What I Learned This Week: Discipline is King

Ixchel needed someone to create this week's "What I Learned" thread, so I'll go ahead and attempt to rise to the occasion. I've learned a few things... Nurses Announcements Archive Article

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1. Discipline is King:

I learned that discipline is fundamental. I am referring to self-discipline. After a decade of shift work, I now work from a home-based office and am finding I lack the discipline to get my day started in a timely manner. When I had to report to an actual workplace and punch a time clock, it was enough of an incentive to arrive on time. However, since I now work under a laissez-faire manager and must determine the course of my own work day, it's been tough.

2. Routine is King:

I learned that some people can go with the flow. I have no problem going with the flow, but my work day needs to be routinized. I need a set wake-up time, a coffee routine, and knowledge of how my work day will turn out. I suppose this is how I remained in LTC nursing for six years...I somewhat knew the residents and routine, which made things easier for me.

3. Networking is King:

I learned that our professional lives are made easier by having a network of colleagues that will have your back, answer your questions, and put in a good word for you whenever you need a reference. I got my current gig by having a friend put in a good word about me to the hiring manager.

4. Reciprocation is King:

I learned that reciprocation is important. If someone does something helpful for you, it will be beneficial for you to reciprocate by doing something helpful in return. Karma will reward you for doing to others as they do to you.

5. People are King:

I learned that relationships with people contribute to the spice of life. For example, I returned from a toddler's birthday party a few hours ago. Both his mother and I are nurses. The toddler's father (my friend's spouse) has a wide social circle of longtime friends. My friend complains about her husband's social circle, but I can tell that these people are enriching his life since he enjoys their presence. Without relationships with various people, our lives and worldviews can be limited.

What have you learned? ?

Specializes in LTC.

I have now been a nurse at my facility for 2 years. It feels like it has been longer.

School is kicking my butt. I think its time for me to reduce my work hours because the exhaustion of carrying a full class load while working full time is too much.

I learned that it really pisses me off when I walk in to shift to find a resident who has PRN haldol and ativan so agitated and out of control and the nurse states "the meds don't work." So I ask when the last time the meds were given and find out the nurse didn't give any of the PRN meds on their shift. I work with this resident all the time so I know the meds work when they are given. Ugh, its so frustrating.

I learned that I really hate working the 2-10 shift.

I learned that I cannot teach my kid how to drive.

kalycat said:
Ugh. I learned a lot last night but I think I'm still too annoyed about some of the details to even vent. I am a control freak and need to learn to let some things go.

Lost a patient I really enjoyed this week but am relieved in the sense that their suffering was not further protracted. Very difficult case but I know this person has peace now.

Had a patient code who exemplified how important communication is in medicine. Frustrated a bit that my best efforts to correct a small part of the situation (but important to the patient's comfort) just didn't seem to carry over from shift to shift. The code likely couldn't have been avoided by this component of care being better managed, but the patient would have been more comfortable and likely less terrified when it happened.

Anyway. I'm home in my sweats with a glass of wine while it rains. That's a pretty good start to a day off. ?

Have a glass for me. Too much gack in my throat.

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
SWM2009 said:
I learned that I really hate working the 2-10 shift.

Same here...the 2:00 to 10:00pm shift takes up most of the afternoon, all of the evening, and a good chunk of the night. I hated it with a passion. In addition, it is the shift when the majority of family visitation occurs, which leads to further interruptions for the nurse.

Hospitals started utilizing 12-hour shifts many years ago due to problematic issues keeping the 2 to 10pm/3 to 11pm shifts fully staffed.

Specializes in CVICU CCRN.
Farawyn said:
Have a glass for me. Too much gack in my throat.

Feel better, friend. Sorry to hear you've got the gack.

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
TheCommuter said:
Same here...the 2:00 to 10:00pm shift takes up most of the afternoon, all of the evening, and a good chunk of the night. I hated it with a passion. In addition, it is the shift when the majority of family visitation occurs, which leads to further interruptions for the nurse.

Hospitals started utilizing 12-hour shifts many years ago due to problematic issues keeping the 2 to 10pm/3 to 11pm shifts fully staffed.

I love 2-10/3-11. I'll trade my nights for evenings any day!

This week I learned

that if a patient has cancer and bone mets and needs serious pain management they better stick with their oncology or palliative provider. Asking a PCP who is not well versed in pain management to adjust something can end up in a total disaster with admission to the hospital for uncontrolled pain. Remember : If 300 mg of morphine a day does not make your pain bearable - why do you think a 50 mcg of fentanyl patch would do better???

that the acute hospital is not very equipped in supporting people who are being told that they have cancer and "by the way no treatment options and perhaps months left at best".

that my laundry dryer gave up because the vent was blocked and lint accumulated. Now a vent repair specialist will come and try to figure something out.

that since my dryer is not working I have to go to the laundromat to dry the laundry and evening hours are best because it is empty.

that my son got a great merit scholarship to a good school

that I am still not loosing much weight and that is due to me eating too much crap ...

Why do people celebrate V-day on V-day? If you wait until the next day, all the leftover chocolate and flowers are on sale. Note to future boyfriend - buy me stuff the next day and double the amount.

I still have little to no clue what specialty to apply for in my residency programs. I'm pretty much open to anything, but I don't have a "passion" for a specific field.

I'm not as good at writing papers as I used to be.

Allen test is used for checking circulation and determining if the ulnar artery pumps blood effectively.

Septic shock is way easier to prevent than reverse. And the mortality rate for septic shock is high.

IV nitroglycerin is prepped in a glass bottle.

Specializes in LTC.
TheCommuter said:
Same here...the 2:00 to 10:00pm shift takes up most of the afternoon, all of the evening, and a good chunk of the night. I hated it with a passion. In addition, it is the shift when the majority of family visitation occurs, which leads to further interruptions for the nurse.

Hospitals started utilizing 12-hour shifts many years ago due to problematic issues keeping the 2 to 10pm/3 to 11pm shifts fully staffed.

Add in the sundowning residents and you've got all the reasons why I hate that shift so much. I covered for a nurse who had a family emergency yesterday and it was a brutal reminder of why I am relieved that it isn't my regular shift.

Specializes in Family Nurse Practitioner.
TheCommuter said:
Same here...the 2:00 to 10:00pm shift takes up most of the afternoon, all of the evening, and a good chunk of the night. I hated it with a passion. In addition, it is the shift when the majority of family visitation occurs, which leads to further interruptions for the nurse.

Hospitals started utilizing 12-hour shifts many years ago due to problematic issues keeping the 2 to 10pm/3 to 11pm shifts fully staffed.

I will be getting off the 230pm to 3 am shift in a couple weeks! Cannot wait...

Specializes in Family Nurse Practitioner.
cracklingkraken said:
Why do people celebrate V-day on V-day? If you wait until the next day, all the leftover chocolate and flowers are on sale. Note to future boyfriend - buy me stuff the next day and double the amount.

I still have little to no clue what specialty to apply for in my residency programs. I'm pretty much open to anything, but I don't have a "passion" for a specific field.

I'm not as good at writing papers as I used to be.

Allen test is used for checking circulation and determining if the ulnar artery pumps blood effectively.

Septic shock is way easier to prevent than reverse. And the mortality rate for septic shock is high.

IV nitroglycerin is prepped in a glass bottle.

You seem to be interested in critical care, judging by the clinical topics you bring up.

Specializes in Med-Surg.
kalycat said:
Ugh. I learned a lot last night but I think I'm still too annoyed about some of the details to even vent. I am a control freak and need to learn to let some things go.

Lost a patient I really enjoyed this week but am relieved in the sense that their suffering was not further protracted. Very difficult case but I know this person has peace now.

Had a patient code who exemplified how important communication is in medicine. Frustrated a bit that my best efforts to correct a small part of the situation (but important to the patient's comfort) just didn't seem to carry over from shift to shift. The code likely couldn't have been avoided by this component of care being better managed, but the patient would have been more comfortable and likely less terrified when it happened.

Anyway. I'm home in my sweats with a glass of wine while it rains. That's a pretty good start to a day off. ?

Amen to good communication shift to shift..good or bad can make SUCH a difference! Sorry you had a rough shift....Yay to comfy clothes and a glass of wine! Enjoy the day off!

You seem to be interested in critical care judging by the clinical topics you bring up.[/quote']

Haha, well I'm in my Critical Care class. So yes, usually what I learn for the week pertains to Critical Care. It does interest me, but I also find neuro, ER, and OR to be quite appealing.