Meerkat

OK, here's the legal clause first....I'm not asking for medical advice, recommendations diagnosis, or treatment. :) Here's the deal, at karate tonight, I was flipped by my instructor, and I landed wrong, sort of on my shoulder/neck and then a MAJOR blow to the side of my face as I hit the concrete. (My face was the only thing that didn't land on the mat). I didn't quite see stars, but I felt like my brain had been rattled and immediately got a headache. Since class finished, the side of my face has felt sort of numb, and strangely burning at the same time. There's no swelling, but I still have a headache. No blacking out, continued with class, etc. Now...*IF* you had a HYPOTHETICAL patient with similar symptoms after a similar incident, what would you think was causing the numbness and burning/tingling? Has anyone every had a similar experience? Just curious, and yes, I know, no one can dx or advise me personally. So I am asking about a hypothetical patient. :)

cervix is el cuello del utero (neck of the uterus) Some Mexican ladies have a sort of blanket called a 'reboso' that they like to keep with them for the birth. Some Mexican ladies will not express their pain...they tend to try to 'be strong' and quiet when they are labouring. On the other hand, some believe that if you do not make alot of noise during the birth it shows that you did not 'work' hard to bring the baby into the world. Many hispanic females, not just Mexicans, are very shy about males being present for the birth. If you really try to speak the language, they are usually extremely grateful and pleased, even if you mess up a little. But be careful! I once had a doc try to show off by speaking Spanish to a young woman. He intended to ask her how old she was (cuantos años tiene?) but ended up asking "How many orificees do you have?" (cuantos anos tiene?)...all because of that little mark over the 'n'!!! Incidentally, I am not hispanic, I was not born speaking Spanish. I just love to help the underserved populations...I imagine how frightening it would be to be in labour in another country where you don't understand the procedures and processes. I self-studied almost every night, and my patients taught me some of their culture along the way. Now, other nurses ask me to translate! It's wonderful that you want to help...don't be afraid to make mistakes (just dont ask how many orificees she has), just keep trying and trying---they will love you for it, especially if you get good over time. These ladies need you, they need the comfort you can bring by helping them thru labour and delivery...ask family members about their culture, their customs, etc. You will be a priceless resource for your patients AND hospital! Good luck!

Thanks for the suggestions! Any recommendations for an online program?

I thought I would never get through doseage and solutions in nursing school. The first time I remember having math trouble was in 1st grade, when there was a problem 0+0=? My answer was 2. I understood the two zeros to be entities in and of themselves, without respect to the MEANING of the zeros. Ever since then I have routinely flunked math, gone to summer school got pushed thru by the skin of my teeth, without really ever learning or understanding. At university, I dropped out because I could not fill the basic math requirement, in spite of being in advanced courses in other subjects. Years later when I wanted to go for nursing, I went straight to the advisor before anything, and laid it on the line. I said I've always flunked math, but I really wanted to learn nursing. The advisor...she changed my life...she scheduled me for disbility testing, and it turned out that I had a 'math processing deficit', or 'dyscalculia'. So I went to the director of nursing...she was about to retire, and I don't think she really cared, so she told me I could substitute an old science course for the math. So I got pushed thru again...much to my relief. Now, with some luck and basic interpretation of the figures, I passed dosage and solutions. The problem now is....I want the bachelor's degree! How on earth can I possibly acheive this? To give you a better understanding of my disability, I 'see' numbers inverted or in the wrong place, much like dyslexia. (At work, I do not have to do solutions and our meds come in pre-portioned packs, but I always have another nurse double check for me--this is an accomodation that I have been granted as a part of the Americans with Disabilities Act. I do, in fact, think it makes for safer administration of meds even if I didn't have the disability, because it is double-checked. I've only had one med error, and it was not on account of wrong dose). Any ideas on how to approach the bachelor's? Thank you so much!

It was a SKIN assessment, not an initial assessment (which I had finished). I charted what I SAW, which was the hematoma and various other scars. He was not called to assess, he was called to witness, and he bullied me out of the room. Literally, pushed me to the threshold of the door. I should not have left, you are right. I was taken by surprise, thinking maybe he knows something I don't, thinking maybe the pt IS embarrassed...

Yep, you're right about that too! Later, the LPN told me there was a 'knot' under the hematoma, so you know he felt around pretty good. That was another thing I resented. I love our LPN's, they are wonderful. But as an RN my job is to delegate. I didn't appreciate being told by an LPN, to leave MY patient. I have never 'pulled rank', I don't like that kind of stuff. In this situation though, I do not feel he had any authority whatsoever to instruct me to leave, whether LPN or RN.

good thinking/...

Good points... As to the nature of his old felony, all I know is this: One night he was scheduled to float to children's unit and he flipped out, saying he was 'cleared' to work with kids, they had to put him somewhere else. His story is that a looooooong time ago when he was 20 (he's in 40's now) he was drunk and struck an officer. Somehow that episode is related to why he cannot work with kids. However, he has children of his own and has been married a few times. So I really don't understand....wouldn't a felony from long ago been cleared by now? And what does striking an officer have to do with kids? Maybe kids were present and he was contribting to delinquency or something. Anyhow, I reported it today. I hope I did the right thing. Thanks for all of your input!

Thanks, everyone for your input, also for pointing out the reasons for not talking to co-workers. I never thought about the rumour mill thing. I will talk to my supervisor today when I go for a team meeting. Your opinions have confirmed my instincts. You are great! By the way, for the poster who said she had never heard of a protocol where we get a same-sex witness for skin assessments, the reason at our facility is because it is a psych unit, and our patients have been known to make allegations of sexual misconduct by staff. Who knows, they might have been right....

Thanks...you are both expressing exactly my thoughts. Something fishy. Is there a way I could discreetly ask other nurses if they have noticed this type of behaviour? I have heard several nurses say that he is a cocky know it all, but never mention of the types of stuff I've noticed.

Would like input please... I work sometimes with a male nurse, who I usually enjoy working with. Tonight I had a new admit, who was also a male, so I called the other nurse to come do the skin assessment with me, which is protocol. My male patient reported a large hematoma inside his thigh. The other nurse told me to leave the room. I told him no, that is my patient and I want to be present for the skin assessment if the patient was agreeable, which he was. So the patient showed us the bruise, which was so high up it was practically perineal. It was a very bad hemtoma, almost black in colour. So, to my shock, the male nurse reaches waaaaaay up to the patients crotch and starts feeling around...without any gloves. It was very uncomfortable and my jaw just about dropped. He paused for a few seconds and then asked me to step out of the room. Again I said the same thing, but this time I stepped out. When the nurse came to the station, he described the bruise as having a knot under it. I explained again that I didn't appreciate being told to leave when my pt said it was fine that I stay. He told me the patient was getting 'embarrassed' that I was there, and he knows this because he is a guy. Anyhow, his 'assessment' seemed very inappropriate to me. Later the patient denied being embarrassed and stated that he would rather i have stayed. When I asked him if he was at all uncomfortable with the other nurse, he deflected the question, 3 times. The is the second time something like this has happened. The first time I asmin'd an IM injection into the gluteous muscle of a young man, and the male nurse stepped in and started rubbing the guy's butt, I mean massaging it, again bare handed...under the theory of rubbing the injection site for whatever clinical reason. I kept thinking OK he's gonna stop doing that any minute now, but it seemed to last forever, him massaging the guy's butt. I was so uncomfortable that I reported it, but apparently the pt was not uncomfortable and so nothing was done. This nurse has a mysterious history. Apparently he had some kind of felony years and years ago, something about striking a police officer, and the story goes that having had a felony, he cannot be around kids, legally. All we really know is that he cannot work on the children's unit or be around kids for some reason connected to the policeman incident. Sounds a little off to me, but OK. Well, what do you think? Am I over reacting?

We call it appropriate self-disclosure for the patients' benefit.

Oh hee hee. You are so funny. The moon! Good stuff there. OF COURSE there was a phone there. Nevermind that I was in la-la land on account of the narcotics. That would have made for a great review, I'm sure.

You poor thing! I am so sorry this happened to you. And even more that it was not documented appropriately. It's never happened to me, although I did have a grand mal seizure under anesthesia once, and ever since then I have seizures now and then. I would call the anesthesiologist, or better yet, make an appointment to see him/her, and find out what happened. Good Luck!

We did CPI too, and I agree with the other posters---useless. For example, they teach that if someone bites you, you are supposed to 'feed' the bite. In other words, instead of pulling your arm or whatever back, push it more into the assailant's mouth. I don't know anyone whose instinct it is to give the patient more to bite on! Further more, striking a patient, even in defense, is automatic dismissal. I just took up karate after having my tooth knocked loose by a patient. Assaults are very common on our unit and I feel that I must know something better than CPI. Good Luck!

Hi everyone....Just wondering: I was on leave from work to have gall bladder surgery, and I was looking forward to my annual review when I returned. I felt it would be a good one and I also wanted to express some feelings about my performance, seeing how the review is basis for a raise. But when I came back, my supervisor told me they had done the review without me! Is this common? He said that they 'couldn't wait' for me. He was in a hurry and told me to contact the secretary to find out about it. I felt short changed. Is it OK to request another meeting? Thanks!

Ours last year was a Walmart card for $50. Probably the same this year.

I am a former anorexic with stable recovery for the past 11 years. Lots of the girls I was in the hospital with acted the same way.I think you should try what the staff did with those girls when their behaviour was obnoxious: ignore them! When they say something snotty, no response. Don't give life to their behaviour. They are losing the only thing they can control (food intake) by seeking treatment...so they are probably trying desperately to get control in other areas. During group, however, that kind of disruption is not acceptable. Offer them 'room time'.

What an negative post, in my opinion. Many people are drawn to their specialties on account of personal experiences. And no matter where you work, you develop relationships that often lead to sharing experiences. It's called team building and rapport. New grads, don't be scared off by psych nursing. You never know if you are a good fit until you try it. I thought L & D would be my 'thing'...turned out, I hated it. Yes, psych nursing is a different animal, but you sure don't have to fit into all of those categories above to be good at it. No matter what you do, you have to learn skills. Nobody is perfect when they begin their specialty. And working in a challening environment, you will learn those skills, such as de-escalating, keeping a cool head, etc.

I just found out we do not get holiday pay! Do you?

Personally totally agree. Glad you brought it up.

I understand that. But if you eyeballed me, you would see that I look absolutely undeniably average. Not overweight, not underweight. Blood pressure isn't something you can eyeball. Our pts can be sitting in front of us non symptomatic, with a BP that's way out of range. I completely see why BP and other vitals are important too measure. But let's look at the WHOLE clinical picture...an average looking person with normal vitals...I don't see the reason to get caught up in the numbers on the scale. Clinically, as long as there is no gross anomolie, it just shouldn't be that important, and certainly not important enough to refuse treatment/routine visits to a pt who refuses. In fact, demanding to know my exact weight (on a scale that probably has not been calibrated in God knows how long)is practically as obssessive minded as the eating disordered pt might have been at one time!

Let me say...Getting on a scalle is NOT the 'first step' in recovery. Indeed, many treatment centers recommend ditching the scale altogether. Secondly, I have been in recovery for almost ten year with no relapse. Very rare for eating disorders, but it's true. Getting weighed is my last 'chain' . I can eat normally and I do. My clothing size is apprpriate for my build. I don't need to be advised to get therapy~~I've had tons of it and my recovery is strong and stable. I just don't want to get weighed. That's all. Thanks for the support!

Come on, there are ways of knowing besides the numbers on the scale whether or not my weight is appropriate. Clothing size being one. I'm 5'5" and wear either a 6 or an 8 in jeans, depending on the brand. That gives a decent estimation is where my weight is, without focusing on the numbers of the scale.

Hi everyone... Was at the doctor for a routine gyn recently and of course the tech was doing all the pre-lims like BP and stuff. She wanted me to get on the scale, which I always defer when I've been to the doctor before. (I see a doctor 'group', so whoever I get on that day is who's there. No particular 'primary'). I politely deferred the weight and the tech told me the doctor would not see me unless I got on the scale. What's that about?! The reason I don't get on the scale is that I am in recovery from an eating disorder, and the scale is one of my triggers. It's so upsetting to me that just the act of stepping on it can screw up my whole day. I've tried standing bakwards on it, not looking at the numbers, etc, but the simple ACT is terribly upsetting. I know this is my issue, not theirs, but I am well within my appropriate weight range and I don't know why I MUST be weighed. Everytime I go there, I have to re-explain all over again why I don't get on the scale. Some are understanding, some are not. It's not like I was at the doc for a weight related issue...Can I refuse and still get treated?