To not take for granted my role as a preceptor. But sometimes it can be just as tiring as if I was running my tail off for the entire shift. The mentee that I have had for the past 3 months has spoiled me because she is very sharp and catches on quickly. The one I had yesterday who has been in the program for the same length of time, is not up to par.
I need to recognize that not everyone learns in the same manner, so I must adjust my preceptorship techniques. The benefit of this young lady is her eagerness to learn and her receptiveness of constructive criticism.
I have also learned that I am one of those who have the string of DNA which predisposes me to a higher perception of sulfur compounds. In other words, I can smell the odor of asparagus in urine quicker than most.
In addition to these findings I learn how precious sleep is and how much I missed it. This is the first week in three months I have not had clinical. On Tuesday I slept until 3 p.m. But school work was not over, and I still have had a few late nights. Next week I'm going to spend quality time with my family.
Opening a new box of books for the next quarter is exciting as if it were Christmas. My midwifery and women's health texts have arrived and I'm excited to face the next chapter in my education
I invite everyone to share what they have learned this week and please remember to keep it nursing related.
A friend of mine had ankle surgery, so I offered to help. She's a nurse, but also an ED nurse, so naturally she's the most non-compliant, bed jumpy, discharge instruction ignoring patient ever. We are the worst patients. :)
Cyproheptadine can treat serotonin syndrome.
Fluoxetine (Prozac) and paroxetine (Paxil) inhibit CYP2D6. Codeine, as you may know, is a prodrug metabolized into morphine by CYP2D6. If CYP2D6 is inhibited enough codeine isn't metabolized and you may see inadequate analgesia.
Smoking 2ppd can cause clinically significant induction of CYP1A2, which increases the metabolism of a variety of psych drugs, but also caffeine and warfarin. So, if your patient is a heavy smoker (as many psych patients are) there may be a difference between their in-hospital INR and their out-of-hospital INR. This might also explain why people pair smoking and drinking coffee (to replace the caffeine being metabolized faster).
Here's an incomplete table to give you an idea of the magical variety of drug-drug, drug-food, and drug-supplement interactions.
Guess who went to a talk on drug interactions yesterday?
Specializes in Med/Surg, OR, Peds, Patient Education.
I learned that while it's not a deal breaker yet, being in the rifle sight of the office snitch is going to eventually make me very cranky, especially since she's not clinical to begin with.
When I first started this job, she told me "You know, I bet I could go take boards right now and get an RN license, I've been around it for so long." Yeah...no. Better yet, when I mentioned it to my Supervisor, she chuckled and said "Yes, I can imagine her saying that". [emoji33]
She's Psych/Soc (apparently a SW at some point) who crawled from minion to management on the broken and bloody bodies of former co-workers. And feels that she is perfectly competent to critique what the nurses do, don't do, how fast they say "How high?" when she says "Jump!"
Don't mind me, I'm just a COB with some indignation I have to unload somewhere. [emoji35]
You have my sympathies. I endured a ward clerk who would often be "A legend in her own mind."
Remember, into every life a fool shall inject his or herself.
I learned that family members with almost no medical experience or exposure will come up with some interesting, but understandable, neologisms for standard terminology.
My Nanny had a "systematic" stroke (systemic or Ischemic). Her left neck is 70% occluded (left carotid. Ok.) But they also said she had a bleed, so I'm waiting to talk to someone who can speak to me in my language.
Not "liking" this. Keep us posted, Shadow. Love ya.
It was a bleed. Not an ischemic stroke. But only her speech is affected. She can talk now but extremely difficult to do spontaneously. Repeats after you if asked.
I hate that distance is between us.
Has she had an MRA? Do they know where/how big it is? I'm sorry, I know the distance can be so tough. Best wishes to your Nanny.
Specializes in Med/Surg, OR, Peds, Patient Education.
I learned that my annual performance raise is $0.71/hr.
Management will let the pre-op nurses leave early while keeping one of the pacu nurses over by 2 hrs to pre-op an outpt...smh over fiscally sound decisions.
Had a busy surgery schedule this past week but got thru it with great teamwork.
Note to self to never consider transferring to the endo unit/pain clinic. One of our nurses just did & is being hazed royally...no assigned preceptor, being ignored, & literally not being trained.
Enjoyed 2 of our peds BMT cases who let me rock & cuddle them during recovery. One in particular had been extraordinarily wild before surgery according to report, but was an angel for me.
Finally have an appt scheduled with a developmental specialist for an autism eval for my son. Simultaneously looking forward to it & dreading it.
Your diligence, knowledge and compassion are all assets to becoming an excellent RN. These attributes will be added pluses, should your son be dx with autism. I will be hoping that he has an eval that proves that all is well, and he may just be a little slower to speak and relate to others.
Specializes in OR, Nursing Professional Development.
I've learned that I will never understand some of the thought processes that go through my surgeons' minds. Weird changes to things we've been doing for years that don't make sense and may actually be hazardous (as in, making it far too easy to lose a surgical needle), make odd non-surgery related changes that make no sense (one day music in the OR is fine, the next absolutely nothing but complete silence), throwing temper tantrums like toddlers. The main culprit is threatening to go elsewhere... I say, don't let the door hit ya where the good Lord split ya. Surgeons- can't work with 'em but can't work without 'em either.
Nurses take the brunt of having to slap bandaids on issues. If the issue is with someone administering a med not properly documenting it, why make the circulator document it rather than going to the source and force the person giving it to document it? Fix the problem, not turn it into someone else's.
Yeah, I'm a little frustrated with work today and needed a mini vent.
Specializes in General adult inpatient psychiatry.
Don't put off communicating with outside organizations when project planning! I'm working on a community health project for my master's program capstone and have had a hell of a time getting things squared away. I've finally spoken with someone enough about building a program that they're willing to consider me as a partner but I'm supposed to write a grant proposal that's due next week and I just don't have the material ready. I'm having to ask my professor for an extension and I'm really embarrassed.
I learnt today that the hospital I used to work at is giving out a double bonus for "exceptional fiscal performance". The double bonus they speak of? $600 for full time employees. Gee, I wonder why performance was so exceptional? Because they don't staff nearly enough nurses and CNAs in any part of the hospital, and make the existing staff work mandatory overtime, either by an extended stay or signing people up for an extra shift over their FTE.
While a small bonus is better than nothing, it's still an insult. I am not getting a bonus from the current hospital I work at, but I don't care. It's not the best place, but it's better from where I came from.
A while ago I learned that whenever one of the wound and ostomy RNs asks if you can lend a hand for a second, drop what you're doing and say yes. I love watching/assisting with wound care of any sort. Today I helped apply a wound VAC and learned a lot about Fournier's gangrene.
WellThatsOod
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