Published
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.
So what did you learn?
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'm voting for not Trump. And I did not learn that this week, so I am OT and will say no more.
You're right. I forgot my manners. No politics at the dinner table.
No matter how many times I watch LOTR, I still find it as entertaining as the first time I watched them.
Everyone went out to buy new dresses for pinning, and I'm wondering why I'm the only one who's wearing one of the ones I already own. C'mon, I just spent $200 for the NCLEX.
Potatoes are high in K+, but if you soak them in water overnight, the K+ will be drawn out of the potatoes.
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.
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.
I'm glad you contributed! You seem like such a great patient advocate.
Medicaid truly does suck sometimes. One of my clients had ALS and needed weekly physical therapy simply to maintain what little flexibility he had left (and according to PT's charts, it had been maintaining). But Medicaid stopped paying because his condition wasn't improving--it was simply maintaining. Made me so mad.
Jensmom, I've missed you. [emoji7]
Missed you too. Hopefully things will level out soon and I can go back to spending too much time in here (as if there could be such a thing lol). I've been lurking and putting up the occasional post, so I kinda sorta am current with AN.
Good luck to everyone with finals!! Or, to put it another way...better you than me!! [emoji56][emoji41]
Farawyn
12,646 Posts
I'm voting for not Trump. And I did not learn that this week, so I am OT and will say no more.