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?
Usually not having PRNs on admit is not an issue for me, because a good amounts of my admits are unconscious. What aggravates me is when they extubate somebody and don't give me a set of PRNs. Hello, if you just d/ced the fentanyl drip, you just d/ced my pain medicine. Also, the patient couldn't tell me she was itching or nauseous before and now all of a sudden she can talk. It's like admitting the patient all over again because all of the basic needs have to be addressed.
It really annoys me when the physicians get all surprised when the patient gets hypertensive after extubation, too. Everything we use for sedation really drops blood pressure. If all of that is off and the patient has a history of hypertension, the patient is going to be hypertensive when we turn it off! I hate that "But her BP was low yesterday!" Yes. Yesterday. While the patient was on propofol.
And it never fails that the physician then wants to put the patient on a critical drip like cardene or cardizem for the BP, when something as basic as restarting the home meds would do. It's not a dang hypertensive crisis. They didn't present to the ED with their BP in the 250s. They just haven't had their home meds all week. Just restart the home meds and be done with it - don't keep them in ICU for an extra couple of days just because it's more convenient to start a drip than it is to have to actually read a home med list. Sorry to make you have to READ something at 0200 - I know that's absolutely terrible.
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]
Coming from a school that churns out students 2-3 times a year and costs a metric butt-ton to attend, yeah I can imagine they want to keep everyone until graduation.
I've renewed my vow to stay as healthy as I can and avoid being a hospital or facility patient as long as I can. I've seen some of the product this place churns out, and it ain't pretty.
Was this for a certain school starting with a C? I think I heard the same commercial and just shuddered!!
Specializes in OR, Nursing Professional Development.
Reinforcement of the "you can't save them all" fact. MVA with abdominal and chest crush injury. Didn't make it out of the OR. We didn't even have ID on the patient, so they left the OR as a J. Doe.
I can cry over the deaths of people I don't even know (Orlando).
My furkids instinctively know when I just need some cuddle time and step up to the plate.
Reinforcement of the "you can't save them all" fact. MVA with abdominal and chest crush injury. Didn't make it out of the OR. We didn't even have ID on the patient, so they left the OR as a J. Doe.
I can cry over the deaths of people I don't even know (Orlando).
My furkids instinctively know when I just need some cuddle time and step up to the plate.
^ 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.
My surgeon's PA forgot to write an order for a PCA. And because the PCA was usually part of the post op orders, nothing else was available. That was horrible.
I learned this week that my penchant for having a HUGE target in my back has come to fruition
I knew it being a part of the bargaining process will do it-I knew a day will come, but basically it is so severe that I may not be able to move up the clinical ladder, get a promotion EVER, and it was based on a scheduling error.
My new boss questioned the whole process, and even cautioned me if I understood the severity-I knew, and I knew I was being targeted, but I stood my ground, refused to sign, and went straight to the union about it, and have proof I did not know about it.
I knew I would possibly be written up, and NEVER in all my 16 years in healthcare have been written up, and for a first occurrence been threatened to be terminated.
I even have proof I didn't know and was never notified to show up for work.
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RainMom
1,117 Posts
Or when the ER doc sends up a pt with a fracture, likely surgical case, with no orders for pain meds at 0200 forcing you to call the attending 😈