What I learned this week (7/11/15)

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Specializes in critical care.

This week, I learned......

1. When a person is anuric, a fentanyl drip may not be the most appropriate option for them.

2. Patients seriously get spoiled in ICU. Boy do they get disappointed when they go out today the floor with 4:1 and higher ratios.

3. "Fever of unknown origin" is not the best possible admission diagnosis for your first ever needle stick.

4. If you're going to give a non-responsive patient a t**** twister to attempt to make them responsive, you should really warn the other people in the room first.

5. I am seriously getting tired of getting off work hours after my shift was supposed to end.

6. My family is out of town this weekend, and I have been working, so clearly, my dog has decided she is dying.

7. So.....apparently 11:30 on a Saturday night is the best time to take the family out to shop at Walmart.

8. If a nurse calls you for narcan, just say yes.

9. It sort of feels amazing to have a respected colleague say you'd be perfect for ICU. At least, I hope it was a compliment. That's a compliment, right?

10. It's crushing to see a person who did everything right in life slowly lose every piece of themselves to random illnesses that hit and leave damage.

11. Wegener's Granulomatosis is evil.

12. My milkshake brings all the boys to the yard.

Man I had a whole list of good stuff a couple of days ago and now I am drawing a blank. I'll have to comment bomb as I remember.

What did you learn this week?

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I learned I want to hear more about #4 on your list.

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Specializes in critical care.
I learned I want to hear more about #4 on your list.

A surgeon who thinks our ICU is his personal patient day care apparently has decided this is an awesome way to determine patient responsiveness. Totally didn't see that coming and totally don't have a poker face. It worked, though. I hear when it doesn't work, he goes south and twists other things. 😬 The patient, thankfully, remembered none of this.

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*wonders what the medical term for a purple nurple is*

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Specializes in Family Nurse Practitioner.

I learned that patients in four point restraints become very creative if given enough range of motion...tie those things tight!

:cautious:*glances at laceration on wrist*

Patient in 4 points bit out her IV and clawed at my wrist with her bloody hands as I tried to tighten her restraint. Very superficial but enough that it bled and needed to take visit to occ health.

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Specializes in critical care.

Holy crap, Lev! I hope it's healing okay!

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Specializes in critical care.
*wonders what the medical term for a purple nurple is*

Purpa Nerp.

As in,

Don't twist that Purpa Nerp,

Don't twist that Purpa Nerp, ehhhhh

Don't DROP that DURKA DURK -- The Best of Vine - YouTube

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Specializes in Neuroscience.

-I learned that it's not uncommon for trauma patients to run tachy. I really need to gauge the reactions of those around me before I start freaking out.

-That patient family members really do expect us to wait on them hand and foot. A half hour wait on a cup of coffee completely obliterated the awesome 6 week stay of a patient's family. On the day of their discharge. I ruined this guy's life by being late on delivering coffee. I think Hospitals should hire a server for their floors.

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I learned that hospitals really lie and say that the little old guy with AMS didn't have a sitter so he can be turfed to a SNF. Still pissed about that.

I learned that bicarb, D50, insulin, calcium gluconate, kayexalate, and Bumex can take a potassium down from 7 to 5 in half an hour while knocking down the phos, too. Pretty sweet.

I learned that a LOL will pitch a holy fit if you give her kayexalate before dialysis. I had to remind her that her heart was a little more important than her bowels.

I learned that sometimes you just have to give up and move on.

And, I learned that an Arizona restaurant's interpretation of NC barbecue is just gross.

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Regarding item 4, and the equally as bad inner thigh pinch/twist. We had a few neurosurgery residents not long ago that were so enthusiastic in performing both that I found a patient with both nipples horribly bruised and abraded, as well as both inner thighs.

It was amazing how quickly this stopped after showing the neurosurgery attending a few photos of the damage.

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Specializes in Pediatrics, Emergency, Trauma.

I learned:

Thinking fast and being vigilant with a positional line that finally infiltrates after giving cefataxime does pay off, but still makes one panic within good reason; as well as it makes it helpful in learning with a lot of seasoned people tell you "it's ok." And help guide to through the process of handling a Grade III-IV infiltrate to find out that I know what to do already.

After said infiltrate incident, one can modify their practice to be even MORE vigilant with IVs-within reason.

I also learned that sometimes new people can be refreshing for a unit-although we are all learning together, there are resources to self study to help one become a better nurse in a new specialty.

"Boarding" pts in an ER Zone is not necessarily a bad thing; my future will be in Obs in a very distant future-still love variety.

My coworkers know who I am and state that I fit in this specialty after knowing me for less than six months-and in the best way...kinda makes me feel special. ;)

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

What I have learned this week is that, to me, being a SAHM is more difficult for ME than nursing. Nursing is hard & grueling, yes; but trying to read the mind of my 1 year old as he throws a tantrum is something that makes me want to pull my hair out.

I love my son to death but I can't wait to get my RN license & start working again. Because he & my husband drive me up the walls!

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