I had a whole different post in mind today, but then realized it needs to wait until next week. Oops!
So what does that leave me today? Very little!
What nursing related thing have I learned? I learn nothing when I'm not nursing. Well, this week, anyway. I have had some evolution as a person, and a patient. But nursing? Nada.
As a patient approaching 6 weeks post op from spinal fusion, I have learned...
...that the torso I see from the side in the mirror doesn't look like mine. My lordosis is gone.
...I am thankful to have cut my med list down so much.
...being really skinny means my hardware presses against my skin and incision site when I bend. I really hoped this would stop by now.
...I never knew how much I relied on pain to be the friend who cautioned me to hold back. I've felt anxiety over losing the pain.
...^^^^ that??? It's crazy.
...I CAN SLEEP ON MY BELLY!!!!!!!!
...I'm EXTREMELY bad at unknown. My post op appt this week will show whether I am fusing at all yet. I just want to know.
...the hardest lesson is this mountain of defeat I'm feeling after such a big few months. I'm seeing pics of graduation, celebrations of employment, and worthy bragging moments on my facebook historical posts. I felt like life was hard then, I celebrated something hopefully becoming easier. It didn't though.
I've lost my muchness, guys. Lots of it.
Bonus:
...it comforts me to know my LEO hubs and his coworkers have devised an apocalypse plan. I also just realized being nurses makes us all valuable (like, save the nurse, kill that guy instead, valuable).
So what have you learned? (And please, if you can, bring it back to nursey since I couldn't! (Sorry, mods!) We need to stay yellow.)
I have some padding to offer! I also make excellent authentic Italian food (if I do say so myself). Perhaps some carb loading?
I was just breezing in to say that. I learned a lot this week but I will have to type it up later when I don't have to get in to the shower for my 9th shift in a row. [emoji99]
Wish I could say I signed myself up for that voluntarily.
I have some padding to offer! I also make excellent authentic Italian food (if I do say so myself). Perhaps some carb loading?
I was just breezing in to say that. I learned a lot this week but I will have to type it up later when I don't have to get in to the shower for my 9th shift in a row. [emoji99]
Wish I could say I signed myself up for that voluntarily.
I did that two weeks ago... worked Wed/Thurs/Fri, picked up Saturday extra, worked Sun/Mon/Tues, and then worked Wed/Thurs at my PRN job. All 12s. The funny thing is that I was happier than I have been in a while (didn't have to stress out about the SO or a lack of a social life on my days off) and I managed to lose three pounds. Not to mention my sleep was also amazing. Working nine in a row is where it's at for weight loss, job satisfaction, and general life satisfaction for me, apparently.
I did that two weeks ago... worked Wed/Thurs/Fri, picked up Saturday extra, worked Sun/Mon/Tues, and then worked Wed/Thurs at my PRN job. All 12s. The funny thing is that I was happier than I have been in a while (didn't have to stress out about the SO or a lack of a social life on my days off) and I managed to lose three pounds. Not to mention my sleep was also amazing. Working nine in a row is where it's at for weight loss, job satisfaction, and general life satisfaction for me, apparently.
Haha! You clearly know how to rock a challenge. I'm impressed. My brain wants to pull it off...my legs not so much. Especially cuz I had to start chest compressions on the floor last night. When did my knees turn 80? I would have sent flowers.
Ixchel, I have been thinking about you, and I'm glad you're doing well. I am especially glad you can sleep on your belly - that's the best feeling! I love sleeping on my belly.
My knee-jerk reaction is that this is absolutely horrible and the physicians prescribing this need to have someone set a stethoscope on their chests to see if they have any hearts left themselves. Hooked up to an IV 24/7 just to keep your heart pumping at any sort of level to sustain life? Ugh. That is just straight up torture for the patients.
I have learned that being short staffed sucks the most when we have a code, and the coworkers in the other section are taking the recent talk of "stay in your section!!!" to heart and don't come to help. I had to do six rounds of compressions last night, and my shoulders are so stiff I can't stand it and my calves aren't much better. Clearly the massage I got on Monday was premature - I need another one. And I'm also a little angry that the main four people rotating were all out of shape females, myself included. I also learned by watching the A-line that my first round of compressions when I'm fresh can get a 130s systolic, but that lasts about ten seconds and by the 30 second mark, the patient systolic is down to the 80s and dropping. Where are all the men when we need them? Oh yeah, that's right - in their sections. Sitting on their butts charting.
I have also learned that being alone and tipsy on a Saturday night results in texts to work crush... which have yet to be answered. I think I'm just going to go hide under a rock somewhere and pretend I don't exist now.
Ummm, I never got your texts...
I've learned that tonsil stones are disgustingly awesome, and I love calling the parents and telling them their little darlings have these disgusting things in their throats. They freak. :)
-I've learned that answering phones, forwarding med requests and deal with poor attitudes exhausts me more than being on the floor doing hands on work. But I've also discovered that the reason I'm put in the phone room is that I'm really good at it, and am one of the few people in that office that can handle the work load.
-I've learned that I actually miss school during the summer. I'm putting that energy into discovery of my new state that I haven't really done since I moved here 1.5 years ago.
Specializes in Oncology, Rehab, Public Health, Med Surg.
Ixchel - I am sorry you are somewhat struggling after surgery. I think that when a person had chronic pain, there is a lot attached to it, emotionally and physically. Also, if you had been on chronic pain medication before surgery and are able to reduce now you may perhaps feel a touch of withdrawal at times creating anxiety...not that I am saying that is what is going on but it is something that I have seen in patients.
However, I wish you a speedy recovery and that things will straighten out and healing will continue on all levels.
What I learned this week:
There is the National Patient Safety Foundation that offers some great information for health care professionals but also patients and caregivers, some of it is very useful for patients. The goal is to empower patients and caregivers to take charge of safety for example with transitions or medications. Here is the link in case you are curious:
Advanced Care Planning : A big part of my job. I learned this week that it starts to sink in with some physicians that an acute situation is not the ideal time for advanced care planning and asking somebody who is in acute distress "do you want us to do everything" will most likely result in the person nodding. Unless they had a discussion with their healthcare provider already and have decided to change their code status. This is why advanced care planning is so important and should also include a conversation with the MD/NP about their wishes in terms of resuscitation, especially when the person has a serious illness, or chronic serious illness and such. Unfortunately, providers are not trained sufficiently and often do a poor job with those discussions. Plus there is a huge discomfort attached to any end-of-life discussion.
However, some providers finally understanding why palliative care likes to see patient outpatient in the office. In that setting, when they are less acute sick, the NP and MD have the time to sit down and start and continue a discussion about code status and advanced care planning in general. They collaborate with other professionals like oncology and PCP. Here is a general link for advanced care planning:
Home Dobutamine iv therapy becomes more "popular" for heart failure patients who have no other option left. While I understand the desire to maximize heart function, I feel conflicted when the person is in general low functioning due to advanced illness and not a candidate for left heart assist device or transplantation. If somebody has a lot of comorbidities and is unable to leave the bed most of the times - does this add anything to the quality of life? Of course I can see why a person who is looking into maximizing their life span may grab that straw but I think it is an option that needs to be explored carefully. There can be significant costs and overall quality of life may not be much better or not better at all in some cases (in my opinion). And patients need to understand the implications and the degree of their illness. There should always be a discussion about the bigger picture with the cardiologist.
Here is a link with some general information about home infusion of positive inotrope medication in home care:
In fact, I did not know about this initiative but have been writing down questions with patient to ask their provider or specialist so they get a better understanding. Most commonly I write down with patients questions like "what is my diagnosis" "what does it mean?" "what is my prognosis?" "what are treatment options?" "what are next steps?". I found that this really helps the patient (or advocate/relative/HCP) to stay on track when the provider meets the patient. Often, patients are so stressed out and anxious that they forget to ask those questions or do not speak up when they do not understand medical English. I have met patients who had cancer stage 4 and had no understanding of what it means, or who patients who did not know what kind of surgery they had - sometimes leading to tragic misunderstandings (I thought I was cured). And I am not blaming anybody - the problem is that communication is often limited and patients do not speak up or misunderstand and the provider thinks they have an understanding.
I learned a lot about sanitation in nail salons as I did some research on it. I usually avoid nail salons and prefer to do my own pedicure. But I really wanted some nice looking feet for my mini vacation and decided to do some research. I found a place that is a short drive out and was actually able to relax while my feet were done. Knowing what to look for is really helpful including that not all salons follow the law and cut corners plus going on days where it is crowded due to a "special" they may not pay as much attention to the required sanitation time. And apparently it is not good to go on the day you shaved your legs because it increases the risk for infections. One physician also mentioned that those "whirlpool" functions can be questionable as bacteria can harbor in there -- uahhhh!
And last but not least - my diet efforts have not resulted in much change. Now I am back to counting calories with an app and scan all the food plus I had the NP increase my Hormone Replacement Patch dose. And I started fitness kickboxing and have been going three times a week for 30 minutes, which is all I can do right now. Seriously - I am so out of shape because for the last year I have focused mainly on weights (I had surgery last year and had to start from square 1 after). The heavy duty cardio part of fitness kickboxing leaves me with a dark red face, subtle nausea for some while after exercising, and the realization that everybody else there is much younger AND in better shape.
Thank you for the above info! Good info to think about. I like the ask 3 idea. Sometimes all the numerous little questions get in the way of the really important ones
And sign me upfor a solid 15 pounds for Ixchel!! Happy to contribute to your padding, lol
What I've learned this week upon returning after a week off from work:
Organizational changes makes no one immune...even when TPTB think they are..:and it makes the others in charge nervous and nasty.
Having new leadership and changing culture is sometimes like a car crash; I sometimes feel as though most of my career I straddled the fence in terms of not getting involved in day shift v. Night shift, management v. staff, etc; I would clock in, clock out until the next job that interest me came along.
Now being at a place that has great coworkers, has the potential of something great while seeing even the minute changes makes me want to reach out to new leadership to help demolish the old status quo, especially when there are still 2 people left from the trifecta of negativity and ineffectiveness; I have to be strategic in my approach while promoting some form of objectivity through it all.
I also learned the more healthy I eat, the more I crave for cookies.
I learned this week that kids are dang resilient and amazing,
I wish I could go on a tour and talk to parents with toddlers with developmental delays of various sorts and instill hope. All 3 of my kiddos were delayed. One due to autism, one due to hypotonia, and the other had a speech issue.
My daughter couldn't hold her head up at 4mo and I was told that physical activity would always be hard for her. This daughter of mine who is almost 13, just received 5 offers from club soccer teams. This is the same girl who needed a feeding tube for 2.5 years.
Also did you know that if said daughters gtube is dislodged Christmas Eve night in her crib and you can't get your next one until new years day... The ED will place a Foley catheter to keep the hole open and intact?
Specializes in LTC, assisted living, med-surg, psych.
I've learned that I can survive med changes without losing all the good the previous regimen did. I have successfully reduced one of my hardcore psych meds and nothing awful has happened...in fact, I'm less groggy in the mornings and no longer walk around for two hours feeling like a bomb has gone off in my head. I'm also still very stable. Yay!
I've learned that my nursing and patient advocacy skills are still good and they're not going to waste at all. I use them all the time in taking care of my husband and working with hospice to provide him the best care he can get. Thank God that surveyor job went by the wayside back in the spring of '14; I can't imagine trying to take care of him and being five hours away, across the state, on overnight trips that may last up to a week or more. I'd probably be twice as crazy as I already am if I'd kept on trying to make that work.
ixchel, I'm sorry you're having a rough time. I don't know your story, but I wouldn't wish spinal surgery on anyone. I suggest we have a potlock. Everyone throw in a pound for ixchel to help pad the hardware.
I learned a lot about sanitation in nail salons as I did some research on it. I usually avoid nail salons and prefer to do my own pedicure. But I really wanted some nice looking feet for my mini vacation and decided to do some research. I found a place that is a short drive out and was actually able to relax while my feet were done. Knowing what to look for is really helpful including that not all salons follow the law and cut corners plus going on days where it is crowded due to a "special" they may not pay as much attention to the required sanitation time. And apparently it is not good to go on the day you shaved your legs because it increases the risk for infections. One physician also mentioned that those "whirlpool" functions can be questionable as bacteria can harbor in there -- uahhhh!
Guess I'm not going to get my nails done today. I hate doing my own nails...it's one of the "me" things I insist on doing for myself but the more I think about it...guess I should research a bit more thoroughly... Plus, it's a weekend day, half the people around here will do the same thing. I have a day off this week so maybe by then I'll have researched it and feel better about it?
kalycat, BSN, RN
1 Article; 553 Posts
I have some padding to offer! I also make excellent authentic Italian food (if I do say so myself). Perhaps some carb loading?
I was just breezing in to say that. I learned a lot this week but I will have to type it up later when I don't have to get in to the shower for my 9th shift in a row. [emoji99]
Wish I could say I signed myself up for that voluntarily.