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!
I learned (many moons ago) that some individuals seek out the 'yes'-people, nodders, PollyAnna personalities, cheerleaders, and head-bobbers to tell them exactly what they want to hear.
This situation can be difficult to initially pinpoint because many people act as if they're seeking advice when, in reality, all they wanted was someone to validate a potentially crappy decision they've already made.
I've also learned that I'll never quite understand human nature...
This sounds like half the stuff ever written I the Internet. :\ Do the people you're stuck with get huffy and nasty when they don't get validated?
I finally had my baby.. 2 kids are a lot more work than 1!
That I am SOOO enjoying my Maternity Leave from work.
I turned my nursing school application in for the transition program. I'll find out in a month or so if I got in.
That the nurses at my hospital rocked despite the ridiculous policies of their units ( L&D and special care OB nurses were being low censused, yet MB had to accept higher that usual ratios (4 couplets).
I finally had my baby.. 2 kids are a lot more work than 1!
That I am SOOO enjoying my Maternity Leave from work.
I turned my nursing school application in for the transition program. I'll find out in a month or so if I got in.
That the nurses at my hospital rocked despite the ridiculous policies of their units ( L&D and special care OB nurses were being low censused, yet MB had to accept higher that usual ratios (4 couplets).
Specializes in Cardiology, Cardiothoracic Surgical.
1) I HATE being right. I had to enact our infection control policy on a patient because I saw ONE bedbug creeping across her pillow. The lab confirmed it. What IS it with me and my patients with parasites lately? (I don't work in the ED)
2) I absolutely do not care if I have to walk into a group of providers and ask who has my patient and clarify/get orders, because our computer system went down. I really, really don't care if this annoys them or my charge nurse. Providers interrupt my work all the time with orders/calls/questions.
3) Patients can be totally asymptomatic with A fib into the 200s after walking. A lot of our post-op patients pop into this rhythm after surgery and this was my first time really handling it till he converted back to sinus.
4) Night shift, how I've missed you!! My favorite people were on my first night back and I was so happy!
That being interviewed by five people at once is a little nerve wracking (and trying to make appropriate eye contact with each person is super hard).
That there is no stress like a time crunch. I have been having nonstop paperwork issues with my BON trying to get my att (December grad here). I accepted a job offer on Monday and have thirty days to do my employee physical, however I must pass boards before I can perform said physical. [emoji29]
That sometimes you must grow where you are planted.
That I should have saved away a larger coffee fund for studying for my boards. The sleep deprivation is real.
I do think that NxStage is a great machine - of course the alarms can be "unsettling"....
I love the NxStage. I love love LOVE having a CRRT - we 1:1 them because apparently someone had a disconnection event once in my system and almost died... someone has to be laying eyes on the connections at all times on my unit per policy. We are supposed to tell another nurse when we are leaving the room to pull meds or need a bathroom break.
It makes for a great night when it runs smooth. I had one all last weekend and it was a godsend for getting my school work done. Studied for a genetics test, started a research paper for genetics lab, completed two worksheets for cell bio lab, and studied for an ecology test. Made 100s on the worksheets and got a 96 on the genetics test. Don't know about the ecology test yet, but I feel like I either got a 100 or a really high A. Out of a class of 220+ students, apparently only 12 people got an A on that genetics test, so I feel extra smart now. I fully credit the NxStage for my success. That kind of free time is rare on my unit.
They don't let us restring them for a long time on my unit. Someone finally let me restring last week! I got my first check off, so that feels good. Just have to restring two more and collect two more signatures before I can be independent with restringing them. :)
In other news, I learned that one of my coworkers is a dominatrix and likes stepping on the balls of one of our intensivists with the heel of her high heels, and that sometimes she ends up with the results of such things in her hair. The funny thing about that is I'm not even remotely surprised, knowing her personality.
I also learned that someone is lifting etomidate off the code carts on multiple floors in my hospital as a date rape drug, and that the dirty jokes that follow this information being disseminated to the staff are epic. As one coworker stated, "Etomidate is really good for suppressing the gag reflex!" "But it's so short acting!" "Oh, I only need 2-4 minutes anyway." My belly hurt from laughing so hard after that. My coworkers are very special snowflakes.
In other news, I learned that one of my coworkers is a dominatrix and likes stepping on the balls of one of our intensivists with the heel of her high heels, and that sometimes she ends up with the results of such things in her hair. The funny thing about that is I'm not even remotely surprised, knowing her personality.
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I had to reread this part three times before it sank in lol.
How in the world do you maintain eye contact with either of them now?? I couldn't do it. Not that I would be embarrassed or repulsed, I just wouldn't be able to stop grinning and possibly giggling (I tend to do that when I shouldn't-used to get me in all kinds of trouble in church).
I had to reread this part three times before it sank in lol.
How in the world do you maintain eye contact with either of them now?? I couldn't do it. Not that I would be embarrassed or repulsed, I just wouldn't be able to stop grinning and possibly giggling (I tend to do that when I shouldn't-used to get me in all kinds of trouble in church).
Honestly... it's just their personalities. This particular intensivist has always been touchy-feely, so I would almost be surprised if he wasn't boning the staff (he's not the only one, there is another intensivist that is even more notorious for it than he is), and the nurse in question has a very strong, dominant personality and brags about not wanting to be officially dating anyone and that she just likes playing around. She has bragged about doing other physicians in the past, and she's very attractive. It's very predictable.
I did smirk at him the last time I saw him, though. We were discussing the merits of Krispy Kreme vs. Dunkin Donuts, and I almost made a comment about cream filling... but I kept it to myself. Don't want him getting the wrong idea, after all, now that I know he has no qualms about doing the staff. That would be awkward.
My unit gets very incestuous. There is a really good male/female nurse split, probably almost 40/60, and we are very close to our physicians, so it's just about inevitable that there are going to be various relationships developing - especially on night shift when there aren't as many supervisor-type people roaming around.
(I don't work in the ED)
ixchel
4,547 Posts
This sounds like half the stuff ever written I the Internet. :\ Do the people you're stuck with get huffy and nasty when they don't get validated?