(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. :)
Patient is good. And was feeling great by the end of my shift.
But jeeze.
Oh, I also learned that new docs will insist that complete heart block is sinus Brady.
Glad I have a great relationship with the experienced attendings.
Sinus Brady! lol They're going to be freaking out over and over their whole first year. Cheezus!
Chevy, you need to put them on some sinus bradys who live in the 20s-30s asymptomatically waiting for their pacemakers or BBs to wear off just to break them in. The residents will be wandering around the bedside with pacer pads in one hand and epi in the other, insisting the atropine MUST BE TAPED TO THE WALL AT ALL TIMES.
Not sure if you've seen atropine ordered at your place like that. We had a hospitalist who did that frequently. Housekeeping would leave it there, of course, and so it would remain until a nurse would actually look and see that the label was not for the patient in the room. Never mind that the crash cart always gets shifted down to the room of our extreme bradys, so if we needed atropine, it was already about 10 steps away.
I wish our hospitals would make MD contracts anything but twelve months. MDs fresh off residency bring some cray cray with them, too, and we get them every time a doc quits in June. Then a freshly minted doctor comes in July looking like a deer in the headlights putting in accuchecks q4h on everyone and their cousin and other orders that are odd. I had a loony patient who suddenly couldn't remember anything (very dramatic attention seeking behaviors from her her whole admission) and of course, this meant immediate CVA protocols initiated. But, apparently our standard q4h vitals weren't adequate. The MD decided this patient needed q3h. Even the MD said this lady is just fine. (This is one small, small irritation with this lady. OMG she drives me nuts.)
My fellow nurses..... Please take some time to beat some common sense into these MDs before you send them out into the world.
At least he came back and thanked me for my tele lesson later that day.
Ugh! The Atropine taped to the wall and pacer pads on the patient.
It's been a while since those were in favor at my hospital, and I'm glad.
How about we can't discharge the pt because they are hyponatremic...at 133.
Sinus Brady! lol They're going to be freaking out over and over their whole first year. Cheezus!
Chevy, you need to put them on some sinus bradys who live in the 20s-30s asymptomatically waiting for their pacemakers or BBs to wear off just to break them in. The residents will be wandering around the bedside with pacer pads in one hand and epi in the other, insisting the atropine MUST BE TAPED TO THE WALL AT ALL TIMES.
Not sure if you've seen atropine ordered at your place like that. We had a hospitalist who did that frequently. Housekeeping would leave it there, of course, and so it would remain until a nurse would actually look and see that the label was not for the patient in the room. Never mind that the crash cart always gets shifted down to the room of our extreme bradys, so if we needed atropine, it was already about 10 steps away.
I wish our hospitals would make MD contracts anything but twelve months. MDs fresh off residency bring some cray cray with them, too, and we get them every time a doc quits in June. Then a freshly minted doctor comes in July looking like a deer in the headlights putting in accuchecks q4h on everyone and their cousin and other orders that are odd. I had a loony patient who suddenly couldn't remember anything (very dramatic attention seeking behaviors from her her whole admission) and of course, this meant immediate CVA protocols initiated. But, apparently our standard q4h vitals weren't adequate. The MD decided this patient needed q3h. Even the MD said this lady is just fine. (This is one small, small irritation with this lady. OMG she drives me nuts.)
My fellow nurses..... Please take some time to beat some common sense into these MDs before you send them out into the world.
When considering my options for grad school I initially went the PA route because my BS is not in nursing and I didn't think it would make me a better clinician to get a BSN.
I had to take a few classes to apply for PA school and one of my profs recommended I apply to the NP program at Duke because they take RNs with other BSs.
I got into both a PA program and the NP program. I just accepted my NP seat and now I just keep thinking "Lawd help me not lose my @&$* on all these stupid people for the next 2 years."
A pirate-themed water park sounds awesome. All I get are dreams of my grandma chasing me with a knife and my brother getting possessed by demons. I think there is some serious need for therapy over here...
I must need therapy too, because my dreams are usually bloody possession dreams too. Either that, or super silly dreams, like Santa giving the United States oil for Christmas.
This week I have learned that I need a t-shirt that reads: "WARNING! UNDER THE INFLUENCE OF PERIMENOPAUSE! APPROACH AT YOUR OWN RISK!!!" I am also formally requesting donations for a straight-jacket. A nice hot pink one with sparkles. And a personal fan. Thank you.
When considering my options for grad school I initially went the PA route because my BS is not in nursing and I didn't think it would make me a better clinician to get a BSN.
I had to take a few classes to apply for PA school and one of my profs recommended I apply to the NP program at Duke because they take RNs with other BSs.
I got into both a PA program and the NP program. I just accepted my NP seat and now I just keep thinking "Lawd help me not lose my @&$* on all these stupid people for the next 2 years."
I have a friend in the Duke psych PhD program if you need someone to tell you where all the good study spots are or where to hide the bodies or whatever.
I have a friend in the Duke psych PhD program if you need someone to tell you where all the good study spots are or where to hide the bodies or whatever.
I learned that "I don't like my medicine" is a good enough reason to call an ambulance, apparently.
I learned that being ridiculously entertaining almost makes up for the fact that you're wasting your town's resources (see above).
I learned that a tearless goodbye is much easier promised than carried out when you're leaving a place and people you love for a place and people you're not so fond of (hoping this year of college is easier than last).
I learned that the Maryland board of nursing does not appreciate it when you call with questions they felt their website adequately explained (for the record, it gives you different directions in different places for the same thing).
I learned that the Maryland board of nursing does not appreciate it when you call with questions they felt their website adequately explained (for the record, it gives you different directions in different places for the same thing).
Guurrrrrlllllll do NOT get me started on that cluster eff. The MBON is an utter DISASTER. The only thing worse than the website is the employees.
ixchel
4,547 Posts
Sinus Brady! lol They're going to be freaking out over and over their whole first year. Cheezus!
Chevy, you need to put them on some sinus bradys who live in the 20s-30s asymptomatically waiting for their pacemakers or BBs to wear off just to break them in. The residents will be wandering around the bedside with pacer pads in one hand and epi in the other, insisting the atropine MUST BE TAPED TO THE WALL AT ALL TIMES.
Not sure if you've seen atropine ordered at your place like that. We had a hospitalist who did that frequently. Housekeeping would leave it there, of course, and so it would remain until a nurse would actually look and see that the label was not for the patient in the room. Never mind that the crash cart always gets shifted down to the room of our extreme bradys, so if we needed atropine, it was already about 10 steps away.
I wish our hospitals would make MD contracts anything but twelve months. MDs fresh off residency bring some cray cray with them, too, and we get them every time a doc quits in June. Then a freshly minted doctor comes in July looking like a deer in the headlights putting in accuchecks q4h on everyone and their cousin and other orders that are odd. I had a loony patient who suddenly couldn't remember anything (very dramatic attention seeking behaviors from her her whole admission) and of course, this meant immediate CVA protocols initiated. But, apparently our standard q4h vitals weren't adequate. The MD decided this patient needed q3h. Even the MD said this lady is just fine. (This is one small, small irritation with this lady. OMG she drives me nuts.)
My fellow nurses..... Please take some time to beat some common sense into these MDs before you send them out into the world.