This week, I have learned... (5/30/15)

[ixchel]

This week I have learned.....

1. Cocaine is still a hell of a drug.

2. No matter how nice you are to everyone, there will be an "us vs. them" vibe between hospital divisions when you're a nurse. It makes me sad because I've gone out of my way to be nice to the workers of the rest of my facility. Can't win them all.

3. Making sure your nurse knows you have breast implants can prevent an embarrassing ICU transfer when a dislodged boob looks like a hematoma.

4. I miss night shift.

5. I'm allergic to Vicks vapo rub.

6. On a related note, I met my match in a colostomy bag and it was horrible.

7. Giving the caregiver the hand written prescriptions for the dementia lady STILL doesn't prevent an angry call from her the next day when she can't figure out which pharmacy has her meds.

8. I effing love the ED, but holy monkeys it makes me sore.

9. There really is no polite way to say, "Welcome to our hospital, new overly cocky (but strangely beautiful) 12-year old surgeon. By the way, if you don't want to get paged for the inpatient management of your surgical patients, then do us ALL a favor and transfer them to the hospitalist."

10. I feel a schadenfreude-like joy when I see the PVT is wrong, especially when people lose money and post about it on a 700-page thread that tells them what NOT to do. (Okay, that's really more of a confession than something I "learned".)

Bonus one - I've only been at this gig for a year and my already dark sense of humor has become sick to the point of disturbing.

What have you learned?

[calivianya, BSN, RN]

Wow, you have had a heck of a month

I'm guessing you work in a SICU or some sort of trauma unit?

Great stories though, although they are no doubt not great for the mentioned patients or their families

MICU, actually, and we don't take any trauma patients because there is a level 1 trauma center next door. It is a major regional referral center, though, so we get some really sick people. The current running joke is that MICU stands for Morgue Intensive Care Unit because that's where so many of our patients end up.

[tsm007]

Hmmm.

1. I learned don't d/c your IV until after you give your IV meds. Duh.

2. I learned hold pressure longer than you think you need to when d/cing an IV.

3. I learned slow down and think for yourself (this goes with number 1). If you are trying to think like someone else instead of for yourself you are going to make tons of mistakes.

4. Brush up on your people skills before taking a new job. Sadly this means the answer to how are you doing today is "Great", "Super" "Fantastic". Not "Overwhelmed" or "Frustrated". Less is more until you learn the lay of the land.

5. Reading How to Win Friends and Influence People was more helpful to me than prepping with nursing material for the job. Sadly, didn't figure this out until 5 weeks into the new job. Taking that with me into the next job. Although I was already fairly positive I didn't figure out that "Overwhelmed" was not positive and there were more steps I could have made to make a more positive image of myself.

5. *I* really do need a year or more's worth of med/surg experience to be successful in other areas and I am willing to enter this profession humbly to get it.

6. I also learned this of myself and this is a big one for me too. I have always said I didn't want to be an ER nurse or an ICU nurse and truth be told the only reason I haven't wanted to do these is because I'm scared. My clinical skills are weak as a new RN. This week has been an enlightening experience for me. If I get more clinical skills under my belt I have the book knowledge. I am very book smart. I read a lot. If I get the clinical skills under me then I can do any job I want and I will not have to be held up by fear. Also, the fact that I have this fear is still smarter than the new RNs that don't.

Sorry so long-winded, but I learned a ton this week! More on a personal level than professional, but still taking baby steps into my nursing career.

[wanderlustnurse88, RN]

I learned not to do a blood draw (lytes) from the same arm that IV potassium is running through. I couldn't figure out how the potassium had jumped in just 8 hours.

[ixchel]

I learned not to do a blood draw (lytes) from the same arm that IV potassium is running through. I couldn't figure out how the potassium had jumped in just 8 hours.

I had a patient on an insulin drip go from a glucose in the 300s up to 900s in only an hour or two. We were ready to accuse her of chomping down some candy or something when I found out the blood was drawn from the arm running D5. :\

[ixchel]

That menopause really really sucks. No periods from August to April. Then 3 within 5 weeks. This stinks.

That losing a parent hurts no matter what your age. (OK, that was in the past month, but whatever)

That no matter how hard you try, there are families that you just cannot please.

Not quite perimenopausal yet, but I've dealt with hell with my periods since my very first one and my heart goes out to you!

I'm very, very sorry for your loss.

[tsm007]

I had a patient on an insulin drip go from a glucose in the 300s up to 900s in only an hour or two. We were ready to accuse her of chomping down some candy or something when I found out the blood was drawn from the arm running D5. :\

I learned not to do a blood draw (lytes) from the same arm that IV potassium is running through. I couldn't figure out how the potassium had jumped in just 8 hours.

I actually learned that too this week. I just forgot I learned it. (Not to draw blood from the same line an IV is running in period.) Although not sure what you do if both arms have something running.

[RainMom]

I had a patient on an insulin drip go from a glucose in the 300s up to 900s in only an hour or two. We were ready to accuse her of chomping down some candy or something when I found out the blood was drawn from the arm running D5. :\

Saw that happen with a non-diabetic pt once. Got a call from lab for glucose 800+; phleb drew from the arm with D5 1/2NS running.

This week, observed what happens when an airway is removed a little prematurely in PACU on an OSA pt. Fastest drop in sats I've ever seen but good learning experience (& glad it wasn't my pt).

[ixchel]

The boob story made me laugh, thanks!

Glad to bring a smile after the stuff you've been dealing with! Funny thing is, the nurse and intensivist on the patient were both male and had the whole floor in there, everyone panicking. They got the patient to ICU, and it was a female nurse who took over. The very FIRST thing she assessed was the site of the "hematoma", comparing it to the other side, and of course the intact side had an implant, whereas the "hematoma" side did not. The ICU nurse didn't mind too much because had she not gotten that patient, she was expecting to get a trauma patient from the OR and it was late in the shift anyway.

[wanderlustnurse88, RN]

I actually learned that too this week. I just forgot I learned it. (Not to draw blood from the same line an IV is running in period.) Although not sure what you do if both arms have something running.

I believe you can stop it for some time and then draw. I want to say its 15 mins but it's probably hospital policy.

[ixchel]

I believe you can stop it for some time and then draw. I want to say its 15 mins but it's probably hospital policy.

Our hospital stops it for 10. You just pick the arm that is running the least critical drip.

[No Stars In My Eyes]

Very interesting thread!

This week I learned that it is okay that I spent all of my monthly social security check AND my weekly paycheck in less than 6 hours.​. Whew!

Because the good news is that my mortgage and all current bills are now PAID, and I have groceries and gas, and the dogs' annual shots taken care of. (sigh of relief!)

[CT Pixie, BSN, RN]

This week I have learned:

quite a bit but what sticks out is this....

In the beginning of the week, no matter what I say or do..OR don't say or do, that one particular nurse who is relieving me will NEVER, EVER be happy. If I say blue she says navy blue. The next day I say navy blue to her and nope..its just blue. I've learned basically anything I do or say will be wrong in her eyes. And...I'M OK WITH THAT. Now she needs to learn that her attempts to intimidate and badger me will no longer work :)

later in the week, I learned if pushed and I push back..same said nurse does back off.

I've learned if a fresh post op patient says they feel queezy and like they are going to vomit..you have exactly 0.003 seconds to move out of the line of fire or wear it! Thankfully I'm quick on my feet :)