12/5: What I've learned this week - No, I don't have "just a second" to help you

[ixchel]

If I make it out of this weekend without losing my mind completely, it will be an absolute miracle. The last few months seem to be trying their best to do me in completely. I could really use a vacation. Just me, the kids, and sunshine. I'd be a happy girl.

So, some lessons from this week:

Someone posted something on Craigslist that was offensive.

It's surprising how surprising hallucinations AREN'T to some people. (Although on the flip side, it's kind of amusing seeing people get confused when I describe my own olfactory hallucinations.)

We have a tech who is a nursing student. He just finished his first semester. Of all of our techs, he's the most bold (abrasively?) in his approach to patient care and has been the only I've worked with who has made decisions "above his pay grade". I hoped with all my heart that some nursing school would add caution to his approach and performance. I've learned tonight that it hasn't. I genuinely like this person, but am afraid for him (and, unfortunately, patients).

Fitbit needs a NOC mode. Or... Is there a way to change its time zone maybe?

It's weird showing up to work with 6k steps already in for the day.

I'm apparently allergic to something I've put on my face in the last 12-18 hours. Love going to work looking like I have two swollen, black eyes.

Insecurity can turn people into monsters. I already knew this. What I didn't know was how much better it feels to ignore it, rather than engage it. (This is not patient-related.)

We have a tech who would rather cause an injury to a patient (pretending she didn't hear what you said), than increase her workload (by taking a BP cuff off, walking around the bed, and reattaching it to the other arm).

If a coworker is charting in a darker, quieter space, YES, they are are hiding. Go away.

If a coworker calls you and says, "I'm in desperate need of uninterrupted time so I can chart. I'll be (insert place here). Please don't tell anyone where I am - I just want to make sure you know where I am if I'm needed", this does NOT EVEN A LITTLE BIT mean it would be a good time to go chart and chat WITH them.

"Really quickly": adj., meaning to occupy a very short span of time

Ex., "Because literally every single person and patient has needed me to help them with something 'really quickly', I have literally not even begun to do MY OWN JOB yet, and it's 0200 now." You keep using that phrase, and yet your definition of "really quickly" has become my definition of "I am now going to be here over an hour late while you and everyone else I helped get to leave on time." AND I CAN'T EVEN HIDE!

I am so overfilled with my quota of rude people that I just clocked out knowing I'll have some notes to finish when I go back. I may be royally p'ed off at my job right now, but I like being employed.

The charge nurse who told me I am inconsiderate of others' time (by taking too long to give report - apparently I'm not supposed to answer peoples' questions?) spends over an hour and a half receiving and giving report from the off-going and on-coming CNs. (Even when she and the other CN are both mid-way through a 3-day stretch together - so mostly updates only.)

Regarding report, when you interrupt report that you are receiving to ask questions, you're probably asking something they were going to tell you anyway. This will cause you to get an unorganized report. This will also cause report to take longer. Rather than interrupt, you could be a polite person and wait until the nurse is finished giving you reports. If you still have a question at that time, then by all means ask.

And...

Please...

For the love of God...

Don't do your assessments while you are receiving report! That is so rude that I have no words for it! The person giving you report has been there for over 12 hours and may have to be back in less than 12. This is not what bedside report is for!

What do I need to learn...?

When there is literally no one and nothing in the caregiver's "face to face world" to actually give that caregiver care, help and respite, how does the caregiver go about finding those things?

Sorry, guys. Majorly cranky OP this week!

Did you learn anything good?

[ixchel]

New week - https://allnurses.com/post8820969-num1.html

[Tenebrae, BSN, RN]

I've discovered that Subq ports hurt. Pt required hydromorphone SC injections every so often for moderate-severe pain, subq port was installed, more pain just giving the injection thru port. And the tubing on the port is quite lengthy albeit very small diameter, I started wondering if my pt is even getting the full dose of what is being injected?? Can someone share their thoughts on this? I'm a new grad, still so much to learn.

Always flush your line after administering meds. Approx 1ml sterile water/saline should do the trick

As for the meds hurting, try and slow down the push and see if that makes any difference

[BecomingNursey]

(((Hugs)))

Thanks ixchel :) I need a hug!

[Txldy]

I learned that you need 2 weeks of mental health days. Unfortunatlely, you are young and have not learned that important word. "No" is generally taught to women as a nono word.

As for the guys, it is STILL apparent that they think they know it all, over and above their pay grade. I have said it before, they are dangerous. You CAN say no to "helping" them, if you find they are behaving dangerously. I can guarantee you will not receive a positive response if you take them aside and point out their errors privately. If you think they are REALLY doing dangerous things, take it to your charge nurse or your nursing supervisor. PLEASE follow chain of command. Follow your policy and procedure manual. As for people doing assessments during report, and they find something you are trying to report, you CAN say "yes, I was reporting about that, I thought you were listening to me

" It should stop them in their tracks when pointed out right in front of the patient, because it's true, and because the patient will report them if they get nasty with you.

[Kellorn, ASN, RN]

I literally just got the shivers about the nitro. I hope you're ok, that could have really been a game changer for you. Glad the patient is ok.

[Kellorn, ASN, RN]

Hey, at least your mature enough to admit that you didn't know, and accept that your practices will change in the future. You're not stupid.