12/19 What I Learned This Week: night shift with Macaulay and polio

Nurses General Nursing

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The thing that has me the most wound up this week? Polio. I may be the last idiot to learn this, but our CIA used a vaccination campaign in Pakistan to collect DNA from Pakistani children, trying to find the children of bin Laden. Vaccination rates there have plummeted as a result, making a nearly eradicated disease remain a current threat.

I've been totally over this Christmas since last Christmas.

It sucks when you have an elderly, full blown dementia patient who is both violent and a screamer, and your hands are tied to say what's going on when one of your other patients is deeply bothered by it, saying, "why can't they just leave that poor man alone?"

A man who wants to die will not tell you when his chest pain is 10/10. He's only there because his daughters made him come.

Never remove an African American woman's wig.

Even nurses might not realize ischemic strokes don't kill you. Skipping anticoagulants might have worse outcomes than death.

Ensuring long blocks of days off on a regular basis seriously is crucial to recharging batteries.

I am still very much baffled by the fact that some respiratory therapists choose to smoke. Nurses, too. Look, I love you all, but if you've worked on a unit that gets bipap dependent or vented patients, surely you have some inspiration to quit? I'm not judging, as a former smoker myself, and I know how hard it is to stop. I just don't understand.

I really hate having to adjust to being awake in the AM after working nights, and I am so incredibly glad my husband is switching his hours to daylight so I don't HAVE to adjust my hours by much.

Hospitals are being fined millions because multiple patients were admitted for what Medicare feels should have been outpatient procedures. I'm annoyed by this. Perhaps they didn't require admission. Or, perhaps they were high risk for complications. I really don't know and wouldn't fault a legitimately applied fine. The problem is these massive sweeping fines make our MDs hesitate when they shouldn't.

Obama is a lefty.

The problem with being open minded is struggling to have actual opinions.

In spite of the night shift hangover, it feels so good to be back on night shift.

A video -

(And for those of you who do not get offended by pretty much anything, get on YouTube and check out the new Macaulay Culkin dryvrs video.)

Did you learn anything good?

^creeper no more^

What I learned this week:

1) A double batch of Kahlua balls only lasts a week at my house. NO bueno.

2) Some people really aren't good fits with certain units, even though they may be rock stars elsewhere.

3) It doesn't matter what job or career I have, I don't like the management or administration because they don't make good decisions. How can people with so many advanced degrees be so stupid? And even stupider when in a collective?

4) A person who scores 14 on the mSAS (bouncing off the walls, ripping IVs out, tachy, and in full DT mode) doesn't qualify for inpatient care without two more scores over 11. I'm going to sue my hospital if they make me hurt someone with their stupid ideas of who belongs in OBS. I'm tired of sending patients to the ICU.

5) I love nursing, but I hate being a staff nurse. I haven't figured out how to reconcile these facts and still make enough money to make my husband happy and meet our goals. Once I do, though, I'm OUT!!

6) New grads don't belong on my unit. It's too fast paced, purposefully understaffed with not enough resources, and requires ridiculous amounts of know-how to keep management and MDs from harming the patients. The people who have been there for years can barely handle it.

7) It is actually possible to fall in love with someone else's dogs when you're dogsitting and then grieve when you have to give them back. **sad face**

8) Shift diff makes up for a helluva lot. Yay, nights!!

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That the single most satisfying thing in the entire week was the peds intensivist telling me "You were right- he was just dry" EIGHT HOURS after I floated the idea. Because you cannot get flow through a BT shunt if your blood is thick. And the only reasonable explanation for a kids sat being in the 40s while exhibiting no signs of distress is no flow through the shunt.

You're welcome Dr. H!

Oh my that is scary! I'm so glad none of our intensivists are that stupid. Residents? Yes.

I learned that my job is causing my anxiety and depression to escalate rapidly. I shake when I walk into my hospital.

Specializes in Psych/Mental Health.

I learned the hospital's new policy for handling illegal substances, as well as learning what meth looks like.

Several patients snuck contraband in, but that was the only illegal one. The others were meds they wanted but knew the doc wouldn't order. The psych on call believes that the patients should be using the coping and relaxation skills they learn in groups, and vistaril is the only thing he will give for anxiety.

Readmitting patients after a trip to the ED takes the same 3 hours as the initial admission did. A patient or two went for vomiting, which was later discovered to be self-induced.

Another patient with an extremely high BP, and a horrible headache, did not go to the ED. Because, evidently nursing doesn't know how to take a BP.

Some patients can talk through seizures

I got an A in statistics :-)

My body isn't recovering from night shift as easily as it used to. I spend 4 days/nights exhausted, and not getting anything accomplished, before returning to work. I had a job interview last week for an day job. As much as I love psych, my body is saying NO. I've been MIA, because staring at the computer, reading, makes my eyes tired. But knitting is happening :-)

Amazon had a daily deal: LOTR bluray, extended edition for $30 last week. I'm wondering if I will get a chance to watch the movies, before the kids wander off with it. I've only seen the first movie, though I've read the books. I'm in the middle of a reread now.

Specializes in critical care.

Some patients can talk through seizures

True.

What you can witness as an observer of seizures depends on what area of the brain has been affected by them. For instance, I have left temporal lobe epilepsy. I have no convulsions, loss of motor function, or loss of ability to speak. I can function perfectly through them and people around me would never know I was having them. I know, though.

No matter how minor the seizures may seem for anyone who has epilepsy, the seizures need to be controlled/prevented. Over time, they will progress in severity and frequency if they aren't controlled.

I've been totally over this Christmas since last Christmas.

(ME TOO):bag:

It sucks when you have an elderly, full blown dementia patient who is both violent and a screamer, and your hands are tied to say what's going on when one of your other patients is deeply bothered by it, saying, "why can't they just leave that poor man alone?"

THAT WOULD BE MY MOM IF SHE WERE STILL ALIVE.:no:

I am still very much baffled by the fact that some respiratory therapists choose to smoke. Nurses, too. Look, I love you all, but if you've worked on a unit that gets bipap dependent or vented patients, surely you have some inspiration to quit? I'm not judging, as a former smoker myself, and I know how hard it is to stop. I just don't understand.

I WORK HOSPICE and both the other nurses are long-time smokers. One has a hx of breast cancer and is diabetic. Smoking is very difficult to quit - glad I never started.

Hospitals are being fined millions because multiple patients were admitted for what Medicare feels should have been outpatient procedures. I'm annoyed by this. Perhaps they didn't require admission. Or, perhaps they were high risk for complications. I really don't know and wouldn't fault a legitimately applied fine. The problem is these massive sweeping fines make our MDs hesitate when they shouldn't.

We are losing many local providers due to government bureaucracy that takes time away from patients and puts the almighty computer in their place. :banghead:

I learned that just because a patient is dying doesn't mean you have to put up with violent behavior.

Other than that, it has been a quiet week. ;)

Specializes in OB.

I learned about an hour ago that my second round of IVF worked and I am pregnant! :D

Sorry, not nursing-related, but I'm so relieved and we're still going to keep it quiet for awhile, since it's so early, so it's fun to tell my anonymous internet friends!

Specializes in OR, Nursing Professional Development.

Congrats, LibraSun!

I learned about an hour ago that my second round of IVF worked and I am pregnant! :D

Sorry, not nursing-related, but I'm so relieved and we're still going to keep it quiet for awhile, since it's so early, so it's fun to tell my anonymous internet friends!

Sure it is! IVF is medicine!

Congratulations!

Specializes in Hospice.
I learned about an hour ago that my second round of IVF worked and I am pregnant! :D

Sorry, not nursing-related, but I'm so relieved and we're still going to keep it quiet for awhile, since it's so early, so it's fun to tell my anonymous internet friends!

Congratulations! My step daughter had 3 successful IVF pregnancies, and then an "oopsie".

Or, as she says, "Buy 3, get 1 free!"

Specializes in LTC.

I learned that some facility MDs think I rock as a nurse. One of them wrote a fabulous email to the DON which she shared with with me. The other one said it to me on the phone after he returned my call to clarify a resident's medications. My crappy day (multiple falls, nurse calling in so I was obligated to stay an extra 4 hours) ended up being much more bearable after all that.

I was reminded again how awkward it is to be the nurse of someone you know. Recently, the mother of a former boyfriend was admitted to my facility. Thankfully I won't be her primary nurse but it feels weird to see her and the ex in the facility especially since the relationship did not end well.

I learned that I definitely have the holiday blues in a big way this year. If I could hibernate from Halloween to January 2nd I would be a happy camper. I hate the holidays. A lot of it has to do with missing my hubby who was the holiday nut of the family. He went all out on Thanksgiving, Christmas, and New Years which was also his birthday. I miss him so much. I have never been a person who loved the holidays but his holiday spirit was infectious and I was pulled in and had fun. Now I feel as if I am just going through the motions for my children who are also not as excited for the holidays anyway without dad around. We are a pitiful bunch. This will be the 5th Christmas since he died :cry:.

Specializes in LTC.

Congrats LibraSunCNM. One of my nursing clinical instructors conceived via IVF and delivered a healthy baby boy earlier this month. I wish you a healthy pregnancy.

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