9/5 What I learned this week.....

[ixchel]

Ahhhhh this week. Kids in school, a nice run of chill nights, and here I am, wiiiiiiide awake knowing my body needs to flip back to awake in the day (for only two flippin' days) this weekend until I have two more nights this coming week. *sigh* I need more summer. Fall means back to mom taxi and learning 3rd grade math. Ugh! No thank you!

Alas, this week I have learned.....

There is a man with a 19 inch member. The head of it is 10 inches in diameter.

Xarelto is a hell of a drug.

Being an assertive person by nature, and after receiving guidance through nursing school and as I've been a nurse on concise and direct communication (how to deliver and receive it), I was reminded this week that not everyone effectively communicates, and it can be upsetting to them to be asked to.

In addition, the very nature of nursing education through school and orientation teaches us how to be able to initially be subordinate, in a way, to those who mentor us, but seamlessly transition to being peers after. This feels like an endemic part of nursing because we all do it, and a good preceptor takes his/her role seriously to ensure safety and adequate care is delivered. That ease of transition doesn't apparently exist in all levels of patient care, though. I'm not sure why it didn't occur to me, but it was placed directly in my face when I was informed that a preceptor tech should not be responsible for correction of an orienting tech, because the orienting tech is a peer to the preceptor. (Huge needs for education, there - I am not the (disciplinary) supervisor of the aids, even as the nurse, and a preceptor is responsible for the learning process of the one orienting - they need to learn how to communicate errors in practice without worrying about the consequence to the peer relationship later.)

I've decided my melanin is useless.

On a related note, I would rather go without a shower than shower with sunburn.

#JunkOff is trending right now. And in the name of science, there is this - The Icelandic Phallological Museum

I want a high and mighty horse to ride in on.

And speaking of horses, never look a gift horse in the mouth. If the whole floor has wild and crashing patient assignments, check in and offer help often, but keep it to yourself that your group was/is easy.

When you read a patient's chart notes and see they couldn't be stopped from punching and spitting on staff with 25 mg haldol and 10 mg Ativan, you might actually think to yourself, "thank god he's only felt me up this shift".

I've decided I'm going to write a book called "You Can't Make This **** Up".

Agony, sweet, sweet little old man reaffirmed for me that we have a desperate need in this country for social services. A person shouldn't decide to attempt suicide because lack of access to adequate care has ultimately (decades later) led to homelessness.

I very much love and miss NOC. It felt so good to do a week of nights!

I've learned how very close to death a person can get during ETOH detox. It doesn't help that the person is 4 months older than my mom, who is 15 years sober right now. Counter transference is a hell of a drug.

Lots of psychosocial stuff this week. Very heartbreaking.

I've learned that simply being in a sinus arrest rhythm while already having a HR in the 30s is not a qualifyer for a pacemaker. (Apparently?)

I've learned that the cutoff for a pause to ring asystole on our tele monitors is somewhere between 4.8 and 5.6 seconds.

I've learned our hospitalists have this magical locked room filled with iced cream. And if you're really nice (and they're tired-giddy at the end of their 7-day NOC stretch), they'll tube some up to you.

Adding with compatible numbers makes no freaking sense to me whatsoever. I am a math smart person with a rather high IQ (logic and I are BFFs) and yet, compatible numbers? Seriously, why?! I should be able to tutor my 8-year old in math without having to learn what it is first, right???

Have you learned anything worth sharing this week?

[OrganizedChaos, LVN]

Oh I want to thank everyone for all the advice! I couldn't have done so great on my interview without help from everyone on AN. :)

[nurseprnRN, BSN, RN]

Shopping with hubs? Good grief! I made the mistake of letting him go with us Sunday afternoon. THAT is sheer torture. Him making comments over my shoulder about every purchase. Dude!!

I finally decided to just stop and finish tomorrow after work before I blew a gasket right there in the middle of Walmart Supercenter.

My husband took over the shopping when he retired. It was a little dicey for a year or two, because I had gotten used to not putting all the staples on the list (like the same gallon of milk, the same raft of cat food, the same four or five entrees for the week and sides to go with...) and he wasn't used to that. He could follow a list fine, but it had to be comprehensive.

Now, years later, we don't need to list cat food :) and he does at least half of the cooking, so that's all fine. We both put things on the list when we notice them needed...and most times he brings me back a container of fresh sushi for my lunch.

There's no reason to accept learned helplessness. I learned that. Cooperation works better.

[nurseprnRN, BSN, RN]

3. My house smells like cat urine in every room but the one with the automatic litter box. But there aren't any wet spots on the floor. What gives? I've had this cat for a few months, but the stench just started today.

Check for spraying on walls, furniture, etc. Males and females will do this. You can see urine spots best with a small hand-held black light; a worthwhile investment.

No, I have no idea why they start doing it. Some sort of insecurity, usually, makes them urgently need to mark their territory. If s/he's an indoor cat, s/he may be seeing a new cat outside the window. Or you may be petting a dog or another cat and the smell comes home with you on your skin or clothes.

[WellThatsOod]

Oh I want to thank everyone for all the advice! I couldn't have done so great on my interview without help from everyone on AN. :)

Did you get there in plenty of time?

[NanaPoo]

My husband took over the shopping when he retired. It was a little dicey for a year or two, because I had gotten used to not putting all the staples on the list (like the same gallon of milk, the same raft of cat food, the same four or five entrees for the week and sides to go with...) and he wasn't used to that. He could follow a list fine, but it had to be comprehensive.

Now, years later, we don't need to list cat food :) and he does at least half of the cooking, so that's all fine. We both put things on the list when we notice them needed...and most times he brings me back a container of fresh sushi for my lunch.

There's no reason to accept learned helplessness. I learned that. Cooperation works better.

Ha! My husband is a lifelong learner of the cheapskate method. If I let him shop he'll come home with "great deals" (aka things we'll never eat that only cost $.010/serving) and the WAY cheaper version of the items I've been buying even though I've tried them and already know to buy the pricier version because the cheap version tastes like crap on a stick!

I do not mind doing the shopping, I just don't want to answer to "His Majesty" while I do so, thankyouverymuch. Again, when do you need to travel again, Mr. Pants?

[OrganizedChaos, LVN]

Did you get there in plenty of time?

An hour & a half early. Ate breakfast there & brushed my teeth. Lol. I even had my interview early!! I hope it made a good impression.

But I'm glad I left early because even though I had been to the hospital before I missed the entrance & it took a little while to find parking.

[nurseprnRN, BSN, RN]

Ha! My husband is a lifelong learner of the cheapskate method. If I let him shop he'll come home with "great deals" (aka things we'll never eat that only cost $.010/serving) and the WAY cheaper version of the items I've been buying even though I've tried them and already know to buy the pricier version because the cheap version tastes like crap on a stick!

I do not mind doing the shopping, I just don't want to answer to "His Majesty" while I do so, thankyouverymuch. Again, when do you need to travel again, Mr. Pants?

Believe me, we ate a fair amount of crap before he learned this. It's like teaching an adolescent who's never had responsibility for food before. Remember, they are handicapped-- they are not experienced, and they have much to learn. But they will. Especially when you serve them crap on a stick once or twice a week.

When the leftovers go down the disposal, you can gently point out that a better cut of meat wouldn't have had half of it inedible gristle and bone (calculate its actual price per serving then). Or that can of store-brand tuna has only about 3/4 of the actual tuna of a can of national brand once you drain it, so that's why the sandwich is skimpier than usual. Or your fantastic 3-bean soup doesn't taste right and has fewer beans in it. Or the cat won't eat that brand, and it will sit in the bowl until tomorrow and get stinky, and the cat will get verrrrry cranky about it.

Really, these are either the products of ignorance or just temporizing maneuvers aimed at getting you to do the caretaking. Then what happens if you go down for some reason? Either way, it's a mercy to teach them.

[Jensmom7, BSN, RN]

I learned which elevator at the facility is tied into the generator during a power outage.

Oh, and all the emergency outlets are in the hall. So guess where all the patients on air mattresses are right now??

[Jensmom7, BSN, RN]

Lol I'm fine, I'm not an employee of the facility, so I just did a quick head count of my patients when the power went out, got one who absolutely positively needs her O2, but is bed bound, a portable tank, and helped move a few to the hall.

Was hoping to see who I needed to and get the heck out of Dodge before the skies opened, but alas that was not to be.

[aeris99]

This week I learned that I retained a fair amount of information I learned as a birthing coach for my sister.

I also learned that it makes me really happy when my professor says I'm not allowed to answer questions 😃 what a confidence boost!

[Rose_Queen, BSN, MSN, RN]

3. My house smells like cat urine in every room but the one with the automatic litter box. But there aren't any wet spots on the floor. What gives? I've had this cat for a few months, but the stench just started today.

Might want to make an appointment with your vet. When my one cat started urinating outside the box, it turned out to be bladder stones. Now getting treatment with a special (very expensive) diet, and haven't had any problems with not using the litter box since. Other than that, agree with GrnTea that it could be sight or smell of other animals. But always a good idea to rule out any medical issues too.

[WellThatsOod]

I just scored 34,807,480 in a level in Candy Crush.

Do you think NOADLS would be proud?