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]

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 :)

Or if they burp. They say they're not nauseated, but then they burp and you have exactly 0.003 seconds to move.

[CT Pixie, BSN, RN]

Or if they burp. They say they're not nauseated, but then they burp and you have exactly 0.003 seconds to move.

Ohhh I learned about fresh post ops and burping..on my first day! LOL. Ohh so close to getting hit with it! I know those signs and move faster than lightening!

[That Guy, BSN, RN, EMT-B]

I didn't learn anything but I was reminded why my guard is always up and why my trust in people is hard to come by. No matter what, some people always try to extort things from you when they are capable of doing it themselves. And sometimes, people really are just after the quick fix of pain meds and are ever too happy to have their mommies call and verbally abuse you about it.

Both of those things remind me that I do actually care about what I do. Sometimes it gets lost in the craziness, but when I legitimately try to help, and it gets turned around and slaps me in the face, it does affect me still.

[LadyFree28, BSN, LPN, 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.

In my arena of nursing (Peds) less is more with sticks, so usually I draw some "dummy tubes" to get the fluid out and then draw the actual tubes, especially since one doesn't want to keep sticking a child over and over; I usually attach a vacutainer (sp?) and draw usually one tube or two and then obtain the actual labs.

[ScrappytheCoco]

I also learned that doing compressions on someone with a developing bowel obstruction will result in fecal matter spewing everywhere. I'm starting to think it's always best to gown up before compressions if there is time, just in case.

I have had several similar experiences with codes s/p bowel surgery or obstruction. It never ends well. Sigh.

I learned that despite all evidence to the contrary...I do have a soul after all. My teenage patient told me her story and how determined she was to be a good mother despite her mistakes. I held her hand and talked her down for 10 hours while she labored and she was able to achieve the unmedicated birth she desired. I cried like a baby when it was over. I have truly found my calling.

[Pepper The Cat, BSN, RN]

A new nurse today learned you never say the "Q" word. We were sitting around chatting, a very rare occurance and she said " this has been a nice..." And 3 of us said "don't say it!" And stopped her just in time. Whew. Close call. We then had a discussion about using that word and how you never use it because you are just asking for trouble!

[mmc51264, BSN, MSN, RN]

I learned how to assess for and experience a positive for compartment syndrome (poor pt rushed to OR for fasciotomy)

[ixchel]

I learned how to assess for and experience a positive for compartment syndrome (poor pt rushed to OR for fasciotomy)

Good job! Feels awesome to snag a win like that!

(Win for you, not the patient. You know what I mean!)

[ShortFuse_LPN, LPN]

I learned that sometimes a meltdown is they only way to get your point across to some people.

[ixchel]

I learned that sometimes a meltdown is they only way to get your point across to some people.

And if that still doesn't get through to them, damn it feels good to have an occasional one.

[Graduatenurse14]

-I learned from- the nice people here at AN- that you can give and IR and ER pain med together. My original post about it is on the Medication Forum.

[Lev, MSN, RN, NP]

I learned that the black cloud from the old job followed me to the ER. I had one patient seizing every couple hours, another with an 8 cm infrarenal AA going to the OR, a drunk guy who pulled out his IV and started running away, and an ICU pt - we didn't know what was wrong with him (Lactate 10, high temp, but not septic yet, with a platelet ct of 19) and he was very hard to sedate.