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?

[Farawyn]

Oodles. I snorted Pepsi. It was a momentous day.

((((cani)))))

Miss you.

[kbrn2002, ADN, RN]

This week I have learned that there is so much more I could learn, and that's humbling and awesome at the same time! I went to visit my friends tiny preemie granddaughter in the hospital and I had not a clue what those nurses were doing half the time. I am very good at what I do, but I do is most certainly not babies. Because I am a nurse my friend of course asks me all these questions that I can only answer "I have no idea." The nurses there were so patient with answering all her questions, thanks to all of them! I give massive kudos to nurses that are comfortable caring for such incredibly tiny human beings.

[Farawyn]

I've learned that Hep C is a helluva disease.

[WellThatsOod]

I've learned that Hep C is a helluva disease.

*hugs*

[loveSBK]

We only do neuro exams together if the pt is neuro-related. I've had nurses ask me to reposition the pt, to get a new bag of this since the one hanging is halfway done, to suction them, to pull out their central line together :Frankenstein:

[Kiki1970]

If some asks for "help for a second" dont be a wuss.

Say " no I cant. I will when I get this done."

There's no I in TEAM.

[Kiki1970]

I learned yesterday, from an RN client of mine to not go into LTC after I grad/pass. She said its almost impossible to get hired in acute care afterwards.

So all I have to do now is freak out if I can't get hired right away at a hospital after I grad/pass. Awesome.

[Alisonisayoshi, LVN]

I learned yesterday, from an RN client of mine to not go into LTC after I grad/pass. She said its almost impossible to get hired in acute care afterwards.

So all I have to do now is freak out if I can't get hired right away at a hospital after I grad/pass. Awesome.

Make sure this is actually true not just a bias against LTC nurses. Get mutiple sources.

[SWM2009]

I learned yesterday, from an RN client of mine to not go into LTC after I grad/pass. She said its almost impossible to get hired in acute care afterwards.

So all I have to do now is freak out if I can't get hired right away at a hospital after I grad/pass. Awesome.

Perhaps that is the case in your part of the country. I can tell you that at the LTC facility where I work, many RNs stay for 6-12 months and almost always move on to work for the large hospital network in the area.

[Kiki1970]

Thanks, I will- she's a good friend and it didn't seem that way, but then, she's in the UC system and an ASN for 20 yrs.

[Farawyn]

I've learned that when a student comes in with a dressing I get insanely excited. There has been so much psych stuff here this year. I miss dressing changes and all things nursey.

[calivianya, BSN, RN]

I did a degree eval out of curiosity for biology... and I learned that most of the pre-med stuff is required for the bio major, which puts me about 5-6 classes away from having a bachelor's in biology once those are taken care of, which is pretty irresistible... looks like I'm going to have three bachelor's degrees before I get to anything else. How many degrees can people obtain before they're officially just morons for liking school too much, anyway?

*hides under a rock*

I also re-learned that one of the NPs with our intensivist group is a moron. Really, really a moron. Who stops an amiodarone drip before the patient is rate controlled and doesn't even order any PO amio or add any new PRNs? The amio wasn't for kicks and giggles when I started it the night before - it was for a-fib with RVR in the 200s, which should maybe be addressed with PO amio before the drip is d/ced?! Who the heck also ignores the day shift RN's approximately ten million phone calls when the HR is creeping up in the 120s-160s range and says, "Oh, it's okay, we can just transfer her out," and doesn't order anything else?

Wish I could be there to see her face this morning when the amio drip she d/ced the day before is re-started, thanks to the nighttime intensivist with some common sense. Geez louise. Everybody in that intensivist group is SO competent except for that NP. Watching people like that have a license to prescribe meds is what made me really not want to go the NP route.