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.â€
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.
This week I also learned that patients at risk for developing bacterial endocarditis should be given Penicillin G before dental procedures. I should also be aware that if the patient has a severe penicillin allergy, they may also be allergic to cephalosporins. Also, apparently, a patient can develop a penicillin allergy without ever having taken penicillin, which is a bit weird and scary. So if I administer penicillin to my patient, especially one that has never taken penicillin before, I should closely monitor him/her for at least 30 minutes to ensure anaphylaxis didn't stop by to pay my patient a visit.
-This week I learnt my facility has no place where EBP resources can be found. At least not a uniform location. It doesn't matter anyway, policy is dictated by those way above me and nurses have no say in those matters.
-This week I learnt I don't give a s*** about my final paper. I just want it done. Too much language in academia is theoretical bulls*** I have no use for in the real world. I'm struggling to speak and write proper academia.
I learned that the hospital doesn't expect you to know /anything/ when starting as a new grad. Ironically, except blood administration, which I never did as a student. Test tomorrow!
I could have done without the half-hour video on how to ambulate pts though...
Give stool softeners to a pt with esophageal varices because they shouldn't be doing Valsava.
Nope. They shouldn't. Nor be in trendelenburg. Worse bleed out I ever saw that wasn't trauma was EV which some rocket science 1st year decided to put in trendelenburg.
Nope. They shouldn't. Nor be in trendelenburg. Worse bleed out I ever saw that wasn't trauma was EV which some rocket science 1st year decided to put in trendelenburg.
SPLASH!!! Buckets of blood hitting the floor.
We were slipping in it.
Er, why was the pt in Trendelenburg? Speaking of Trendelenburg, apparently some preterm labor moms are in Trendelenburg for weeks to a month, which seems like an awfully long time.
Er, why was the pt in Trendelenburg? Speaking of Trendelenburg, apparently some preterm labor moms are in Trendelenburg for weeks to a month, which seems like an awfully long time.
Because the med student and first year were in there and the guy's BP was dropping so they put him in trendelenburg, but duh, it was dropping because his varices were bleeding out. So, they said lets do this, and bye bye bed 14 Window.
This week I have learned just how solid the brick wall can be when you crash into it, figuratively of course.
I successfully tested out of 12 credits in less than a week. Passed 2 out of 3 of my classes. Got an excellent review from both my preceptor and CI regarding my senior rotation in the ICU.
I also made a mistake which put my overall grade at a 79 for med/surg 2. I need to kill the final in order to pass. Given my past exams scores for this class it's feeling like I'm walking into the Hunger Games.
Final on Friday. Two more presentations and hopefully graduation in 10 days. [emoji46]
-This week I learnt I don't give a s*** about my final paper. I just want it done. Too much language in academia is theoretical bulls*** I have no use for in the real world. I'm struggling to speak and write proper academia.
I've had several assignments this past semester where I had to locate a research study of some sort and write about it. I remember looking at so many studies that seriously made no sense. As in, once you deciphered all of the overly scientific and unnecessarily verbose language, there was literally nothing substantial there. I was often left wondering how many of these BS "studies" were somebody's grad school project that they were just slapping together because they had to.
I'm all for research that is relevant and looks to answer important questions, not a pile of big words and statistics covering up a poorly thought out and executed study.
Trump won the primaries in IN. What has the world come to, that Trump and Clinton are facing off for the presidential election? Well, I couldn't vote for the primaries when I recently registered to vote, but I'm not even sure who I will vote for in the general election. Hmm, possible third-party run?
This week I also learned that patients at risk for developing bacterial endocarditis should be given Penicillin G before dental procedures. I should also be aware that if the patient has a severe penicillin allergy, they may also be allergic to cephalosporins. Also, apparently, a patient can develop a penicillin allergy without ever having taken penicillin, which is a bit weird and scary. So if I administer penicillin to my patient, especially one that has never taken penicillin before, I should closely monitor him/her for at least 30 minutes to ensure anaphylaxis didn't stop by to pay my patient a visit.
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"??
Purple_roses
1,763 Posts
This week I also learned that patients at risk for developing bacterial endocarditis should be given Penicillin G before dental procedures. I should also be aware that if the patient has a severe penicillin allergy, they may also be allergic to cephalosporins. Also, apparently, a patient can develop a penicillin allergy without ever having taken penicillin, which is a bit weird and scary. So if I administer penicillin to my patient, especially one that has never taken penicillin before, I should closely monitor him/her for at least 30 minutes to ensure anaphylaxis didn't stop by to pay my patient a visit.