WILTW 7/18: I'm tired :\ (complaint department and other things)

Nurses General Nursing

Published

Good lord I'm worn out. It's weird because I honest don't do as much as I did while working, but here I am. It's not as much body tired, but brain tired.

Recent weeks have been eventful, though. Appointments, benefits crap, recovery crap, bakers cysts (OMG), and family crap. It's all that and arguing kids. I can't figure out who decided I have to adult, but that person needs a good throat-punch.

So, as a patient, I have learned...

1. Recovery from spinal fusion is excruciatingly slow. Yes, I mean "excruciatingly". I don't know how to do slow.

2. A doctor is as strong as his staff. I am so thankful for a great team.

3. My time off was extended. This is terribly bittersweet. It feels like I failed missing a landmark, but I'm glad it was obvious I needed to.

4. It is possible to develop bilateral baker's cysts. It is possible to have bilateral cyst rupture. It is possible to have synovial fluid in your feet bilaterally. This will hurt. HORRIBLY. For days.

As a nurse, I have learned:

1. People who have inpatient stays with histories of receiving meds late might bring their own. They might also bring meds from home if they decide staff doesn't administer enough. (Disclaimer: yes, I knew this might happen, but I had a person admit and defend it. They said the staff would never know. I asked what she would do when staff brought meds she already has taken. NO RESPONSE.)

2. I'm now terrified of patients being like that person. When an autopsy shows an overdose of med reaction, the family will blame us.

As a human, I have learned:

1. Even if you think you don't care about a person's opinion, she might still see you for all your faults and weaknesses and tear you limb from limb, destroying your heart in her wake.

2. If you leave your dog home for a week with brief visits from a sitter, when you get home, the dog might not let you beyond paws' reach for days. (Meaning, expect an extremely persistent animal laying on you constantly, and smacking you hard with a paw if you decide to do something with your hands other than hug or pet.)

3. This is a delayed thing, but we got a spacecraft into Jupiter's orbit and watching mission control live as it happened was the most awesome thing!

4. YOU GUYS. You need to watch Stranger Things on Netflix.

I am going to keep this short this week. I was thinking about going longer, but honestly, you aren't the complaint department! Onward and upward, my friends... :)

(I have veered a little from the nursing path, so I'm adding this quick reminder that these threads turn blue when they remain too far off the nursing path.)

What have you learned this week?

So orientation began this week, and my first shift on the floor is Friday. I have to admit that I'm feeling intimidated and unprepared as that first day approaches. I've met several of the new nurses/externs I'll be working with, and I feel like my program didn't prepare me as well. I know that I'm intelligent and retained a lot from nursing school, but the nursing skills that many people obtain through their program is something that I know I'm lacking. I guess I'll just have to learn a little more than the other new hires. Please pray that I have a patient, understanding preceptor.

I learned that there are Power ports, where dye can also be injected.

While technology is helpful and convenient for many things, it can also make the staff too dependent and careless.

Pressure ulcers are now called pressure injuries because not all of them are ulcers.

Yeast can look like a pressure injury but blanch when you put pressure on it.

Specializes in critical care.
I learned that sometimes GoFundMe is necessary. It's the only way I'll be able to pay for my husband's funeral expenses. I never knew arrangements were so costly! We both are on Social Security so no resources to speak of, and of course the funeral home wants all their money upfront. Ouch.

I learned that hospice facilities are a Godsend when a patient's pain is out of control and nothing you give them even touches it. I'm so glad we got him there in time for him to get some pain and agitation relief. His nurse and CNA were top-notch and I'm so grateful that he was able to die peacefully. God bless hospice nurses!

OMG Viva!!!!

I am so, so sorry for your loss!

Specializes in critical care.
From ixchel: (I couldn't get the quote feature to work.

1. Recovery from spinal fusion is excruciatingly slow. Yes, I mean "excruciatingly". I don't know how to do slow.

2. A doctor is as strong as his staff. I am so thankful for a great team.

1. I agree. I had a spinal fusion in 2006. Mine was cervical, not lumbar like yours but recovery was painstakingly slow. My recovery was complicated by CRPS which led to me eventually going on disability years later. I've had to learn to do slow but I still don't do it well and often forget Im supposed to be doing slow. I hope your recovery continues to go well.

2. So very true! And the opposite is also true. I currently am struggling with the decision of leaving a very good doctor because of his office staff. Most of the time I can overlook stuff but when it starts having a direct negative affect on my treatments & health and repeated attempts to resolve it have been ignored, it's time to make a change. It's still incredibly hard to actually do.

Congrats Chaos!

Viva, I'm very sorry for your loss!

Thank you for this.

My kids' pediatrician had terrible issues when they were little. Slow slow slow, terrible communication, other providers lacking in clinical and diagnostic skills. But their pediatrician, I loved beyond measure. It was a very hard decision, but I chose to take them to the family practice my spouse and I had been going to. I ended up going back to the original guy as soon as I could because I just missed him so much. Over time, the office has gotten better and they've had some providers come and go. I'm much happier there now, but this took a few years.

The struggle is real, and yes, incredibly hard. I hope your outcome is one you are truly happy with!

Specializes in ED, psych.

I'm so sorry, Viva.

So many (((hugs))).

Specializes in critical care.
I learned ativan is one hellofa drug and damn I wish that lady yesterday hadn't run out. She drove me crazy. Really irrational anxiety septuagenarian.

"Are you SURE my organs are ok. How do you know I don't have blood sepsis."

After about a dozen (no exaggeration) times of explaining how and why, I was finally able to get her to the lobby to await her ride. I really almost needed an ativan myself.

I have learned it brings me joy to see you here. :) (I already knew that, but it's the VOLUME of joy I am experiencing.)

Specializes in critical care.
So orientation began this week, and my first shift on the floor is Friday. I have to admit that I'm feeling intimidated and unprepared as that first day approaches. I've met several of the new nurses/externs I'll be working with, and I feel like my program didn't prepare me as well. I know that I'm intelligent and retained a lot from nursing school, but the nursing skills that many people obtain through their program is something that I know I'm lacking. I guess I'll just have to learn a little more than the other new hires. Please pray that I have a patient, understanding preceptor.

1. Everyone you are about to work with on the floor knows up front that you will suck. Be okay with you knowing you will suck. Try the best you can, and know you will make mistakes. YOU WILL. And everyone else knows it to. They expect it. You know why? Because they sucked. They made mistakes. Everyone starts where you are now.

2. If anyone treats you like dung because of the mistakes and the sucking, let it roll off your back. DO NOT TAKE IT PERSONALLY. Maybe they're just A holes. Maybe you created more work for them, or disrupted their day. Or, maybe they REALLY are just A holes. You can't change them. You can, however, change you. Whatever was messed up, LEARN from it. This is how you improve, and this is how you turn the A holes into nice people.

3. Always remember that learning is YOUR responsibility. Yes, there is someone teaching you. They may be held responsible for your progress by management, BUT, as a person holding a professional license now, what you don't learn will be your responsibility. Sounds scary, right? It's not, I promise. You have people surrounding you every minute of every shift. You have access to written policies and protocols. You have access to lab, respiratory, pharmacy, doctors. They are always available to you. Use these resources. If it's something easy, like changing an IV site, you can ask a nurse to help walk you through it. (Although, I recommend grabbing supplies and walking yourself through it sans patient before trying it yourself because nothing says, "I'm too new for this!" more than leaving a catheter open and bleeding all over the place, etc. lol)

4. That said, if you need information, not skills, instead of asking, "what is the policy for xyz?", ask, "Where can I find policies and procedures so I don't keep bugging you for info I can find myself?" This wins bonus points from those around you.

5. If it turns out your preceptor is not well matched to you, you can still learn from this person. Try hard to get all you can from him or her. Give it time. If you have reason to feel you are severely lacking due to your preceptor, ask the unit manager if you can talk for a few minutes. Don't put the blame on your preceptor, because it might be you. Just ask - "am I progressing at the pace you would expect for a new grad?" It is very possible you are expecting more from yourself than you should be. I actually had this conversation when I was 2 months in. My boss wrote on a sticky note, "I have only been an RN for two months," and told me to put it somewhere where I'd read it when I needed to. If your preceptor is the problem, chances are that has already been noticed, and you may be reassigned. Just keep an open, willing mind.

6. This first year is brutal. Nursing students are used to hitting the ground running. Nurses do not run in the first year. It's horribly frustrating. You'll get there. It just takes time. Set your expectations at "learn" only during this beginning part. Employ "observe, do, teach," and know you can repeat steps as needed.

7. Even the best nursing schools turn out nurses who feel they didn't learn enough. I say this from first-hand experience. You didn't learn enough because teaching more is silly when you figure hospitals pick up where school leaves off. That, and people go into specialties. If all you ever dreamed of is public health nursing, how often are you going to be placing foleys? Your education was what it needed to be. It gave you an introduction. You are doing your real learning now.

8. Enjoy the COBs on your unit. You might hate them at first, but once you get over this Bambi stuff, they'll be your favorite people. They'll be the first to come running when you shout "help" out of a patient's door. They'll be the first to find humor in the dark and twisty that could overwhelm you otherwise. They'll be the first to give you doses of reality without sugar coating. Again, it is not meant personally. It might save your patient's life.

9. Communication in fast-moving situations is short and sounds very rude to the casual observer. It has to be. You will get comfortable with communicating in the same way over time. You'll hear and use it most in codes. There just wont be time for please and thank you.

10. I don't know why I've typed all this out because I'm sure you already know it. You're already awesome! :)

Specializes in critical care.

Who wants to host the next WILTW thread?

So orientation began this week, and my first shift on the floor is Friday. I have to admit that I'm feeling intimidated and unprepared as that first day approaches. I've met several of the new nurses/externs I'll be working with, and I feel like my program didn't prepare me as well. I know that I'm intelligent and retained a lot from nursing school, but the nursing skills that many people obtain through their program is something that I know I'm lacking. I guess I'll just have to learn a little more than the other new hires. Please pray that I have a patient, understanding preceptor.

I learned that there are Power ports, where dye can also be injected.

While technology is helpful and convenient for many things, it can also make the staff too dependent and careless.

Pressure ulcers are now called pressure injuries because not all of them are ulcers.

Yeast can look like a pressure injury but blanch when you put pressure on it.

Good luck on the floor! I'm sure you'll do great!

I got a call for an interview, tomorrow afternoon. I'm excited and nervous. It's a spot on tele, which will hopefully give me the right experience to get back to ICU eventually.

Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
That's just crazy to me. I would never talk to my coworkers about my mental health diagnosis or share meds & for the same reason you explained. You might be friend(ly) now, but what happens if you piss a coworker off? I'll pass!

I so know about the favoritism thing and have been extracting and checking for the knives in my back on a regular basis for awhile now. LOL. I remember this group not long ago talking about when their meds are readjusted and I don't trust anyone at work enough to discuss these issues.

I have been on zoloft 18 years....yes count them....18 years. I have weaned myself to half the dose while I wait to see a new doctor and have my antidepressant changed. (insurance is a pain in the patooty). I thought it would be no big deal. I have heard patients talk about issues with tapering their SSRIs. WOW nothing helps your understanding and empathy like walking a mile in another's shoes.

I am scared of changing to a new med, it took like forever to find one I didn't have problems with. So 2 weeks into decreasing the dose of zoloft I am feeling a bit off key. Memory issues (or early alzheimer's). Sleep disturbances. Headaches. I have an eye twitch/nervous tic that has started back up. It has been ages since that happened. Short tempered. Little things which are getting a bit bigger. I have read about brain zaps (shudder). Makes me think about bug zappers we use in the summer. God I hope my brain doesn't start zapping on me.

I will certainly have more compassion when a patient tells me they are weaning or changing their antidepressants or psyche meds from now on.

Specializes in Pediatrics, Emergency, Trauma.
Who wants to host the next WILTW thread?

I can-I had such an eventful week!

If you want me to...:shy:

Specializes in M/S, LTC, Corrections, PDN & drug rehab.
I so know about the favoritism thing and have been extracting and checking for the knives in my back on a regular basis for awhile now. LOL. I remember this group not long ago talking about when their meds are readjusted and I don't trust anyone at work enough to discuss these issues.

I have been on zoloft 18 years....yes count them....18 years. I have weaned myself to half the dose while I wait to see a new doctor and have my antidepressant changed. (insurance is a pain in the patooty). I thought it would be no big deal. I have heard patients talk about issues with tapering their SSRIs. WOW nothing helps your understanding and empathy like walking a mile in another's shoes.

I am scared of changing to a new med, it took like forever to find one I didn't have problems with. So 2 weeks into decreasing the dose of zoloft I am feeling a bit off key. Memory issues (or early alzheimer's). Sleep disturbances. Headaches. I have an eye twitch/nervous tic that has started back up. It has been ages since that happened. Short tempered. Little things which are getting a bit bigger. I have read about brain zaps (shudder). Makes me think about bug zappers we use in the summer. God I hope my brain doesn't start zapping on me.

I will certainly have more compassion when a patient tells me they are weaning or changing their antidepressants or psyche meds from now on.

I just went off Zoloft due to my pregnancy. Holy hell. I was miserable! I was on 150mg but hadn't been taking it for only 1/2 a year. The side effects I experienced was enough to make me never go back on Zoloft. The brain zaps were the worst thing ever. Not to mention I was always tired & sick. Thankfully the side effects are pretty much gone now. I know what you are going through, it's not fun.

Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
1. Everyone you are about to work with on the floor knows up front that you will suck. Be okay with you knowing you will suck. Try the best you can, and know you will make mistakes. YOU WILL. And everyone else knows it to. They expect it. You know why? Because they sucked. They made mistakes. Everyone starts where you are now.

2. If anyone treats you like dung because of the mistakes and the sucking, let it roll off your back. DO NOT TAKE IT PERSONALLY. Maybe they're just A holes. Maybe you created more work for them, or disrupted their day. Or, maybe they REALLY are just A holes. You can't change them. You can, however, change you. Whatever was messed up, LEARN from it. This is how you improve, and this is how you turn the A holes into nice people.

3. Always remember that learning is YOUR responsibility. Yes, there is someone teaching you. They may be held responsible for your progress by management, BUT, as a person holding a professional license now, what you don't learn will be your responsibility. Sounds scary, right? It's not, I promise. You have people surrounding you every minute of every shift. You have access to written policies and protocols. You have access to lab, respiratory, pharmacy, doctors. They are always available to you. Use these resources. If it's something easy, like changing an IV site, you can ask a nurse to help walk you through it. (Although, I recommend grabbing supplies and walking yourself through it sans patient before trying it yourself because nothing says, "I'm too new for this!" more than leaving a catheter open and bleeding all over the place, etc. lol)

4. That said, if you need information, not skills, instead of asking, "what is the policy for xyz?", ask, "Where can I find policies and procedures so I don't keep bugging you for info I can find myself?" This wins bonus points from those around you.

5. If it turns out your preceptor is not well matched to you, you can still learn from this person. Try hard to get all you can from him or her. Give it time. If you have reason to feel you are severely lacking due to your preceptor, ask the unit manager if you can talk for a few minutes. Don't put the blame on your preceptor, because it might be you. Just ask - "am I progressing at the pace you would expect for a new grad?" It is very possible you are expecting more from yourself than you should be. I actually had this conversation when I was 2 months in. My boss wrote on a sticky note, "I have only been an RN for two months," and told me to put it somewhere where I'd read it when I needed to. If your preceptor is the problem, chances are that has already been noticed, and you may be reassigned. Just keep an open, willing mind.

6. This first year is brutal. Nursing students are used to hitting the ground running. Nurses do not run in the first year. It's horribly frustrating. You'll get there. It just takes time. Set your expectations at "learn" only during this beginning part. Employ "observe, do, teach," and know you can repeat steps as needed.

7. Even the best nursing schools turn out nurses who feel they didn't learn enough. I say this from first-hand experience. You didn't learn enough because teaching more is silly when you figure hospitals pick up where school leaves off. That, and people go into specialties. If all you ever dreamed of is public health nursing, how often are you going to be placing foleys? Your education was what it needed to be. It gave you an introduction. You are doing your real learning now.

8. Enjoy the COBs on your unit. You might hate them at first, but once you get over this Bambi stuff, they'll be your favorite people. They'll be the first to come running when you shout "help" out of a patient's door. They'll be the first to find humor in the dark and twisty that could overwhelm you otherwise. They'll be the first to give you doses of reality without sugar coating. Again, it is not meant personally. It might save your patient's life.

9. Communication in fast-moving situations is short and sounds very rude to the casual observer. It has to be. You will get comfortable with communicating in the same way over time. You'll hear and use it most in codes. There just wont be time for please and thank you.

10. I don't know why I've typed all this out because I'm sure you already know it. You're already awesome! :)

Absolutely the VERY BEST guide for a first day nurse that I have read in over 30 years of nursing! Where were you when I hit the floors running back in the early 80s??????? Please share that in the article section or on the student nurse boards or somewhere. It is too good and well balanced and honest to be just in the one thread.

:yes::yes::yes::yes:

p.s. Hitting the LIKE button once does not do this justice.

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