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.
There are few things more rewarding than watching someone go home with a new heart. Especially if that someone experienced a massive complication and coded 6 days after surgery. For reference, it can be very hard to get heart transplant patients back if they actually make it to asystole. Luckily this was caused by cardiac tamponade.
Never thought I would use *those* words together in a sentence.
I have a full week of classes/continuing Ed scheduled so perhaps I will have more to post next week.
I learned that my time in the OR made me really good at setting up unfamiliar equipment during a code. It was my first week on the code team "officially".
We can't win them all, but the learning we take away may just help save the next one.
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.
I don't have a definitive answer for you but I would be thinking along the lines of: changes in the bacteria's environment as a result of those conditions: changes in temperature, pH, etc. I would suppose that these changes, 2/2 poor perfusion, support a more favorable environment for bacterial growth. Bacteria can be opportunistic; what do they need to thrive, what do they eat, what supports their exponential growth?
ETA: on my third glass of bubbles so apologies if I just stated the obvious for you :)
I learned that when three different people diagnose you with the same thing, you ought to start believing it.
I learned that I miss nursing more than I thought I would. Having my husband's hospice RN visit us every week reminds me of what I used to love about being a nurse. I'd give almost anything to be able to come back, but the politics and the ridiculous workloads would drive me even crazier than I already am. I know---I've been through it.
I learned that watching someone you love fade away is a little like Chinese water torture. Every day it seems there's a new symptom, a little less energy, a little more discomfort. It's awful to witness, and there's not a damn thing I can do about it.
I hated to "like" this post because I really kind of hate it, but I do like you. So sorry for what you're going through. I helped take care of my Dad through the end of his life and can relate to the devastation of helplessly watching somebody you love fading away. It just sucks.
Oh, and maybe this should have been on last week's thread (no time to post) but I learned that having a long time patient play April Fools pranks on you with their chest tubes is decidedly NOT funny.... And apparently I need to hide my facial expressions better, even while wearing a mask.
"Your eyes were priceless"
I guess seeing this formerly quite depressed patient laughing hysterically (with 5 chest tubes, no less) was worth it. Maybe.
I learned that dentists really do have a good gig, and if I could do it all over, I'd deal with my disgust of the mouth and go to school for it (no weekend, evening, holiday, or even spring break hours; get to charge large fees up front, etc).
I don't have a definitive answer for you but I would be thinking along the lines of: changes in the bacteria's environment as a result of those conditions: changes in temperature, pH, etc. I would suppose that these changes, 2/2 poor perfusion, support a more favorable environment for bacterial growth. Bacteria can be opportunistic; what do they need to thrive, what do they eat, what supports their exponential growth?
ETA: on my third glass of bubbles so apologies if I just stated the obvious for you :)
Aha! I finally found the answer.
The local ischemia causes a hypoxic environment, that encourages growth for anaerobic organisms.
I've learned that when I think of all "our students" graduating, like crackle and Half Pint and aeris, and when I read Purp's eloquent posts (when she's not busting my chops) that I am so geekily excited for them.
(((Viva))) I wish there was more I could say. Love to you.
What I've learned this week:
*I apparently DO have somewhat of a voice at my PRN gig. I worked half a night shift where I floated for a new grad and traveler. Each with 8 pts a piece, the new grad being thrown into the charge role. I am seriously glad I was there, an already dangerous situation could've been much worse. So first thing the next morning I made a call...and let TPTB know just what I thought, that the nurses and patients should've never been put in that situation. They listened. Surprisingly.
*A hospital will freaking lose their **** if a bed bug is found. I get a page saying I am getting a transfer from another floor because they found a bed bug and had to decontaminate the room. I literally (hate that word...but literally) said "Okay" and walked out of the nutrition room and he was being wheeled down the hall. NO report, nothing. I didn't even know his name. So when his previous nurse calls to give report I said "And you can send his chart down since it was so much of an emergency that he couldn't wait for it", the poor girl didn't even know they had brought him down. I think she was almost as mad as I was. I felt bad for the poor patient.
*I get very defensive when it comes to breastfeeding at my PRN gig. In the past I've actually printed out the laws and handed them to TPTB. I've been breastfeeding for 27 of the last 41 months, (The months in between I spent pregnant and unable to nurse) and this weekend I was told that I should be going off the floor to the "pumping station" to pump. Excuse me, but our headphones don't pick up on that floor, and I want to make sure my pts are taken care of while I'm gone. Technically if I left the floor, my co-worker would be left with 11-12 pts by herself, which is illegal. Get me a float to cover me and I'll leave the floor, until then, deal with it.
*We had our house under contract. Got a call Wednesday saying the buyers loan fell through. This has caused MAJOR anxiety. We had already started packing. Not only that but we NEEDED to sell, not just wanted, but needed. Prayers on that, friends.
*I LOVE my school nurse job. After a week off I was actually excited to come back, see my kiddos. I've never had a job like that before and I am beyond blessed. Just wish it paid a little better. I am in an LPN position so times are hard in the Sully house. But the less stress/more happy is worth it.
kalycat, BSN, RN
1 Article; 553 Posts
I've learned that damn... I'm tired.
There are few things more rewarding than watching someone go home with a new heart. Especially if that someone experienced a massive complication and coded 6 days after surgery. For reference, it can be very hard to get heart transplant patients back if they actually make it to asystole. Luckily this was caused by cardiac tamponade.
Never thought I would use *those* words together in a sentence.
I have a full week of classes/continuing Ed scheduled so perhaps I will have more to post next week.
I learned that my time in the OR made me really good at setting up unfamiliar equipment during a code. It was my first week on the code team "officially".
We can't win them all, but the learning we take away may just help save the next one.
Viva -- I have no words. Thinking of you.