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

Nurses General Nursing

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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?

I think I give a really good report, but it drives me crazy when I get asked for what times I gave or started what meds. It's charted, they can see it. I don't remember all that down to the minute, I just remember what I have given and what drips they are on, and at what rate they are currently running.... lol. I always tell them where their access is, etc. It's funny how everyone has their "thing"...

Dude, yes! I'll take a patient to the floor from PACU and I know how much of what meds I've given them but occasionally there will be a nurse who wants to know what time they last got something for pain. So my answer is always "...ummmm, sometime in the last hour?" (Assuming there isn't a family member in the room) I dunno, look on the eMAR that's on the computer that is right in front of you? I don't get that particular question often but I've gotten it 3 or 4 times this week and it takes me a second to get back into my report grove every time lol

I learned that it takes about 3 days to get a license number from the NCBON after taking the NCLEX.

Also, that I should save all of my receipts for scrubs and shoes for tax writeoffs in 2016.

Specializes in Med nurse in med-surg., float, HH, and PDN.

I learned that a supportive shoe with an enclosed heel actually decreases some of my "splin-shint" or "shlin-spint" discomfort. I have been ​ wearing my much-loved slip-on clogs, however, if the difference in pain levels means I have to convert back to those ugly ol' sports shoes, I'll do it. But, it doesn't matter what colorful designs on the outside or how comfortable they are, they are UGH-LEEE!

Specializes in critical care.
I learned that a supportive shoe with an enclosed heel actually decreases some of my "splin-shint" or "shlin-spint" discomfort. I have been ​ wearing my much-loved slip-on clogs, however, if the difference in pain levels means I have to convert back to those ugly ol' sports shoes, I'll do it. But, it doesn't matter what colorful designs on the outside or how comfortable they are, they are UGH-LEEE!

I feel the heelless shoe pain almost immediately, and it sucks. You walk with your foot in a totally different way! I never did understand how nurses fall so in love with clogs. I stick with my closed back clarks and my boys' merrells (womens in the nurse shoe section don't come up to the ankle either, plus they're half the price). The clarks aren't too ugly. I have slip ons that hug well to my feet and they're a darker blue (not quite navy). But... I say that usually being a fan of very plain shoes.

Eta: these, but minus the laces.

Clarks Women'''s Wave Trek Sneakers

Specializes in Med nurse in med-surg., float, HH, and PDN.
I feel the heelless shoe pain almost immediately, and it sucks. You walk with your foot in a totally different way! I never did understand how nurses fall so in love with clogs. I stick with my closed black clarks and my boys' merrells (womens in the nurse shoe section don't come up to the ankle either, plus they're half the price). The clarks aren't too ugly. I have slip ons that hug well to my feet and they're a darker blue (not quite navy). But... I say that usually being a fan of very plain shoes.

Eta: these, but minus the laces.

Clarks Women'''s Wave Trek Sneakers

Thank you! I will go hunt down a pair; my fav clogs are Clark's and I have worn them for years and years! And years! Now they are difficult to find, fashions changing as they do.

But the Clark's you linked me to look more like normal shoes.

Do you have flat feet as well? I ask that because I have to wear stick-on arch supports on top of the

full shoe-length arch supports, when the only width sizes available are mediums or wide. What, people don't got NARROW feet no more? So the arch supports help with the flat feet, but they also help take up the space in the too-wide-for-me medium width shoes.

I am the least 'One-Size-Fits-All' kind of person; it's quite frustrating!

I feel the heelless shoe pain almost immediately, and it sucks. You walk with your foot in a totally different way! I never did understand how nurses fall so in love with clogs. I stick with my closed black clarks and my boys' merrells (womens in the nurse shoe section don't come up to the ankle either, plus they're half the price). The clarks aren't too ugly. I have slip ons that hug well to my feet and they're a darker blue (not quite navy). But... I say that usually being a fan of very plain shoes.

Eta: these, but minus the laces.

Clarks Women'''s Wave Trek Sneakers

I loved the arch in Dankso professionals clogs, but I have wide feet, and the rigid shoe causes major pressure on the first joint of my great toes, to the point of causing numbness that takes weeks to heal. Clarks are too narrow for me as well... I mostly work in high quality athletic shoes, and have fortunately only had them saturated with something unsavory once...

Specializes in LTC.

This week I discovered the joys of compression socks.

Specializes in Med nurse in med-surg., float, HH, and PDN.
This week I discovered the joys of compression socks.

I know "used to" doesn't help, but one used to be able to buy compression knee-hi's in the same colors as scrubs: ceil, maroon, etc. I don't have to wear scrubs anymore, and I only have one pair of the socks left, ceil blue.

I've always been a fan of coordinated socks because, being tall-ish, for a long time it was hard to get a pair of scrub pants where the legs didn't hike halfway up my shins when I sat down. Having my ankle bones hanging out below the hem of my pants was a top peeve for me, so having the same color socks as pants just made me feel better.

Specializes in critical care.
Thank you! I will go hunt down a pair; my fav clogs are Clark's and I have worn them for years and years! And years! Now they are difficult to find, fashions changing as they do.

But the Clark's you linked me to look more like normal shoes.

Do you have flat feet as well? I ask that because I have to wear stick-on arch supports on top of the

full shoe-length arch supports, when the only width sizes available are mediums or wide. What, people don't got NARROW feet no more? So the arch supports help with the flat feet, but they also help take up the space in the too-wide-for-me medium width shoes.

I am the least 'One-Size-Fits-All' kind of person; it's quite frustrating!

I don't have flat feet but I do have tiny and narrow everything (except in the booty department) and don't find shoes easily as well. You might love these!

Specializes in critical care.
I loved the arch in Dankso professionals clogs, but I have wide feet, and the rigid shoe causes major pressure on the first joint of my great toes, to the point of causing numbness that takes weeks to heal. Clarks are too narrow for me as well... I mostly work in high quality athletic shoes, and have fortunately only had them saturated with something unsavory once...

The saturation factor is what makes me crazy when it comes to work shoes. I need, at the very least, water resistance and no laces. Laces kind of destroy the point of waterproofing.

Specializes in critical care.
I know "used to" doesn't help, but one used to be able to buy compression knee-hi's in the same colors as scrubs: ceil, maroon, etc. I don't have to wear scrubs anymore, and I only have one pair of the socks left, ceil blue.

I've always been a fan of coordinated socks because, being tall-ish, for a long time it was hard to get a pair of scrub pants where the legs didn't hike halfway up my shins when I sat down. Having my ankle bones hanging out below the hem of my pants was a top peeve for me, so having the same color socks as pants just made me feel better.

Amazon. Lots of fun colors that can coordinate, or not. I like fun, regardless of whether they coordinate. But, like I said before, I'm miniature, so I usually find stuff too long, rather than too short.

Having a broken spine, it has absolutely saved me to prevent leg and feet pain and swelling. Compression is fantastic! Don't leave home in scrubs without it!

I got my first pair of compression socks about halfway through school. Magically, my hip pain disappeared!

Sockwell has a ton of cute options that I can actually choose from now that I'm not decked out in all-white seethrough scrubs.

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