4/16 What I learned this week: POD2 and I want my button back

Cheyenne RN,BSHS · Apr 19, 2016

It's 5:30 in the morning. Do you know where your sundowner went?

(((( ixchel.)))) Prayers for you to be well soon.

cracklingkraken Prayers that your mom does well. Having fraught the big C myself it is a scarey battle.

FurBabyMom, MSN, RN · Apr 19, 2016

ixchel, hoping things are going well for you - good thoughts/vibes sent your way :)

Last week I learned:

1. No good deed goes unpunished. Sometimes multiple times over.

2. Things aren't always what they seem (I knew this but I got the reminder again).

3. The grass isn't always greener.

4. Someone must have made mention to my ominously colored cloud again - one of the things that happened last week just fits the MO of my cloud.

5. Time with family is glorious (I got to see my mom and brother!).

6. The furbaby is a lot of work. But when she's gone (visiting my parents) you realize how much you gain from having one around.

7. Vacation cannot come soon enough.

8. I figured out the living situation after the end of my current lease! Heck yes figuring out where I'll live next!

9. My impatient self called grad school admissions where I applied to grad school. I still hadn't heard from grad school about admissions status. Turns out, no decisions have been made about my program. :unsure:

10. I had another to share and can't remember it now. Oh well.

calivianya, BSN, RN · Apr 19, 2016

What kind of unit do you work on? I'm still orienting and I am still learning new things even taking a full pt assignment in the ED (4:1). I think a lot of it at a certain point becomes self-initiated. There's always something to learn if you look for it :)

I work ICU - our ratio is 1:2, technically, but we haven't been staffed to have 1:2 ratios for a long time. Especially when the 1:1s roll in - we've had lots of those lately, so everyone who doesn't have a 1:1 has three patients on those days. Everyone. It makes it really hard to find enough help to get anything at all done.

I just have a hard time feeling sorry for orientees complaining about three patient assignments when their preceptors are right there with them all shift. They don't have to hunt anyone down for turns, or for signing off protocols/drips/etc., because they have a dedicated second set of hands. The rest of us don't have that luxury.

How can we get away with stashing patients in rooms that don't have a private bathroom and only one shower on a floor with 28 beds?[/quote']
Are private bathrooms and showers important? None of my unit's rooms have private bathrooms - there's a toilet that comes out of the sink area, but there's no curtains/doors/anything of that nature, and there is no sort of bath/shower anywhere on the floor. I didn't realize that was something JC looks at.
On a related note, I realized yet again how tacky some patient family members are. Found a patient's relative pooping in the room toilet the other day... as in, I walked in to do an assessment and got greeted with the view (and smell) of the visitor sitting there with his pants down. Really?! I don't understand what is wrong with people.

canigraduate · Apr 20, 2016

I learned it is possible to go through 13 3L bags of NS in one shift on a particularly difficult CBI.

I learned to wear PLASTIC PPE when aspirating clots and hand irrigating said CBI. No one wants to wear bloody pee home.

I learned that I know more than I thought I did and that somehow I am becoming a resource at my job.

I learned that taking over a third unit when the two we already had were mismanaged is not turning out well for anybody.

I learned that I am getting old and bitter. I don't like being that way, so some life changes are in order. My goal is to be like my 72 year old Uncle Mike, who still has as much fun as a teenager but isn't TSTL.

Hugs to ixchel. I hope you are feeling better!

Jensmom7, BSN, RN · Apr 20, 2016

Ok, nursing related to keep it on topic:

I learned that the attending MD who wants to remain attending and will sign the death certificate but has turned over *all* the orders to my Medical Director has just become my favorite person ever. SO much easier to call my doc, present an issue and hear "Ok, let's get this person comfortable. We'll do..."

Now, personal WILTW:

I learned that being married to someone significantly older, who has always been a bit of a "Special Snowflake", with more than a few medical issues, who has been retired for 18 years and has no concept of today's work environment, who thinks nothing of expecting me to complete the "honey-do" list while I'm at work, and then give him my undivided attention when I'm home, doesn't get any easier to deal with the longer we're married (33 years now). I love him, but...dayum!!

I've been following the usual threads, but just haven't had the energy to post very much. I truly feel for everyone going through problems, both personal and professional, but I'm barely holding myself together right now, with not enough left in the tank to "like" some of the awesome (and heartbreaking) posts lately, much less respond to them.

I'll be fine in a little while. In the meantime, I'm thinking of all of you, and wishing good things to come.

NotAllWhoWandeRN, ASN, RN · Apr 20, 2016

-This week I learnt or rather it was reinforced, that Joint Commission is not worth taking seriously. I am very surprised my place of employment did not have major citations, but only minor ones. How can we get away with stashing patients in rooms that don't have a private bathroom, and only one shower on a floor with 28 beds? Plus, this overflow area is staffed with random people, who were floated or got mandatoried to staff this floor.[/quote']
Good ol' JC cares about whether your linen cart is covered (with a filthy drape that everyone has to touch to get to those sheltered linens) but not whether 28 patients have to share one shower? Fascinating.

NotAllWhoWandeRN, ASN, RN · Apr 20, 2016

WILTW:

-I will never be able to haggle about pay. My employer did a market analysis and raised my pay nearly $2, which brings me back to what I used to make anyway. Every employer claims everyone's rate is based strictly on years of RN experience, but I never quite believe it.

-I work with some pretty phenomenal techs (Ok I knew that well before this week). My unit's nurses knows they have great techs, and look after them them accordingly.

-A shift full of newbies is rough on the charge nurse. When we had a question, we had to get in line.

-I felt relief when I hit "send" on my request to go part-time. It may not be forever, but it relieves some of the anxiety of going back to the job where I got hurt, and where each shift still causes an increase in pain. It hasn't been approved yet but my manager said it would be my choice, so I expect the request to be approved.

ixchel · Apr 21, 2016

Many 'Get Well Soon' wishes to you Ixchel!!
Can I just add... I was really surprised to read you are pediatric sized- just by reading your posts, I've always imagined you to be more Amazonian! Funny how you get a picture of people in your head...

Amazonian! Like, massive? [emoji5]ï¸

Like, badass?

[ATTACH]21737[/ATTACH]

ixchel · Apr 21, 2016

It all sounds very exhausting and challenging! I think the "mommy misses you" gifts are an amazing idea. Please give yourself credit instead of beating yourself up about "could have done better". We all could always do better.
Prayers for a speedy and complete recovery!

Jess, thank you so much for this! [emoji173]ï¸

ixchel · Apr 21, 2016

I work ICU - our ratio is 1:2, technically, but we haven't been staffed to have 1:2 ratios for a long time. Especially when the 1:1s roll in - we've had lots of those lately, so everyone who doesn't have a 1:1 has three patients on those days. Everyone. It makes it really hard to find enough help to get anything at all done.
I just have a hard time feeling sorry for orientees complaining about three patient assignments when their preceptors are right there with them all shift. They don't have to hunt anyone down for turns, or for signing off protocols/drips/etc., because they have a dedicated second set of hands. The rest of us don't have that luxury.

On one hand, yes. On the other, they're likely thinking about being fresh off orientation in the near future and getting 3 patients. Just TWO is overwhelming often.

canigraduate · Apr 22, 2016

Hugs, Jensmom7!!

ixchel · Apr 23, 2016

Slow week this week! Goodness! I'm not sure we've ever had so few posts in our WILTW thread. Perhaps we are all mourning the loss of Prince. [emoji17]

This next week will possibly be brought to you by Farawyn. I've been back and forth about it because I didn't make a list, but I actually have a lot I could add in my brain. Keep an eye out later in the day for it. I'll try to remember to link it here.

Love and gratitude to all for the support! You are good people and I am thankful for that. [emoji173]ï¸