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defying.gravity

defying.gravity

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  1. defying.gravity

    Why is it inappropriate to stand up for yourself?

    I wouldn't want to place a judgment on you or the MD based on one encounter. I've seen the nicest professionals lose their cool at times and I've seen some of the crankiest professionals do and say things that are just short of saintly. It'd be great if everyone could maintain a perfect demeanor all the time, but in all my years, I've just not ever seen that happen. There's just so much pressure working in the medical system, especially the modern medical system where the MDs are really feeling a crunch they never felt before with the insurance changes and pressure from administration. This is my experience, anyway. I'd love to say that no one will ever act out of line, but that's probably not really realistic. You'll act out of line once or twice yourself, as well, is my guess. It usually happens when your workload demand outweighs your ability to humanly perform it all and one innocent person will say or do the wrong thing and .... ugh. We all try for it to not happen, but I haven't met a person yet that it hasn't happened to. I hope I don't sound like I'm enabling bad social behavior, I'm not. Bad social or unprofessional behavior is never good or "ok". There are reasons for it, but no "good excuses" for it, if you know what I mean. I do think, depending on the severity, it should be addressed and corrected. If it's habitual, it probably should be reported, depending on the circumstances. I can't help but be curious why the MD was so concerned about being undermined with that particular patient. It's hard to tell from your post if there was an underlying reason for the MD's concern. Clearly he didn't handle it well, he escalated a situation that he should have known wasn't a good idea. Not only did he not communicate to you what he might have wanted to communicate to you, he undermined himself by losing his cool so publicly. I wish I could say that I've never had an MD or another nurse or other professionals yell at me or embarrass me in front of a group, but that wouldn't be true. The truth is, I have, and more than a couple times. Most of the time it's in the heat of a moment and there's a miscommunication at the core of the issue. Sometimes it has been in a high pressure situation and it was the last thing I was worried about because our focus was on the patient. Sometimes it was someone who was misdirecting anger or frustration that I was the unlucky person to walk past. There has been a time when it was out of line, very unprofessional, and consistent and reporting it and correcting through those means was the only viable option. I'm very glad that modern workplace culture is starting to respect and value the communication between professionals. It wasn't always like this, so this is a step in the right direction, if you ask me. At the same time, I think it's wise to keep a certain level of understanding that when humans work in high pressure situations, sometimes they do make mistakes and are less than stellar with one another, and sometimes they are just plain in the wrong. That doesn't make it right, but it also doesn't have to define a person, either. In really high tension situations where I'm pretty sure nothing I say is going to be heard or valued at that moment and the other person is clearly triggered emotionally, I try to take deep breaths and calm myself and try to hear at least something worthwhile the person is saying. This is a skill I found very helpful with patients as well. This is probably my "type A" personality shining through, in that, if I have to be there listening to someone lose their cool at least I'm learning something from it so I don't feel like I'm wasting my time. If that doesn't work for me, I do something that I remember from the Brady Bunch. I imagine the person in their underwear as they are doing their thing, yelling at me or disrespecting me. If you ever do that method, be careful not to smirk or smile towards the person you are imagining in their underwear, they probably won't see the humor in it. At least not in that moment. Good luck working through this one, it's never fun to be yelled at or embarrassed, I hope you find some insights from those of us who have also been through it, or maybe who have even done it.
  2. defying.gravity

    Melanoma

    I would ask. I hope they will accommodate you. My best wishes to you for your healing and health.
  3. defying.gravity

    Must... Find... Food...

    great writing ... "It's utter pandelirium!" ...I had to look up the word "pandelirium" .. and laughed when I read the results. One of my favorite types of laughs, I might add. If your writing ever becomes a sit com, I can see the type of actress like Julia Louis-Dreyfus, Tina Fey, or Amy Poehler playing the role of Agency Girl. Highly intelligent, quirky, hard working, charming, caring, self reflecting, and hilarious. Love that humor. ... waits for the next episode ...
  4. defying.gravity

    clinicals

    lol! Definitely don't be impressed, I'm looking back through rose-colored glasses. If I really think about it, there were many times they were outside the door banging and looking under the door completely unconvinced that I deserved alone time. lol ...
  5. defying.gravity

    Is This Behavior Inappropriate?

    My honest opinion is be careful about letting your co-worker get into your head space. For your own best interest, try to remove the emotional connection you have to her and try to re-focus on the here and now, as objective as possible under the circumstances that are "here and now". That's my opinion in dealing with anyone that behaves in ways that are spiteful, unhealthy, or distracting to my life goals. Removing the emotional connection you feel towards her can help you look at the situation with more objectivity and react to her less than honorable behaviors in a way that is pro-active rather than reactive. It's very disappointing that she has acted the way she has, don't give her more power than she deserves. For you own benefit, keep a personal and objective log of the behaviors you notice. If the behaviors you log interfere with patient care or are clearly hostile, they are reportable. If they do not interfere with patient care or are clearly hostile, it is grey area and that can be very emotionally draining trying to make a case about grey area. Empower yourself, don't let her into your head. Don't let one woman define your emotional state and define your goals for you. Make it up with your husband if you can to relax the pressure at home. That's my personal advice. Sorry you have this situation. It sounds very stressful and unfair.
  6. defying.gravity

    clinicals

    It's been a long time since I was in nursing school so I can't really answer. There's a chance the agreement between your school and the clinical site is strict, which might explain some of the circumstances you describe. If you said you were not able to have lunch at all, it would be a red flag. Having an hour lunch but being limited to where you eat it is probably within reasonable bounds, however frustrating that is. If I were in your situation, I'd probably feel a bit uncomfortable adjusting to what I perceived as a loss of freedom and lack of autonomy. I very much like my time to clear my head as well. If I were in your situation, I'd probably be taking a couple bathroom breaks during lunch and using the stall to get in a 5-10 minute meditation. lol ... pretty gross, I guess, meditating in a bathroom stall, but I've raised children and there were times raising them that I resorted to meditating in the bathroom because it was the only place I could hide and they accepted that it was my private time ..... (I miss those days, by the way ... miss them a lot ...) so gross or not ... sometimes we do what we have to do! Are you able to bring a small book and read during lunch? I'd probably do that. When I'm really frustrated or bored, I pull out my mantras and run them over and over to find my center and feel my sense of well being. Good luck!
  7. defying.gravity

    Hippie Chick CNAs, etc

    * Joni Mitchell's "Both Sides Now" song playing in the background* .... Hippies? hm ... a few .... definitely lots of squares though ... "Every hippy is somebody's square."
  8. defying.gravity

    I Hate People (my rant)

    Good luck with your therapy, AlyaMF. I respect your interest in self reflecting and correcting some of the aspects of your thinking that might be getting in your way of the success you want in life. Your wording is a bit intense, which I imagine is how it feels for you, based on the things you say. Hate is a lot of energy to focus towards anything, which creates the problem of not having that energy to focus on what you actually want in life. Having that much energy can be a wonderful benefit for you, focused in the way that makes your life work for you. My view, anyway. I'm not sure how familiar you are with how cognitive processes work and how the quality of our thinking can influence the types of emotions and feelings we experience. Your mental health professional will hopefully introduce you to cognitive behavior therapy or a variation of it. You might find it very helpful to learn a little about what "cognitive distortions" are and how to manage them in a way that can help you achieve your professional and life goals. Here is a pretty basic explanation of what cognitive distortions are: 15 Common Cognitive Distortions | Psych Central By the way, I totally hate the internet and being online ... lol ... yet, here I am ...
  9. defying.gravity

    Calling diabetes experts

    lol .. indeed, Ilg ... barring the throwing juice at a nurse, I'm right there with you. I'm pretty sensitive to pt baseline as well due to my personal experience. I added some examples in with my previous insights (which were as you say, check baseline) that were questioned, which is why I redirected the questions to someone with expertise. The author I referenced has rather extensive information in terms of diabetic care for nursing, that particular article is just a small part of her expertise. A good direction to point in, at least I think. It does highlight a need for more studies for the diet controlled type 2 patients, if you ask me. Hopefully one day we can start to populate that particular section of the research. I'm laughing at throwing the juice. I almost did that precise thing during one of my pregnancies with the GTT. I tested marginal with the GCT and went on to the GTT. A couple sips in and I realized how stupid I was being, I knew I was going to spike, I didn't need a test to tell me. Insurance did, according to the nurse. lol ... I threw it away and called my physician and said, "look, we know this isn't going to work, how do I get past this without being non-compliant". We just used my personal BG charting to submit to insurance. I wish I was nicer to that nurse, I know she was only doing her job. That wasn't one of my nicer days, and I blame myself. I knew better to mess with my BG like that just to prove what we already knew. Strange rules sometimes.
  10. defying.gravity

    Calling diabetes experts

    Dogen, I would like to adjust the word "will" in my post to "can". Hypoglycemia can be a symptom, not will be a symptom. I should have been more careful in my post, there is a big difference between "will" and "can" and "can" is more appropriate. Not every patient will experience it, but some can. I, personally, am one of the dm2-diet controlled-patients who do get the rebound hypoglycemia on corticosteriods. I don't like using my personal point of view, though, because it blurs the boundaries of my objectivity when discussing professional topics, but that is something I've experienced personally more than once. Needless to say, I try to stay away from them as much as I can ....
  11. defying.gravity

    Calling diabetes experts

    Good question (s), Dogen and Libby. Here is something that might help you with your questions: https://www.netcegroups.com/1024/Course_34651.pdf Diane Thompson is definitely a solid resource for any questions and concerns regarding diabetic care.
  12. defying.gravity

    Calling diabetes experts

    Rebound hypoglycemia is a risk for diet controlled type 2 diabetics when on a course of corticosteroids or infection. The BS will trend up after eating, most likely, but the rebound hypoglycemia, which can drop pretty low and often unexpectently for the patient, will also be a symptom. That's what I would be looking for with the low numbers, if it were lower than the patient's baseline, I'd expect the numbers to go higher as well. I'd be on the look out for destabilization in general. Not unusual for inpatient, in my experience. Since I don't know what the patient was being treated for, it's really just theoretical information. Whatever the illness that brought the patient into inpatient would shine a lot of light on the rest of the question (s). It's hard to answer without the rest of the information from my point of view. It seems like maybe it was on another thread, but I didn't read that thread so I'm just throwing out common reasons a diet controlled type 2 might get destabilized.
  13. defying.gravity

    Why so many tattletale nurses?

    If you google "Kathleen Bartholomew", you might find a lot of the answers you are looking for. Kathleen Bartholomew dedicates her career to researching, answering and helping with the questions you ask.
  14. defying.gravity

    Doctors Don't Always Listen: Bridging the Communication Gap

    Great article, the one you wrote as well as the one you used as a reference. I'm loving "Justina" right now. The "Justinas" of the world are the people I admire greatly and have always used as my own personal role models. A quote in the article that you referenced is something I believe has a very significant impact in some of the communication challenges between nurses and physicians. "Another consideration is the difference in how nurses and physicians approach patient care. Nurses are educated to see the broader health care picture; they tend to focus on holistic issues and the more human aspects of care. Physicians have been educated to focus on "the case"; they're concerned more with strategies for medical cure or management and may not focus on emotional issues, discharge planning, social and cultural concerns, and helping patients live with their disease and treatment." Nurses and physicians are taught to conceptualize and communicate differently about the same issue. Essentially, speaking different languages, even though some of the words are the same. SBAR is a great bridge. With the rise of NPs and PAs the gap has closed considerably over the years, in my view. That might be my own experience talking, though, it's hard for me to be objective when it comes to something that has become part of who I am for so long. I've always said that something like "communication boot camp" would be extremely helpful in nursing school or even as a CEU idea. Any bright and creative entrepeneurs should pick up that idea and run with it. Communicating effectively under pressure and sometimes under adverse conditions can be a game changing skill. That's what I think, anyway.
  15. defying.gravity

    Your worst nightmare

    That's a shame that happened. I'm having a hard time understanding why there was a missing ECG, that seems pretty sinister on the part of the facility, which surprises me for a London facility. London hasn't traditionally been as litigation laden as the US, at least not in my experience. I lived in London in 2005 (ugh, the bombing, can remember it like it was yesterday, it's surreal that it was a decade ago). That experience sounds very disturbing but it does highlight the important of keeping a high level of awareness, understanding the importance of documentation and taking gut feelings seriously. The art and science of our profession. I had such great experiences with the medical facilities in London, I'm sad to hear this darker side that I was not fully aware existed.
  16. defying.gravity

    Are We "Glorifying" Nurses?

    Am I the only one who laughed reading that? Lot of extreme examples she used ... black/white thinking .... where are the shades of grey that most of us live and work in? Not the 50 shades, that's a whole other topic altogether.
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