WILTW-Summer Edition: What HAVEN'T I learned?

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Specializes in Pediatrics, Emergency, Trauma.

Hello AN!!!

I haven't posed in a while! :wacky:

My initial plan was to regroup after my vacation during memorial day, but it didn't work out that way. :down:

I missed everyone-I wonder how Cherrios baby is doing, whether he is a baby primed to be a good linebacker someday, xxemmylouxx and her transition to the RN world is doing, how far students and baby to my crusty nurses have been getting along with their goals.

I know people are wondering what the other stages of grievances are with bated breath-Next week I will continue-I will .:yes:

During my break from AN, I have had more ups than downs, goals delayed and a good amount of goals achieved.

I am still the Grievance Chair and still battle with management to understand the management-employee relationship is on equal footing, and the past is the past and they are still a student to preventing labor violations by listening to their employees.

So far it has been a 100 percent new hire-new members sign-up, growing our power.

Professionally, I have obtained and passed through orientation to be a ECMO specialist; I will continue to learn and care for babies by using my "baby"-the ECMO pump- to help with better outcomes; I am humbled and pleased to dip my toe into Critical Care nursing while hoping to use this new specialty to help my peers in the ED to feel more comfortable with cardiac kids that enter our ED-we have so much work to do in that area, and while I am still in the beginner phase, I hope this will be my next big teaching product.

Speaking of teaching, I had my first staff development class teaching with ED and Critical Care nurses! It was very fulfilling, and I know more is to come!

I have also accepted a per-diem position at an Adult ED. I am very excited and anxious to get started; helping me further expand my knowledge in a specialty that I call home.

I also have some bittersweet moments-I have increased in having to care for my mother. She is 70 years young and had a bad flare-up of vascularitis; also her Creatinine was 3.8 and she is near Stage IV of kidney disease, but her kidneys are working well. :woot: However I learned that she has chronic Hepatitis C. Despite her chronicity, her markers in her labs have shown that the Hepatitis C is undetectable, however, we plan to follow up with a specialist. She currently has nursing care for her wounds.

I also have to plan for her increasing cognitive decline. For a year she did not take her Blood Pressure medications prior to her flare up-she even refrained from even going to her specialist and called me on vacation, where I was hours away from the state to ask to go to which ED, which I stated, "the hospital that knows you best" she decided to go to the closest hospital, which did not know her history; it wasn't until another week when she got the appropriate attention and her legs had more than +4 edema, weeping wounds; I visited her house while she was in the hospital and found her kitchen a mess-my mom has OCD, and this was not like her at all. I have to come up with at least a 4-5 year plan where she has to move somewhere where it is one level, pet friendly, and at least have someone to check in on her when I continue to grow personally in my life. As her health care proxy, I learned that I had to step more in the forefront, while attempting to respect her rights as a patient, but to inform her and uphold what she wants per her living will, even if she declines at first, I explain the treatments that are necessary, and she actually agrees to them. I learned that she does want to uphold those aspects of her living will, even though it seems to me that she is definitely going to need more care and I eventually will have to be a voice for her eventually.

I've learned a lot this past few months; at least this upcoming week has been sending two nieces to college, potential moving, recent nuptials and getting ready for this new per-diem position; I am nervous, excited, and any other adjective that can account for nervous bubble guts. :dead:

So, what have YOU learned this week?

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Specializes in PACU, pre/postoperative, ortho.

I've learned that I miss this thread! Where is everybody!?

The eclipse this past week apparently had a similar effect to a full moon on a freaky Friday the 13th in October. And I'm talking about in outpt surgery. Nothing went smoothly. We had multiple pts decide it was ok to have breakfast (like biscuits & gravy), no shows, add-on cases galore... My first pt had a reaction to the pre-op antibiotic, my second pt was canceled for cardiac clearance...About the only thing that didn't happen in the dept was a code for a LAST reaction during a nerve block.

Also...when agreeing to be on call for the floor, it never fails that there is a mix up. I had a call at 0700 this morning wanting to know where I was. Um, I didn't get a phone call? Gotta let me know if you need me to come in!

Not something totally new, but just was reminded this week how much I dread assisting with knee blocks with a couple of our MDAs. They only use versed, no propofol. Ouch! For many pts, versed alone is not enough.

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Specializes in PACU, pre/postoperative, ortho.

Ladyfree, it sounds like you have been super busy! Are there others to help you care for your mom? My oldest sister & I did most of the planning & caring for my mom in her last yr or so with some additional help at times from our 4 other siblings. I can't imagine trying to handle it all alone & keep up with other work obligations. Best wishes!

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Specializes in Private Duty Pediatrics.

I learned that I don't like electronic charting. Not yet, anyway. It's such a bother to keep having to go from screen to screen to screen. It isn't enough to chart meds under the MAR. We also have to chart the amount in ml in the I & O - they're usually liquid meds - and we have to chart it in the hourly narrative notes, as well!

Also - of course - until we go live, we have to paper chart, too.

At least with a paper chart I can see the whole thing. And I can see what areas still need to be filled in without going from screen to screen to screen ...

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Specializes in Oncology (OCN).

Ladyfree, it sounds like you have had your hands very full this summer. I'm sorry to hear about your mom. I also recently learned how hard it is to balance respecting your parent(s) wishes with doing what is medically best for them. My mom was diagnosed with end stage liver disease/cirrhosis secondary to non-alcoholic fatty liver disease last year. She had DM II but it was well-controlled and she really didn't have any symptoms. It was discovered incidentally on a CT scan which they were doing for another purpose. In February, she had a sudden onset of ascities and when they did the paracentesis we discovered she had developed hepatocellular carcinoma. The next few months were a blur but many decisions had to be made and my parents and sister looked to me to guide them through a lot of those decisions. I was my mother's healthcare proxy. My dad has some cognitive issues related to a multiple sclerosis diagnosis, so my parents felt more comfortable with me making decisions once my mom was no longer capable of doing so for herself. It was very, very difficult. Sadly, my mom passed away in May. My sister and I are still faced with respecting my dad's wishes to remain living in my parent's home alone with our concerns for his safety. It is not easy caring for aging parents.

This week I've also learned that going back to school at my age (I'll be 50 in a couple of months) is still very anxiety provoking. Although I have been looking forward to this for many years, now that it's finally here, I'm having a little bit of a panic attack. I'm taking a RN refresher course to reactivate my nursing license. I've been on medical disability now for over 9 years due to CRPS. Thanks to new treatment options, I'm doing really well but I still have concerns about school and my treatment schedule, whether I'll be able to handle clinicals physically when the time comes, if anyone will even hire me after all this time, etc. I'm trying to take it one day at a time. This week I just have to get through orientation (and do 4 days of ketamine infusions while dealing with possible flooding from huricaine Harvey....but, hey I got this! Lol!)

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

Sorry to hear about your mother.

Thank you for thinking of my son. :) He's a chunky monkey. He wears 18 month onesies, he's only 5 months! He turns 6 months on the 4 of next month. It's so crazy! He's also the happiest baby ever! He wakes up smiling, smiles all day & goes to bed smiling. :D

I also applied for some jobs. I applied for an agency job to work in corrections & then I applied to work directly with the company. I'm hoping I get a job so we don't live paycheck to paycheck any more.

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Ladyfree, I'm so sorry to hear about your mother.

Even though I didn't participate much, I found myself missing this thread!

I'm in the limbo of waiting to hear about acceptance to the schools that I applied to. This is really nerve wracking. I'm really hoping I hear something this week.

I just got home from my newish neurologist. We tried some meds that weren't effective, and in between appointments, my GP put me on a low dose of norco to help relieve this headache (that I've literally had since February). I've taken it twice in the past month, and it's helpful when my headaches are bad. When I mentioned this to my neuro, he told me that it was against practice policy to prescribe narcotics. I was really surprised - headaches and neck pain are the two main symptoms of my condition. He also wants me to take magnesium instead. I'm frustrated, and sick to death of this never-ending headache. I feel like I'm not being taken seriously.

What I learned this week was that corneas don't have a blood supply, so they get their oxygen directly from the air. I love cool facts like that!

I hope everyone has a wonderful week :)

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Specializes in Pediatrics, Emergency, Trauma.
Ladyfree, it sounds like you have been super busy! Are there others to help you care for your mom? My oldest sister & I did most of the planning & caring for my mom in her last yr or so with some additional help at times from our 4 other siblings. I can't imagine trying to handle it all alone & keep up with other work obligations. Best wishes!

My sister helps, however it's the medical information that stumps her; along with my mom being stubborn that can be a challenge-which I have perfect practice of not tolerating stubbornness (if that's a word) and knowing what to say to proftect her rights as well a making her understand the befits and ways to get around side effects of medications.

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Specializes in Pediatrics, Emergency, Trauma.
Sorry to hear about your mother.

Thank you for thinking of my son. :) He's a chunky monkey. He wears 18 month onesies, he's only 5 months! He turns 6 months on the 4 of next month. It's so crazy! He's also the happiest baby ever! He wakes up smiling, smiles all day & goes to bed smiling. :D

I also applied for some jobs. I applied for an agency job to work in corrections & then I applied to work directly with the company. I'm hoping I get a job so we don't live paycheck to paycheck any more.

That is very great news!

Living paycheck to paycheck is stressing-sending positive vibes for your family, and that wild weather in your state!

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Specializes in Pediatrics, Emergency, Trauma.
Ladyfree, it sounds like you have had your hands very full this summer. I'm sorry to hear about your mom. I also recently learned how hard it is to balance respecting your parent(s) wishes with doing what is medically best for them. My mom was diagnosed with end stage liver disease/cirrhosis secondary to non-alcoholic fatty liver disease last year. She had DM II but it was well-controlled and she really didn't have any symptoms. It was discovered incidentally on a CT scan which they were doing for another purpose. In February, she had a sudden onset of ascities and when they did the paracentesis we discovered she had developed hepatocellular carcinoma. The next few months were a blur but many decisions had to be made and my parents and sister looked to me to guide them through a lot of those decisions. I was my mother's healthcare proxy. My dad has some cognitive issues related to a multiple sclerosis diagnosis, so my parents felt more comfortable with me making decisions once my mom was no longer capable of doing so for herself. It was very, very difficult. Sadly, my mom passed away in May. My sister and I are still faced with respecting my dad's wishes to remain living in my parent's home alone with our concerns for his safety. It is not easy caring for aging parents.

This week I've also learned that going back to school at my age (I'll be 50 in a couple of months) is still very anxiety provoking. Although I have been looking forward to this for many years, now that it's finally here, I'm having a little bit of a panic attack. I'm taking a RN refresher course to reactivate my nursing license. I've been on medical disability now for over 9 years due to CRPS. Thanks to new treatment options, I'm doing really well but I still have concerns about school and my treatment schedule, whether I'll be able to handle clinicals physically when the time comes, if anyone will even hire me after all this time, etc. I'm trying to take it one day at a time. This week I just have to get through orientation (and do 4 days of ketamine infusions while dealing with possible flooding from huricaine Harvey....but, hey I got this! Lol!)

Sorry for your loss!

Sometimes being the family healthcare proxy is stressful, but an obligation I uphold; she doesn't advocate we'll because of many stereotypes about healthcare. For example, she thought she wouldn't get a refill of her pain medication, making her hours of her pain untolerable; she even was saving meds until

the pain was so great she wasn't getting any pain relief. Helping her adhere to her doctors that know her and care correctly coordinated is helping her stay comfortable and able to function.

I'm also excited about your treatments! CRPS is a beast to have; my last relapse was at least 18 months ago. My neurologist is also a pain management specialist, which helps with my migraines as well. I haven't needed to bring down that hammer of infusion therapy, but if I ever need to, I'm glad to know it is effective.

My positive vibes are with you and hope you are safe!

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Specializes in Pediatrics, Emergency, Trauma.
Ladyfree, I'm so sorry to hear about your mother.

Even though I didn't participate much, I found myself missing this thread!

I'm in the limbo of waiting to hear about acceptance to the schools that I applied to. This is really nerve wracking. I'm really hoping I hear something this week.

I just got home from my newish neurologist. We tried some meds that weren't effective, and in between appointments, my GP put me on a low dose of norco to help relieve this headache (that I've literally had since February). I've taken it twice in the past month, and it's helpful when my headaches are bad. When I mentioned this to my neuro, he told me that it was against practice policy to prescribe narcotics. I was really surprised - headaches and neck pain are the two main symptoms of my condition. He also wants me to take magnesium instead. I'm frustrated, and sick to death of this never-ending headache. I feel like I'm not being taken seriously.

What I learned this week was that corneas don't have a blood supply, so they get their oxygen directly from the air. I love cool facts like that!

I hope everyone has a wonderful week :)

I hope you find a neurologist, and corneas and eyes are cool, especially if one ever has to use a Morgan lens!

Positive vibes in getting into nursing school!

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.
That is very great news!

Living paycheck to paycheck is stressing-sending positive vibes for your family, and that wild weather in your state!

I'm back! I just worked a week straight & now I will be heading to orientation. Then I'm going back to work. They are keeping me busy. I still have no word on if I got the job directly with the company but as long as the agency keeps me busy, I'm fine!

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