I'm writing for ixchel this week-I enthusiastically volunteered, and I wanted to keep with the continuity; sometimes I become a creature of habit with routine and habits, and I surely didn't want to disappoint members.
I actually am off this week from work, but not without interesting WILTW tidbits, even on my days off; I am currently waiting to send a co-worker, who is a NP off in fashion; she's leaving to go to Texas, where she is going to have a blast-I'm going to miss her, but we will be in touch; she is a great clinician , and a wonderful person who helps my personal procrastination-such as my wedding plans-move forward.
So, without any more introduction:
I learned that negotiating the balance beam between union activities and engaging in management is very interesting to say the least; management has become more transparent since a prior WILTW experience-the sweaty flu-riddled meeting where I enthusiastically volunteered to help with morale to end the meeting and teleport to my bed-and although they are trying to "get things done", the union is making in roads for a process, whether they like it or not.
Soft skills can work...I have learned to talk down very challenging parents, more often because even though volume has been down, the acuity of pts are still there-parents want to be reassured, whether they desire to curse someone out or question what we do at every turn, especially when said parents had a very unpleasant experience with said hospital; at least turning around impressions goes a long way with good holistic psychosocial nursing care-at least this time.
Having three traumas with spinal precautions makes for an interesting night:
L5 injuries can produce back pain and nerve injuries, especially to the sciatic nerve, even if there is no spinal cord damage.
C7 injuries can produce referred shoulder pain, even though there is no spinal cord damage.
Spinal shock can still occur, where it's important for pts to follow-up after discharge.
Miami J collars are my favorite collars-they are more comfortable for the pt-ahh memories working at an acute rehab hospital...
Being a go to person of advocacy for seasoned peers and newbies is a great feeling; I'm never the person who is a "cheerleader" type, but more of an "activist cheerleader" is something I can be comfortable with-being positive, realistic, and being empowered as a nurse can be interesting to say the least.
-This week I learnt on the IV pumps my facility uses I can give boluses of precedex if I need to. Although frankly, if I have a patient who is wildly anxious after surgery, I prefer to give a small dose of versed over a bolus of precedex due to blood pressure issues.
-This week I learnt when a kid comes up with an airway, let them wake up on their own and let them try to pull it out. That way, you know they are awake enough to maintain their own airway.
-This week I learnt extubating under deep sedation reduces the risk of laryngospasm, and that helps for patients who have a known or unknown diagnosis of asthma. Of course when they come to me they should have an oral or nasal airway. Some CRNAs are good about that, and some are not so good about that.
Only in Indiana would it be 40 degrees with 20 mph winds and cloud on graduation day, making it nearly impossible to get good pictures with my youngest brother and friends.
I have another interview in MI, so I'm really hoping I receive an offer from either interview. I really like that the hospital is so heavily invested and involved in research, which is ultimately what I want to do.
I have no idea where to start for NCLEX studying. I feel like there is so much that I don't know. So far, I've been focusing on OB and Peds, since I feel that my knowledge is lacking in these areas. I'm going to MI early to study with my friend who graduated from a Pharm D program and is also studying for her boards. Hopefully, it'll help me focus more and motivate me.
After 18 weeks, the fundal height is approximately the age of the fetus +/- 2 cm. Women can feel quickening between 16-20 weeks.
Basically, all your antivirals and Abxs make OCPs ineffective.
I learned that I've become much more comfortable with saying "no," even to wives of hospice clients. I used to have a very hard time saying no to patients who requested me frequently, and I ended up working 60 hours while taking 15 credits of prereqs. If I always say "yes," I'll never get a day off, and I need those days off as "mental health days." It's ok to look out for myself while still being a good caregiver.
Melatonin makes me have bat-crap crazy dreams. I don't know if the full-night's sleep was worth those crazy nightmares!
Being an adult often means that you start to worry about your mom. Tables have turned, and now I'm the one sitting with her on her bed while she cries. This is also why I need melatonin to sleep.
Any of you hiring? [...] Clonidine overdose can be treated in part with narcan.
Oh heck yes we are hiring. In any department you could possibly ask for. I've spent all week trying to recruit people at my PRN job to come work at my full time job. I am a bad influence.
And I didn't know about the narcan, but I did know that clonidine can be used for sleep as I have had a couple of patients that took it for that reason. I wonder if whatever it does to make people sleepy is why narcan works for it... *goes off into Google land*
I sleep best with someone laying on me. Weird, huh?
People are the best weighted blankets. Especially attractive people of whatever gender you prefer.
People actually do sing "Staying Alive" during chest compressions.
Too bad that's on the slow end now for the current recommendations. That was a great song for compressions. I just speed it up in my head a little now...
This week I learnt extubating under deep sedation reduces the risk of laryngospasm and that helps for patients who have a known or unknown diagnosis of asthma.[/quote']
The thought of extubating under deep sedation is just a little terrifying, IMO.
Non-nursing related, but I'd appreciate some good thoughts about me figuring out what the heck to do in my personal life. I have made a couple of phenomenally bad decisions lately and I have no idea what to do about it. All I know is that I am really, really good at making bad decisions.
I grew up with smaller cousins, brothers, pets, etc., sleeping with me. As you know, little ones have no personal boundaries. I still don't sleep as well alone, so I let my fur babies sleep in the bed with me.
I'll never forget the time, in the height of the 80's waterbed craze, I woke up face down in between the water mattress and the side of the bed. My little cousin, whom I was babysitting overnight, was sleeping peacefully on my back!
Luckily, it was one of the rigid mattresses with water pockets so I had a little airspace. It felt nice, except for the elbow digging into my kidney, so I just wiggled her a little and went right back to sleep!
I forgot to say something about adult bed mates. It really depends on how much they thrash and if they hog the covers.
My hubs, bless his heart, is relegated to his side of the bed and we are almost to the point where I am getting a second set of covers for me. He rolls like an alligator, with elbows out. He has a seven foot wingspan. Ouch!!
We have a king size now. I've learned to sleep at the bottom of the bed.
-This week I learnt extubating under deep sedation reduces the risk of laryngospasm, and that helps for patients who have a known or unknown diagnosis of asthma. Of course when they come to me they should have an oral or nasal airway. Some CRNAs are good about that, and some are not so good about that.
That must have been what they did with me when I had my gallbladder out (known asthmatic).
The only thing I didn't like was that while I was waking up, I dreamed that I was at the bottom of a VERY deep lake, and was swimming to the surface as fast as I could before I had to take a breath. Just a bit disconcerting lol.
I bought resume paper and am revising my resume for the interviews If anyone would like to critique my resume, I would appreciate it! I opted to remove my clinical rotations and list my total number of clinical hours at the bottom, including the units (is 530 hours of clinical too little? Because it seems like everyone has >750 hrs). I figure that most clinical experiences are the same, and it's obvious that, unless I list something extraordinary, my clinical experience is irrelevant.
That a man in his twenties (my hubby to be exact) can become severely dehydrated from a stomach virus in 4 hours, pass out, and slam his head on the bathroom floor. He managed to crawl back to bed (I was upstairs so didn't hear it). I came downstairs to him sitting up in bed with a beat up face. I took him to the ER for a head CT and some IVFs. And to boot had to call out in for first 90 days of employment at my new job because while I was at the hospital with him, my mom calls and goes, "Hey I'm throwing up now. I don't know if I should keep the grandbaby." Yea...prolly not.
That you should never drive and try to eat a KFC "bowl" in a rush on your lunchbreak. You might run over a slight median and blow out your tire and sit there 20 minutes before someone stops to help. God bless that kind man that did stop.
I bought resume paper and am revising my resume for the interviews If anyone would like to critique my resume, I would appreciate it! I opted to remove my clinical rotations and list my total number of clinical hours at the bottom, including the units (is 530 hours of clinical too little? Because it seems like everyone has >750 hrs). I figure that most clinical experiences are the same, and it's obvious that, unless I list something extraordinary, my clinical experience is irrelevant.
Spidey's mom, ADN, BSN, RN
11,305 Posts
We need a smilie that shudders . . . .