WILTW 9/13: Social Calls and Social Justice

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Specializes in Pediatrics, Emergency, Trauma.

Hi all!

I have gotten permission by ixchel to host WILTW. I feel EXTREMELY honored to keep a thread going that inspires, and helps many of us who want to work or work in this business.

This week, has been the most SOCIAL week; with enjoying the last week of summer break behind me and celebrating labor day as a unionized employee at work, the rest of the week was exciting with the increase of social cases, and my ever frustration with how social services is fragmented, in trouble, and fails the kids and the families that I see, along with actual lateral violence-not amongst nurses by the way-in my face, and support for a issue arise, it hasn't been a bad week! ;)

So, without further preamble what I learned this week:

1. Nurse who are out of work or at their undesired job due to the nursing surplus in my area that want to be Peds nurses could MOST likely run social services much more efficiently and effectively. :yes:

2. Being recorded is NOT such a bad thing when you see a trauma fellow screaming and pushing nurses during a trauma, twice in the same weekend for two different traumas.

3. That I enjoy sedations; and this is another option when I plan my pre-semi retirement.

4. That I will be a part of learning to be a educator on sexual assault, assault collections; we play an important part of collecting to ensure that DNA is not compromised; even if not discovered immediately, anything and any part of the process where I can assist in protect the public's health and safety, then I can be confident in supporting that justice.

So, what have you learned this week?

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Nothing of note to learn. So glad to see you, LadyFree! My thoughts are with you guys.

I'll post later in the week when I actually learn something.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I learned that having a newly hired orientee can be daunting, especially if this person has extremely literal thought processes. It makes training the person so much more difficult than it needs to be...

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Specializes in ED, psych.

I learned that there are 92 days, 5 hours, and 3 minutes until nursing school graduation.

(Not that I'm counting or anything)

I also learned:

(1.) That balancing two clinical rotations is challenging. I have one day off to study ... and somehow see my family in there too :cry:. With 3 classes, and one a grad class, and 4 day clinicals, I'm beat. I feel like I'm failing the "I'm a decent mom" category, as I missed the first day of school (at clinical), 3 soccer games (at clinical, at class), 2 cross country meets (clinical, studying, class), and a trip to NYC (had to stay home and study). I suck.

(2.) School nurses are superheroes. Being a former teacher, I already had great respect for them. But as one of my rotations is school nursing ... good gosh! She barely eats, kids come in all the live long day, and the parents - gah. Yet she still comes in every day with a smile.

(3.) There are 92 days, 5 hours, and *2 minutes* until graduation ....

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I don't know if I want to get back into nursing in the future. I didn't renew my license & I don't know if I want to. I have awhile to decide but the thought of working at a job I hate or going back to school is just so unpleasant.

Any input would be appreciated.

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Specializes in NICU, ICU, PICU, Academia.

I learned that my father's death has, in a way, freed me. I have not even allowed myself to think about relocating somewhere warm and sunny from the Midwest- as I needed to be nearby in his old age. Now that he's gone, I find myself looking daily at real estate listings in Florida (we have a daughter there). My work-from-home job is portable. All we need to do now is get our youngest through college, and we can go! (Gotta have that in-state tuition rate)

I also learned how to calculate a baseball team's 'magic number'.

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I learned that getting a mortgage now is a lottttttttt more complicated than before the housing bubble went boom. I might have to get an apartment for a few months while I sell my current house and keep everything in storage. There's just not enough time to handle the move for my new job any other way.

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I learned why so many projects fail how to initiate and start projects with all the science that is actually present. I also learned how to calculate costs /budgeting for projects, stakeholder management. Now that I have more solid knowledge about how to really plan and execute a project I hope to use that for some quality improvement project I am planing.

I learned that there are still physicians out there who believe that palliative care is only appropriate "when the patient is ready and there yet" - meaning basically 2 days to live. Never mind that it is not the same as hospice care and focuses on prevention of suffering, increasing the quality of life in serious illness, and tries to help patients to align the goals for care/care plan with their values and wishes.

And - how is it beneficial to say "Hi - the doctor told you that you have 2 days to live - what are your wishes and goals?"

When talking about serious illness a conversation method that is not so much focused on the medical detail but on the patient values and goals is more effective and the rest will usually follow. But - those conversations need to happen earlier in the disease, more, and better according to the research from the Ariadne Lab

Clinicians learn how to talk to patients about what matters most and be change agents for better care | Ariadne Labs

If you have time and are interested in child birth /maternal care or improvements in surgery or end-of-life care check out their webpage !

Their training and workshop has transformed the way my team approaches serious illness conversations.

We started to use this conversation guide for those conversations though have to adapt it for acute care as patients may be sicker and in crisis :

Redesigned Serious Illness Conversation Guide supports more, better and earlier conversations about what matters most | Ariadne Labs

What was especially important for me to learn is that there is a huge difference between saying "I am concerned" (more of a medical jargon) and "I am worried about you / I am worried that your time might be shorter than you think it is" (empathy and emotion focused). I learned that the effect is different. I had a hard time to say " I am worried" - it does take away some distance and signals that something serious is going on plus a person cares.

And I would like to also put out that as palliative care team we do not see a patient with a set agenda. I learned that a lot of healthcare workers still think that our job is to "make that patient DNR/DNI" or "make that patient CMO" or that if a person has not changed their mind about their code status to what the nurse thinks is the "right code status" for patient after seeing palliative care I have not achieved anything. There is no set agenda!!! The goal is to explore the goals and values, discuss what is going on, what is important, identify palliative care needs, sometimes symptom control. If it also happens that somebody decides to change code status fine but if not that is also ok. People need time to process things.

I learned that due to my age fitness kickboxing is pushing it at times... as a martial artist I like the fitness kickboxing stuff because I do not have time to focus on martial arts right now and I am too old now for any sparring or competitions. The fitness aspect is great though and I have gained back a lot of strength and mobility. Not to mention that exercise is good to relieve stress.

I have signed up for American Sign Language to build some basic vocabulary. I probably wrote already some while ago that the appropriate pain scale to use in non hearing patients is usually Wong Baker.

Looks like most of my writing is related to palliative care (again).

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Specializes in Pediatrics, Emergency, Trauma.
I don't know if I want to get back into nursing in the future. I didn't renew my license & I don't know if I want to. I have awhile to decide but the thought of working at a job I hate or going back to school is just so unpleasant.

Any input would be appreciated.

I think at least keeping your license active while not working is a better advantage to letting for lapse.

You are also in a position where you are about to bring another life into the world; once they start school and are settled into their studies, you may find yourself at the kitchen table too doing homework. ;)

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I don't know if I want to get back into nursing in the future. I didn't renew my license & I don't know if I want to. I have awhile to decide but the thought of working at a job I hate or going back to school is just so unpleasant.

Any input would be appreciated.

Don't let your license lapse, please Cheerios!

Please. You never know.

*hugs*

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I learned that my father's death has, in a way, freed me. I have not even allowed myself to think about relocating somewhere warm and sunny from the Midwest- as I needed to be nearby in his old age. Now that he's gone, I find myself looking daily at real estate listings in Florida (we have a daughter there). My work-from-home job is portable. All we need to do now is get our youngest through college, and we can go! (Gotta have that in-state tuition rate)

I also learned how to calculate a baseball team's 'magic number'.

So sorry for your loss, MMJ.

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I've learned that parents will do ANYTHING not to share their kid's medical history with THE NURSE.

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