(Forgive the early submission this week. Got a busy day tomorrow and last week's thread has just changed its code status to DNR, with a discharge to hospice. Thankfully, most of the family agrees. Unfortunately, one person thinks I'm trying to get more inheritance than Farawyn, but thankfully that's what probate lawyers are for.)
This week, I have learned:
Creatinine can go from 9 to 1.9 in 12 hours. Then 0.65, 24 hours after that, with 13,000 mL out in two shifts.
If you're prepared to ask if your patient group can be split up tomorrow, be prepared to be made out to be an a-hole in front of the rest of the staff just for asking.
My legs are a-holes.
Furry woodland creatures are terrifying.
Metoprolol is a hell of a drug.
Cardiologists should consult nephrologists for beta blocker dosing once a creatinine hits, like, 2.
Some patients would rather walk across the room to pull the code blue button rather then push the nurse call button on their remote they've had glued to their hands for days.
It appears the end of August is "Celebrate Right Before Shift Change Disasters" season.
There are two miserable ladies who post in every thread. But now I'll never know who they are.
There is a person with an STD in their colostomy stoma.
An iPhone can delete all of your contacts in one area code and rename all of your contacts 'Steve'.
I am incredibly frustrated that hospitalists don't clarify code status at admission. Families are SHOCKED to consider that just because their kids know what they want, doesn't mean we'll know.
The State Highway Administration employs archaeologists.
My baby turns 8 tomorrow. I remember feeling impatience at the end of that pregnancy because I wanted to KNOW her. She was the most beautiful thing I'd ever seen, and has grown more so with every passing year. As fulfilled as I am by being a nurse (I was one of those disgusting "called to it" nurses. Wear gloves when you read my posts, friends. That icky stuff might be contagious.), being Mommy is my one true superpower. :)
I know how you feel. :/ Since I started school again my desire to work out went out the window. I was working out 5-6 days a week now it's 0 days a week. But I also think my medication is playing a part in that.
I used to run five miles a day! Now I'm huffing and puffing at 1.5. Boo me.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Yes, that income could make a big difference. Do you think maybe he just needs more time to adjust? Like, what if you went into the daycare on your day off and stayed the whole time with him, just so he could get used to the place. Think that would work?
Well he can't go back to daycare, he was pretty much kicked out cause he was crying & disrupting the other kids. I'm gonna stay awhile when I drop him off at my husband's best friend's place. Obviously I can't just drop him & run.
I learned that when the facility Speech Therapist hears that a Hospice patient is starting to occasionally not swallow and pocket food, the appropriate response is apparently "Well then, she must be made NPO and there must be a discussion about G-tube insertion."
Really??
No. The appropriate response (from me!) is "When she does that, give her more time, realize that if she licks the plate clean at breakfast she might not be hungry for lunch, monitor how often she's doing it and let me know."
I learned that when the facility Speech Therapist hears that a Hospice patient is starting to occasionally not swallow and pocket food, the appropriate response is apparently "Well then, she must be made NPO and there must be a discussion about G-tube insertion."
Really??
No. The appropriate response (from me!) is "When she does that, give her more time, realize that if she licks the plate clean at breakfast she might not be hungry for lunch, monitor how often she's doing it and let me know."
You know, thank you for advocating in this way. A doctor, years ago, talked my mom into a J-tube for my grandmother. My 96 year old hospice care, late stage dementia, grandmother. My mom was just so afraid my grandmother would starve, that the fear guided her to make a choice she feels she will regret forever. My grandmother died a few weeks after the surgery. She developed pneumonia post-op, and died in an ICU. That kind of thing just isn't right.
You know, thank you for advocating in this way. A doctor, years ago, talked my mom into a J-tube for my grandmother. My 96 year old hospice care, late stage dementia, grandmother. My mom was just so afraid my grandmother would starve, that the fear guided her to make a choice she feels she will regret forever. My grandmother died a few weeks after the surgery. She developed pneumonia post-op, and died in an ICU. That kind of thing just isn't right.
A big part of my role as a Hospice Nurse is education, and supporting families whatever their decision.
Oftentimes I cringe inwardly at some of the decisions, but I understand the fears that drive them. The natural decrease in food consumption can be mimicked in patients with feeding tubes by gradually decreasing the amount of formula given. They still get water flushes. I have had good luck doing this, as families are more willing to slow down feeds as opposed to stopping them abruptly.
Did you know that feeding tubes were originally to be used short term in patients who had head and neck surgeries, or were getting head/neck radiation and had trouble swallowing? Short term as in 3 weeks' duration.
They were never supposed to be used to prolong existence for years.
I agree! Our system sends our phones things like v tac or asystole, we have to follow up by calling the techs. I called regarding a message saying tachycardia 178 and they said the patient was only 89. I was so excited we finally got it down so I said "really,yay!!!" I was lectured after that.....
Guys, I've learned that it's too late for me to exchange my school scrubs. The bottoms are really tight around my bum. Looks like I'll be working out a little bit more. Why do I procrastinate these things???
I'm thinking the school will rather you hit up a scrubs store than split your bottoms at clinical. Ours never fit me either, so I went and bought my own elsewhere, and still wore the school's embroidered scrub tops.
I'm thinking the school will rather you hit up a scrubs store than split your bottoms at clinical. Ours never fit me either, so I went and bought my own elsewhere, and still wore the school's embroidered scrub tops.
That's a good idea. I may go do that and still try to drop 10 lbs so that I can have extra bottoms.
Purple_roses
1,763 Posts
I used to run five miles a day! Now I'm huffing and puffing at 1.5. Boo me.