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!
Always a very important lesson, unfortunately one we too often don't do.
It becomes very liberating when you can say "No" without feeling guilty. Even better when you can say it without adding "...sorry, because...".
Man I need to work on this.
So. Hard.
It's like I have 2 speeds - easy going, take on way too much, yes to everything....and heinous witch. I'm reading one of the recommended books on being assertive. People who know me would laugh if they heard that, but my witchiness is really just a well honed defense mechanism. I had no problem being appropriately assertive back when I was the boss, but there is a lot more to changing careers than learning a new set of skills. One important lesson is learning how to advocate without coming on like a freight train. I love my unit and the other nurses I work with, but I still have a lot to learn with communication to ancillary services, etc. :blush:
Thanks for the safe place to get that off my chest.
Numbs 'em right up, and you get a high that lasts longer than snorting. Then your teeth fall out on their own.
So, the question really is, do you want dentures?
Hmm. Tempting proposition, but, considering nasty dentures are one of the few things that can activate my gag reflex, I think I will stick with marcaine and a nice single malt.
Hmm. Tempting proposition, but, considering nasty dentures are one of the few things that can activate my gag reflex, I think I will stick with marcaine and a nice single malt.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Hmm. Tempting proposition, but, considering nasty dentures are one of the few things that can activate my gag reflex, I think I will stick with marcaine and a nice single malt.
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.
We must have different books then. I'm really liking mine as it goes fairly in depth on the patho which is one of the things I love. It really stinks you don't get to do ICU this semester. It must be hard to have a hospital let students into one. Fortunately, both of the hospitals here in town are student friendly. I did have one day in the cancer center which was mainly infusions. We didn't get to do anything as it was just observation. We didn't have an instructor with us. We also got a day in surgery in which I learned I could never be a circulating nurse. I applaud those who can. But wearing the lead vest for over two hours and just standing there about killed me. I couldn't imagine an 8 hour surgery!! But I did get to see some very cool surgeries.
I really enjoyed oncology. I could see myself there one day.
JenTheSchoolRN, BSN, RN
3,035 Posts
I learned how to better practice saying no this week.