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?
I learned that being a nurse and being a caregiver are two totally different things. My husband has terminal pancreatic cancer and has decided that if the chemo they want him to go on doesn't kill him, it will make him wish he were dead and he wants no part of it. As a nurse, I can maintain a clinical distance and discuss these things intelligently with his doctors; as a wife, I'm scared and sad and I don't know the first thing about any of it.
I've learned that being able to assist someone with their emesis, clean them up & go back to nurse station starving is an actual "asset" on the Psych Unit. So is being able to perform wound care on nasty & scary wounds, clean out bedside commode,& still be hungry --- always get the "in awe" look when I wash up then head for my snack!!!
I've learned that I really am a Psych Nurse (dang it!)
I learned that being a nurse and being a caregiver are two totally different things. My husband has terminal pancreatic cancer and has decided that if the chemo they want him to go on doesn't kill him, it will make him wish he were dead and he wants no part of it. As a nurse, I can maintain a clinical distance and discuss these things intelligently with his doctors; as a wife, I'm scared and sad and I don't know the first thing about any of it.
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.
I straight up tell my smokers that I'm a smoker, and I use a nicotine patch at work. I have found that they are more apt to request the nicotine patch when I relate (and show) my patch. My weakness is their weakness, and it helps to acknowledge it.
1 - I learned this long time ago - am an ex-smoker from the mid-1970s, but I don't harp. Yeah, I know all the benefits - improved pulmonary function, improved sense of taste and sense of smell, clothes don't smell or have that greyish/yellow/tan color (smokers also have that same skin color - makes them look older), cost savings, etc. I'll never preach to that choir about the glorious benefits of quitting. But nor will I enable them.
Honestly (and somewhat embarrassedly) have to say this though, every now & then when someone lights up, I do so remember FONDLY the experience. There was rarely anything so good as lighting up with a fresh hot cup of coffee - good memory!!! ALMOST makes me want to light up again, but not quite.
2 - Also learned (much to my consternation) that I am getting OLDER. Too many celebrities are dying that were ones I liked and were my age or so. When Sinatra died years ago, it was ,yeah, good singer, but my parents' generation. Now it's been David Bowie, Natalie Cole and Glen Frey - whoa! Too young! WE are not old. I want to be like Peter Pan and never grow up and never grow old!
I have learned more about cysts than I wanted to know - and watched a few cringe worthy videos of cyst I&Ds.
I have had a decent sized cyst on my back for probably a year at least. It didn't bother me so I didn't bother it. But the other day it became red, inflamed and painful. It looks like it wants to do an impression of Mount Vesuvius!
MD appt in the morning to see what should be done about it.
Confession - I'm kinda wimpy when it comes to pain...
Very few things give me greater satisfaction than doing an I&D on a really gnarly cyst. It's kinda like cleaning the bathroom-instant gratification without a lot of time. Get lots of lidocaine before they drain it!
Very few things give me greater satisfaction than doing an I&D on a really gnarly cyst. It's kinda like cleaning the bathroom-instant gratification without a lot of time. Get lots of lidocaine before they drain it!
And wear a mask-nothing like the smell of what comes out of a sebaceous cyst...[emoji33][emoji33]
I almost never suggest "quitting smoking" to my clients anymore because, absolutely, the automatic answer is "NOPE". Instead I've been having better luck suggesting using nicotine patches to help them "cut down a little bit." It's all about realistic goal-setting.
I don't know if family physicians are just getting a ton of pressure to slow down on prescribing opiates, but I've been having a rash of palliative/hospice clients with nothing but stupid things like Tylenol or diclofenac for their cancer pain. Really? Really? What in the hell is Tylenol going to do for my clients? My little old lady with ovarian cancer, belly as big as a beach ball, taking enough Tylenol to fell a horse and finding no relief. WHAT A SHOCKER. For the love of god can we get this woman some opiates?! I'm not ashamed to say I spoke a little sharply to the doc when I called her that day. At what point is it no longer "conservative" and becomes unethical, poor treatment, irresponsible?
Were the pain meds changed? Is she getting adequate relief now?
pecas
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((((Viva))))