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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]ï¸
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?
That I can get that hard stick and save my patient anxiety and or a 2nd stick or trip to the lab, but dang if I can figure out the how. Why one week and not the next?
It happens. I haven't started an IV in years, but I was pretty good at it.
I used to say there were days I could get one with my eyes closed, and there were days I wouldn't be able to hit the vein if it was laying on top of the skin lol.
My personal limit was 2 sticks. Sometimes one if I knew it was a very hard stick and it wasn't going to be my day. I figured, why traumatize the patient any more than necessary, and why ruin a site someone else might be able to hit?
It happens. I haven't started an IV in years, but I was pretty good at it.I used to say there were days I could get one with my eyes closed, and there were days I wouldn't be able to hit the vein if it was laying on top of the skin lol.
My personal limit was 2 sticks. Sometimes one if I knew it was a very hard stick and it wasn't going to be my day. I figured, why traumatize the patient any more than necessary, and why ruin a site someone else might be able to hit?
Me too. If I couldn't get it in 2 hits I would "phone a friend".
Oh boy, I've learned a lot. Here are my top 4.
1. After being in and out of the hospital (and not as a student), I now understand why patients need advocates. I mean, I really understand. Let's just say I'm now leery of everything and everyone - which will hopefully make me a more thorough nurse.
2. I'm not scared of nursing school anymore. Stressed out of my mind, but not scared. I figure I'm in the same boat as everyone else.
3. When one friend leaves, another walks in. Actually, several walk in.
4. Writing a scholarship essay whilst high on post-op meds is NOT a good idea, even if you're a published author and confident in your writing skills. *cringe*
It happens. I haven't started an IV in years, but I was pretty good at it.I used to say there were days I could get one with my eyes closed, and there were days I wouldn't be able to hit the vein if it was laying on top of the skin lol.
My personal limit was 2 sticks. Sometimes one if I knew it was a very hard stick and it wasn't going to be my day. I figured, why traumatize the patient any more than necessary, and why ruin a site someone else might be able to hit?
As hospice, I've drawn blood but haven't started an IV in years as well. Our hospital policy is 2 attempts, then go get the ER folks. (Small rural hospital).
I'm hoping to hang around the ER or pre-op to get a chance to start a few IV's again. Like riding a bike, right?
2. I started 2016 off working New Years. Plus side? My scheduled holiday is over for 2016.
You only have to work ONE scheduled holiday? Whoa. That's just... whoa. We alternate years for which holidays we work, but we are scheduled for half of them every year. Last year was Easter, Labor Day, Christmas, and New Year's Eve for me - this year will be Memorial Day, Thanksgiving, Christmas Eve, and New Year's Day. Nobody is allowed to take PTO to miss a holiday, and you can't just switch with someone in the same week - you have to trade holidays if you want a holiday off. If you want both Christmas Eve and Christmas off, someone is going to have to work both of them and you would take one of their other holidays, for example.
I have never worked anywhere that was so obnoxious about holidays. Not to mention I'm extra resentful because the holiday differential is only $1.25/hr. Time and a half would at least be worth getting out of bed for.
ONE scheduled holiday... *mutters off into the distance*
I learned I really need to work palliative or hospice or something. I'm casually looking now. I got so mad at my patient's contact person this week that I was *this close* to saying something that would get me fired.
I had one of the most unfair things happen this week. Had a "well meaning neighbor" drag a frail 50 kilos 70-something woman into her car when she didn't want to go to the ED. She kept telling the ED people she wanted to go back home and didn't want treatment, even after being told she really needed surgery. Alert and oriented, as far as I can tell. The neighbor somehow managed to convince someone down there that she was mentally incompetent and had her involuntarily committed. She was up with me with a huge midline abdominal incision, vented, and tied down, and is probably going to die anyway of massive sepsis. Of course. Because when someone says no, the answer is to have them involuntarily committed so we can cut them open anyway. As far as I'm aware, I don't work in Guantanamo Bay, this crap shouldn't be happening here.
The neighbor's excuse for her behavior? "Well, I hate that she's going to be mad at me when she wakes up because she really didn't want surgery, but it was LIFE AND DEATH!" As if that's a valid excuse for torturing someone against her will.
I am just really tired of dealing with these evil piece of crap excuses for human beings who are hell bent on torturing their loved ones right up until the second they die.
You only have to work ONE scheduled holiday? Whoa. That's just... whoa.ONE scheduled holiday... *mutters off into the distance*
The perks of working in a procedural area where we go minimal staffing on weekends and holidays. Although I'm a bit jealous of only 1 holiday per year. I have to do one winter and one summer, although our holidays are only New Years, Memorial Day, July 4th, Labor Day, Thanksgiving, and Christmas. We don't count the eves as holidays.
Forget what I've learned...I want to learn more about THAT story.
Honest to god, words don't exist to describe this smell. The potency alone was taking breath away as far as the nursing station, which was nowhere near the patient's room. I have no idea what could possible make a smell like this. I am hoping the mystery will be solved before I go to work next.
A&Ox6, MSN, RN
1 Article; 572 Posts
The weird thing is that this has been happening for about a week...