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CountryMomma ASN, RN

Med-Surg RN

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  1. CountryMomma

    I Fear for the Future of Nursing

    Whoa now. That's quite the list of overwritten cliches stuffed into a paragraph of mostly nonsense. Don't strain yourself. Nursing is less what I anticipated (hard physical and mental labor for substantial mental and monetary gain) and more "everything's your fault and nothing's your credit". Classes can't warn a student that the UM will crawl all over your a$$ about overtime you ended up occurring as you accompanied your vent put down to MRI because the resident wouldn't listen to your warnings about increased sedation and instead lectured you on oversedated the pt even though all they had was a Tylenol. Theoretically it shouldn't happen. Realistically a good chunk of my shift, cleaning up others messes both literally and figuratively. I still love nursing, it's the buttkissing and beauracracy I was surprised by and tired of.
  2. CountryMomma

    Anyone Who Says They Don't is Lying: Medication Error

    This, and there isn't really a hard stop for "right route". The eMAR can't substitute for a nurse's critical thinking, and to become reliant on the eMAR to do it all is opening oneself up to a med error/sentinel event.
  3. CountryMomma

    Nursing: The Highly Skilled Customer Service Representative

    It's nice that management has figured out another way to get their brainwashing crud to nurses when said nurses are off the clock and out of their cold, steely claws. OP, I am not sure if I entirely believe you are all starry-eyed with exuberant excitement about how this could be a game changer for healthcare if we'd all lie back in the grass and enjoy it. If you are, how cute and oh honey. If you are here to "spread the word", please stop. We get enough of this HCAHPS is the Future crap from our own management. Over and over. On my floor they are taped in our breakroom so we can see our "progress". You want increased scores? Don't look at the nurses - they can't pull anything more out of their rectums, they've already given about everything. How about cutting back on those C-level bonuses and grand lobby renovations and putting that money into safe staffing? With better staffing and environment, management can afford to be picky about who works there, not just scrambling to hire another warm body to replace the three that just walked out because they can't take anymore of the crap benefits, crap pay, and crap environment. Nurses and aides drive a unit, and yet they are treated like the biggest, most annoying expense on management's sheet. Stop blaming the floor workers for management's failure to provide adequate staff and supplies. The average American reads at a 6th grade level, can't locate more than 10 countries on a world map, and is 3 months from being financially insolvent. You think they can identify excellent healthcare? Heck no. But they can suuurrrreee tell you about that time the nurse wouldn't give them their dilaudid an hour early, or that time their roommate wouldn't stop snoring, or when the nurse kept changing their bandages even though it hurt. Seems totally reasonable to base a nurses's pay and treatment off of those complaints!
  4. CountryMomma

    Funniest, Weirdest, Most Unusual Baby Names

    My eldest son has a Larkin in his class, and none of the kids seem to think his name is out of the ordinary. Honestly, my son's class is quite diverse in names - there's Peyton(f), Larkin(m), Ishnala(m), Serenity Grace(f), Walker(m), Ryder (m), Jaylen(m), Jaiden(f). Plus 10,000 ways to spell traditional names. Sometimes I think kids pick up on how adults view names.
  5. CountryMomma

    IV starts in arm with a DVT

    I've seen quite a few UE DVTs in our IV drug abusing folks. A few isolated hypercoagulated oncology patients.
  6. CountryMomma

    Think Before You Speak: The Last Words Your Patient May Hear

    I chatter to my patients as I do cares - tell them how their vitals look, their heart/lung sounds, what I'm doing, plan for the day. If they can't see outside I tell them what it was like outside when I arrived. I talk about my farm, harvest/planting, near holidays. I do talk to my coworkers as well - ask them about their kids, their holiday plans, that kind of stuff. I want the pt to hear about things not related to their hospitalization. I also leave the music on, or TCM, or Animal Planet. I have a couple of aides that like to leave the news channels on, and I change it immediately. Patients with ICU delirium, AMS, don't need a steady auditory diet of yelling, fear, and exaggeration. There's one station in particular I'm thinking of.
  7. CountryMomma

    The Heat is On: Why the Temporal Artery Thermometer Should Be Your "Go-To"

    Don't have any temporal thermometers on my floor. We use oral, axillary, or catheter. Too much chance for user screwup.
  8. CountryMomma

    What She Couldn't Tell You

    We've all met this type of mom before. It's 2330, her 8 year old daughter is struggling to breathe, and you know for a fact you saw them two weeks ago for the same thing. You also know for a fact you gave her a prescription for an inhaler, a follow-up appointment with a pediatrician for asthma, and got the information for applying for state aid for medical assistance. Yet, there they are, the child anxious and pale, the mother unable to make eye-contact and answering in quiet, short statements. A little eye-rolling as you walk into the room helps you keep your tongue civil during the H&P. Definitely an asthma attack, the kind you had educated this mom about avoiding and preventing two weeks ago. You sigh in frustration (and a wee bit of anger) without realizing it, but the mother does. She shrinks a little more in the chair, stares at the floor at little harder, and tightens her hand around her daughter's hand. Her behavior sets your teeth on edge, and you hurry out of the room so you don't say anything you think will get yourself in trouble later. As you head down the hall to let the on-call know that FF#3 is waiting for a neb, you shake your head that just about anyone can have kids nowadays, and wonder at that mom's gall to come in and be so diffident when it is clearly her fault that child is having another attack. You make sure to share your opinion with the nurses at the station. Venting helps. Meanwhile in that room, a very anxious mother, who is struggling with an Atlas-sized load of guilt, tries to sooth her anxious child while they both wait uncomfortably for the doctor. Mom knows what you think of her. You aren't as unbiased and neutral as you thought. She can't tell you why they are here on a cold snowy night, at least not straight out, and you didn't ask. She can't tell you that her husband has threatened to kill her and the daughter on numerous occasions if she ever thought about leaving him. She can't tell you that he broke two ribs and tore out a chunk of her hair the size of a golf-ball when she tried saving up money for the daughter's birthday presents. He needed that money, there was beer to be bought. She can't tell you that he disabled her car four times in the past two weeks while he was out drinking, and one of those times fell squarely on the day of the child's appointment. She can't tell you that he routinely takes all of the money out of her purse, and she can barely feed her daughter, let alone get medication for her. She can't tell you that he's a twice convicted felon, and because he won't leave, and won't let her leave, she can't get federal or state aid, because one of those felonies involved drugs. She can't tell you these things, because he's out in the car, partially drunk, with a gun hidden under the seat, and if she takes what he thinks is too long, this might be the night he uses it. So she hides. She does what she can, and tries to keep her daughter and herself alive. She takes all of your judgement and frustration and internalizes it, reinforces her belief that she is a horrible person, a horrible mother, and deserves every little bit of scorn and distaste heaped upon her. She knows all this, and yet she brought the daughter to the ER anyways, knowing that you will still care for the daughter, even if you hate the mother. She trusts in your care, your skill, and your oath to care for the ill. She pays you in nickles, dimes, and her self-esteem. She might not have been able to tell you, and you didn't ask.
  9. CountryMomma

    Dear Family Members

    I'm on both sides of the line. I have been that family member. I have berated a nurse, and a NAP, because they, in my eyes, were quite derelict in their duties to the point that I was caring for my father while he was still in the hospital. There is no reason I should have to empty my father's urinals, TWO FULL URINALS, that are sitting in plain view on his nightstand. There is no reason he should still be covered in coal dust three days after admission to the cardiac floor. There is no reason he should still have coal-dust covered sheets on his bed. These things are not just slight mishaps. When I have been asking to have him sponge-bathed, to have his sheets changed, for two days after admission, the time for diplomacy has passed and I will break out the bad language and threats if it means he is treated like a human being. It is not always the family's fault alone. Stress, fear, anxiety, all lower our reasoning and inhibitions. I've cursed at a nurse while in labor. I've done controlled screaming to deal with pain. I asked nicely to begin with, that they cease doing a non-required task that was distracting me. I've asked nicely if they could please stop forcing me back to the bed for no reason other than their own comfort. Once a nurse, or any HCP, places their convenience or preference over the client's, all bets are off. I suspect many people lash out because they are terrified, in pain, and feel reduced to another sheet of paper, another annoyance. When I can come to them as a nurse with care and compassion, open and understanding about their unique being, ears listen and mouths still. And, as a CNA, I have had family accuse me of stealing, berate me for not having knick-knacks just so, lambast me for not going against facility policy, and degrade my coworkers while expecting me to agree. I worked very hard to cultivate a feeling of understanding, that there are many reasons a person may do what they do, and most of them do not involve me directly. Water off a duck's bottom and all that. My goal is to not see family as hindrance or annoyance, as an obstacle. I truly hope that my outreach to them will engender like behavior, or at least deflect their negativity. I wish to be the change I wish to see in the world.