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Skittles767

Skittles767 RN

Critical Care
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  1. Skittles767

    Death Walks the Halls

    Death walks the halls tonight. It is not our first encounter. I recognize his presence. I picture him pacing up and down, for he is patient, and can wait as long as he needs for us. We can try to stop him, but we never will. At best, we can trick him, maybe he can leave, maybe he just waits. But one day he will return to continue his hunt. On any other patient, who lacks a signed DNR, she would be in the ICU no questions asked. Her blood pressure is dropping; 79-45-77. Her breaths are shallow and irregular, but her non-rebreather mask keeps her saturation in the mid 90’s. I give her morphine to ease her gasping, but she continues to do the same. Eventually, she can close her eyes to sleep and I wonder if she will ever speak again? What were the last things she said, and to whom? At least she can nod. She hasn’t shaken her head yet though; what if that’s all she can do right now? She looks like every other patient I have seen that has died on this unit. Her limbs are cold. Her whole body has severe swelling. The edema on her extremities forms to any pressure. On could sign their name on her legs with their finger and the impression would last for hours. Her stomach is distended far beyond what it should handle. It is hard with a spring, like a red dodgeball. Her labs show how hopeless this case is. Her organs are failing, she is deadly acidotic. I pray she is not suffering too much. One never knows the true pain of passing until it is too late. She is younger than my own mother. Her family came up by her side and paced the room as I lay my stethoscope to listen to her raspy breaths. Her daughters are stricken with grief. This day was to come, but they never thought so soon. You think you can prepare for when this moment occurs. But, when that day finally presents its darkened face you realize: you are weak, and you are forced to witness the harsh reality of mortality; a trait we are all burdened with. Throughout the night her pressure continues to drop. 66-58-56. The heart monitor shows her pacemaker working flawlessly to keep what at her age should be a very healthy organ, alive. It beats without fail in perfect sinus. 90-90-90. Does the pacemaker make the dying process longer? I can’t help but wonder. 90-90-90. Funny how resilient the heart is; how it will pump hard until your last moment. They don’t get the credit they deserve. Her family has gone home now. It’s just I, and what little presence she continues to have. I rest my palm on her chilly hand. The human touch is such a sacred thing in this world, but I can’t stay like this for long and a force draws my hand away. If I get attached, this job will become impossible. I have other patients to tend to. People who are having the most miserable days of their lives. And I must provide the same amount of compassion to them all. Can a single person run out of compassion? I suppose so. We always hear about compassion fatigue plaguing the healthcare worker. Perhaps true genuine compassion in a certain amount of time will inevitably run dry. But, I can put on a smile in every room. Even if it's fake, I don’t think they know. If only they knew what was happening right now just a few yards down the hall. When I return to that grim room down the hall I gently lift the sheets to take her vitals; she opens her eyes and stares into mine. She raises her arm as the cuff begins to squeeze; the most reaction I have gotten from her this whole night. I ask if she hurts but she only stares. I pray she nods to let me give her some morphine but her heavy lids close again as she returns to her slumber. There is an eerie stench in the room. It smells rotten and familiar. Every patient that has died on this floor with hospice care has it. It is death; waiting in the doorway behind me. But I am all too familiar with his presence lurking these halls. I know his tactics, his ins, and outs, its what I have spent years mastering. I watch my patient struggle to breath; he patiently waits for his chance. There is only one thing on my mind: Not today, not my shift. Photo credit: Robert Reid (1918)
  2. Skittles767

    Living Will Tattoo

    I read about this story and actually learned that after some effort they were eventually able to find the man's signed DNR. I agree though a bracelet would save alot of time money and pain for everyone.
  3. Skittles767

    Kicked off unit when Joint Commission arrives

    Haha! I was thinking about that, on the other hand it would give good experience to see how to function with TJC, but I still don't want to put the hospital and especially other nurses at risk of any repercussions. What kind of questions do they ask if I were to get cornered?
  4. Skittles767

    Kicked off unit when Joint Commission arrives

    Haha! I was thinking about that, on the other hand it would give good experience to see how to function with TJC, but I still don't want to put the hospital and especially other nurses at risk of any repercussions. What kind of questions do they ask if I were to get cornered?
  5. Skittles767

    Kicked off unit when Joint Commission arrives

    I know they got the 40 dollars for the modules because other clinical groups don't have to do them and it was done through their website. I know it may seem like a little... But my minimum wage job and living alone in the cheapest apartment I can find means I can't spare any expenses. Especially since my dog got hit by a car and needed surgery the week I needed to do this stuff (I know that's a personal problem but the chairperson of the program had the nerve to call that a sob story). Anyways thanks for your response! I think my best option is to ask if we can arrange to float to a different unit that day, they did say that may happen. Fingers crossed!
  6. Skittles767

    Kicked off unit when Joint Commission arrives

    I would love to but given out back to back clinical schedule, the facility having a different school every day, and the overall stubbornness of our chairperson. I will ask but doubt that will be an option :/
  7. Rant/ vent time. I'm in my last semester of nursing school in a peds rotation at an excellent magnet status hospital. Firstly the facility required we pay 40 dollars to complete a few online modules and an exam. I do not understand why that wouldn't be covered in tuition and fees but I don't want to complain too much. To the point today was our first day on the unit and our instructor chose to use this day as an orientation day for us (showing us around the hospital, learning the unit, etc.). However what should have been a 2-3 hour experience ended up taking all day with us sitting in an empty patient room going over basic locations of things, the instructor on the phone for some MAR difficulties, and going over the parking situation for some students for at least an hour. All things said and done the clinical was very boring and mundane and we did not come in contact with a single patient to even just talk to. Fast forward to this coming Friday and we are told that the Joint Commission will be at the facility and we will not be allowed on the unit. Instead we are to attend a grand round (which we are expected to do anyways) and then for the rest of the day we will look over specific conditions and try to guess which meds would be expected. That counts as two days of no patient contact in the slightest, and only 3 days would remain. I am feeling cheated out of my clinical time and am very aggravated by the fact. Can the staff really kick us off the unit if we are paying quite a bit to be there if the joint commission is there? I understand why they would but wouldn't it be okay to just be there for basic cna duties and our own assessment, no med passing or other procedures.
  8. Skittles767

    Other students don't think I'm good enough

    I'm just like you! In my second to last semester and incredibly quiet around patients.... But as soon as there is just enough stress to cause mild anxiety I am focused, structured, and prioritize everything. Just because you're a little withdrawn does not mean that you won't be good at anything. Acute care isn't psych and we don't have to interact and be the most talkative extrovert on the floor. I think if you focus well with a little anxiety you will do great in any field.... Show patients your confidence with your care not your words (though words won't hurt to be confident with) lol good luck and happy nursing!
  9. Skittles767

    Practicing what we preach: Patient teaching and cigars

    Thanks all for your replies... I gained some insight much appreciated!
  10. Skittles767

    Practicing what we preach: Patient teaching and cigars

    I appreciate your responses! I wrote this yesterday during some acute anxiety and realize that it was just a mumble jumble of words haha! Perhaps I just needed to get it off of my chest. I think what I am asking is: is there a point that is too much? I have tried to find research but most findings I have discovered are the "All tobacco products are the devil" or some form of reasoning that isn't without the actual numbers or studies.
  11. I posted this in the general forum but am thinking it belongs here also... Let me start by saying that I have a long history of depression and anxiety.... I take part in one on one therapy and medications which has greatly helped but I have one unorthodox technique that gives me concern: I love cigars.... I have discovered that a cigar at the end of the week or during a high stress time like exam weekends they help me relax and reflect and enjoy the outdoors and slow down for a second.... I am aware of the negative effects of smoking and tobacco products which brings me some guilt when I tell a patient they need to avoid tobacco.... I think I am just venting but is it really so wrong that I like them.... Not in an addictive way but as a relaxing social mechanism.... I sometimes like to sit outside and study while I have a good smoke.... I have found this to be a fun hobby much how I have done with beer (but much cheaper) and realize that there is a big community out there that take part in discovering different tastes and types and I enjoy doing this... Does anyone else have experience like this that may help? Just trying to understand my confusion.... Thanks and happy nursing!
  12. Let me start by saying that I have a long history of depression and anxiety.... I take part in one on one therapy and medications which has greatly helped but I have one unorthodox technique that gives me concern: I love cigars.... I have discovered that a cigar at the end of the week or during a high stress time like exam weekends they help me relax and reflect and enjoy the outdoors and slow down for a second.... I am aware of the negative effects of smoking and tobacco products which brings me some guilt when I tell a patient they need to avoid tobacco.... I think I am just venting but is it really so wrong that I like them.... Not in an addictive way but as a relaxing social mechanism.... I sometimes like to sit outside and study while I have a good smoke.... I have found this to be a fun hobby much how I have done with beer (but much cheaper) and realize that there is a big community out there that take part in discovering different tastes and types and I enjoy doing this... Does anyone else have experience like this that may help? Just trying to understand my confusion.... Thanks and happy nursing!
  13. Skittles767

    The film: Vaxxed.

    I happen to know many people in my network of people who happen to believe such ideas... The first thing I tell them that if it doesn't have APA style citations from credible sources such as universities or recognized medical journals then it is false until PROVEN other wise.... Next I encourage them to take a microbiology class (medical terminology class wouldn't hurt either now that I think of it) and they will quickly realize the falseness in these articles videos and stories..... I'm very passionate about this topic and could rant all day but I'll just leave it at that Happy nursing!
  14. Skittles767

    What was your first time like?

    Nursing actually took time for me to grow to like it.... I was very unsure what it would be like at first, but I decided to trust my gut. I will however tell you about the moment where I knew what I wanted to do as a nurse! There I was.... Doing my OB/GYN rotation, as a male I felt highly unwanted and underappreciated by the staff with attitude coming in left and right, I wasn't allowed into a patients room without a fellow female student with me. Luckily the low level nicu was on the same floor and I was allowed to spend time in there where the nurses loved me and their jobs so much. There was this tiny little thing who the floor called "Polly Pocket" who was a 28 week 2 lbs something ounce premature baby. She was the cutest thing you ever did see even with all the tubes and lines and lights she had coming out of every direction, she was so small and fragile. One day the nurse asked for my help to change her sheets, we weren't allowed to touch her as she was in the incubator but this time we needed to take her out and I was to hold her as the nurse did the linen change. I put her in my arms and this tiny little girls entire body would fit in my one manly hand, she was almost always asleep but this time she woke up and looked at me with the gorgeous big eyes and smiled this biggest smile you could imagine and I swear she tried to laugh a little as I talked to her. Oh my this is a moment that I could never forget and right then and there this big manly man of the group wanted to be a neonatal nurse practitioner and that's what I'm going to do! Patient experiences like that one are 1 in a million for me and I think that's a sign!
  15. Skittles767

    Nursing is my passion but I feel like I am too dumb.

    Welcome to nursing haha, This basically sums up my entire experience of nursing school, To be honest I was (and to an extent still am) terrible at anatomy, I barley passed those classes but I promise the anatomy part gets so much easier after those classes.... You will be putting nursing practice in with anatomy and it will start to come together like a puzzle I am almost at my last semester and I only just now figured out how to study.... Go figure.. I recommend for you that you practice with the models putting things together.... Come up with little songs to help you remember.... And if you are blessed to get a cadaver really focus on that! If you want to invest perhaps get yourself a mini model for the systems you struggle the most with... For me it's the nervous and muscular... Hope this helps!
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