Hello, everyone! ixchel has been a trooper, juggling many things on her plate, so I have relieved her for this coming week. Here are some of the things I've humbly learned throughout this week:
1. That confused LOL who presses the call light constantly, and presses it several times while you're in the room with her, is charming for the first 5 minutes you meet her. Every time the call light goes off after that makes you want to run in the opposite direction, as fast as you can. Now, I understand what people mean when they say they hear a call light going off during the night. I've been hearing call lights ever since I got home.
2. I'm almost as giddy as my patient when his Foley and wound V.A.C. are removed after weeks of being hospitalized.
3. I emptied my first colostomy bag and was able to teach my fellow cohorts how to do it as well. I've never felt so happy to see a BM (On a side note, am I the only one who notices that my BMs smell like my pt's later on in the day?).
4. A positive Kernig's and Brudzinski's sign are indicative of meningeal irritation and that's not good.
5. Pseudomonas aeruginosa is a gram negative bacteria that is multidrug resistant. Also, not good.
6. Just plastering a smile on your face throughout the shift can really brighten people's days. Although internally, I might not be feeling it, I don't let it show because, come on, the people in the hospital need a LOT more cheering up than I do.
7. Don't inject air into Dilaudid because it will blow the end off the vial. Thankfully, I did not do this, and my instructor told me not to before I even started drawing it up. I also got to flush a central port.
8. My sarcasm and dark/dry humor is not wasted on my clinical mates.
9. There are doctors who don't see some tasks as "beneath them". Garbed in isolation dress, I poked my head out to have a fellow mate grab me some iced water. Seeing my searching gaze, a passing doctor - who was easy on the eyes - asked me what I needed and then brought me some water for my patient.
10. I've been having trouble with frequent urination, including waking up in the middle of the night, even though my bladder isn't that full. It's been irritating, and I'm wondering if I should go see my doctor sometime. I haven't been too concerned, but since it's been persisting for a month now, I do wonder... I've ran through, in my head, the possibilities of diabetes, cancer, and hyperthyroidism with my current symptoms.
When I was but a brand-new baby nurse I was thrown to a complete mess of a hospice client. She was young, had a terrible cancer with huge fungating wounds, very active user of many substances, and multiple psychiatric diagnoses on top of that. The poor woman was actively dying, homeless, running from the police believing they were trying to abduct her. Finally one of the organizations in the community managed to convince her to come inside and let a nurse come take care of her. Lucky me! I was with her for 12 hours (I'm normally a 9 to 5 kinda girl) before she passed. She required constant care and couldn't be left alone and there was nobody else. I'll never forget her name. I had nightmares for weeks after about her suffering.
Now I'm having major and horrifying deja-vu because I just got another referral for a VERY similar client - same age, same cancer, same psychiatric diagnoses, same substances used. Fortunately this one isn't quite as far along in her trajectory and is still well enough to be out using and working (in the sex trade). Which is great for her! Not so great for me because I can't ever FIND her. I'm scared that soon one day I'll find her and she'll be as sick as the first one and I won't have been able to do the things I can do to alleviate some of her suffering a bit earlier on. These cases are just the worst.​ She never even had a chance, you know?
Will you press your button while staff is in the room?
Wow, actually had a resident do that, and got angry at the staff, because he didn't think it was working, because he could not see a light come on. Went on for two hours.
Wow, actually had a resident do that, and got angry at the staff, because he didn't think it was working, because he could not see a light come on. Went on for two hours.
I had one on night shift who refused to stop until the doctor arrived. That was a very, very long night.
The first time I saw a nurse do this, I thought to myself, "what the ****!" BUT! The LOL absolutely loved that she was helping us, her fidgeting urge was satisfied, anxiety/agitation was reduced, she was cooperative, and she was HAPPY! It is a fantastic diversion technique!
Oh my goodness it works so much better than I imagined it would! I was a skeptic too. It *may* have been how we got a combative LOL off restraints, off the low bed and to placement in a LTC/SNF...she was only combative at night and two or three nights of the diversion tactics, she secured placement and was able to leave acute care!
My shift was incredible last night. I saw so many things. I saw 3 intraosseous infusions last night. I also got to see how the whole organ procurement process goes. That was interesting.
We also had a lot of sadness. I saw some bad things. Always, always wear your seatbelt. I saw the effects first hand on an MRI this morning.
I worked with an incredible team of nurses last night. I was thanked 4 or 5 times last night for my help. And they are patient in teaching me. It's hard to remember all of the equipment as you may see it quickly in lecture in school and then you forget all about it. So when they need something, I don't always know what I'm looking for but they have been great. I'm enjoying getting to learn and get my feet wet before I graduate. I am very lucky to have landed this job. I feel confident that when I start orienting as a RN, I will get great training.
Sorry I haven't responded! I've been in the woods (literally, in the woods where service is virtually non-existent) serving at a church retreat. I have been reading through all your posts, though.
I'm so sorry, Viva. I can't imagine what you're going through.
I am going to my doctor's for an overdue Pap, so I'm going to mention my symptoms to her and also get a prescription for OCP.
I learned that, when I'm with my healthcare friends, I actually understand what they're talking about. We discussed everything from drugs to wounds and all the in-betweens. Meanwhile, the non-healthcare friends were staring at us in a mixture of confusion and disgust.
I learned what necrotizing facsiitis is.
I'm ready to graduate and work. I'm tired of being a poor, unemployed college student.
I'm ready to graduate and work. I'm tired of being a poor, unemployed college student.
You should be excited! It's a fun time! I'm trying to be positive, but the reality is that I'm a poor, employed nurse who is (hopefully) about to be juggling grad school and work...
If you have a drawer full of pens, pencils, paper clips, etc., you could mess it up a bit and ask your LOL to help you sort it out. You're giving her something useful to do, and helping her calm down, too.
I feel like I'm in limbo at the moment. I like being busy rather than having nothing to do, which is where I'm at.
Also, can anyone tell me why localized ischemia and necrosis, resulting from necrotizing fasciitis, contributes to bacterial proliferation? I'm stumped.
annabanana2
196 Posts
When I was but a brand-new baby nurse I was thrown to a complete mess of a hospice client. She was young, had a terrible cancer with huge fungating wounds, very active user of many substances, and multiple psychiatric diagnoses on top of that. The poor woman was actively dying, homeless, running from the police believing they were trying to abduct her. Finally one of the organizations in the community managed to convince her to come inside and let a nurse come take care of her. Lucky me! I was with her for 12 hours (I'm normally a 9 to 5 kinda girl) before she passed. She required constant care and couldn't be left alone and there was nobody else. I'll never forget her name. I had nightmares for weeks after about her suffering.
Now I'm having major and horrifying deja-vu because I just got another referral for a VERY similar client - same age, same cancer, same psychiatric diagnoses, same substances used. Fortunately this one isn't quite as far along in her trajectory and is still well enough to be out using and working (in the sex trade). Which is great for her! Not so great for me because I can't ever FIND her. I'm scared that soon one day I'll find her and she'll be as sick as the first one and I won't have been able to do the things I can do to alleviate some of her suffering a bit earlier on. These cases are just the worst.​ She never even had a chance, you know?