Alright, friends. I'm keeping this one short and sweet because my brain is sore and my dog is annoying.
This week, I have learned....
1. There should be a time limit hospitals should have to fix a problem. If things aren't better after, say, 15 days, let someone else try.
2. I'm in the mid Atlantic of the US with spring travel plans to Florida, and I'm actually feeling nervous about Zika. I had a guillian barre syndrome patient in nursing school. On his way driving home from work, his chest felt off, so he course corrected to the ED. When he pulled up and walked to the doors, he struggled with leg weakness. After he was done in triage, he couldn't stand. He was intubated, and completely paralyzed, before he left the ED for ICU.
3. A patient on neuroleptics will still have detectable epileptiform patterns on an EEG.
4. A good neurologist knows no matter how crazy the patient sounds describing symptoms, what they say is legit and will stay the course for diagnosis.
5. My favorite doctors to work with are the ones who will sit and talk patho with a nurse and enjoy that the nurse legitimately loves to learn.
6. Sliding scale coverage alone for inpatient management is not currently supported by research.
7. If working day shift doesn't eventually make me check into a psych ward, nothing will.
8. The GI doc who left me scrambling to save a guy's life (what felt like) single-handedly by doing no intervention before he got dumped on us (actively bleeding out 2 points of hemoglobin over 8 hours and maintaining a BP that won't leave 70s-80s) has suddenly become cautious enough to send a perfectly stable (hemodynamically, symptomatically, and on CBC) rectal bleed to ICU before meeting or scoping her after I've literally done all the work needed on her for the shift. And of course, I was rewarded with an end of the shift admission.
9. The Florida Man Collective has evolved to include its latest - Wrinkles the Clown. He is a scary-looking clown who is for hire to scare anyone you want, for any reason.
10. The more you annoy the doctor about the same thing, over and over and over, the more likely it is they will listen and maybe put in an order.
I have nothing else right now. My broken brain is feeble!
Specializes in OR, Nursing Professional Development.
Monte what?
I have the worst oral outcome ever. Even though I brush and floss regularly and avoid sweets (sometimes) I somehow always end up with cavities.
I think I'm to the point where my teeth are more fillings than actual teeth. Maybe that's why I didn't have any cavities at my last cleaning? There's no teeth left that haven't already had them!
Some people are either lazy or just like taking advantage of people. What nurse goes to take a nap in the middle of her shift for over an hour gives you her phone number and says call me if you need me especially when she is about to get an admit then later oh ask for us to draw her patients blood and give meds because she is really behind charting. Who does that?! Who puts a bipap on someone who just threw up in that bipap? Who doesn't get o2 to put on the person while cleaning out the bipap full of vomit? Who stands there while the patients o2 drops to the 70s and tells the patient to cough while I run and get high flow 02 and put it on the patient while she is still telling the patient to cough and cleaning out the bipap. I learned this week that a new nurse on my unit does... no icu experience and no preceptor but she floats all over so she won't ever get proper training...
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Numbs the nose, too. Use it in some pretty invasive nasal/sinus surgery. It's a pretty shade of blue.
For all of those dealing with losses, hugs.
Cheerios, glad things are going well with the new job.
I've learned that I seem to have finally transferred my black cloud to someone else. It's both a blessing and a curse in that I get to sleep through the nights I'm on call but I'm also not getting the OT.
I've learned that just when you think your team is working really well together, someone will screw the team over. Just because none of us like getting pulled out of our specialty, doesn't mean that calling off makes that go away. Someone else (ahem, me) will end up getting pulled instead.
Thank you. I still have to work nights but I don't care. I just wanted to work & get my benefits! Lol.
I've learned that cardioversion is only used if the patient has an R wave. Otherwise, defib!
I actually have a solid understanding of fluid and electrolytes, despite my lack of understanding in all other areas.
A-fib gives you all sorts of problem.
If a patient has an MI, there is a crapload of stuff that can result from it. And an MI yields necrosis while angina is reversible.
Troponins are the best indicator of myocardial damage.
In case you can't tell, cardiac was on the schedule for this week.
We tested on cardiac last week. We are doing respiratory and fluid and electrolytes this week. Do you like our book this semester? This is the first semester I've actually used a book and I really like this one. I'm loving ICU by the way. I think it's where I'm going to be working once I get my license. It's been my favorite rotation so far.
I have learned so much this past week. I got a job offer!! Yay!! It's designed for a student nurse. I will be a pct the next 6 month and if all goes well and I work hard I can become a RN on the unit once I obtain my license. It's in an icu dept. A specialty icu. I'm really excited about the opportunity. I go for my physical Monday and orientation is the following Monday.
I learned that that even a student nurse can contribute and help with a critically ill patient. My nurse went on break and I was kind of, sort of in charge of my patient. RT was with her and gave me report after taking my patient off bipap. I continued to monitor and assess. When my nurse came back I gave her report of our patient in which I noticed some significant changes occurring with her. My nurse knew then to check on this patient first. She was not doing well off the bipap. I got an atta girl from my instructor who listened to me give report. I know I didn't do anything big, but I felt like I actually practiced the art of nursing that day.
I learned house hunting and purchasing is stressful no matter how strong the relationship is. I haven't done the whole house buying thing in 20 years. I forgot the process.
I also learned in the whole house buying process, there are things I'm not so comfortable with when it comes to money and it has made me think and question A LOT of things. I think my relationship with my ex damaged me more than I like to admit. I've always kind of prided myself on not needing therapy after what I went through with him, but maybe it would have been beneficial.
But all in all, life is good and I'm now 3 months away from graduation and obtaining a college degree.
We tested on cardiac last week. We are doing respiratory and fluid and electrolytes this week. Do you like our book this semester? This is the first semester I've actually used a book and I really like this one. I'm loving ICU by the way. I think it's where I'm going to be working once I get my license. It's been my favorite rotation so far.
Ah, already did respiratory. We have F&E this coming week. No, I haven't really been using the book. It's the same book we've used for MS I & II. I've been using Saunders a lot.
We don't have a rotation in ICU unfortunately. I'm in oncology and LTAC. Some of our cohorts are in PCU.
cracklingkraken, ASN, RN
1,855 Posts
Monte what?
I have the worst oral outcome ever. Even though I brush and floss regularly and avoid sweets (sometimes) I somehow always end up with cavities.