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? ?

Farawyn said:
What's your nationality?

Half white/Caucasian (whatever the PC term is) and half Korean.

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Rose_Queen said:
Really? If someone comes to my facility with a history of MRSA, we do swabs of nares, groin, and axilla. If they come back negative, patient can come out of isolation.

Yes, that does make more sense. But for some reason, the hospitals here keep you on isolation precautions. Same goes with VRE.

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cracklingkraken said:
Half white/Caucasian (whatever the PC term is) and half Korean.

:inlove:

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This week I learned:

I'm not going to be an OR nurse. As fascinating as the surgeries are, I got woozy and then later, I got bored.

That the cell-saver does a number on blood cells. Eventually you have to transfuse.

What the term "barrel chest" really means. Saw one for the first time today...whoa!

That I have no sense of direction. I got lost coming back from the bathroom and had to ask for help.

That my capstone project topic has been vetoed. I followed the rubric and PICO format and was told two totally different reasons, by both professors, which contradict each other and the rubric.

And finally, that my first responder teacher (he's an EMT who teaches a class) is a total jack***

He actually told a student that "the problem with nurses is that they all have an overinflated sense of worth." Right after he finished explaining the morphine is a benzo. Ugh!!

Is it May yet??

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Specializes in ICU.
cracklingkraken said:
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.

No offense to anyone who does neuro, but neuro to me was one of those things that was absolutely fascinating to learn/read about, but then when I encountered them in inpatient rehab, I said nope, nope, nope, all the nope. Half paralyzed strokes we had to get up to the bedside commode, half of them thinking they were just fine and could walk unassisted and the other half so scared it was a 30 minute ordeal to even get them to try to get up, traumatic brain injuries who were violent and inappropriate... all the nope ever. The brain is interesting as long as all I have to do with it is study it in a classroom.

CBlover said:
I need to quit giving myself such a horrible assignment when I'm in charge. I always have the worst day if I'm charge because I hang myself.

What I have learned about being charge is that it's another NOPE! And I will protest loudly if anyone ever tries to make me be charge. On my unit, the charges just about have to give themselves the worst assignment because of the sheer amount of whinypants I work with. I was strategically positioned to listen to one of the Unit Drama Queens accuse the charge of favoritism because she had another three patient assignment AGAIN! (so did I, and I kept my dang mouth shut, thank you very much) and listened to her cry all kinds of fake crocodile tears about it. This girl has been a nurse longer than I have; her behavior is just not cute. She didn't look like she was suffering as she put Pandora on her phone later and walked around the unit singing loudly at 0300. Obviously real suffering happening there. :sour:

Heathermaizey said:
Besides, who wants to study electrolytes when their boyfriend proposed to them last night??? I'm too busy admiring my shiny, new ring! :yes:

CONGRATULATIONS! That's wonderful. :cat:

Wrench Party said:
2) Nothing sends me faster into a rage than crappy nursing care.

You would have hated following me last shift I worked. Fortunately, day shift was agreeing with me on my logic so I didn't get eaten alive when I gave report, but I let a patient run hypertensive all night long. Like really hypertensive. >180/110 hypertensive. A few 190s and higher sprinkled in there.

Patient had been on a labetalol drip, we weaned it off... and she promptly decided she didn't like swallowing pills. Really. Refused all her BP meds. Every last one of them, over the course of two days. Either she didn't like the coating on them which tasted bad, or they made her nauseous (offered to bring her some Phenergan/Zofran with her pills, which she refused because she'd just rather not take any pills at all, and didn't want IV nausea meds either), or she was tired and didn't feel like sitting up. Patient was YOUNGER THAN I AM and in kidney failure and heart failure due to untreated hypertension. Probably related to her extra-morbid obesity, and her refusal to take any pills at home either.

So what did I do? I made a note of it and left her alone. I snuck in a few IV push labetalol and hydralazine doses (which brought her done from like 188/- to 185/- if that) while she was sleeping because she'd refuse them if she was awake, but that's all I did. Maybe everyone is all shocked that an ICU nurse is going to let her patient run hypertensive (I know I got some side eyes from my coworkers), but restarting the labetalol drip because the patient won't take PO meds is putting a band-aid on a bullet hole when she just needs to be discharged so she can go home and do whatever the heck she wants to do with what couple of years she probably has left, if she even has that long. What's an extra day or two of ICU going to do for someone who refuses to take meds at home anyway? We can't lock her in ICU for the rest of her life and throw away the key, so just let her run hypertensive and send her home. Yep, my filed vitals looked like crap all shift long.

Still can't decide if that's me being a reasonable person or me being a really apathetic nurse.

:blink:

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Specializes in Cardiology, Cardiothoracic Surgical.

Calivianya, I guess I need to be more specific. I don't mind when nurses have had total SHTF days with their patient load and didn't get around to the little tasky stuff- that I can deal with. Just let me know in report. Or if the patient is refusing treatment, also relevant.

I do mind the "pass the buck" mentality that occurs, especially on otherwise stable patients. It speaks more to lazy unit culture and lazy than anything else.

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Specializes in OB.

This week I learned that the 52 seconds it can take to dislodge a shoulder from a pelvis during a shoulder dystocia can be the longest 52 seconds ever.

Luckily baby was fine and mom is doing good too.

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Specializes in acute rehab.

My dog's chest is "pristine" on X-ray, she is not obstructed after eating an unmentionable, and I accidentally out myself as a nurse even in the dog ER.

My dog is 10 years old and still eats unmentionables.

The dandelion wine I made back in 2013 has aged very nicely. However, it's not strong enough to counteract all the coffee I drank on the icey-rainy-foggy drive home tonight.

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Specializes in CVOR, CVICU/CTICU, CCRN.

I've learned that I HAVE to get off night shift ASAP. I used to be all gung-ho about nights, but maybe I'm just getting older ...

I really enjoy the company of snarky, sassy, and sarcastic people. Really!

I miss my culinary career sometimes, but then I remember how much stress and how little pay was involved.

I still have trouble saying no to extra shifts. That paycheck tho ...

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calivianya said:
No offense to anyone who does neuro, but neuro to me was one of those things that was absolutely fascinating to learn/read about, but then when I encountered them in inpatient rehab, I said nope, nope, nope, all the nope. Half paralyzed strokes we had to get up to the bedside commode, half of them thinking they were just fine and could walk unassisted and the other half so scared it was a 30 minute ordeal to even get them to try to get up, traumatic brain injuries who were violent and inappropriate... all the nope ever. The brain is interesting as long as all I have to do with it is study it in a classroom.

I have considered this, too. Neuro definitely is not one of the more "glamorous" specialties. But it is amazing how it is clinically expressed in a patient. I'm not very found of the personality changes or sudden seizures. This one I'm still hesitant about but we'll see.

Circulating or scrub nursing has recently peaked my interest.

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I learned that there are some doctors that are completely dillholes. And not because they have a God complex.

I learned there are some nasty nurses at my hospital; not nasty as in dirty, nasty as in bad attitude.

What I hope to learn. .....

Better time management

How not to get frustrated when you keep getting called away while trying to pass meds

When will my legs and feet get used to being on them

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StripeyDog said:
My dog's chest is "pristine" on X-ray, she is not obstructed after eating an unmentionable, and I accidentally out myself as a nurse even in the dog ER.

My dog is 10 years old and still eats unmentionables.

The dandelion wine I made back in 2013 has aged very nicely. However, it's not strong enough to counteract all the coffee I drank on the icey-rainy-foggy drive home tonight.

Dandelion wine? I'm intrigued.

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