What did you learn today as a nurse?

[minnib]

Greetings fellow nurses, I thought it would be interesting to have nurses tell what we have learned at our place of work in the course of our shift....

Yesterday I learned that 2 nurses should indeed check a heparin drip calculation upon learning the PTT as our facilities protocol states! If not...yikes and well just one wrong calculation not caught will throw off the rest of the calcs!!! and NOT good for the pt and could possibly lead to some serious problems...GI BLEED:uhoh21: And since I am an LPN I usually am not too involved but an RN kindly gave me an inservice on how to follow protocol, which is pretty self explanatory on the paperwork provided by the hosp. and WHY it needs to be followed EXACTLY!!!

[JSRN81]

nope ICU. But this actually happened to one of my 16 year old daughters classmates. A day later another one of her classmates died from scraping the coating off of extended release morphine tabs and died while spending the night at a friends house. Where do they get the drugs, where do they get these ideas?

A couple of weeks ago we had a kid who almost died because of a fentanyl patch. He didn't freeze it, but he did scrape the gel off and chew on it. After we saved his life and discharged him, the narc guys were in and it was all over the news that a pharmacy about an hour south of our hospital had a few boxes of fentanyl patches stolen and then they reported that one kid almost died from chewing on the patch (the kid in our ICU). Go figure. Also, I went to a legal conference last week and there were reports of people extracting the liquid fentanyl from the back of a patch with a needle before applying it to the person. I always check location and integrity of the patch, guess I never thought to check for pinholes or to make sure the med was actually there.

As for what I learned today, is that sometimes you just have to go with the flow and let other people help you out...and its okay to say "I defer to you, I don't know what to do"...(regarding how to tell my boss that I thought it was ridiculous for him to ask me to teach an open heart class on MONDAY....good thing HIS boss told him it was ridiculous for me to do...and I didn't have to do it!).

JS

[Roy Fokker, BSN, RN]

Nothing fancy....

"When trying an IV flush, make sure the trap isn't clamped"

I've done hundreds and more flushes, but today was so embarrasing :imbar

:smackingf

EDIT: Also when running a code in the ER, please be careful when switching IV solution bags. People don't like to be drenched in IV fluids... :stone

[Antikigirl, ASN, RN]

You know what...I never even THOUGHT of the fent patch deal...I learned something new not on shift! LOL!

Oh and making sure the clamp was off an IV..yep...did it times two today on a femoral triple lumen..LOL! Unclamped on port...put put my flushes on the other one that wasn't...LOL! Um duh...slow down a bit there Triage! LOL!!!!!!!! Lucky for me the patient was asleep! LOL!

[nursepenny]

I worked last night. So, this is what I learned:

Nothing is a easy as it looks.

Everything takes longer than you expect.

If anything can go wrong, it will.

Oh, wait a minute, that is Murphy's Law. LMAO

Still applies though.

Great thread. Have a good night.

[belfry]

I learned that if I have had a really bad day and am itching for a confrontation, the meanest doctor in the world (who is usually a poisonous troll) will sense it a mile away and actually be pleasant for the first time ever!!!

LOL

[EVIL][/EVIL]

[JSRN81]

You know what...I never even THOUGHT of the fent patch deal...I learned something new not on shift! LOL!

Oh and making sure the clamp was off an IV..yep...did it times two today on a femoral triple lumen..LOL! Unclamped on port...put put my flushes on the other one that wasn't...LOL! Um duh...slow down a bit there Triage! LOL!!!!!!!! Lucky for me the patient was asleep! LOL!

The other night (at 1am mind you)....I was helping another nurse bring her patient to CT Scan and as we were going down, her I-Med kept beeping. Anyway, I saw her keep pushing a few buttons and then it would stop for a few min, then beep again. Well...since it was her patient, I thought she had control of things. Anyway, it CONTINUED to do this t/o the entire scan. So finally, I went in there to see why and if the line had infiltrated or something and wasn't running properly. So...I go in and it was a double pump. On one side, she had labeled "KCL" for a mini-bag and the other side was IVF. So I look at the pump, and the KCL mini was set at 100ml per hour, running and beeping occulsion, and the IVF pump was off. Since it had beeped a couple of times already, I looked at the site, then followed the line up thinking maybe it was clamped or something. Nope, not clamped. Kept following the line up, and then ;aughed and said to the nurse "I'm not even going to tell you what is wrong here!!!" and made her come fix it... she had the KCL (which was on and running at 100ml) going through the pump and then hanging up on the IV pole with a cap on the end (not even connected to the patient) and had the IVF connected to the patient and not even running. I just laughed again and promised not to tell anyone when we got back upstairs! Don't worry - it happens to all of us!

JS

[twinmommy+2, ADN, BSN, MSN]

The last day I was working was Sunday and lets see... The thing I last learned that night about nursing was that Kayexalate can be taken PO and Rectally (thought it was only taken down under) and that it can't be mixed with any juices, only water or taken like a straight shot (and seemed like it tasted nasty according to his face)

[Fairemaid]

Today I learned that if you stick your finger in an electrical socket, you may have to have it partially amputated. And when this same pt wanders down to the nurse's station, with her IV pole in tow, all the while eating Doritos out of her emesis basin, and asks for some more of the "Diluded" it's probably not a good idea to help yourself to the Doritos even if the pt offers them.

Rebecca

[greatshakes]

Hi

I wasn't working but learned today I have an interview on Monday as a nurse at a boys boarding school. I was told at first when I spoke to nurse in charge that I would not be alone but then today that I will be and that it is pretty straightforward nursing. I am looking forward to it if I get it but will be super careful, after all it's what I don't know that could kill someone.

Speaking of which I saw a great quote today and it deserves to be shared.

"Be diligent. Be meticulous. Be honest. Account for every variable. Acknowledge that which you do not know, and then at the first opportunity learn it. Believe in yourself. That is our system. Honor it and it will support you like a rock, Honor it and even the death of a patient will be no failure" (it was apparently by someone called Davenport and in Michael Palmer's Flashback). Let me know what you think.:chair:

[not now, RN]

My new job is subacute where all patients are on vents (stable) and my first time working with vents since, oh...nursing school. I learned I'm not as scared of vents as I once was. Granted I'm still a little nervous but not nearly as much.

[JSRN81]

Today I learned that there is at least one nurse manager, one director of critical care (MD), and at least 3 committees full of people who reviewed a policy and not one of them can spell the word dysrhythmia. I was looking over some material to teach a CTS class and ran across a policy (that I don't use much) that was changed over the past few months...and the 3rd line of the policy refers to "disrhythmias"....apparently these are MUCH worse than DYSrhythmias.

JS

[MMARN, BSN, RN]

****NURSING STUDENT ALERT*****

I learned that I passed my exam. :monkeydance: