5/01 WILTW: Margaritas and Oral Thrush

Nurses General Nursing

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I've been asked to start the WILTW thread, and I'm more than happy to!

This has been an exciting week for me, as it was the last week of my Med/Surg I rotation. I'm trying not to feel too relieved though, because finals are next week. That being said, I will still absolutely squeeze in time to catch up on GOT.

This week I learned:

That my clinical instructor is a big ole softy. I can't believe that I thought she was super scary when the rotation first started.

That having just one year left of nursing school doesn't feel like enough time. Don't get me wrong, I feel like I've learned a ton in the one year of school I've had (and I'm more than ready to graduate so that I can get my social life back), but when I think of just how much I still don't know, I get a little worried.

That I wish I could take some patients home with me. Throughout clinical, I had nice patients, but none that really lingered in my thoughts when I went home for the day. But last week I had a patient who had already been through so much. His whole family had already been through so much. Sometimes it's hard to know just what to say, and I hope I was more helpful than I felt I was.

That I'm probably going to have a lifetime of telling family members, I'm not a doctor. You really need to talk to your doctor about that. I will probably NEVER be able to diagnose you.”

I've also learned that said family members, when you actually do give them advice (such as dietary advice), will say Oh, you're just regurgitating what you've learned in school,” and will continue to eat everything under the sun while wondering why their blood pressure isn't controlled. Why yes, I am telling you what I've learned in school, but apparently you'd rather hear that steak for every meal paired with a margarita is the best possible chance for survival.

That being said, I do follow the steak and margarita diet. But hey, I'm working on it.

That the best way to get a resident to like you is to empathize. Let them vent. Losing my independence is something I can hardly fathom, and I'm sure I wouldn't handle it with grace. (Like, really I'm very certain that I'll be the LOL trying to escape everyday and falling out of my wheel chair in an attempt to lunge out the door). It's ok to let residents feel angry about it. It's ok let them know that, yes, it does suck, and that you'll be right around the corner when they're ready for help.

But it's not ok if they scratch you. Or bite you. Oh swear at you. We still need some limits.

That I will never ever forget to do an oral assessment on my patients. This is the second time I've shined a penlight in there and found a massive case of oral thrush.

On that note, I'm also very glad I'm not a dentist or dental hygienist. I'll wipe all the butts in the world, but don't bring that mouth any closer to me.

But what's grosser than the grossest mouth? Maggots. I was not pleased to learn that maggots are still being used for wound debridement. That...is my limit.

So what did you learn?

Specializes in Pediatrics/Developmental Pediatrics/Research/psych.
May the odds ever be in your favor!

And not to cause issues between the fandoms, but

May the fourth be with you!

Specializes in critical care.

I was offered a job this week in an IMCU unit. I really had my heart set on L and ;) but will wait until I have a year under my belt. There just isnt a L and ;) job for a new grad to be had in the city. I get to go through critical care training and I will learn so much on this step down unit...or am I just trying to convince myself I will be happy?

It's possible you wont be happy, but you WILL get a huge amount of experience and knowledge. Nurses who immediately go into L&D frequently (anecdotally) find themselves stuck there. That's okay if you fall in love with it and never want out. If you want out, or immediately hate it, though, you'll need that background in something WAAYYY less specific to get out.

Specializes in Pediatrics/Developmental Pediatrics/Research/psych.
Her name is Luna. She's a little calico, 8 weeks old

After Loony Lovegood?

Specializes in critical care.
It is a pity they don't make an icon that says "I so get what you are saying."

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Specializes in critical care.
I've learned that life sucks & it's only getting worse. My husband hasn't started his new job yet & I don't know how we are going to pay bills. Our son's birthday is next month & we don't have the money to do or buy anything for him & we feel like crap. I hope things get better soon!

Cheerios, I am so, so sorry. [emoji17] I hope with all of my heart that thing get better quickly.

After Loony Lovegood?

I'll have to ask the kiddo why he picked that name.

I thought he meant Luna from Sailor Moon but when I pointed out our Luna is more what than black he said the moon is white so her name is Luna.

Gotta love kid logic!

Specializes in Pediatrics/Developmental Pediatrics/Research/psych.

I've learned that I really want to be a nursing professor at some point down the line.

I learned that I am really excited to start my PMHNP program this month, but have been wondering why none of my classmates seem to be on here. Maybe I'll have to start a thread.

I learned that people are really shocked to hear about some of the nursing opportunities that I have had so early in my career.

I learned that the job that I really want pays really poorly and significantly below market rate. I am debating what I would do if they made an offer because there is no negotiating on salary.

I learned that it is a real problem when I can no longer bury myself in Harry Potter. I think it is my 20th time reading the series, and it has gotten a little bland. (Forgive me, JKR).

Specializes in critical care.
I had an anaphylactic reaction to Ceclor about 25 years ago. Had never in my life taken it. However, this was back in the day when antibiotics were in individual unit doses, and we reconstituted the powder in the med room.

Sometimes the powder would "poof" when the bottle was opened. Apparently I had been sensitizing myself for some time, and got "proofed" once too often.

Truly scary experience. Especially because it was just myself and one CNA, who couldn't convince the PM Supervisor that I was turning blue in front of her. When said Supervisor arrived on the floor, she refused to call a code, and took me down to the ER. In a wheelchair. Without a patent airway. Before I stopped breathing, I told her to get some Epi. STAT. She refused, because there was no order.

Had a grand mal seizure in the ER, apparently puked all over the doc, PO2 and PCO2 were both 50ish, wound up with conjunctival hemorrhages from being bagged before they were finally able to intubate me.

I was very lucky. I could have wound up at the local county run LTC facility, drooling into my oatmeal. Are any of us surprised that the incident report documenting this Chinese fire drill mysteriously "got misplaced"??

I have so many cuss words for this!!!!!!

I recently also had a medical emergency at work that was completely ignored. It is terrifying to think back on what happened and how it was handled, to know that I (and you!) work in an environment completely surrounded by medical professionals and yet, an obviously dire situation was ignored.

All that to say I am blown away that you (and the CNA) were ignored. NO EXCUSE FOR THAT.

Specializes in OR, Nursing Professional Development.
And not to cause issues between the fandoms, but

May the fourth be with you!

To cause issues with 4 different fandoms (Star Wars, Star Trek, Harry Potter, and Lord of the Rings):

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Specializes in critical care.
I read these every week (and love them!) and finally decided to join the conversations :)

I learned that when Medicaid insurance changes in your state it wreaks havoc for patients and staff alike. I have argued more with insurance companies in the last month than in three years combined. They denied an injectable anti-psychotic for a patient that has been stable on it for years. I argued for hours with them, only to continue to have them deny it. Thankfully, with the help of an amazing drug rep, who used to be a nurse, we were able to get her several months of free injectables and she can remain stable while I continue to advocate for her. Apparently the insurance company thinks it would be cheaper to hospitalize her when she lights herself on fire or drinks bleach, both of which she has done when not on her medication.

The psychiatrist I work with is correct - "the hardest part isn't connecting the dots, it is collecting the dots".

Getting a "thank you" from a patient who went from being acutely psychotic to much more level means a lot. She remembered that even though she had to be restrained for injections due to some violent episodes, that we were all "nice and didn't judge". wish I had more patients like that.

WELCOME!!!! and thank you for joining in on WILTW!

Also, it sounds like you are awesome at your job. [emoji4]

Specializes in critical care.
I recently asked about app functions not working (it teased me so badly by saying I could get a notification when one of my posts was directly quoted :sorry:) and Joe V said the mobile site was the priority. What worked in my app still works. The view of bookmarked threads is nice (mobile site is buggy and things overlap, doesn't include all the same info), but it doesn't know when you've gotten likes, much less send any of the other notifications it lets you select. I think it would be a REALLY fantastic app if it let you like others' posts, if all the features it appears to have worked, and if there were some way to have the front page not covered with all the nursing student posts looking for their classmates. Maybe it'll be back some day.

If you tap a post that you like once, you'll get a few choices pop up, including liking a post. To like, tap "thank".

Specializes in critical care.

I learned that I may be in the running for a position I didn't willfully seek out but that had always been my goal. I'm hoping the stars are aligned and that it's the right time. I appreciate positive energy.

Noted, and will be given. [emoji4]

Good luck to you!

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