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?

[cracklingkraken, ASN, RN]

Yeah that thread is making me "shutter"

I'm passively liking posts. Nope, I'm not getting sucked in.

[Jensmom7, BSN, RN]

I'm passively liking posts. Nope, I'm not getting sucked in.

Yeah, I'm keeping my thumb far, far away from the reply button on that thread. I can't even read it every day.

I just find it interesting that the students who expect the floor nurses to teach them all the things are the least likable, rudest, snottiest posters I've seen in awhile.

If a student ever spoke to me the way some of them are talking to experienced Nurses in that thread, their CI would hear about it, as well as my supervisor and possibly the Director of their Nursing program.

I can be persuaded to assist students with a learning experience, but I'll be darned if I'll be treated like their personal tutor. (I almost said I'll be darned if I'll be bullied into doing it, but that word has been overused, and incorrectly much of the time as well.)

[cracklingkraken, ASN, RN]

Yeah, I'm keeping my thumb far, far away from the reply button on that thread. I can't even read it every day.

I just find it interesting that the students who expect the floor nurses to teach them all the things are the least likable, rudest, snottiest posters I've seen in awhile.

If a student ever spoke to me the way some of them are talking to experienced Nurses in that thread, their CI would hear about it, as well as my supervisor and possibly the Director of their Nursing program.

I can be persuaded to assist students with a learning experience, but I'll be darned if I'll be treated like their personal tutor. (I almost said I'll be darned if I'll be bullied into doing it, but that word has been overused, and incorrectly much of the time as well.)

Their posts are also indicative of their lack of professionalism and ability to use reasoning. You can repeat your post as to why "this is not the case", and they STILL don't get it.

[WellThatsOod]

I thought preceptors were (mostly) floor nurses who (mostly) volunteered for the job? Am I wrong? (Remember I haven't started yet, so I don't actually know.)

[Nurse Leigh]

I worked nights in the hospital so I had few interactions with students.

However, if they had joined us on nights and we were *appropriately* staffed, I think I would have enjoyed taking a student or two in with me when I had a procedure to perform. Or if they had one of my pts and there was an issue that required intervention I would probably have discussed it with them and what needed to happen - and if it required a call to the provider, I'd have liked a setup where the student could listen in as the hcp and I spoke. That was something that terrified me as a new grad....calling the physicians and having some clue as to what I needed.

I don't think most nurses are anti student but staffing really needs to improve for nurses to have the time to impart wisdom.

[cracklingkraken, ASN, RN]

I thought preceptors were (mostly) floor nurses who (mostly) volunteered for the job? Am I wrong? (Remember I haven't started yet, so I don't actually know.)

For our clinicals, we don't have a specified preceptor. We are assigned to a pt and report to whichever nurse is in charge of said pt. So in our case, no, the nurses were not volunteers.

[Jensmom7, BSN, RN]

Their posts are also indicative of their lack of professionalism and ability to use reasoning. You can repeat your post as to why "this is not the case", and they STILL don't get it.

That's another reason I don't want to get embroiled in this.

I don't mind saying something once. Possibly twice, if it's a difficult concept.

That thread, however? It needs to be printed out and framed along with Einstein's definition of insanity...

[Jensmom7, BSN, RN]

I thought preceptors were (mostly) floor nurses who (mostly) volunteered for the job? Am I wrong? (Remember I haven't started yet, so I don't actually know.)

Ood, when you're in school you don't have a preceptor. You have a patient, and the floor nurse is just kind of attached. The floor nurse really doesn't have a say; their patient was chosen because they have an interesting diagnosis, or a really gnarly wound.

Once you start a job, then you have a preceptor, and that should ideally be someone who has the right temperament and the desire to instruct on all the "nursey" things you don't get in school. Unfortunately, sometimes people are "volunteered" for the preceptor program, and really wish they didn't have to do it.

[WellThatsOod]

Either way you don't be rude and indignant to someone who has the knowledge and ability to teach you SO MUCH. I don't understand these people.

[Jensmom7, BSN, RN]

Either way you don't be rude and indignant to someone who has the knowledge and ability to teach you SO MUCH. I don't understand these people.

Yes, but you're a normal person, not a Snowflake. 😘

[WellThatsOod]

Ood, when you're in school you don't have a preceptor. You have a patient, and the floor nurse is just kind of attached. The floor nurse really doesn't have a say; their patient was chosen because they have an interesting diagnosis, or a really gnarly wound.

Once you start a job, then you have a preceptor, and that should ideally be someone who has the right temperament and the desire to instruct on all the "nursey" things you don't get in school. Unfortunately, sometimes people are "volunteered" for the preceptor program, and really wish they didn't have to do it.

I see. Thank you!

See, this is why I love you guys.

I feel bad for the floor nurses then though, having this shadow they probably don't want.

[weirdscience]

Ixchel, Xarelto *is* a hell of a drug, but don't ever make the mistake I did and say so in front of a hem/onc doc. She bit my head off when I noted (not in front of patients, of course) the number of hospitalizations we saw with Xarelto-related bleeds.