1. I've decided to keep a tally of most critical labs in one admission, starting today (not including renal failure patients): hgb, glucose, potassium, chloride, PT and INR
2. Farawyn's what I learned thread was way cooler than mine are.
Adding an 80s song makes any thread way cooler.
3. Don't trust a 0600 portable chest X-ray to tell you if pulling a chest tube at 1600 is a good idea. It really sucks to tell someone they have a pneumo still.
4. If someone has q4h benzos and opiates, bring both when they ask for one because they'll just ask for the other after you've already run to the med room twice for them.
5. When someone's paracentesis site is still actively dripping rather steadily, it makes me want to squeeze that sucker and see how far I can shoot the fluid out.
6. This week, it actually was sarcoidosis.
7. I know what sarcoidosis is now.
Sarcoidosis sucks.
8. Doctors really need to stop saying, "we're going to go ahead and discharge you," without adding, "this afternoon", especially when they know full well they won't be putting in discharges anytime soon.
9. I think I've realized that the best docs we have actually enjoy my unit the best because they chart there.
I attended college at a university not terribly far from Terre Haute and OMG we had a joint that served deep fried everything and ice cream (including *fried ice cream *) that -get this-DELIVERED!! That's right - ypu could have a cheeseburger and an ice cream sundae delivered to your door. (I almost always went with the fried ice cream) :)
It was epic. And a miracle I managed to stay thin throughout my time there.
It probably helped I schlepped around a huge (gorgeous)campus day in day out.
I have learned that someone who is so addicted to etoh will do anything to get drunk including drink hand sanitizer and the moment that paint is discharged from the hospital they will go to the store and get themselves so drunk they are re admitted in less than 24 hours and are on a vent. Alcoholism is one hell of a disease.
I have also learned that at one of the local restaurants around the hospital if you show up in your gown and no shoes, and have a saline lock in they will still serve you alcohol.
I have learned that my mother in law is going to drive me to drink. She fixates on the dumbest stuff.
I had a blast at the Kenny Chesney concert last night. My husband and I go every year now. I know he will be back next August and it will be awesome and we will go again. Maybe next year we will go with other friends.
Club level seating leg room is crappy. There is really no such thing LOL.
That nursing instinct is real even when you're a new nurse.
my preceptor wanted to extubate my emergent c-mag pt because he was "doing so well" but I wasn't convinced. True he was responding to commands and on 40% fio2 but he still didn't look "right." His flows were great, everything on paper looked great but he just didn't look right, ya know?? I feel bad and I feel like I didn't advocate for my patient by saying "hey, maybe we should wait or at least get him bronched before extubating". I felt like since she had 10+ yrs experience and I have less than 1 yr I should suck up the experience for what it's worth and help when I can.
She had RT put him on cPAP while we weaned him off diprivan. He was following commands and oxygenating well. We called the doc and he gave the green light to extubate 10 mins later. We extubate and he's making the nastiest rattling sounds, it's not stridor but clearly there's something in his airway. He's trying to cough as hard as he can but its not completely clearing his airway. Secretions are copious, bright pink and frothy = flash pulm edema. We call the pulm doc to bronch him immediately and he comes within 6 minutes. We bronch and reintubate. PA pressures skyrocket and don't come back down. As we're re intubation, bright pink frothy secretions shoot out of the ETT. Dude went into flash pulm edema before my eyes and I feel like crap because I didn't speak up on my intuition. I had a feeling it wouldn't go well but I didn't say a word....out of fear that my inexperience would invalidate my intuition.
I learned that you can get glass stuck in your finger from a broken phone screen.
That stinks. Maybe try a LifeProof Case (or its equivalent) next time. I do not know how many times my daughter has dropped the phone in the sink/toilet, thrown it across the room at the wall/hardwood floor, etc. The thing won't die-just keep a supply of Clorox wipes to disinfect the thing later.
True he was responding to commands and on 40% fio2 but he still didn't look "right."
40% is way too high to extubate someone, IMO. I've seen a few extubated on 40% and none have done well. I'm sure there are people that do fine, but I'm not comfortable extubating until they're down to 30% and 5.
I learned that physicians really have no idea about the BS we put up with. I came into work today in street clothes because I remembered I had forgotten to document a critical result notification Friday night. Ran into one of the intensivists in the elevator, who cracked the obligatory joke about not recognizing me in street clothes. I told him why I was there and he goes, "So, what happens if you don't document that?"
I explained that lab prints out a report of the notifications that they called, and then our team leaders take that report and audit our charting to see if every critical that lab called was documented in the charting, and that we could be put in disciplinary action if the information didn't match because critical result notification is a big hairy deal with Joint Commission. He was surprised!
Hey, at least I educated one physician about why we call in the stupid BS things to them even though we know that sometimes that information isn't important, or they already know it.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I've learned that Organized Chaos apparently does not sleep.
I do sleep, lol! Sometimes not much & generally between the hours of 10/11p- 6/7a. Haha! I have trouble sleeping which is not a good combo with my epilepsy.
meanmaryjean, DNP, RN
7,899 Posts
St. Mary of the Woods?????