Ixchel asked me to guest host WILT for the second time.
I will say-my French is not that great...the best I can do is relegated to ballet terms at best; one of my nieces is heading into the direction of becoming a principal ballerina; she is heading to New York for a Summer intensive in one month, and goes to a world renowned school in my area-she has been dancing for 11 years; her youngest sister is in her same shoes; this week I was able to see them both perform on stage at their dance school's end of year performance-it goes beyond the average recital...and they both know French
So, jete' simply means "thrown", rather a leap in which one leg appears to be thrown in the direction of the movement in ballet. I always felt I have "thrown" myself into nursing; meaning, I never had a specialty I had my heart set on, when I was a LPN, and even as I progressed to an RN; I had goals, yes, but most of those actions meant to transcend specialties, which I think I have accomplished nicely.
I have come come to a point in my career where I found a specialty that is a fit; I have focused on one position, however, I see a per diem position where it's working with adults, in the same specialty as opposed to children; it would give me additional experience; also a few people that I network with and a few recruiters have been asking for my resume.
The jete' in me wants to apply and see if I can juggle both (the per diem is truly per diem) but the practical side of me wants to wait another year before applying.
Ah, decisions, decisions.
So, what I also learned this week:
I have passed my "black cloud" onto one of my coworkers due to my long hiatuses from work, which got longer when I ended up with a cold this week; I helped her out as much as possible because I understood the struggle of constant work ups, bizarre pts and families.
I still need practice with accessing ports; I have an idea how to achieve this, and know who to ask in terms of having more practice during a low season; before I probably would've gotten a no, but now that a new regime is in place, I have renewed hope.
I also started a hand IV on my first chunky baby...one of my other banes of existence to conquer!
I'm a de-facto resource person post orientation and newbies are feeling very comfortable talking to me about their new life in the world of a Level 1 PediED.
After talking about my other two nieces, their sister, the middle one who is 14 and destined to be a veternarian, placed second in her FIRST horse show! I'm hoping she can go for gold someday...
Ixchel asked me to guest host WILT for the second time.
I will say-my French is not that great...the best I can do is relegated to ballet terms at best; one of my nieces is heading into the direction of becoming a principal ballerina; she is heading to New York for a Summer intensive in one month, and goes to a world renowned school in my area-she has been dancing for 11 years; her youngest sister is in her same shoes; this week I was able to see them both perform on stage at their dance school's end of year performance-it goes beyond the average recital...and they both know French
So, jete' simply means "thrown", rather a leap in which one leg appears to be thrown in the direction of the movement in ballet. I always felt I have "thrown" myself into nursing; meaning, I never had a specialty I had my heart set on, when I was a LPN, and even as I progressed to an RN; I had goals, yes, but most of those actions meant to transcend specialties, which I think I have accomplished nicely.
I have come come to a point in my career where I found a specialty that is a fit; I have focused on one position, however, I see a per diem position where it's working with adults, in the same specialty as opposed to children; it would give me additional experience; also a few people that I network with and a few recruiters have been asking for my resume.
The jete' in me wants to apply and see if I can juggle both (the per diem is truly per diem) but the practical side of me wants to wait another year before applying.
Ah, decisions, decisions.
So, what I also learned this week:
I have passed my "black cloud" onto one of my coworkers due to my long hiatuses from work, which got longer when I ended up with a cold this week; I helped her out as much as possible because I understood the struggle of constant work ups, bizarre pts and families.
I still need practice with accessing ports; I have an idea how to achieve this, and know who to ask in terms of having more practice during a low season; before I probably would've gotten a no, but now that a new regime is in place, I have renewed hope.
I also started a hand IV on my first chunky baby...one of my other banes of existence to conquer!
I'm a de-facto resource person post orientation and newbies are feeling very comfortable talking to me about their new life in the world of a Level 1 PediED.
After talking about my other two nieces, their sister, the middle one who is 14 and destined to be a veternarian, placed second in her FIRST horse show! I'm hoping she can go for gold someday...
So, what have you learned this week?
THANK YOU!!!!! for getting this party started!
To your jetè, and newfound nursing passion, I say, "le coeur veut ce qu'il veut." If you don't try both, you'll regret not knowing if you could have done both happily. If you're miserable, you'll know you found a limit and you'll have no regrets there either. And keeping yourself in adult/gero will keep your mind active in adult/gero health. I'm learning in nursing, you use it or lose it. You do NOT want to forget adult stuff when the zombies get here!!!!
As for me, I've learned I need to give up on my stethoscope, and I'm damn near positive who stole it. Allow me to reveal how embarrassingly naïve I am: I am completely shocked and saddened that a person could see my name on my locker, open it, and say to themselves, "she's out on FMLA. I can totally steal this way expensive thing from her." My stethoscope had been a gift from my hubs after graduation.
Since I'm not working any more I don't have any nursing WILTW. My husband is starting the prison academy at the end of this month. The black cloud is finally moving off from over us! Whew!
Welcome to the sisterhood of CO wives!
You know how to track me down if you ever need to connect. It's not the easiest job to be married to.
That said, though, I am soooooo glad for the forward momentum! Congratulations, love!!!
I learned this week that I love the lecture audio from Mark Klimek. His content and tips for the Nclex are amazing! Here is what I learned
In congenital heart deformities, if it begins with a T like Tetralogy of Fallot then it means trouble. If it doesn't begin with T, then no trouble and not a priority.
With V fib, you Defib
With atrial arrhythmias you use ABCDs for treatment. Adenosine, Beta blockers, CA channel blockers and Digoxin.
And lots more. I am hooked listening to his audio files.
Between that and Uworld, I am getting set for testing. Hopefully next week, I can schedule my test.
You've picked some memory tools I used, too!
If I recall, ABCD works for HF as well, although you replace A with ace inhibitor.
Worked a prn shift & agreed to take the "heavy" group because the other nurses were floats & I had the most experience on that floor. Contrary to popular belief, the pt that refuses everything (VS, assessments, meds, PT) was not a nightmare...she just wanted to get the hell out (elective post-op). Easy peasy - document a note for refusal of care. Offgoing nurse acted like it made it a hard shift for her. Pt did the one thing the provider requested of her (PT session) & then we discharged her by 10. Besides that I had a pt with a high pain rating (not unusual) & a dementia pt that had been trouble in the night pulling everything out but, of course in daylight, was sweet as pie. Discharged 3 of my 5 & no admissions! Best floor shift in forever.
Heard of an opportunity to crosstrain into a prn radiology position at my facility. Mulling that over a bit & plan to look into more details regarding expected hrs worked & whether call is required. Everyone already thinks I work everywhere, haha! Guess I just want to be well-rounded.
I'm so glad to hear that, OC. You've struggled for so long, it's time you got a break.
I learned that I really like doing free CEs online. I don't have to have them to keep my license, I just enjoy doing the modules for my own edification. My most recent CEUs came from a course on bipolar depression, and case studies on the topic of type 2 diabetes. I also have certificates of completion in geriatric psych, infection control, and a few others I can't recall at this moment. It doesn't matter that I'll probably never use this knowledge, because education is never wasted. :)
I am an absolute DORK for learning! With another month (at least) off, I know I have to finish something my hospital paid for (SCRN), but the site they got me a membership for has soooooooooo much stuff! I don't know if the membership was module specific or open access, but I'm ready to dig in now that my brain and body feel like MINE again.
As for me, I've learned I need to give up on my stethoscope, and I'm damn near positive who stole it. Allow me to reveal how embarrassingly naïve I am: I am completely shocked and saddened that a person could see my name on my locker, open it, and say to themselves, "she's out on FMLA. I can totally steal this way expensive thing from her." My stethoscope had been a gift from my hubs after graduation.
My master cardiology walked a few months ago, so I feel your pain. I haven't been able to bring myself to replace it. I have just been using those ratty contact stethoscopes on everyone.
It is very difficult to talk about the concept of palliative care in a society that denies death as a natural process and likes to ignore that we are human and thus can die of illness/accident/age. Most people try to avoid this fact that dying will happen to anybody at some point and hope "it will all go away" if you ignore it enough.
I loved reading that whole palliative section of your post. This is what has been the biggest point of moral distress for me lately and what's making me really unhappy about my job. We have so many patients on my unit right now that have been there for weeks, that are all but brain dead, or some vital body part is pretty much all the way dead and they aren't transplant candidates, who families refuse to withdraw on. Out of 30 patients, I think the ethics committee was following six or seven of the patients who were there the last shift I worked.
I hate families. I hate them. It has gotten to the point where if I see family members in my room when I'm getting report, my mood is instantly sour. Sometimes they are awesome and we are best buds and laughing together by the end of the shift, but tolerating these unrealistic people who are torturing their "loved ones" to death is something I'm struggling with emotionally. The urge to ask these whackjob people "Did your mom/dad/grandma abuse you as a child or something? Is that why you're doing this?" gets stronger every day. One of these days I'm going to lose it and it's going to happen.
Specializes in Med Surg, ICU, Infection, Home Health, and LTC.
Since I'm not working any more I don't have any nursing WILTW.
You don't really have to be working to learn something new as I am sure you know. As much as this group studies and reads there is always new facts and lessons shared.
I learned that I have to start standing up for myself more when they want to send me a new patient after 10..... She had called me to send me a patient and I told her I was still trying to get blood from patient #1 so could she please send me a lighter patient who could sit in the room. Well instead she calls me and sends me this unresponsive seizure patient on a nonrebreather at 1020 (10 minutes before I'm supposed to give report). I stayed late catching up and then I was told that the nurse who sent me the patient has been writing down the names of people who refuse to take patients.
It is not just standing up for yourself, but also for your patient. That ED nurse should be the one reported for sending up unstable patients that need care at a time in the shift well-known for gaps in services and care. It is dangerous for the patient to have to wait for assessment or interventions to be started while the floor nurses are just starting their shift. Sounds like the ED nurse must be a B.
You do NOT want to forget adult stuff when the zombies get here!!!.
ROTFLMAO I want a zombie smiley..
As for me, I've learned I need to give up on my stethoscope, and I'm damn near positive who stole it.
Sorry that someone stole it. Karma will get them. Have your name engraved on any new one you get and put a lock on your locker.
So here is some of the things I have been exploring this week:
Vein illumination is one of the most important newer technologies. The hospital bought one for each floor - not the hand held ones but the ones that come on a stand so you can actually illuminate the vein and stick right away. Not all hospitals have an IV team or phlebotomy staff - this is great technology that will help as our pat population is increasingly older and fragile. The link is to a specific company but there are other products out there as well. I have seen this product in action and think it will help a lot. There are gifted nurses out there who can put an iv into anything but not everybody is that gifted and secondly time also matters and we do not want to stick a couple of times before we can get an access. I do not put in ivs anymore but think it is great technology:
Leadership : Quantum leadership. The concept seems to apply to out healthcare systems where everything is ever changing and every action influences or has implications for somebody else. We do not work in linear processes anymore, so thinking has to shift from linear to relational and whole system thinking. We need to focus on the outcome, not so much on the process only. Today's leader in nursing also need to have some specific skill set that allows them to lead the staff who is nowadays the front line decision maker in a lot of ways. One of the most interesting ideas of quantum leadership (in my opinion) is the concept of not saying we are working towards that goal and the goal is the goal - instead we are looking at constant change and say we are "journeying" ... The book is very expensive - I am renting it for my class, I included a link in case somebody wanted to look at the book.
Lately, we are having more conversation about palliative care in patients with cardio problems from advanced heart failure to the ones who are looking into assist devices for their not-enough functioning heart. Cardiology as a specialty has not been very open to working with palliative care in my area. Perhaps they perceive getting palliative care involved as a "failure" . We get involved very late although a patient can have palliative care and cardiology care at the same time. Here is an interesting blog
Another topic that comes up regularly is the question "Can I stop dialysis" or a request to palliative care because the patient decided to stop dialysis. While it is usually more clear when a 85 year old patient decided to stop because they feel that they have no quality of life and usually multiple co-morbidities , it gets more complicated when the patient is young and does not want to continue dialysis because "my life does not make sense". I have worked in acute dialysis and it is not uncommon to have patients come from the ER who decided to stop dialysis and not show up as a suicidal process but get short of breath and unwell after 2 or 3 missed treatments and decide to continue. Often enough, the psych consult will find out that the patient is depressed but not suicidal (anymore) and entitled to "bad decisions". The National Kidney Foundation has some useful information for patients, families and also providers :
It is very difficult to talk about the concept of palliative care in a society that denies death as a natural process and likes to ignore that we are human and thus can die of illness/accident/age. Most people try to avoid this fact that dying will happen to anybody at some point and hope "it will all go away" if you ignore it enough. It is sad when a 90+ year old patient has to realize that there is no surgical option to fix the heart that is so sick and that the body is aging in total and death becomes a reality when you move towards 100 years of life. "What do you mean - I can not have surgery? What am I supposed to do? Just die???" It would have been much better for this patient and the family to see palliative care earlier , for example when the heart became so sick that there were serious concerns. Palliative care can help with discussions around goals of care, advanced care planning, and even symptom control if it can't be fixed. But having the conversation and continue a conversation is so important. Some PCPs and specialists are good at having a conversation around serious illness. But most, even when well intended, do not have the training and time to have those conversations. There are different options of getting trained or approaches. This is a webpage that will give some ideas and strategies, there are also tool kits and it is gear towards patients to take the initiative but also offers some vital information to staff. As part of my job I introduce the idea of palliative care and what resonates a lot with people who have a serious illness is that palliative care can help to find out what the wishes are for end-of-life care and to be in control over what happens. Often enough I hear "I did not know I have choices! I thought I have to do "everything possible". Provider bias can keep physicians/NPs from telling patients and their families that there are choices for example not to pursue a feeding tube for a patient who has dementia and becomes unable to swallow at the late stage of the illness. Instead have the illness unfold the "natural" way with the support of hospice/end-of-life care.
I learned how much it sucks when you best friend texts to say that her dad with cancer is no longer walking by himself, and refusing to eat. I feel like I should be able to do something. I am glad her family has called in hospice. Hopefully they will be there on Monday.
Going to Target should be banned for me. I never leave without spending at least $100 LOL. Bought my son a bunch of summer clothes. Bought a birthday present for my friend's daughter's party later today.
Going back for my BSN and almost being done makes me almost, almost want my MSN.
Conversions, conversions, and more conversions. After a million dosage calculations, I am beginning to feel a bit like a nursing student. I also learned that I really shouldn't be paired with an oriented. I don't think I have enough experience to train anyone.
Specializes in M/S, LTC, Corrections, PDN & drug rehab.
Thank you everyone for your positive thoughts while I went through this rough spot in my life. It wasn't easy, to say the *least*. I'm so thankful to have all of you, I don't know what I would do if I didn't have you guys. [emoji4] ixchel, I will definitely be reaching out to you!
Specializes in long term care Alzheimers Patients.
Since I'm not working any more I don't have any nursing WILTW. My husband is starting the prison academy at the end of this month. The black cloud is finally moving off from over us! Whew!
ixchel
4,547 Posts
THANK YOU!!!!! for getting this party started!
To your jetè, and newfound nursing passion, I say, "le coeur veut ce qu'il veut." If you don't try both, you'll regret not knowing if you could have done both happily. If you're miserable, you'll know you found a limit and you'll have no regrets there either. And keeping yourself in adult/gero will keep your mind active in adult/gero health. I'm learning in nursing, you use it or lose it. You do NOT want to forget adult stuff when the zombies get here!!!!
As for me, I've learned I need to give up on my stethoscope, and I'm damn near positive who stole it. Allow me to reveal how embarrassingly naïve I am: I am completely shocked and saddened that a person could see my name on my locker, open it, and say to themselves, "she's out on FMLA. I can totally steal this way expensive thing from her." My stethoscope had been a gift from my hubs after graduation.