I apologize for starting this thread late! Ixchel asked me to host this week's thread for the first time , and I put a reminder on my phone, for the wrong date!
This week has been filled with ups and downs, but then again that feels like my life in general the past few years.
First I learned that I officially won a scholarship through NAHN (National Association of Hispanic Nurses)! I'm still surprised I won it, seeing as to how I sent in my completed application, paid for it to be overnighted, on the *day* it was due. Talk about procrastinating. It's for $1500, and considering I'm at a community college, that's great. I have to go to Chicago to accept it. Which will require an overnight trip and traveling & hotel costs. Fine, we were going to make a family trip out of it.
My husband also go offered a promotion at his job! Most people go through a few rounds of interviews before finally getting promoted and he got his on the first try. However, he was offered a really bad shift for us, and he was going to turn it down, but, they worked it out to having him start on a different shift, not the ideal one, but a shift we can work with.
And then, the chalk happened. I've been trying to not be a helicopter mom, and have been letting my daughter play outside of our apartment complex on her own, with me checking on her every 15 minutes or so. Well yesterday, her and her sister decided to chalk/draw on a few of my neighbors cars. And scratched them. My neighbor was nice about it, but it's a new car and he rightfully wants us to pay to fix the scratches. Thankfully the other car was a hoopty/clunker and he didn't care. But it is likely going to cost us $400. There goes my traveling and hotel money for the scholarship.
But I also won a full scholarship through school! So no loans for my final year of nursing school. But I'm still sad about not being able to accept the other scholarship, I put a decent amount of work into it. And I was also looking forward to getting all dressed up and visiting Chicago.
So far my summer Pharmacology class has been refreshingly easy. Almost too easy, because I space out alot in class, until the end when he stops to tell us the questions for the next quiz. Now I almost wish I had taken it during the regular semester, as I usually pride myself in understanding the information, not just getting good grades. It's alot for 4 weeks.
Oh and I lost some weight! Maybe 8 lbs in total over the last 5 to 6 weeks. This is with just healthier eating, no dieting, and exercising 3 to 5 times a week. The goal is to fit BACK into my scrubs before I'm back at clinicals.
So, fine, more ups than downs. So what have you learned this week?
Ixchel, my thoughts and prayers are with you and your family.
This week I learned that when you have hyper or hypo kalemia... Your symptoms go the way of the prefix except for the heart urine output.
The quickest way to fix hyperkalemia is to run D5W with regular insulin. The insulin causes uptake of potassium into the cells. When they come out the kayexalate will then get rid of it in the bowels.
I have a standing job offer for working on nights on a stepdown unit but I really want labor and delivery. Well I got a call last week from a hospital that I forgot I applied to back in April. They are hiring 9 nurses for labor and delivery.. But not all new grads. I have an interview Wednesday.
1) despite an outward appearance of being full grown adults, people can still act like nasty 8th graders.
2) it kinds rubs me the wrong way to get unwittingly booted out of the "clique" at work. Not that there was ever much of a clique with only 5-6 of us across the whole department. It just seems like I was vital until they got someone else. My sin? Stating that I really did not want to discuss some aspects of my personal life anymore. No we are not "all friends here." It's work, not my be all, end all of existence.
3) I have committed one (or possibly more) grievous sins by no longer offering to be of assistance with the new EMR system implementation. I've told them for 7 months that I know the system well and was ignored. Now I'm supposed to be impressed that a certain supervisor is sucking up to me since the corporate training folks have pulled back. Ummm, no.
3) I've learned that a transfer request cannot come through fast enough.
1) despite an outward appearance of being full grown adults, people can still act like nasty 8th graders.
I've got some of this going in my unit right now and it sucks. It's actually mostly on my side. I messed up and did some things that I shouldn't outside of work, and the other person involved has decided to be avoidant about the whole thing, which I find to be childish, so I've just been avoiding said other person as well because I feel like the behavior he's exhibiting is disrespectful.
I have discovered that people who are too alike, especially when it comes to total social awkwardness, would actually make terrible couples because neither one wants to be the brave one that brings up a difficult topic and makes him/herself vulnerable, so neither does, so avoidance and awkwardness ensues.
Oh well. I've always said that the phrase on my tombstone should be "She Made a Lot of Bad Decisions, But She Dealt with Them and Moved On with Her Life." That'll work unless I do something really stupid like stick a fork in an electrical socket one day and die from that - then the second part of that phrase can be omitted.
I've learned that a radio ad for a for profit nursing school gives me the jeebies.
Part of the copy goes; "Isn't it better to have a program that keeps students IN, rather than weed some OUT?" [emoji33][emoji33]
I know I've said this before because it's a soap box thing with me, but I totally agree with that statement. Even for the nonprofit schools.
I mean really - you have hundreds and/or thousands of applicants for a few spots, they are picked through very carefully for the best candidates, and people still fail out? Nursing school is hard, but it's not aerospace engineering. The applicants who are accepted didn't end up with 4.0 averages because they were stupid and unable to figure things out, especially when the pre-reqs for nursing school include things like physiology, anatomy, chemistry, and statistics, which are all difficult classes. A 4.0 student should not fail out of nursing classes. There is something very wrong with that picture.
It's got to be the teachers. My school had exceptional teachers and we only lost two students along the way, and one was because her husband needed emergency surgery and she had to stay home and take care of him, so she lost a year but graduated the year after us with the following class. I believe our first-time NCLEX pass rate was 97% the year I graduated, so clearly being able to keep our students in the classroom instead of failing out these really bright people who beat out tons of others for the spots didn't hurt us in the slightest.
The only nursing related thing I learned this week is that my transcript has still not been received by the BON. And I am so frustrated I can't even express it in words!
It's been a month since graduation and I still can't schedule a test date!
The BON hasn't responded to my emails or calls. The school is placing blame on a "computer glitch" despite the office staff saying something totally different.
I'm still doing questions everyday but I'm getting lazy about it. I just want to test already! I need a paycheck.
I learned that 3% "permanent impairment" (I'm fighting that) is 100% jobless.
Waiting on HR; all I know for certain is that they won't let me back on my unit. I have a funny feeling they're not going to make much effort to place me, so I'm going to clear out my locker today to avoid having someone rehome my Littmans.
(I'm no fool, I am in contact with an attorney, but under state law and the way my injury was treated, there's not much I can do here that won't cost me more than it benefits)
I also learned that disability insurance doesn't cover workplace injuries.
I learned that 3% "permanent impairment" (I'm fighting that) is 100% jobless.
Waiting on HR; all I know for certain is that they won't let me back on my unit. I have a funny feeling they're not going to make much effort to place me, so I'm going to clear out my locker today to avoid having someone rehome my Littmans.
(I'm no fool, I am in contact with an attorney, but under state law and the way my injury was treated, there's not much I can do here that won't cost me more than it benefits)
I also learned that disability insurance doesn't cover workplace injuries.
I liked that one for support.
That's terrible! I'm so sorry you're going through that load of crap.
1. I'm eligible to sit for the ANCC Medical-Surgical Nurse certification exam. I have 90 days to test. I may (or may not have) thrown up a little bit when I found out.
2. A patient can refuse medications, assessments, and other nursing interventions, but be deemed to lack capacity to sign themselves against medical advice.
3. 12 hours is my limit on how much screaming, yelling, verbal abuse, and nagging I can handle from one patient (and their family). At hour 13+, I started to lose my cool, and demanded that the Nurse Supervisor come to the unit to help reign this family in. What can I say? I'm only human.
4. Extending some empathy and compassion to a patient with advancing Alzheimer's disease really goes a long way towards making their loved ones feel as though their family member is more than their disease. It's hard to remember there was once a prideful person in that body: a person who had a profession, education, family, hobbies, and who was once a contributing member to society. It's hard to accept these behaviors as manifestations of the disease and not as a representation of the patient's true feelings. I have learned, however, if you put in the effort to see past these behaviors, you'll find much deeper rewards, and help the patient more than you know.
5. RNs on my unit are far under utilizing PRN medications (this includes for anxiety, agitation, pain, nausea, insomnia, etc). This causes them to feel more stress and anxiety over things they could control if they'd just help themselves!
5. RNs on my unit are far under utilizing PRN medications (this includes for anxiety, agitation, pain, nausea, insomnia, etc). This causes them to feel more stress and anxiety over things they could control if they'd just help themselves!
I will never understand this behavior. Never, ever, never. Even if you are looking at this from the purely selfish perspective, giving the PRNs is a good thing. Say Patient A has repeated admissions and you know him well. He always wants his Phenergan, Dilaudid, and Benadryl together and in the same syringe, and that's what he's asking for now. He has hit the call bell 47 times in the past hour asking for these. You check and they are all syringe compatible, so you give them all in the same syringe and push fast as requested. You just gave him what he wanted - good for you! Now he's quiet because he is passed out (but breathing 13 times per minute with a SpO2 of 99%) and you can check on your other patients. You also have time to catch up on your charting, which you could not do because of his screaming out into the hall asking for pain medication earlier. Everybody wins!
I don't understand the logic in holding PRNs if it is time for the patient to have them.
I learned it is impossible for we lower beings to determine whether pupils are equal without specialized equipment. Not sure what that equipment is. Apparently my own hospitalists have been fools for believing my neuro assessments.
Nurses who don't give clearly needed PRNs have always puzzled me. If a patient's BP was out of range, and you had a PRN to correct that, you'd give it, right? Likewise if your patient had heartburn, chest pain, or a temp.
Then why oh WHY would you not treat anxiety, insomnia or pain?
Specializes in Cardiology, Cardiothoracic Surgical.
^ I am all about the PRNs, and it infuriates me when docs don't write me a basic set of PRNs to cover post-surgical care. You should have something for pain, breakthrough pain, sleeping, anxiety, itching, blood sugars, nausea ALWAYS in the order set. I hate wasting a good amount of time calling for these obvious things.
Lauraingalls, BSN, RN
169 Posts
Ixchel, my thoughts and prayers are with you and your family.
This week I learned that when you have hyper or hypo kalemia... Your symptoms go the way of the prefix except for the heart urine output.
The quickest way to fix hyperkalemia is to run D5W with regular insulin. The insulin causes uptake of potassium into the cells. When they come out the kayexalate will then get rid of it in the bowels.
I have a standing job offer for working on nights on a stepdown unit but I really want labor and delivery. Well I got a call last week from a hospital that I forgot I applied to back in April. They are hiring 9 nurses for labor and delivery.. But not all new grads. I have an interview Wednesday.