4/23 WILTW: It turns out nurses do make the worst patients

[ixchel]

It's been a busy week for me, even though I feel like I've done very little actively. I've got a little extra bounce in my step (figuratively) since surgery and it has made me decide to get things done that I have been putting off for ages. Along the way, I've gathered some nursey lessons, some non, and I am still getting employer/employee lessons, but that was expected.

This week, I have learned...

(for my own health stuff, good to know for future patient care)

I have gratitude for the donor I received a part from. The feeling is stronger than I expected. I wish I could say thank you to the family of the cadaver I received bone from.

After a lumbar fusion, the anti-inflammatories they pry from your desperate hands (and refuse to give you anymore) will be the best possible reliever of post op pain. The second best will be muscle relaxers (skeletal muscle relaxants, not benzos).

When spinal post op pain finally reduces, it does suddenly and dramatically. What a beautiful event that is!

Due to my post op high fevers, it is really hard to shake the fear of infection. Last cefdinir was yesterday morning. Now I wait.

I wanted to be able to say that nurses DON'T make the worst patients. But, apparently during my first set of vitals on the floor, I told the CNA she was doing it wrong. And then I took everything away from her and did it myself.

It's become harder to remain appreciative and to continue to express appreciation to a person who is hyper and argumentative, and who has been home most of the days between March 6th and today. And who has a very different definition of helping. And who has no knowledge of ability beyond ABLE. Still, "appreciative" is appropriate because, overall, he's been amazing and he drops everything for me at the first hint I might ask for help. That said... I'm so glad he went in to work today! Now I'm on the lookout for "caretaker appreciation" gifts, or acts, that I am capable of right now. He's driving me nuts, but he does deserve actual gratitude.

Counseling is the best thing I've done for myself in ages.

(medical/nursing oriented directly)

A cardiac nurse who just moved floors (probably this week) to post op spines will be so bothered by the amount of pain medication available to a patient that she'll blow the patient off (in the hopes of spreading out doses enough that SHE feels more comfortable giving them). And then the patient will spend hours trying to get it back under control again. In tears. Because pain. Horrible, horrible pain.

Hemochromatosis is a malabsorption disorder in which iron levels become toxic (high, not low, in case that wasn't obvious), resulting in organs being overrun with iron. Other secondary diseases can result, which is how people usually are diagnosed. Hemochromatosis is usually not caught before damage is caused to organs (cirrhosis is typical), which will cause symptoms and lead to testing.

(And now I'm geeking out on this - are there homeostatic processes that become permanently disrupted as a result of the high iron level? Or, if not permanently, for a prolonged period of time after iron level stabilization? Oxygen level, pH regulation, CO2, what drives breathing (O2? CO2?), etc.?)

It sucks being the normal patient sandwiched between the escape artist who goes room to room insulting perfect strangers, and the lady with the curious family member who just stares in the neighboring rooms. Just keep this in mind if the normal patient prefers to keep the door closed.

In the posterior open approach to lumbar interbody fusion, the surgeon really thinks on the fly through a lot of it. They obviously have the basic expectation and steps for the procedure as pretty standard for the technique they use. But some of the details and steps of it can't even be decided on until midway through.

Related to that, I have half of an L5 vertebra. Also, the anticipated net balance of the loss of discs and bone, and the addition of hardware and cadaver bone, is + 3 mm.

(lessons in employment)

If I decide to not go back to my current/not current/current/maybe current/finally actually current job after everything I have gone through (believe me when I say it has been utter hell), *I* will be the one who looks like a jerk. I will never stop being appalled by this whole situation.

Relating to that, there is a cardiothoracic scrub nurse needed locally (not my current employer) for 4-10s per week plus call (frequent) that pays $8-9 more per hour than my current job. Its making me wonder if I really do care how good of a recommendation I keep if I jump ship. Then I remember this is my first nursing job ever and the only person who screwed up in all of this is the manager. Absolutely everyone else has had my back and has treated me well. So, now, I email my friend, my person on the "inside" who got my foot in that door without me realizing it, and tell her gracefully that I can't burn this bridge. But, I think I might when the timing is better.

(totally unrelated)

There is a show called You Live In What, and it's so cool! I'm ready to comb through the countryside for historical landmarks and abandoned warehouses.

My wallet has, in fact, been on vacation in Cape Canaveral, where they generously cut all my cards up including a $50 gas gift card I keep in there in case of emergency. It's home now. Yay. :\

All this and I know I'm forgetting stuff still! Oh, well!

What did you learn this week?

[calivianya, BSN, RN]

I'm glad you're feeling better! :)

I learned people definitely see me as a resource. I had five different nurses coming up and asking me questions about what I thought they should do about things last night. I also wandered over a lot and tried to keep two of them from killing their really sick ones... if I had a dollar for every time I asked, "Have you called a physician about that yet?" I'm pretty sure I'd have at least $15. Everybody was still alive when we left, but it was close. I would be greatly surprised if either of those people were still alive tonight.

I've learned that it's a good emotional/ego boost to be the person people come to in a crisis, but it's also a real pain in the butt to be on top of everyone else's patients on top of taking care of my own. I definitely understand why people can snap at less experienced/less quick on their feet nurses. It was all I could do at one point to avoid saying, "Are you actually TRYING to kill that guy?!"

However, then the end of the night was awesome because a day shifter I've been encouraging to sit for specialty certification ran over to me before getting report and told me after following my advice, she just passed her CCRN. It was a good feeling.

[cracklingkraken, ASN, RN]

I'm glad you're recovering, ixchel. I can't remember the title of the book, but I remember reading the first chapter of a book that mentioned how hemochromotasis played a role in the survival of the fittest, and how it benefits individuals in certain scenarios. I'll have to look for that book.

This week I learned:

1. My sister and brother-in-law want me to be the godmother of any children they have in the future. They're moving to the UK, and they plan on trying for a baby within the next year.

2. This is my last week of classes, and I could not be more done. I have no motivation whatsoever, which is fine, since I'm doing well in my classes.

3. My mom's Pap test was, apparently, not negative. Rather, the doctor failed to get enough cells to test, and this is the 2nd time this has happened. My mom was annoyed, decided not to go in for another Pap test, and is going to a different physician next year for the Pap test. In addition, when I'm looking through ny mom's lab values, I actually understand what the numbers mean!

4. My sister and brother-in-law are both Airforce and have suggested joining the military as a nurse. I have to admit, I've been looking into it and am considering this option after a few years of hospital experience.

[TheCommuter, BSN, RN]

This week I learned:

1. Getaways can be invigorating in a different kind of way. I was in NYC this past Monday through Thursday and was amazed at seeing nearly 1.7 million people crammed into the 23 square miles that constitutes the island of Manhattan. As a comparison, the city where I was born and raised has about 200,000 people living within 27 square miles. Big difference in population density...

2. It is hard to return to work after being off. I must return Monday.

3. Aggression is the same behavior whether it is expressed directly or via passive aggressiveness. Passive aggressive people are simply putting lipstick on the pig, or sprinkling potpourri into the poopy toilet bowl.

[ixchel]

3. My mom's Pap test was, apparently, not negative. Rather, the doctor failed to get enough cells to test, and this is the 2nd time this has happened. My mom was annoyed, decided not to go in for another Pap test, and is going to a different physician next year for the Pap test. In addition, when I'm looking through ny mom's lab values, I actually understand what the numbers mean!

Kraken, I don't know how to say this without being scary. The reason for pap testing during GYN check ups is because lady partsl, cervical, uterine, and ovarian cancers grow/spread very quickly and aggressively. They typically remain asymptomatic until they've progressed rather extensively.

The abnormal result being due to not enough cells means there is no reason to assume it might come back positive. If she is recommended to receive them yearly, though (meaning a higher risk category than, say, someone getting them every 3 years), it would be good to ensure a valid and reliable negative.

((((hugs))))

[ixchel]

This week I learned:

1. Getaways can be invigorating in a different kind of way. I was in NYC this past Monday through Thursday and was amazed at seeing nearly 1.7 million people crammed into the 23 square miles that constitutes the island of Manhattan. As a comparison, the city where I was born and raised has about 200,000 people living within 27 square miles. Big difference in population density...

2. It is hard to return to work after being off. I must return Monday.

3. Aggression is the same behavior whether it is expressed directly or via passive aggressiveness. Passive aggressive people are simply putting lipstick on the pig, or sprinkling potpourri into the poopy toilet bowl.

Poo-Pourri – Poo~Pourri

[cracklingkraken, ASN, RN]

Kraken, I don't know how to say this without being scary. The reason for pap testing during GYN check ups is because lady partsl, cervical, uterine, and ovarian cancers grow/spread very quickly and aggressively. They typically remain asymptomatic until they've progressed rather extensively.

The abnormal result being due to not enough cells means there is no reason to assume it might come back positive. If she is recommended to receive them yearly, though (meaning a higher risk category than, say, someone getting them every 3 years), it would be good to ensure a valid and reliable negative.

((((hugs))))

I am aware of this, which is why I insisted she go in for re-testing. However, since she has yearly physicals, she doesn't want to go through the hassle of doing it again. She wants to just wait until next year. She's quite stubborn.

[NotAllWhoWandeRN, ASN, RN]

Poo-Pourri – Poo~Pourri

Don't forget the commercial!

.

[OrganizedChaos, LVN]

I learned that laughter is the best medicine & my son is the best medicine of all. [emoji173]️

[Kitiger, RN]

I've had bronchitis this last couple of weeks, with coughing jags that lasted 5 to 10 minutes at a time. This week I learned:

1) Never trust a fart!

2) Don't forget to take your "no-pee" pill (Ditropan).

Ixchel, I'm glad the pain decreased dramatically! May you heal quickly! :)

[Farawyn]

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Never trust a what?

[annabanana2]

Interesting fact I just learned recently about hemochromatosis: a treatment for it is bloodletting! Usually I think folks would donate that blood assuming they meet the system's criteria.