1/9: What I learned this week - Worst. Vagina. EVER.

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Specializes in critical care.

I still can't believe it's January! Where did 2015 go?!

If your unit is like mine at all, brace yourselves.... Respiratory failure is coming. Out of 10 different patients since 1/1, I've had only one non-respiratory failure patient. Only two of those had sputum cultures with the same type of bug. That bug was a rare one for adults, too, so it's been fun, to say the least. All's fun and games until you get a patient who has no concept of covering a cough.

Regardless, Ixchel Medical Center and Chez Ixchel have both been full of lessons. Hard to narrow this week's list, but for the sake of people actually reaching the bottom of it, I did. [emoji5]️

This week, I have learned.....

1. I am fully convinced I have smelled the worst possible smelling lady parts.

2. Apparently I am a great big baby about getting invasive procedures done on me.

3. Receiving unsettling news about your health is much less unsettling when the doctor is hot.

4. Also, receiving unsettling news about your health gets easier to process emotionally with each new diagnosis.

5. It seriously sucks to clock out from caring for a whole unit of respiratory failure (half dead) patients only to come home to your smoker spouse.

6. The first couple of times you get asked, "Am I going to die?", it's a little creepy, until you have enough experience in nursing to be able to answer, "not on my watch!" with a reassuring smile, followed with, "you will be okay." But then, when someone actually does die on that admission, after asking repeatedly, it goes back to being creepy again.

7. My unit tends to be a bit wild, so staff turnover ends up being high. This changes the "personality" of night shift a lot, since the new to nursing newbies like night shift. I like the night shift personality right now and hope the newbies stay.

8. It still feels weird to be the most experienced nurse on a shift besides charge.

9. I might lose my shizz if we don't get psych on consult. As much as our hospitalists feel adequate to handle psych, they simply aren't.

10. You should have 1-2 people on your "speed dial" (hahaha!!! You guys remember speed dial?!) as your medical procedure go to people for those times you can't do medical procedures on yourself. (i.e. Stitches removal in hard to reach places.) (Thank you for that idea, Dogen!)

11. My primary care doesn't feel qualified to remove a mole from my shoulder because it's too big and looks like someone more specialized should do it. (This is the 5th item in this week's list related to this topic. I may need some tranquilizers, to stop thinking about this.)

12. I met my favorite patient ever. EVER. I want to take him home and name him Grandpa.

13. It's hard enough to stop being lazy after night shifts when I get an ideal schedule. When my schedule sucks, it's impossible. Seriously, ugh.

14. BEST THING EVER! (That may be an exaggeration.) Medscape sent out an article saying contact precautions for MRSA and VRE are no more effective at preventing transmission than standard/universal.

15. Our legal system may be corrupt, or be inefficient, but that doesn't mean a suspect is innocent.

Phish, anybody? (Don't worry, Farawyn, no one dies in this one.)

So, my loves, what have YOU learned this week?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

1. I learned that New Years' resolutions are difficult to maintain, even if the goals are small and attainable. I resolved to obtain a minimum of 100 minutes of exercise each week as a starting point. That can be broken down into five 20-minute sessions or three 35-minute sessions weekly. However, it is easier said than done.

2. I learned that my sense of smell has become hyper-sensitive over the past year. I can now pick up peoples' pheromones (a.k.a. personal scents) more keenly than ever. BTW, pheromone is not synonymous to body odor.

3. I learned that the field of case management nursing is throwing me a steeper learning curve than I imagined. However, I am still in training and up for the challenge to forge my place in this new specialty.

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Specializes in CVICU CCRN.

Ditto. Respiratory failure. Ugh. Two patients that were reportedly stable, then crumped. On a weekend. Just before shift change...hospitalists turf to cards and well, they're less than enthusiastic to phone consult at 0530.

Night shift is still good to me and I'm finally getting better at managing my days/nights on my day off.

Resolutions. Meh. Hoping if I maintain a constantly nonchalant approach I will be able to maintain a few. (Reverse psych? Reverse reverse psych? Someone Freud me, quick!)

The more geri psych I see the more I affirm my end of life plans and realize we need more skilled folks dedicated to caring for these cases.

A post this week really brought back a lot of memories and started some self reflection about my long term goals. The struggle is real.

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Before I start, I've been missing a lot. I know. I apologize to those who care.

1) Nursing school is no joke. Between fundamentals and pharm I have 9 chapters to read and 5 assignments to do before the first week of school.

2) My first for real nursing class is my first day of clinical, which is thankfully an ACE class (alternative clinical experience) and I'm TERRIFIED.

3) Luckily I have 2 good friends going through this program with me, so we already have a study group.

4) People are already asking me, "can you look at this? What I'd this?"

I have no clue, can you not? Go to your Dr.

5) I'm becoming better at not snapping when someone says "What's wrong with that kid" when I'm talking about my autistic son.

I still dwell on it though.

Okay, I have to get back to work now. I know I keep saying I'll try to peek back in but then I disappear for weeks (or months) but I'll try...

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Specializes in CVICU CCRN.

OOD, #5 - you're a better person than I. I still snap after 20 years. Usually loudly.

:bag: (apologies to Far for borrowing her patented emoji)

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Specializes in PACU, pre/postoperative, ortho.

* The stiffness, pain, & swelling in my hands is indeed arthritis. Yay.

* Cross-training into preop makes me feel once again like a new nurse with 5 thumbs on each hand...like literally. The stiffness in my fingers is making it hard to pick up things without dropping them.

* Being told "we use lidocaine for ALL IV starts" makes me feel a bit obstinate. I don't feel it's all that necessary unless the pt is anxious & wants it.

* Used lidocaine for IV starts for the first time ever... Maybe my attitude will change after I get used to it.

* Hearing about a local tragedy at bedtime involving a drowning (floods here) makes me have nightmares about floods & my family.

* Floating an OB nurse to aide one hall on the med/surg ortho floor when it is short staffed doesn't really help me. OB always calls them back to their home floor (by about 0900 this time). When I asked if she had started any baths yet (I usually do 1-2 myself if I can), I got a vague "oh, not yet..." She did VS, but didn't bother to chart them until she was back on her floor (obviously they needed her back badly...she had time to sit & chart). I know she was out of her element & it's not her fault. It's just frustrating when you're short so they send you "help" that really can't help much.

* The newest anesthesiologist at our facility will come flying in with supplies for a nerve block, demanding the US, when the pt doesn't even have an IV yet. Apparently at times he has been known to get things ready while the nurse had stepped out for something & then states when she gets back, "I've already done the timeout". Huh?

* There will be a shortage of pca syringes (morphine, dilaudid & fentanyl) that is expected to last into March. No idea what the plan is for managing our fresh post-op ortho pts. Anyone else hear of something like this?

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Specializes in Behavioral Health.

- I had a top 5 worst shift last weekend, one of the ones where your goal is just to make sure everyone gets through it alive, literally. Came back the next day and had the best shift. Everyone was punch drunk, even during report with night shift we were all in stitches. There's a camaraderie in my unit that I've never had in other hospitals, and it really makes all the difference.

- Go figure, I actually do use med math at work.

- I'm not comfortable treating dementia. I've made it my goal to learn more about it, so that I can provide better care to patients and make better suggestions.

- Also, sleep meds. Considering the number of patients I see that use trazodone for sleep but have never tried melatonin, I've decided I want to develop more expertise with sleep medicine (and non-medicine, see here). This has been more difficult than I imagined. Anyone know of a good resource?

- I like having a conscientious, thoughtful, hardworking psychiatrist during rounds and a nonchalant, "how much of that do you want me to order?" psychiatrist on call in the evening.

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Specializes in OR, Nursing Professional Development.

I've learned that even those who have never cried openly on the job have a breaking point and will shed tears in front of their coworkers.

I've learned that in a crisis, many people can pull together and do our best for a patient even when the final outcome is heartbreaking.

I've learned that letting myself cry and vent here is therapeutic and keeps me from bottling things up inside until they explode.

I've learned that I don't love my job every day, and the day I've least loved my job so far was just this week.

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((((Rosie))))

I've learned that I can respect Phish even if I'm not a phan. That guitar solo around 4:15 was ripping! Boy. Man. God. ****

I've learned that I am an "intuitive" nurse, and that's not a dirty word. I can always learn da facts, but that right there cannot be bought.

I've learned I can sleep a lot, once I fall asleep, that is.

I've learned I can combine Valerian tea and Melatonin and not die.

I've learned the longer I work in a school, the more I miss medical people. Teachers, psh.

I've learned I miss Ood in this thread, and I'm geekily happy to see her here.

I've learned that EVERY single time I drink Montepulcano d'Abruzzo I think of kalycat.

I've learned that people get really clutched up and angry over Star Wars, and I enjoy exploiting that. :bag:

That's it so far.

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Wait, one more. I've learned the "I'm a male and I'm a nurse" and "Men don't gossip" threads aren't fun anymore. They are boring, and done to death.

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Specializes in I/DD.

Rough start to the new year where I am

1. It's really hard to be a good nurse when a coworker has experienced a deep personal loss. It's a good thing I didn't have anyone super sick because I was doing silly things up the wazoo!

2. On the positive side, it was neat to see my unit pull together, we really are a family

3. I might be turning into a gamer- when did that happen??

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Specializes in Behavioral Health.
It's a good thing I didn't have anyone super sick because I was doing silly things up the wazoo!

Be careful doing things up the wazoo at work, that's really more of an "alone time" thing.

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