I'm having my annual struggle to decide what I want to be when I grow up. Thankfully, things are feeling a bit narrowed down this year. At the very least, I think it's time to start the typical core NP classes.
Every level of care provider at my facility is frustrated by our current lack of psychiatric specialty care, psychiatric consulting provider, and poor staffing for acute psychiatric needs, but no one knows what to do about it. Why aren't we diverting some of these patients?
Huh. Perhaps becoming a PMHNP would knock out both those birds with one stone. (Honestly, though, I'd burn out faster than The Donald's political dreams should have. Hey, Dogen, come to the mid Atlantic when you graduate. We have crab cakes and they are amazing.)
A terminal DNR patient will become full code if they are admitted from an incomplete suicide attempt. I have a serious problem with this.
If you only see one piece stitched in on a central line (IJ, SC, or femoral), you should get in touch with the MD to get the second piece stitched in. That is a lot easier than having to pull a line and reinsert a whole new line. If you only see one piece capable of being stitched in, the other piece wasn't put on, and it needs to be. You'll have someone irritatedly inform you that that will require wasting an entire central line kit just for that little thing, but again, this is better than requiring a whole new line insertion. If you notice this is a trend, consider incident reports. Seriously, it's not okay to increase infection risks and invasive procedures to patients just because the ED doc or intensivist just didn't feel like sewing in a couple more stitches. (See picture) [/rant]
The Fitbit charge HR is my favorite toy right now.
Every time I open the AN app on my iPad, I want to get the eye booger off the right eye of the nurse in the front.
Herpes can literally get in and on every part of the body. I'm glad my innocence was already shattered by sidepockets because for real, people. EVERYWHERE.
My fellow Walking Dead community - blood does not pour like that from the second intercostal space lateral to the midclavicular line, and there are no intestines at approximately the fifth or sixth intercostal space, even if that was somewhat midline. I'm just saying.
I hate to admit this (because I'm in love with, and rather loyal to my hospital), but lately, some ED shifts have been a little scary. I really hope they get their act together quickly.
One of my floor's charge nurses has advanced so highly on my "you are an amazing nurse and charge nurse" scale, that I think she broke the meter. During some of the hardest shifts I have ever had, she has put herself right at my side, battling through the thick of it with me. She has truly made me realize the value of a charge nurse you can TRUST.
That does, unfortunately, make it suck to realize how much harder a shift can be with a charge you can't trust. My understanding is that a previous manager made it a habit of promoting the slower, lazier nurses to charge. Look, if you are a manager and you think it's easier to promote them than it is to fire them when it is obvious the bedside isn't a good fit, you're doing it WRONG.
I have heard that in the last two years, my unit has gone from "fend for yourself" to a cooperative team that has each other's back. It's sad to hear that it was that way, but I'm proud to be part of the change.
This makes me laugh every time I see it:
Apparently my screenname is a planet name in A Wrinkle In Time where Aunt Beast lives. How did I not remember this?! Charles Wallace knows!
After the last two fresh off residency new hires we got (who are absolutely terrible to work with), I never expected to feel the massive amount of relief I felt when we just got a new hire who has a decent background and enough experience to realize nurses are a valuable resource, not competitors in an ego pissing match.
What have you learned this week?
As a friendly reminder, it is important to keep our WILTW threads mostly related to nursing. It's okay to throw in personal life observations, as long as the main focus of discussion remains nursing. Be safe on this All Hallows' Eve, my friends. :) And all you ED peeps - I'm hoping for some really good lessons from you on Sunday!
Spidey's mom, ADN, BSN, RN
11,305 Posts
So far, this hasn't happened.
We've been really lucky with esophageal cancer patients as well.