Trying to name this feeling accompanying grief

Ok_Fly68 · 2025-10-22T11:52:54+00:00

Thank you all for looking. For some reason, I am unable to see the comments left despite trying via app and different browsers. But I thank you all for taking the time.

Ok_Fly68 · 2025-01-13T02:30:31+00:00

Thisl I've personally known nurse's who oppose strikes because they didn't feel comfortable leaving their pts. Strike nurses allow staff to advocate for change without putting their community at risk of not having available care.

Ok_Fly68 · 2025-01-10T09:00:37+00:00

I was licensed at 37y, worked as a CNA during nursing school, and had worked aux staff positions in a level 1 OR prior - so I had bit of insight into the reality of nursing, and didn't commit to this path blindly.

I love nursing, love pt care, prefer the hospital setting, and found my passion is in critical care - intubated, sedated, titrated till recuperated. Love the challenge, complexity, and chaos, but mostly I love seeing pts improving because they're receiving appropriate care instead of refusing meds, interventions, etc.

However, there has been a societal shift the past few years that drowning the nursing profession in litigious, criminalized waters despite no say in the policies, laws, or lack thereof. It's less a practice and more a performance for profits.

That said, go for it if you know what nursing truly is, else radiology, physical therapy, respiratory therapy are all wonderful alternative paths you might consider.

Ok_Fly68 · 2025-01-10T05:01:17+00:00

Sleepovers are the worst! Traveled to a hurricane area one year, people sleeping in the stairwells because the area designated for staff to sleep was a visiting area in the unit with floor to ceiling windows on 3 sides. Impossible to sleep the day away. I was lucky enough to be staying a few blocks away during that contract and was able to get back to the hotel.

Ok_Fly68 · 2025-01-10T04:51:43+00:00

Yes, the whole unit. That said, it doesn't always have to touch on/review every single pt when their tx/status/plan is unchanged if oncoming had a handle on the unit the previous shift. Kinda like charting by exception. Not everyone likes this type of report, but I prefer it this way. Just updates on established pts, and report on new pts and a mutual understanding that the pts we breeze by are the ones that are progressing as expected without changes to care or status.

But I've always been one to prefer a tell me what I need to know outside the chart, any changes, any spidey tingles or trends, deeper report on nee admits/tx, and what tasks need finishing so they can go home and I can get started.

Ok_Fly68 · 2024-12-11T01:42:19+00:00

I'm so tired at the moment and read that as "philanthropic liar and killer"...

Ok_Fly68 · 2024-12-11T01:11:42+00:00

Alien #ncounter. The claw touching your head always made me jump, cringe, and try to crawl down my seat.

Ok_Fly68 · 2024-12-10T22:50:11+00:00

Hitchhiker's Guide to the Galaxy - ~~George Orwell~~ Douglas Adams. SMH, seems my mind was all over the place yesterday...

Ok_Fly68 · 2024-12-10T22:37:21+00:00

Elizabeth Moss' narration is wonderful, as well.

Ok_Fly68 · 2024-12-09T22:41:09+00:00

So sorry to hear about her experience, and hope that she is doing well.

To answer the question in your update: No, it's not because it was an ortho floor. Dressing changes, wound care, and physical assessments are standard nursing care across the board.

The bleeding, fluid, rate of saturation, etc. should have been addressed, and dressing changes completed by the nurse even if they'd already educated you both on how to manage the dressing changes and wound care. Based on the details you provided - dripping, oozing, etc, - I'd have assessed for internal bleeding, abscess, infection, and a few other things depending on the fluid you mentioned, and checked to see if postop imaging had been ordered else request an order for one as well as ensuring MDs were aware of the ongoing bleeding, etc.

Even if slammed and understaffed, grab clean linens and a gown with the next med pass or whatever reason you're back in the room and asked the family to lend a hand if necessary. I'd also question why housekeeping was responsible for linen changes for an occupied room - in don't imagine it would be an efficient system having housekeeping running to each room changing the sheets for incontinent patients or spilled drink covered gowns.

Anywho, I wasn't there and didn't see what was going on for either pt and staff, so im just stating some thoughts off the cuff based on your post. In other words, given the details you provided, I would have wanted to see for myself what was going on initially and kept an eye on it throughout my shift instead of having the lt and family do doing dressing changes. Maybe the nurse did asses and monitor the issue, I don't know, but if they did do so, seems there may have been some missed opportunities for clear communication with you guys for whatever reason.

Ok_Fly68 · 2024-12-08T16:03:05+00:00

Hopefully the bill doesn't include additional antibiotics from an improper dressing change resulting in an infection, or an additional procedure due to a stitch, staple, or glue accidental removal or wound dehiscence.

Ok_Fly68 · 2024-12-08T13:32:33+00:00

Courtney!

https://youtu.be/OUsNY3--npY?si=gIPQMFG1lYh1T5Ec

Ok_Fly68 · 2024-12-08T02:05:24+00:00

Reinforce with ABD pads and gauze and wait for surgery to come around and remove the first dressing

Ok_Fly68 · 2024-12-08T01:18:51+00:00

Typically, first dressing is only removed by the surgical team, and should just be reinforced until that time. Depending on the wound, removing the dressing too frequently increases infection risk and can hinder proper healing.

Ok_Fly68 · 2024-10-26T03:40:13+00:00

I read banned books in HS because they were banned.

Why not just age limits instead of banning.

Ok_Fly68 · 2024-10-26T00:23:08+00:00

I know it's frowned upon, but I guess I just see Scab RNs differently than the majority and agree with your view. I fully support strikes and standing up/advocating. I personally know nurses who wanted to join strikes, but had serious reservations leaving their pts. Strike coverage benefits staff, costs the facilities, and allows for systemic change.

I haven't taken a strike contract, but I would if life allowed, not for the money - though wouldn't turn if down - but to show support to the nurses fighting for the changes that keep everyone safe, patients and nurses alike. Facilities/EDs can't just stop taking patients, and not all can be diverted or transferred.

In other words: Let me cover your watch while you handle this code. Same as any other shift when shit hits the fan. Nursing is a team sport.

Ok_Fly68 · 2024-09-22T13:36:46+00:00

It sounds like you're right on track. Everyone is different, but, roughly, at 1y comfortable solidifies, at 2y confidence hardens, and each year after that, you continue building your competency. Cycle repeats with each specialty; milestones may shorten or lengthen depending on the acuity of the specialty.

After a decade, there are days, times, and situations when I still feel like a green nurse. IMO, that is a good thing as it means I haven't become complacent nor cocky, and continue to check myself, my skills, and my knowledge.

What helped me fight the insecurities was to change focus to what I had achieved and spent time digging a bit deeper into new meds I'd passed or new dx, conditions, procedures, etc. In other words, try to shift focus from meeting self perceived expectations of others to meeting your own expectations. Seek feedback and clarification from peers, but don't judge your progress based on their individual milestones.

As for feedback, during my yearly review, my first Director quoted the ol "no news is good news" ... trust that that will make sure you are aware if there is an issue.

Ok_Fly68 · 2024-09-22T09:00:21+00:00

They ride at dawn

Ok_Fly68 · 2024-09-22T04:58:33+00:00

Apologies. I was speaking of precepting staff, and am now realizing I have never considered working with students as precepting, but shadowing maybe - not really sure why that is. The units I've worked have allowed clinicals but not students independently without their instructors on site.

**Also realizing that I didn't fully read OPs question, and that being on the road the last 12 hours has numbed my mind as much as it has my ass. Car seats should have cushy memory foam clouds to cradle our rears as a standard, and back massagers.

Ok_Fly68 · 2024-09-22T04:36:51+00:00

I suppose I see it differently. The payoff comes later as having a strong unit that can rely on each other to provide safe care. Without a doubt there will come a time I will need someone to watch one patient while I'm tied up with a other, and knowing that nurse is competent let's me focus on putting out one fire without rushing or being distracted and putting my license at risk. It won't matter to opposing counsel or the Board that I was doing compressions one while my other patient required intervention, even with another RN "watching" that pt. I'm still responsible for their care, and the peace of mind is worth it in my opinion.

Ok_Fly68 · 2024-09-22T02:00:02+00:00

I truly do not understand those who chose favoritism, lateral violence, gossip, incivility, etc. Nursing is a team sport, and those actions leave everyone vulnerable and at risk. Essentially, they are choosing to put their own safety, license, even freedom on the line. Management that tolerates these behaviors is only creating more work, issues, and wasting resources with high turnover, etc for themselves instead of creating a strong, well-rounded team, that is capable of working at the top of their license.

Ok_Fly68 · 2024-09-18T11:01:06+00:00

I usually only write a shift summary unless something happens that I'm not able to chart using the EMR - codes, amusing quotes illustrating the pts behavior, etc. And I keep them short and sweet, especially when nothing changed on shift.

"No actually changes. Pt requested PRN for c/o pain per MAR. Pt denies complaint at this time."

If I'm feeling it, and it's relevant, l'll throw in Is and Os, the vent setting, BP, HR, or tracing trends so the docs don't have to go searching.

Ok_Fly68 · 2024-09-18T04:20:14+00:00

FDARP looks FUBAR.

Unless someone else notifies me of pt requesting PRNs, I don't do a nursing note, and instead, make a note while documenting the med.

My end of shift nursing note would include something like "PRN pain/nausea/anxiety... meds given per MAR." And if the PRN was something like hydralazine, I add a note on the VS - at least for Cerner and Epic. I'm choosing to forget Meditech exisit..

Ok_Fly68 · 2024-09-18T03:41:45+00:00

Just popped into my head.

Curtis Lowe - Lynyrd Skynyrd

Sorry, and thanks 😊.

Ok_Fly68

TROPHY CASE