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2/13/16 What I Learned This Week: Discipline is King

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TheCommuter has 10 years experience as a BSN, RN and works as a CRRN, now a case management RN.

19 Likes; 1 Follower; 228 Articles; 315,269 Visitors; 27,607 Posts

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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... You are reading page 4 of 2/13/16 What I Learned This Week: Discipline is King. If you want to start from the beginning Go to First Page.

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I've learned the low dose narcan in conjunction with narcotic pain medication pca can prevent itchiness.

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VivaLasViejas has 20 years experience as a ASN, RN and works as a Retired/Disabled Nurse and Blogger.

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Some do. Work with one who told one of my coworkers no way was she coming back before the full 12 week FMLA was up after a lap chole.

You're kidding, right? I went back to work (med/surg) a whole WEEK after my lap chole. Maybe I shouldn't have, but I did it. I also pulled a month's worth of weeds out of my garden and went to an all-day picnic within days of my surgery. I felt so much better that I couldn't wait to get back to my "old" life of being active and healthy!

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Rose_Queen is a BSN, MSN, RN and works as a Staff nurse educator.

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You're kidding, right?

Nope. She wanted to come back at 6 weeks. Tried to get him to compromise on 8-10. No go. She did have a little bleeding intraop (not enough to require open incision) so maybe that was part of it?

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kalycat works as a RN.

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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. :)

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SWM2009 has 2 years experience.

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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.

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Farawyn has 25 years experience and works as a RN.

49 Likes; 2 Followers; 97,239 Visitors; 12,639 Posts

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.

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TheCommuter has 10 years experience as a BSN, RN and works as a CRRN, now a case management RN.

19 Likes; 1 Follower; 228 Articles; 315,269 Visitors; 27,607 Posts

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.

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kalycat works as a RN.

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

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

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OrganizedChaos has 10 years experience and works as a LVN.

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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!!!

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4 Likes; 1 Article; 14,219 Visitors; 1,509 Posts

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 ...

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12,822 Visitors; 1,855 Posts

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.

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SWM2009 has 2 years experience.

7,749 Visitors; 421 Posts

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.

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