourself, which is why I say use as much PTO as possible and remember who you are outside of work. If nights are making it even harder to deal, maybe consider transferring to days; just know that the patients and families will all be awake and clamoring to have their needs met. If you've been on that unit for a while and feel it's time to try something different, you can do that too! There's no right or wrong, it's just about what will work for you and allow you to take the best care of your patients. Ultimately, bear in mind that these 36 hours per week are not your real life, even if some of themare awful. You are going home to a fiance and, I assume, other loved ones and various hobbies and possessions that bring you joy. If you can keep this in mind, while also remembering that for your patients this very much IS real life, you may buy yourself some time from burning out.
  16. NightNerd

    Tired and burnt out from the abuse

    Very much agree with Kooky Korky on this one. Not that I don't think this patient was out of line; it sounds like she was rather mean and she should have expressed her complaints differently. She could also probably use a reality check, because it's a hospital and obviously isn't going to be as comfortable as home. However, from what I'm reading, you essentially told the woman to stop bothering you. Using the call bell is how we want patients to contact us. Like, it's understandable that you were annoyed, just having checked on her five minutes before and found her sleeping. But this is part of the job, and I'm not sure that was the best battle to pick at 2 AM. Believe me, I am all about zero tolerance for abuse, verbal or otherwise, and I don't think being sick or scared is any justification for cruel speech or actions. But it sounds like this woman, while maybe a little needy, was merely expressing anxiety and discomfort at first and could have used a little extra attention. Instead, she heard that her issues were not urgent and she needed to stop calling the people who are there to help her. I don't want to dismiss your feelings - the struggle is real! Night shift does take a lot from your life, and sometimes you do wonder why you're doing all this for precious little thanks. Use your vacation and personal time liberally, vent on here to us, and consider looking for a new job if you don't feel adequately supported. Everything you're experiencing is, unfortunately, sort of common, so you absolutely deserve to acknowledge those feelings, and figure out how best to address them so you can be a dynamite nurse and also live your life outside of work. I just think it's important as well to think of how you might phrase things differently next time - sometimes our own choice of words can make or break a patient interaction. Stand up for yourself when necessary, but also try to recognize which patients might just need a softer approach. It's not allowing yourself to be disrespected in that instance; it's just trying to keep things peaceful for the patient AND you for the rest of the shift. 🙂
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