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

[ixchel]

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?

[cracklingkraken, ASN, RN]

No Mila Kunis in Ted 2?

Unfortunately, no. But Amanda Seyfried didn't do too bad (badly?) for a sequel. I love the cameos in it, especially a special celeb at the grocery market (won't give spoilers for those who haven't seen it yet).

[Been there,done that, ASN, RN]

Wonderful observations. Love One Republic :)

[Farawyn]

Wonderful observations. Love One Republic :)

Me too, love that song.

I've learned that I will avoid the paperwork for my HH job as much as I can.

I've learned that some nurses will tape up a rectum or a lady parts if there is a wound on an 88 year old woman's labia, and that is not okay. I've committed to doing her dressing 3 days this week including Christmas morning because it really got me angry. I used a combine to hold the gauze in place, taped the combine to her butt and her abdomen and and then pulled up her undies.

I've learned that I will miss the SN board over Christmas break.

I've learned The Big Kid is growing up and has given me comfort since he's been home from college.

I've learned when I am up all night and sleepless I'm grateful for the AN app and night nurses.

I've learned that despite dropping the ball, I seem to be pulling Christmas together in a few days and it's okay to not do "everything".

[smf0903]

I learned that...more surprised myself that...I did not cry the first time one of my patient's died. We had a patient die while I was on orientation, but was also the same night I got to respond to my first RR (not on that particular patient) so I wasn't as involved with that patient's death. I thought for sure I'd cry when this week's patient passed, as it happened I was alone with pt as family had gone home and didn't get back in time. Instead I was grateful to be in the room holding her hand as she passed.

I learned that families can be big, ginormous pains-in-the-you-know-what. "My parent never acts like that" (sundowners), packing the room with 10, 12 people, calling every 20 minutes for updates and getting angry when you won't give info because they don't have the HIPAA password.

On the same subject, I found the line where my patience ends with said type of family. When no one would leave this poor patient alone I finally strongly suggested that they leave...strongly but as politely as I could. The rest of the night was trying to keep this patient from ripping out lines and such. Never have I felt so bad for a patient and the garbage pt has to deal with alongside condition (believe you me, there's a small novel I could write here, but I'll spare you---and many of you have, I'm sure, already deal with families like this.

I learned that I must put on a really good game face. Most of the time I feel like I have no flipping clue what I am doing (I am a newbie nurse) but everyone seems to think I have it together? I guess that's good, but usually I just feel completely inadequate as a nurse. The seasoned nurses tell me it just takes time, so I hope I don't feel this inadequate for too terrifically long

I learned that I have lost around 10 pounds in my first two weeks of the 21-day-fix. I feel tremendous working out every day, and it's gotten much easier as I thought my leg muscles wouldn't hold me up after the first 3 days of workouts

I learned that I appreciate a new pair of slippers. I guess when the loft goes out you don't notice it as it happens gradually. But dang, put on a new pair and it's like walking on a cloud!!

[RNBSN1591]

This week I learned to never go over your CNA boss's head to HR when you are trying to get your medical reinstated. I also learned that unless you are friends with HR, and go over your boss, you lose. I learned that the boss will retaliate and write you up for something else. Political BS sucks.

I also learned (and this is very important for students) that even with a BSN, unless you work in ICU or ER for two years, you're not really qualified for much. At least where I live.

I I also learned that nursing is not always what you know, but who you know.

I learned that people can earn 10k (yep,10k a month) and still get welfare. Even foodstamps. You just have to know how to lie well. 👿. And, these ppl are often the most ungrateful people. A sense of entitlement irritates me.

Rant over.

[quiltynurse56, LPN, LVN]

I learned this week that working with a mask covering your mouth and nose gets really really hot.

I have also learned that when someone is diverting narcs, it makes for much more work for us nurses.

I also have a resident who has been a PIA, but was put on antidepressant 10 days ago and wow, the improvement shown so far is wonderful. Now many we can learn to appreciate said resident now that she is not so negative and argumentative.

[nynursey_]

It's a really bad idea to wear a pair of trial contact lenses for longer than the trial period.

Working 5 8-hour shifts isn't as fun as it sounds.

I really enjoy patient education when the patient is receptive and motivated to get better. I don't much care for it when it's part of a "mandatory" requirement and not totally appropriate (for example: Coumadin education to a 99 year-old who doesn't even know her own name).

If satisfaction scores have become more important than common courtesy, it may be time for me to leave the hospital. Being told to "ignore" a patient's hateful, racist comments rather than reminding them that they are rude and uncalled for in order to have an "excellent" survey score is just not in my genetics.

I am still just as capable of learning disease processes now as I was when I was a student. I was able to make a connection regarding rhabdomyolosis to an ischemic limb without much research. It's nice to know I can still connect the dots.

Patients are more familiar with difficult generic names of their medications than the easier, more pronouncable trade names! "Sir, I have your Plavix for you this morning." "I don't take that! I take Clopidogrel!"

[CelticGoddess, BSN, RN]

I learned that you should NEVER trust the nurse who talks about her other co-workers behind their backs. She'll run to the manager faster than a dementia pt can jump out of bed and wander to downtown, 5miles away.

I also learned that the city I work is so filled with nuts that a dementia patient walking down the street in a hospital gown does not attract attention. It took the police over an hour to find the patient.

I've also learned that the speed of a dementia patient jumping out of bed and eloping is inversely proportionate to the number of staff. The shorter we are, the faster they are!

I have also learned that my co-workers are absolutely NUTS (I mean certifiable) and I wouldn't trade them for the world!

[vintagemother, BSN, CNA, LVN, RN]

I learned that the field of case management is filled with thousands of acronyms and many more regulations. I hope I can rise to the occasion and become a competent case management nurse sooner rather than later.

I learned that earning a 4.0 grade point average in my first semester of graduate school can be fulfilling and vindicating at the same time. It provides a personal affirmation that I am not the stupid person that certain people insisted I was.

No, don't do that. Due to negative historical connotations, we can be very sensitive about our hair, natural or synthetic.

Oooh! You hit 2 nails on the head with this one, commuter! Kudos to you! Thank you for posting before I had the chance to! [emoji3]

[ixchel]

Guest OP needed for the next WILTW thread!

I'll be pulling 4 straight starting the 24th. I was thinking since its night shifts, I'd hold out and see if I'm able to find the time. Alas, sense is kicking in and reminding me every time I hold out like that, it never goes right. [emoji23]

PM me if interested. (Those who have volunteered are welcome to do it again.)

[Farawyn]

Guest OP needed for the next WILTW thread!

I'll be pulling 4 straight starting the 24th. I was thinking since its night shifts, I'd hold out and see if I'm able to find the time. Alas, sense is kicking in and reminding me every time I hold out like that, it never goes right. [emoji23]

PM me if interested. (Those who have volunteered are welcome to do it again.)

I'll do it.

[emtb2rn, BSN, RN, EMT-B]

Unfortunately, no. But Amanda Seyfried didn't do too bad (badly?) for a sequel. I love the cameos in it, especially a special celeb at the grocery market (won't give spoilers for those who haven't seen it yet).

"But you understand that i myself am not a child"