WILTW 9/13: Social Calls and Social Justice

Nurses General Nursing

Published

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?

Specializes in Oncology; medical specialty website.
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'.

Don't need that where I live, thanks to the Phillies, who excel at snatching defeat from the jaws of victory.

I'm sorry about the loss of your father.

Specializes in Transitional Nursing.

"Real" Nurses come in all shapes, sizes and education levels.

LTC nursing is no joke. It's exhausting and mind boggling at times.

People who don't do patient care really shouldn't be making rules. A med pass at 1500, 1800 and 2000? Why?

Not all CNAs are hard workers like I was. Some really have no business working with patients. :(

Specializes in critical care.
"Real" Nurses come in all shapes, sizes and education levels.

LTC nursing is no joke. It's exhausting and mind boggling at times.

People who don't do patient care really shouldn't be making rules. A med pass at 1500, 1800 and 2000? Why?

Not all CNAs are hard workers like I was. Some really have no business working with patients. :(

I hate how crazy med admin times are! I have a sheet I use to organize my day, and the days when I look down and see things due literally every hour are just ridiculous. BUT! My favorite thing? When med admin times actually do coordinate properly, leaving you with 4 IV meds that take 30-60 min each all due at the same time, and it's on a patient with limb precautions and 18 blown veins.

Specializes in Private Duty Pediatrics.

I learned that I cannot work 6 days straight anymore without feeling totally wiped out. I work with a NP at my per diem job who is a full time professor and clinical instructor and also works every weekend in Urgent Care to help support an ill family member. She never has a day off. Did I mention that she is 79? I am a wimp.

You are not a wimp if you can do 6 days straight. Your 79 year old sounds amazing.

Specializes in PICU, Pediatrics, 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.

May I ask...why didn't you renew? Would like to give input, but not sure what the issues have been. I kind of feel like I'm jumping into a personal conversation/situation. I'd like to be supportive...

Specializes in PICU, Pediatrics, Trauma.
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).

Palliative care is long overdue...so sad many still don't understand the purpose. Thank you for doing this work. I wish all hospitals provided this service as a "normal" specialty like GI or Resp.

although we mostly see the need for

this care for patients with terminal illness, their are so many more chronic illnesses people must live with for many years. Helping these patients cope with the challenges is so important and helpful...for

the families as well.

I learned a lot just reading your post. Thank you for the information. :)

I learned that it's a lot easier to write a rant or a personal experience than it is to write an actual article with references.

I learned that I miss my AN friends when I am busy with life.

I learned a LOT about the limited access that mental health patients have to quality care, and the hoops that mentally incompetent people have to jump through are unintentionally designed to make sure that they can't get care.

I learned a lot about rape culture in colleges and how medical professionals are trying to take a stand for women's rights.

I learned that I still have no patience for willfully stupid or manipulative people. Patients included, unfortunately. I need to get over my bias. There is a disproportionate amount of drug users and BPD in the population I treat. 9/10 are OK, but that one... I really need to develop some kind of cone of objectivity for the patients who get on my last nerve.

I also learned that aspirin and lovenox are perfectly OK to give to a rule out stroke patient, but you really shouldn't combine them with Plavix. Also, check behind your docs so you aren't giving three antiplatelets. Oh, and check behind them and make sure you're not giving ANY antiplatelets to someone whose platelets are already under 90. (Just saying... doc's are busy, too.)

Have a good week, y'all.

I've learned what "swamp butt" is from the 8th grade girls.

I've learned I can take a louse between my fingers and crush the life out of it with no remorse.

I've learned that a rainy Monday means lots of traffic here, but this time a lot of it was "real". Puke City, wooohoo!

I've learned I miss you too, cani. :inlove:

Specializes in OR.

PixieRose, don't feel bad. At least she knew there was somethinsg important about that day! I haven't forgotten my kids' days yet, but I did tell my son "happy 25th" on his 26th birthday....

Specializes in OR, Nursing Professional Development.
I've learned what "swamp butt" is from the 8th grade girls.

You just learned that? Oh dear.

Ive learned that some things aren't worth the mental stress of trying to make it work. I will be filling out job applications later tonight. The grass may not be greener on the other side, but it'll be different grass.

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

Thank you everyone for your input & thoughtful replies.

It has been over 30 days but not 90. I just have to send in the paperwork, CEUs, the fee & I will have my license back.

I did not renew because every job I've had recently I quit within a couple months if I even go at all. The last job I got I didn't even go to orientation.

So with my mental health being what it is & my job history, I figured what's the point? I can't get a job that I want because I've been out of practice since I was pregnant with my first child & my job history is a disaster. But with everyone's comments I will renew & maybe work again or go back to school. But that is waaaaay down the line.

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