I can't wait to see what our ED nurses might contribute to this thread tomorrow morning.
This week, I learned.....
1. I understand anorexia comes hand in hand with laxative abuse, but I'm pretty sure my non-anorexic self may consider an abuse of laxatives habit after the number of little old ladies I keep getting with bowel obstructions. For reals, y'all.... This never ends well.
2. A rat will dissolve in Mt. Dew in 30 days.
3. I have officially created a "do not touch me" list with two MDs names firmly on it. I have made my wishes known to my coworkers.
4. Every now and then, one of our hospitalists will comment to how great our nurses are - how they're supportive of the MDs, attentive, alert, etc. I always figured they just say that so we don't turn on them. lol We had a MD leave last week, though, and he expressed this same thought. The supportiveness of the nurses is the exact reason I came to work at this hospital, so its very awesome to hear that my instincts were good from people who have experienced nurses at other facilities.
5. People with insecurities will project them on to people they feel jealousy toward, especially in the professional environment.
6. I need to meet ZDogg.
7. Lorazepam is a hell of a drug.
8. To all the MDs out there, if nurses are telling you something big is being missed with a patient, PLEASE listen. We don't want to bug you over and over just as much as you don't want us to bug you over and over.
9. Never underestimate the power of counter transferrence. I saw an MD cry this week as he informed a patient she may likely have cancer.
10. Regarding the patient, cervical cancer looks very icky "face to face".
11. Also regarding that patient, it is so weird what people will lie about. Its better to admit you haven't seen a GYN in years than to pretend you were just there. By the size of that black icky spot, you haven't been in awhile.
And for my PSA, ladies get your paps and pelvics whether you've bumped uglies since the 90s or not.
I just had a patient a few weeks ago who walked in for an outpatient procedure with lips and tongue visibly swollen. Patient had chalked it up to a reaction to the bowel prep even though it's happened once before.... Patient wasn't in any distress, but I still alerted the anesthesiologist. Even though pt takes an ace inhibitor, anesthesiologist said not to worry because patient's "been taking it for months". I've seen angioedema from an ace inhibitor in a pt that had been on lisinopril for 3 years so severe that pt was trached and transferred to ICU, but I'm not getting into a p***ing contest with a physician. I watched this patient like a hawk and documented my tail off. IV Benadryl helped with the swelling a little, but the physician's indifference was really unsettling!
Yep, no one knows really why it can happen when someone has been on an ACEI for a long time. Because it's not a histamine-mediated reaction, steroids and Antihistamines usually have minimal to no effect,but they don't do harm either.
Please say that someone told the pt to stop taking the ACEI and see the PCP!
I learned that there is only so much that one person can handle at a time, and that right now I'm about halfway between scared, crying, and RainMain in the airport level freaking out.
My stepfather has been sick, my mom is having surgery next week, my husband is getting his stuff together to go to Mexico for a visa interview that I *hope* he'll return from (we think we're ok but no guarantees, he could get stuck), I've got a particularly intense end of semester happening right at about the same time. I'm learning to step back and let other people help....that's hard, esp as a nurse. We're used to being able to make it all happen, and right now I can't. There is only so much I can do with the two hands/two feet God gave me.
Specializes in Cardiopulmonary Stepdown/Cath Lab, ICU.
I learned that:
A long dilaudid-induced sleep can completely change someone's outlook on their situation and make them realize everything might be okay.
Helping above person finally rest makes you the best nurse ever and make them indeed start dialysis.
Retired police officers have just as many awesome/funny/ridiculous stories as nurses.
Spending 45 minutes unwrapping cleaning and re-wrapping your century old patients legs also makes you the best nurse ever.
That 8 times out of 10 if the patient is younger than 50 and admitted to the floor, they will be suddenly helpless, in extreme pain, or just a plain ****. Or worst, all of the above (not really new, just re-affirmed.)
10. Regarding the patient, cervical cancer looks very icky "face to face".
11. Also regarding that patient, it is so weird what people will lie about. Its better to admit you haven't seen a GYN in years than to pretend you were just there. By the size of that black icky spot, you haven't been in awhile.
And for my PSA, ladies get your paps and pelvics whether you've bumped uglies since the 90s or not.
Unfortunately, I've also seen cervical cancer face to face. But nobody wants to hear those gory details.
This week I learned:
-Giving report to the one grouchy nurse on your floor will still things to complain about. No matter how many i's are dotted and t's are crossed.
-Grouchy will complain about a patient receiving IV morphine for 9/10 pain, "because they can't get discharged if they received IV narcotics within 24 hours."
-Patient still was discharged.
-If you come to the USA on a student visa to learn English, try to learn English. You might need it when you're in the hospital.
-I'm sure happy I won't be working on Monday if someone decides to do sperm banking.
-Apparently IR will try to refuse to do a procedure if your patient doesn't speak English.
-No IR, you still need to do the procedure! If I have to use a translator phone to find out when my patient last pooped, you can use it to get consent!
-No matter how many times I give report, no, I don't know what time the procedure is. IR works bankers hours and I can't call them on night shift.
-I can scare the poop out of a patient by threatening to give them a suppository. Yes it goes up your butt.
-Sometimes patients will try to talk your ear off when they're bored. There's a lot to learn about trains.
-Oxygen is real important. Hypoxia confusion/rage can also make it difficult to get said oxygen back on the patient.
I learned that there is only so much that one person can handle at a time, and that right now I'm about halfway between scared, crying, and RainMain in the airport level freaking out.
My stepfather has been sick, my mom is having surgery next week, my husband is getting his stuff together to go to Mexico for a visa interview that I *hope* he'll return from (we think we're ok but no guarantees, he could get stuck), I've got a particularly intense end of semester happening right at about the same time. I'm learning to step back and let other people help....that's hard, esp as a nurse. We're used to being able to make it all happen, and right now I can't. There is only so much I can do with the two hands/two feet God gave me.
(((((Elvish))))))
You hang in there, and let other people help you, and come here and vent if you can't let your guard down in RL!
I learned that even though I've mellowed some over the years, finding out that Hospice status apparently isn't considered important enough to relay to the oncoming shift, resulting in an agency nurse listening to some random visitor's assurance that my suddenly lethargic patient really IS a full code, with attendant sternal rub (you should see the bruise on her chest-she weighs 90 pounds), IV start and 911 call STILL makes me want to bite someone.
Fortunately, her POA arrived for a visit before the ambulance got there, so she didn't go anywhere. But, Jeeze, people!!
When a doctor comes in at 0630 on a weekday to write orders, it is beneficial to socialize with the doctor and offer them coffee. Their orders will be written in when the next shift is on and you'll be free of any responsibility.
You know what? Amen to that!!! Ain't nobody gonna die if they skip that "now" dose of their daily statin.
-I can scare the poop out of a patient by threatening to give them a suppository. Yes it goes up your butt.
I laughed. It's so true - I have also scared the poop out of patients this way. I am the queen of just digging up there to see if something's waiting for the gate to open wide enough, though.
I learned that a person can suddenly go into rigors from sepsis and go from a central temp of 100.4 to a central temp of 103.0 in 20 minutes flat despite rectal Tylenol and ice packs to the groin/armpits. I have never seen a temp spike so fast, and it was terrifying.
Specializes in Mental Health, Gerontology, Palliative.
I've learnt that this week being a nurse (palliative care) and the daughter of a woman with stage four small cell lung cancer sucks
Shes being very out of character yesterday. I find myself wondering if she has secondaries in her brain, or if the cancer is in her bones and dumping a truckload of calcium into her blood
Working on the Fouth wasn't so bad, until after 9-crush and back to back devolving to keep me on my toes; but had a helluva-time eating and contributing with water ice help keep smiles on the staffs' (and my) face.
5 traumas on the 5th and dealing with parents who were left waiting as all physicians were on deck in the bay earns the badge of being called "the boss" (many years ago, I posted in a thread that I have been called "lieutenant" and "warden")-is fitting without having to do all the other stuff that comes with being a BOSS. :)
And...
Having knowledgable staff is key...the ER is very "young" meaning new to specialty and new nurses and even a new physician that ended his fellowship and can on staff July 1st; we have so much to learn and it helps with having the right senior staff-physicians and nurses to help shapes is into great ER Trauma Pedi nurses (and providers)!
dudette10, MSN, RN
3,530 Posts
Yep, no one knows really why it can happen when someone has been on an ACEI for a long time. Because it's not a histamine-mediated reaction, steroids and Antihistamines usually have minimal to no effect,but they don't do harm either.
Please say that someone told the pt to stop taking the ACEI and see the PCP!