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coffeemamaRN RN

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  1. coffeemamaRN

    What would you think if you saw this patient?

    Thank you to everyone for your responses, I really appreciate the different perspectives. To me, it seems like all around, the doctor should have referred the patient to ER immediately. In this case, it was my youngest brother who went through this. The symptoms developed over a couple of weeks. His breathing was not compromised, just his ability to swallow and talk. I did not include the type of cancer he had, but it was a malignant brain tumor at the age of six. He was in remission for all this time until these symptoms occurred. The doctor was aware of his history, yet still prescribed Robinul and referred to GI. After almost two weeks, he went to the GI appointment, who was the one who told them to immediately go to ER. As to why my parents would take him to the outpatient clinic instead of ER...I don't know. I can only think that maybe it was a certain level of denial in hoping that it was a temporary ailment that would resolve, rather than a return of his cancer. Unfortunately, it was a brain tumor even larger than the one before, and it is terminal. He is on hospice care now. I guess I'm still trying to come to terms with the whole thing, especially trying to figure out why the doctor would advise my parents the way he did. He is also the same doctor who told them that he no longer needed follow-up CT scans, despite the high risk that his childhood cancer might return. So by the time he had his symptoms, the tumor was too large (plus there were other smaller tumors present). I know that if it were different, it doesn't necessarily mean that my brother would have survived. But I still do not understand the doctor's reasoning behind all this. Anyway, thanks again for all the responses.
  2. Just curious to know what other nurses think. To me it sounds obvious, but maybe I'm missing something... Let's say you have a patient in an outpatient clinic with the following symptoms: he cannot swallow, cannot talk, and is drooling because he cannot swallow properly. He never had problems with swallowing or talking before this. He is in his 20s, and has a history of cancer when he was a child. No facial drooping or other symptoms present. As a nurse, would you recommend: A)the patient should go to ER immediately for further evaluation, and it is most likely neurological rather than a GI issue Or B)the patient should be prescribed robinul and referred to a GI specialist. To me, A seems obvious. But in this case, the doctor went with B, and I still don't really understand why. Any insights?
  3. coffeemamaRN

    Need help from mom nurses please

    I have been a nurse for two years now, as a second career. I first got a Bachelors in psychology and then decided to go back to school for nursing (my ADN, planning to go back for my bachelor's soon). I am married with a 13 yr old, an 11 yr old, and a baby who is 8 months old. I am lucky that I am able to work full time while my husband stays at home with the kids, but I have many coworkers who have children and usually have daycare or a trusted friend or relative to take care of their kids, or they alternate their schedule with their spouse so that one parent is always with the kids. I am a worrier like you, so here'so my advice to you: first decide if nursing is really what you want to do. For me, I am like you, I really wanted a job where I made a difference. Nursing definitely fits that description. It is stressful and you have to deal with a lot of crazy situations (being short staffed, rude doctors or family members, confused and combative patients, etc), but you also have times where you realize you are making a difference and it is worth it (patients and family members who thank you for your help, coworkers who are supportive and work well together, doctors who respect nurses as colleagues, etc). Once you know that nursing is something that you really want to do, you can figure out all the details after that. If possible, finish nursing school and work full time first, before having a baby; it will be easier to go down to part time or per diem after working full time for awhile and getting experience. But even if you have a baby first, you can finish school and work full time (I did); it is very possible, just harder. :) I know a few women who had a baby while in nursing school, and they were able to finish school. Try to develop a support system of friends and family members if you can, always helpful during challenging moments in life. As for getting nervous under pressure, I am the same way. I did fine with lectures and tests, but during clinicals I always got so nervous passing meds while the instructor watched me. But you just take a deep breath and make sure you are prepared; as long as you are prepared, you should have confidence in yourself and your abilities. And the more experience you get after you start working, the less nervous you become. Hope that helps! I think nursing would be a good idea for you, it is a good job where you can make a difference, it pays a decent salary, and it something you can fall back on even if you decide to stay home as a mom later in life. Good luck!
  4. coffeemamaRN

    Day 7: 2016 Nurses Week Caption Contest

    Oops, sorry! Next time I will knock before coming into your room!
  5. coffeemamaRN

    Day 6: 2016 Nurses Week Meme Contest

    Only three more hours until my shift is over and I finally have a day off...after three days straight of 12-hour-shifts, can't wait to start drinking! :)
  6. coffeemamaRN

    Day 4: 2016 Nurses Week Top 5 Things Contest

    1. Some patients want their pain medications on the dot when they are able to have them, even when it doesn't seem like they are in pain; while other patients don't want pain medications at all, even when it seems like they are in pain. 2. No matter how long you've been a nurse, you don't know everything and there is always something new to learn. 3. Although there are doctors who are complete jerks, there are other doctors who are very, very nice. The same thing goes for patients and family members; some are awful and always complain all the time, but then it makes you grateful for the ones who are nice and friendly and seem thankful for all the work you do. 4. Many patients have amazing stories about their lives, and my favorite part of being a nurse is hearing those stories and getting to know my patients. 5. The best thing I've learned since becoming a nurse is that being a nurse is the hardest job I've ever had, but also the most rewarding.
  7. coffeemamaRN

    Day 3: 2016 Nurses Week Meme Contest

    Yes, I finally started an IV on my own without any help! Maybe I can make it as a nurse after all!
  8. coffeemamaRN

    Day 2: 2016 Nurses Week Fill In The Blank Contest

    That their colostomy bag is leaking everywhere...again...
  9. coffeemamaRN

    Day 1: 2016 Nurses Week Caption Contest

    I know this is how Mommy uses it. But I wonder what would happen if I put it in my mouth....
  10. coffeemamaRN

    Being a Nurse After Being a Patient

    I became a nurse two years ago as a "second career" (although I never really made a career from my first degree, a Bachelors in psychology). Since becoming a nurse, I had never had any major surgery, nor had I ever had to stay in the hospital. Until the birth of my third child. Unlike my first two children, I ended up having an emergency cesarean section and felt the utter helplessness that can come from having a procedure that you didn't expect or ever want to have. I cried as they rushed me to the OR, because my baby's heart rate dropped to 40 and I was convinced that he was dead. (Thankfully, not only was he still alive but totally healthy, not even needing to go to NICU). I was in shock and didn't even feel it as they inserted an epidural (because up until that point, I had been going through contractions without any pain medication and had been doing fine) and a foley catheter. I didn't really hear much when they asked me to sign the consent (because how am I going to say no when I was convinced my baby was dead?). I do remember somebody telling me to try and stop crying because I needed to breathe for the baby. And I remember looking for my husband, who came once they had prepped me for surgery. I had never felt so helpless in my entire life as I did when I was lying on the operating table. Thankfully my baby's heart rate had gone back to normal once I had gotten to the OR, and he was okay after he was finally out into the world. It was an interesting perspective, to be a patient in the hospital after being a nurse. Here are the things I experienced/learned/relearned during my short stay at the hospital: I hate the pain scale: I have never experienced pain as I did when I had my c-section. All women experience labor pains differently, and for me, labor pains were a cakewalk compared to the pain I had after surgery. It was truly 10 out of 10 pain. What I never realized, however, was how annoying that question is. How can you tell which pain is 7 compared to 9? For me, it was either "extremely painful" or "slightly more tolerable." But to distinguish between the numbers was really annoying. I began to think that maybe it was annoying for my patients as well. Pain is serious business: As I said, I was in serious pain after my c-section. I had never felt pain like it before. I couldn't even lift my baby in or out of his bassinet after he was born. Things that were so simple, like readjusting my position in bed, were suddenly excruciatingly painful. Despite my very real pain, however, I realized that I actually felt guilty for having to call my nurse for help, and for asking for pain medicine every few hours. I felt like I had to justify my request for pain medicine, or apologize for bothering her because she might be busy. I realized how important it is for us as nurses to never make our patients feel guilty for asking for help, no matter how busy we are. We also must try not to make assumptions about how much pain a patient is in, because everyone expresses pain in a different way. While some are very vocal about their pain, others (like me) might be quieter about it. We "grit our teeth and bear it" because we don't want to seem like a burden, or we are afraid of taking too much pain medication. Pain assessment, and trying our best to manage our patients' pain, is a very important part of our job as nurses. Hospitals are the worst! I love working at a hospital, but I hate being there as a patient. It is impossible to get decent sleep, the food is different from what you are used to, and there is a loss of control and a feeling of helplessness when you are a patient in the strange environment called the hospital. I was admitted Thursday night, had the c-section Friday evening, and by Sunday morning, when the nurse asked me if I wanted to leave that day or stay until Monday, I jumped at the chance to leave as soon as possible. All I wanted to do is be at home, and I know that most of my patients feel the same way. I was grateful, however, to have nurses who were nothing but nice and considerate the entire time I was there at the hospital. We all have our days of being stressed and tired as nurses. We get caught up in checking lab values and passing our medications on time and doctors who are mean or patients who snap at us or take up a lot of our time or family members who are rude, and we sometimes forget what it must be like for our patients to be in the hospital. Being a patient, even for such a short time, reminded me of how I need to always try to see things from my patient's perspective and to always try to put myself in their shoes, no matter what happens during my crazy day at work. And it reminded me to always be grateful to have a job where I can make a difference, even a small one, in people's lives.
  11. First I just want to say that I love being a nurse. I have been a nurse for almost two years now, and it is the hardest job I've ever had, but the most challenging and therefore the most rewarding. I became a nurse as a second career, after first starting off with a BA in psychology and then working random jobs that had nothing to do with my degree (from being a daycare teacher to working in a medical billing office doing data entry). I love the feeling of making even a small difference in someone's life, and I love the challenges and variety of experiences I have from day to day. However, there's no denying the fact that nursing is stressful. I work full-time in a long-term acute care hospital, and bedside nursing, especially med-surg, is crazy busy almost all of the time. I worry about the long-term effects of stress on myself, and I'd love to hear more experienced nurses' advice on how you deal with it. I'm already starting to get high blood pressure, and I'm only 34! Plus, I'm married with three kids, including a baby who is four months old, so my days off aren't as restful as I'd like them to be. I see nurses who have some bad habits, even though they know better (smoking, eating junk food, binge-drinking alcohol on days off). For me, I tend to eat more junk food than I should, and I sleep a lot on my days off. How do you deal with the stress of being a nurse, and how do you balance work with family life?

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