1/23: What I learned this week: Long, long week. But the bagel was tasty.

Nurses General Nursing

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This week has felt painfully long. And here it is: the end. Just in time for the new one to begin already. I'm so not ready for a new week to begin, especially if it's going to be more of the same.

In my world, I've learned....

How fast a 31 year old being treated over the last year for skin cancer can go from okay, to gone.

How utterly heartbreaking it is to watch her husband fall to pieces.

How the very first RR code I ever witnessed, EVER, is doing now. It was during my internship in school. After a narcan bolus woke her up, a narcan drip didn't KEEP her awake (or breathing for that matter). It's been years since that day, and I imagine she thinks we're idiots with tiny fish brains. Her "allergy" to narcan with the response "heart stops" really isn't convincing.

On further reflection, if you ever want to stop someone from giving you narcan, tell them it will stop your heart - the one thing worse than the overdose it is supposed to be stopping.

I can't decide which hospitalist is worse: the one who totally ignores nurses (leading to malpractice suit-worthy near misses), or the one who thinks nurses are secretaries and puts pointless testing and orders in, and schedules things at times that make absolutely no sense. This one is a fan of q3h vitals (floor protocol is 4, so we thankfully can override that), q8h orthostatics (usually they're q12h), q4h fingersticks on NPO after midnight NONDIABETIC patients... The list goes on. Both these people need to go. Apparently people can't be terminated for simply sucking at their job.

It is so, so sad to watch a sweet, elderly, a&o, dignified, former doctor become humiliated by his sudden rush of diarrhea, which he did not make it to the toilet to pass. It was kind of beautiful, though, seeing his recognition and deepening respect for all that nurses do. I don't think that he knew. With one doctor ignoring us, one treating us like secretaries, and this guy, I truly wish we could take time with each physician (especially on a hard day) to show them what we do, and share with them what we know, what we see, support and experience in any given shift.

Kidneys suck. Especially when contrast literally kills them.

I strained stone fragments out of urine that looked like poppy seeds and sesame seeds. Totally got an everything bagel on the way home. Toasted. Cream cheese. YUM!!!

Ages ago I started a thread asking for advice regarding good scrubs for a short, tiny person with a big booty. It's probably been a good year since I asked, but I've finally found my answer! Butter Soft Stretch 8-pocket pants (in petite sizes) and 5-pocket v-neck shirt.

I've decided to hop on a project, choosing frequently seen chronic and acute conditions to gather EBP on for the unit committee I'm on. And suddenly, I'm back on the books and research article libraries like they're crack and I'm hooked.

The recent dynamics change that we are experiencing on night shift are so not good. We've had a rather dramatic drop in the last quarter's satisfaction scores, and as we went through respondent comments, it was pretty clear that a core group of night shifters are likely the cause of the drop.

There are some nights when I feel like I'm the only one chasing down the noisy pumps to make them stop beeping and bed alarms when the ninjas come out of the LOLs. They'll all be online, looking up stuff to buy, while I'm all go-go-go all night. Then, shift change comes, and they're all waiting to clock out and leave. I'm still charting and wrapping up my shift.

Caring for a patient with a horrible looking skin wound might make you slightly freaked out when you get a red spot on your nose that begins to breakdown like 3 days later, then takes days to show progress of healing.

I was really hoping I would have learned the result of my biopsy by now. I have kept this mostly to myself, because of the passing of the wife mentioned at the top of this list. It hasn't helped, though, to feel the sadness and horror of her sudden loss of life due to skin cancer. Just please let this be negative.

This week, the drug of choice appears to be heroin. And hookers. And drunken brawls in the ED.

Deciding to always stay up all night was the best decision I could have made. It's amazing how much more productive I am on my days off when I'm not all jacked up trying to sleep.

I have a person in my life who is constantly looking for things to be angry about. Seek and ye shall find. Not only is this utterly exhausting, but it's incredibly frustrating.

So, yeah, long and complicated week. And I'm way behind on this place. Share with me what I should have learned!!! And, of course, I'd love to know - what have you learned this week?

Eta: I didn't add a video!

What the heck ISSSS this?

I've learned that it is very annoying when books contradict each other while you're trying to study for a test. Different books tell me different things about what the priority intervention is if a chest tube comes out. Some say place the tube in sterile water, while others say place a sterile dressing over the site (I would probably do the sterile dressing first).

My capstone course feels like endless paperwork that is not preparing me at all as a future nurse.

My last semester is already flying by. And my money is slowly dwindling to nothingness as my NCLEX fees, mandatory live review session fees, and other money blood-suckers present themselves.

I started watching Shannara Chronicles, and I'm fairly intrigued. Lost just wasn't doing it for me (sorry, ixchel).

Oh, and Labryinth is just as fabulous as I remember. Also, the plot is frighteningly more creepy than I recall.

I've learned that I'll be doing some rehab for a while thanks to having yet another stroke. This is number 5 in 20 years! The only good thing I can say is that, so far, the worst I've had is left-sided weakness.

What??? Poopy!

Specializes in ICU.
I've learned that it is very annoying when books contradict each other while you're trying to study for a test. Different books tell me different things about what the priority intervention is if a chest tube comes out. Some say place the tube in sterile water, while others say place a sterile dressing over the site (I would probably do the sterile dressing first).

Dressing's definitely the way to go. If the chest tube is out and laying in the bed, it's not going to un-dirty itself because you put it in a cup of sterile water. Now, if they're talking about the chest tube being still inside the patient but disconnected/torn before it hits the atrium, sticking that end in a cup of water is a very good idea so air can still escape from the pleural space but not get back in.

And I love me some Labyrinth. I remember being so upset I nearly threw something at the TV the first time I watched it over Sarah picking Toby in the end. I mean, hello, baby brother so annoying that you wished him away to the Goblin King, or supremely sexy Goblin King who is singing to you, wearing deliciously tight pants, and offering you a whole kingdom? That's just messed up.

Specializes in acute rehab.

I learned that if I follow the instructions in that "how to drive a regular-a55 car in the snow" article that was making the rounds on FB last week, I CAN in fact drive a beat-up front-wheel-drive sedan 26 miles during a state of emergency/travel ban, and hit the floor in one piece and only 15 minutes late. (New driver, as well as new nurse).

Having to do the above was the result of poor planning. Next time I will drive in BEFORE the storm so I can claim one of the good cots.

I will never leave home again without two shovels, a bag of cat litter, and a sleeping bag. Army cots aren't that bad if you can scrounge up an extra pillow and have a good sleeping bag.

I am terrible at prioritizing when I have a patient refusing all food and meds, and the roommate is having anxiety attacks about it, and they're both sitting in their own waste, and one has multiple PUs and the other MASD with open lesions*, I'm doing primary & have four more rooms, because so many other people planned equally badly but are more risk-averse.

(*they were admitted that way, and are healing well thankyouverymuch.)

I will cry when a coworker walks miles through a blizzard so I can have a tech. I will cry when the maintenance guy tells me he got my car out of the ditch I accidentally parked it in the day before. I will manage not to cry in front of my of patients, though, no matter how tired and hungry and overwhelmed I am.

*hands Stripey a tissue*

Specializes in Pediatrics/Developmental Pediatrics/Research/psych.
That's cause you're the real deal, bae.

Aw, thanks Far. I just got home. It took me four hours to get to work last night and three hours to get home this AM.

Specializes in Pediatrics/Developmental Pediatrics/Research/psych.
Isn't it interesting how those who live closest are the first to cal out and those who live farthest are the ones who make it in?

It kind of helps that I am the new gal. I need to make a good impression.

Specializes in allergy and asthma, urgent care.
Holy crap!!!!!! That is terrifying!!!!! Thank goodness he's okay and you had an epi pen!

I have to ask - were you panicked, scared, freaking out? Or were you calm, collected, "it's okay! I came prepared!"

I do wonder how calm I'll be able to be if something major happens to one of my kids. I imagine myself panicked and hyperventilating and completely useless.

That, or I'll be the horrible nurse-family member in the ED who hovers and obsesses over every tiny detail. If they don't get the IV the first time I'll be all like, "gimme that, you're done."

Thank you for good thoughts!!!

I was calm, cool, and collected while the reaction was occurring, but got really scared once I knew he was ok. I made sure he took the Epi-pen to work with him today.

Poppy-I hope you're doing ok.

This week I learnt I really do miss my Mom. I have been living on my own for more than a year for months at a time, while my Mom is in India. And even though I enjoy living alone, I still miss her.

This week I learnt the reason why a surgeon resigned unexpectedly. It was shocking to say the least.

I was reminded that not all "children's" hospitals are the same. I have been trying to make contact with someone at a certain facility for a patient who has a new onset, quickly progressing, and very scary neuromuscular disease (at least that is our current best guess). This facility only has 1 person who is qualified enough to make an appt or even to receive records. Said person has not answered my calls or returned my voicemails in a week.

I'm pretty frustrated. Luckily I have found other facilities who actually want to see this patient.

This week has felt painfully long. And here it is: the end. Just in time for the new one to begin already. I'm so not ready for a new week to begin, especially if it's going to be more of the same.

In my world, I've learned....

How fast a 31 year old being treated over the last year for skin cancer can go from okay, to gone.

How utterly heartbreaking it is to watch her husband fall to pieces.

How the very first RR code I ever witnessed, EVER, is doing now. It was during my internship in school. After a narcan bolus woke her up, a narcan drip didn't KEEP her awake (or breathing for that matter). It's been years since that day, and I imagine she thinks we're idiots with tiny fish brains. Her "allergy" to narcan with the response "heart stops" really isn't convincing.

On further reflection, if you ever want to stop someone from giving you narcan, tell them it will stop your heart - the one thing worse than the overdose it is supposed to be stopping.

I can't decide which hospitalist is worse: the one who totally ignores nurses (leading to malpractice suit-worthy near misses), or the one who thinks nurses are secretaries and puts pointless testing and orders in, and schedules things at times that make absolutely no sense. This one is a fan of q3h vitals (floor protocol is 4, so we thankfully can override that), q8h orthostatics (usually they're q12h), q4h fingersticks on NPO after midnight NONDIABETIC patients... The list goes on. Both these people need to go. Apparently people can't be terminated for simply sucking at their job.

It is so, so sad to watch a sweet, elderly, a&o, dignified, former doctor become humiliated by his sudden rush of diarrhea, which he did not make it to the toilet to pass. It was kind of beautiful, though, seeing his recognition and deepening respect for all that nurses do. I don't think that he knew. With one doctor ignoring us, one treating us like secretaries, and this guy, I truly wish we could take time with each physician (especially on a hard day) to show them what we do, and share with them what we know, what we see, support and experience in any given shift.

Kidneys suck. Especially when contrast literally kills them.

I strained stone fragments out of urine that looked like poppy seeds and sesame seeds. Totally got an everything bagel on the way home. Toasted. Cream cheese. YUM!!!

Ages ago I started a thread asking for advice regarding good scrubs for a short, tiny person with a big booty. It's probably been a good year since I asked, but I've finally found my answer! Butter Soft Stretch 8-pocket pants (in petite sizes) and 5-pocket v-neck shirt.

I've decided to hop on a project, choosing frequently seen chronic and acute conditions to gather EBP on for the unit committee I'm on. And suddenly, I'm back on the books and research article libraries like they're crack and I'm hooked.

The recent dynamics change that we are experiencing on night shift are so not good. We've had a rather dramatic drop in the last quarter's satisfaction scores, and as we went through respondent comments, it was pretty clear that a core group of night shifters are likely the cause of the drop.

There are some nights when I feel like I'm the only one chasing down the noisy pumps to make them stop beeping and bed alarms when the ninjas come out of the LOLs. They'll all be online, looking up stuff to buy, while I'm all go-go-go all night. Then, shift change comes, and they're all waiting to clock out and leave. I'm still charting and wrapping up my shift.

Caring for a patient with a horrible looking skin wound might make you slightly freaked out when you get a red spot on your nose that begins to breakdown like 3 days later, then takes days to show progress of healing.

I was really hoping I would have learned the result of my biopsy by now. I have kept this mostly to myself, because of the passing of the wife mentioned at the top of this list. It hasn't helped, though, to feel the sadness and horror of her sudden loss of life due to skin cancer. Just please let this be negative.

This week, the drug of choice appears to be heroin. And hookers. And drunken brawls in the ED.

Deciding to always stay up all night was the best decision I could have made. It's amazing how much more productive I am on my days off when I'm not all jacked up trying to sleep.

I have a person in my life who is constantly looking for things to be angry about. Seek and ye shall find. Not only is this utterly exhausting, but it's incredibly frustrating.

So, yeah, long and complicated week. And I'm way behind on this place. Share with me what I should have learned!!! And, of course, I'd love to know - what have you learned this week?

Eta: I didn't add a video!

What the heck ISSSS this?

Good luck with the results. Waiting is awful. It never hurts to call and check on the status of things if it has been a few days.. (Hugs)

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I can't with the new generation of nurses/nursing students. I just can't.

I'm talking about the young ones. Omg. What is going on with the world???

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