After last week's fun and games, I'm feeling rather boring!
Here is what I've learned:
1. Hepatitis, PVD and pyoderma gangrenosum are a horrible combination for medical history. HORRIBLE!
2. Chasing a person's heart rate, blood sugar and blood pressure all night long while this normally walkie/talkie person won't wake up, makes it a bit frustrating to have an extremely conservative hospitalist on board that night.
3. Going completely out of your way for a complex dressing change (moving slowly to let pain ease, knowing the lady in #2 will be crashing again soon) makes it incredibly frustrating to learn this guy complained about getting two changes in one shift. Dude. First time was for assessment and that shizz was nasty. Second time was because dude acted like he had compartment syndrome (he did not), and the bandage was again nasty.
4. I've been a city mouse in the country way too long.
5. My little girl does not want to be a nurse when she grows up, but she does very much want to learn nursing stuff. Her timing could not be more perfect. My son helped me study for my bachelors degree. Now she can help me with my doctorate!
6. That same little girl has been a wonderful wound care nurse for my biopsy site.
7. The original Siamese Twins had 21 total children. Their cause of death - one had a stroke and died a few days later. Apparently you don't survive having a dead person's blood running through you. Incidentally, they shared a liver.
8. Morphine is a hell of a drug.
9. It is actually possible for a systolic blood pressure to go from 90s to 190s and back to 90s in the span of a half hour without medication being administered and with absolutely no change whatsoever in patient or blood pressure cuff. (Would absolutely love to hear theories on this.)
10. People respond better to smoking cessation education when you cut them some slack.
11. Smokers can also sniff out a never-smoker from a mile away. I'm sorry to say it, guys, but many (if not most) of these smokers are tuning your out as soon as they hear, "quit smoking". It has nothing to do whether they're considering quitting or not. They know you don't know how hard it is to quit and they feel judged.
12. Scarlet fever comes with a white strawberry tongue.
13. If you're getting lidocaine SQ/IM, ask for a nurse to give it to you. I have gotten this stuff from doctors and they just go grab the biggest needle, draw a bunch up, and shove it in. This NP grabbed an SQ of reasonable size, injected a tiny bit, waited, then injected the rest rather slowly, making sure the first part was able to numb the rest. This is why nurses rock. We think of stuff like this.
14. Hope for Alzheimer's research: the brain of a mouse has lymphatic vessels, draining fluid and WBCs from the brain. Also, medications which enhance the "brain cleaning" system (preventing/decreasing the amount of tau buildup) are being researched. Unfortunately, those already known to be affected won't benefit from this research. But it is certainly promising for those of us being left behind by Alzheimer's sufferers.
15. Apparently a kid played a trick on his nurse mom by convincing her she won the Powerball. If any of you is that mom, I'm sorry. So, so sorry.
Alright, peeps. How about you? Learn anything good?
9. It is actually possible for a systolic blood pressure to go from 90s to 190s and back to 90s in the span of a half hour without medication being administered and with absolutely no change whatsoever in patient or blood pressure cuff. (Would absolutely love to hear theories on this.)
I am with you on this one. We have a resident that was admitted, probably will be long term as this is her second admission in 6 months, with the same problem. She has these weird non-responsive episodes lasting anywhere from a few seconds to 15 minutes that were initially diagnosed as syncope and her BP is all over the place! She can go from systolic's in the 80's to over 200 during the course of a shift. She has been worked up by cardio and now neuro is seeing her and still no definitive reason for the crazy BP readings or the non-responsive episodes. Best even the experts can come up with is possible seizure activity, which makes sense for the type of episodes she is having but I don't understand how the see-saw BP factors in. The BP readings aren't even consistent when she is having an episode. BP checks when she goes non-responsive can range from low to high or even absolutely normal with seemingly no effect on the onset or longevity of the episode. It's very strange and I would love to hear everybody's thought on this.
PS...number 15, the kid that tricked Mom. That's just cruel. The kid should learn that practical jokes are not always funny. That child would be grounded for a VERY long time.
1) Payments made towards your student loan while you're in school only go towards principle, not interest
2) Out of the states I've applied to for license endorsement, Texas has made me jump through hoops more than North Dakota and Minnesota. I don't know why I decided to apply for a Texas license. I'm not in a position where I want to move, yet.
3) It takes a long time to reactivate a license, even though I have 2 active licenses in other states, and have worked full time on one state's license for 3 years.
4) I think I may have a form of SAD. My energy levels are low, and usually are in the winter months.
1) Payments made towards your student loan while you're in school only go towards principle, not interest
2) Out of the states I've applied to for license endorsement, Texas has made me jump through hoops more than North Dakota and Minnesota. I don't know why I decided to apply for a Texas license. I'm not in a position where I want to move, yet.
3) It takes a long time to reactivate a license, even though I have 2 active licenses in other states, and have worked full time on one state's license for 3 years.
4) I think I may have a form of SAD. My energy levels are low, and usually are in the winter months.
Wondering why you are already paying for a license in a state you are not planning on working in, at least not for awhile. That's a rather expensive "what if" since you could apply for license endorsement when you actually need it. ND and MN I can see as at least they are border states so it's conceivable that you could work in both. Assuming since you hold licenses in border states that you live in one or the other, TX doesn't make much sense...that'd be one hell of a commute!
1) No matter how awesome you actually did on the NCLEX, you will have your stomach in knots for the next 48hrs absolutely convinced that you failed. I had heard this many times but didn't actually believe it until now. I almost cried in relief.
2) I relearned that the state of CT takes forever to change your license to active status. Already knew this, but hoped something had changed, took almost a month for my paramedic license to go active years ago. But also learned that I should actually have a license but the state is just slow updating the online system. Going to call tomorrow.
3) Now that I am done with the testing etc, I am so much more excited to start my new job in a few weeks than I expected. But also pretty terrified. Ordered 3 ED nurse textbooks. One is all procedures. I wanna be prepared and not look like a jerk. I know that ED emergency nursing is going to be so completely different and also at times much the same as prehospital emergency paramedic-ing. Thanks to everyone who has posted about their experiences moving from the field to inside. I know this is going to be extremely challenging, I just want a seamless transition, so any and all advise is welcome.
4) I am dreading any snow more and more each passing day. I have enjoyed this easy winter so far.
I've read this posting religiously for a long time, but this is my first time posting. So here goes...
1. I've learned that no matter how long I've been nursing, something will come along that will make me feel like a new grad.
2. I've been worried about the toll that floor nursing is taking on my 58 yr old body, but Im not ready to leave the floor quite yet. Too much to learn.
3. The title 'Charge Nurse' doesn't entitle you to take charge - of everything, every time.
4. That even though I know I need to get my BSN, if not my MSN (see #2), it's really hard to get motivated to do so while working two jobs, (with house, husband, addict son, custody problems with grandkids, etc). Not to sound whiny, I know I can do it, just need to get off my butt.
5. I really, really appreciate the nurses who post on here for their advice, honesty, humor & the chance to 'let our hair down'!
I've read this posting religiously for a long time, but this is my first time posting. So here goes...
1. I've learned that no matter how long I've been nursing, something will come along that will make me feel like a new grad.
2. I've been worried about the toll that floor nursing is taking on my 58 yr old body, but Im not ready to leave the floor quite yet. Too much to learn.
3. The title 'Charge Nurse' doesn't entitle you to take charge - of everything, every time.
4. That even though I know I need to get my BSN, if not my MSN (see #2), it's really hard to get motivated to do so while working two jobs, (with house, husband, addict son, custody problems with grandkids, etc). Not to sound whiny, I know I can do it, just need to get off my butt.
5. I really, really appreciate the nurses who post on here for their advice, honesty, humor & the chance to 'let our hair down'!
Specializes in Complex pedi to LTC/SA & now a manager.
1 infants are amazing can go from HR's in 200's to 90's in a minute once all comfy (I'm a mean nurse that changes soaked diapers overnight and I have the audacity to put the pants back on!)
2. Infants are awesome for 8-12 hrs then you give them back.
3. I'm best with the littlest ones. And my agency is desperate for baby nurses.
3. My prescription benefit company must live in hades. Over 1500: BBB complaints!
4. My father's curse/wish has come true...in many ways my child is just like me.
5. I should have been a troll and live under a bridge but night shift will have to do.
- that little old combative ladies are actually kinda fun...I'll volunteer to take them in a minute over a sassy mouth 18 yr old male
- that I need to work on keeping my composure with sassy mouthed 18 yr old males...told one this week "Hey bud, this ain't a bed and breakfast" and went ... "Did I just say that?!"
-that IV drug abuse is a sad sad story and that it can make a 18 yr old male look 38 and nearly paralyzed from the waist down due to an abcess in the spine
-that I'm really grateful I've made some right choices along the way
Like PP cagilg, I learn something new all the time even as I've retired. Just googled to look up something from another post question. Interesting answer to be found.
NURSING - lifelong learning.
I've also learned that I SECRETLY seem to like snow. Just started a light snow here in west central NJ. Had to check it out - heretofore I disliked snow r/t commuting to work. With retirement, I can just look out the window, smile and then make some soup.
1) No matter how awesome you actually did on the NCLEX, you will have your stomach in knots for the next 48hrs absolutely convinced that you failed. I had heard this many times but didn't actually believe it until now. I almost cried in relief.
2) I relearned that the state of CT takes forever to change your license to active status. Already knew this, but hoped something had changed, took almost a month for my paramedic license to go active years ago. But also learned that I should actually have a license but the state is just slow updating the online system. Going to call tomorrow.
3) Now that I am done with the testing etc, I am so much more excited to start my new job in a few weeks than I expected. But also pretty terrified. Ordered 3 ED nurse textbooks. One is all procedures. I wanna be prepared and not look like a jerk. I know that ED emergency nursing is going to be so completely different and also at times much the same as prehospital emergency paramedic-ing. Thanks to everyone who has posted about their experiences moving from the field to inside. I know this is going to be extremely challenging, I just want a seamless transition, so any and all advise is welcome.
4) I am dreading any snow more and more each passing day. I have enjoyed this easy winter so far.
Congrats!
LI here and we are getting a few flakes right now.
Well, this past week was a lot more interesting for me than it usually is, and it's my first week of class!
I learned how to read EKG strips and identify the basic cardiac abnormalities. Any ventricular dysrhythmias tend to be more critical. V-fib and V-tach can give you a pulseless patient if you don't get catch it quick enough: Code Blue.
If you're calling a physician at night, always have your ducks in a row. More likely than not, they won't really want to speak to you.
For dysrhythmias, don't use a Dinamap because there is apparently new research that possibly indicates inaccurate BP readings - use a manual cuff.
12-lead EKGs are use for diagnosing heart rhythms, as opposed to telemetry.
This is anecdotal, but I've taken BPs on many a dysrhythmic patient, and have *never* found a clinically significant difference between automated and manual BPs - although the equipment I'm talking about is ICU monitors and not dynamaps meant for doctors' offices and outpatient clinics.
... "Did I just say that?!"
kbrn2002, ADN, RN
3,969 Posts
I am with you on this one. We have a resident that was admitted, probably will be long term as this is her second admission in 6 months, with the same problem. She has these weird non-responsive episodes lasting anywhere from a few seconds to 15 minutes that were initially diagnosed as syncope and her BP is all over the place! She can go from systolic's in the 80's to over 200 during the course of a shift. She has been worked up by cardio and now neuro is seeing her and still no definitive reason for the crazy BP readings or the non-responsive episodes. Best even the experts can come up with is possible seizure activity, which makes sense for the type of episodes she is having but I don't understand how the see-saw BP factors in. The BP readings aren't even consistent when she is having an episode. BP checks when she goes non-responsive can range from low to high or even absolutely normal with seemingly no effect on the onset or longevity of the episode. It's very strange and I would love to hear everybody's thought on this.
PS...number 15, the kid that tricked Mom. That's just cruel. The kid should learn that practical jokes are not always funny. That child would be grounded for a VERY long time.