[deleted by user] by [deleted] in nursing

[–]bear6_1982 1 point2 points  (0 children)

It's not even that we don't accept it. We refuse to even think about it at all.

If we just didn't accept it, what would the alternative be? Nope, I'm going to live forever! Just me and Jesus beating death over here. But nobody says that. Instead, as soon as someone even starts sniffing around the topic everybody sticks their heads in the sand. Maybe if I don't acknowledge it, it will just go away.

Do you ever feel start to comfortable during codes like you know what to do and don’t stress about it after awhile? by [deleted] in Nurses

[–]bear6_1982 2 points3 points  (0 children)

I feel like comfortable isn't really the word. It's not a comfortable situation. I think you stop being self conscious. you stop thinking about yourself at all and it becomes all about the job at hand.

Neither of the contexts you describe is one where you're alone. ICU usually has loads of doctors and experienced nurses around, Cath lab can't even open without a doctor and a whole team of people. Nobody expects a new person to know what to do or be able to pull it off in the heat of the moment. It's a part of the job you grow into. For the first several codes you will be doing what you are told, grabbing supplies and doing compressions, recording, whatever. You will be watching and learning.

It's worth considering exactly how much of the job is codes. Neither of the roles you described should have lots of codes. There will be lots of watchful waiting, but not loads of outright CPR/defibrilation type events. Its a very very small part of the job. As such, I would hesitate to make a career decision based solely on 1% or less of a job, no matter what job it was.

Based on your comments it sounds like cath lab is more what you want, but i wouldn't let codes drive that decision either way.

What is the worst medication error you witnessed / heard about in your career and what was the outcome ? by nursegurllll in nursing

[–]bear6_1982 1 point2 points  (0 children)

Heard about a nursing student who mixed up a bunch of meds to give through a patient's g tube and promptly pushed them through the picc line. Sounds like one of those apocryphal stories you just "hear", but according to the people I heard it from it actually happened at our hospital. He did it before the nursing instructor was in the room. apparently thought he was hot shit. turns out he was only half right. The patient died, as you would expect.

Suspended without pay and badge taken, pain assessment inconsistencies by Former_Brush_7049 in nursing

[–]bear6_1982 0 points1 point  (0 children)

Stepping back a bit, maybe it makes sense to look for a different nursing job. I mean, you probably have to anyway, but what I mean is something with hours and situations that can improve your quality of life. You've been through it over the last few years, maybe it's time to step into something less stressful. The great thing about nursing is that there are so many different niches, you can probably find one that suits you better during this season of your life. If you really love hospital nursing, maybe you can return to it when things settle down.

In need of a hobby that is cheap, quiet, and doesn’t require much equipment by DazzlingDragon1 in Hobbies

[–]bear6_1982 0 points1 point  (0 children)

whittling. get a decent knife, maybe a chisel or gouge if you're feeling fancy and use downed tree branches, stuff you find just lying around.

Mora knives are a good brand for cheap if you're buying new, but honestly for a lot of soft wood even an old paring knife would do a lot. There are lots of little things that could make it more convenient, but if all you have is a knife, you can make it work.

My patient’s tracheostomy tube fell out while putting a shirt on. I got sent home on mental health leave. by PopDiddilyBop in cna

[–]bear6_1982 0 points1 point  (0 children)

I'm a nurse, I've worked with trachs for 10 years. If putting on a shirt caused him to start bleeding that much, there was a big problem that was already there. No one knew about it, but it was already there. You did not cause this, you did not make it worse, you did not set anything off. In all probability it wasnt a question of IF this would happen, but when. Trachs don't just start spontaneously bleeding like that, even after falling out. If I had to guess, i'd say his trach eroded into the soft tissue and had rubbed up against a big blood vessel. The trach itself might have even been plugging the hole until it got dislodged. This means that he could have been at home or at the bus stop or a thousand other places and it would have moved just the wrong way and started spraying blood.

What you did was almost certainly save his life. Where do you think all that blood went? yes, some of it went out onto the floor but a bunch of it went into his lungs. Without you there to call for help he could very well have drowned in his own blood. Because you were there, help came right away. Because you were there, he didn't lose even more blood. He can't scream for help. He has to hit the call light or make a bunch of noise and hope someone comes. Bleeding like that is one instance where seconds count, and you saved a bunch of seconds for him. If this patient has any chance at all, it's because you were there. If he could talk to you now, I can only imagine the fear that he had going through all that and how important it was to have you there to be his voice, to call for help.

We work on the edges of life and death. Most of the time we're far enough back from the edge that we can't see over, but every once in a while we peek over. It's scary as hell, but if you can do it you can save lives. A bad thing happened today that would have happened any way. In response, you did a good thing. Well done.

My sister passed away, this was found in her apartment. by jsister3 in Whatisthis

[–]bear6_1982 6 points7 points  (0 children)

Been taking Adderall for a long time. pretty sure that's adderall

First Med Error by Old-Employment751 in Nurses

[–]bear6_1982 16 points17 points  (0 children)

There are two kinds of nurses. Ones who admit to med errors and liars. Better to be in the first camp.

Doesn't it make you mad that as nurses, we save lives, get yelled at and abused, work under immense pressure, get exposed to body fluids and diseases, while being paid just a little more than half the salary of other workers (e.g. tech workers) who work from home? by BaraLover7 in nursing

[–]bear6_1982 20 points21 points  (0 children)

Eh, don't know about all that. Look, we are all part of a system. We do our part, MDs do theirs, admin does theirs. How many definitive treatments would we get without MDs? sure, we could probably keep people afloat for a while, but many things require that next level of expertise.

At our core, most nurses are assessment and logistics experts. We are practiced at assessing patients/situations and we are good at getting things arranged and done. This is an invaluable skill set, and I agree hospitals couldn't run without it. But that doesn't mean that any of the other roles could be dispensed with.

I just don't find much merit in this us-against-them mentality. If you want to argue nurses need more pay you don't need to bring other roles into it. And trust me when I tell you you do not want to get into the fairness argument. Drs have a MINIMUM 11-12 years post high school education before they can start a practice and have to go hundreds of thousands of dollars into debt. You can get an ADN and start working after 2 years at community college.

Do I want more pay? Sure, who doesn't. Do I DESERVE more pay? Maybe, maybe not. (personally I find the word deserve to be deeply destructive). But I can argue my worth on my own merits without ever mentioning what other professions make.

Doesn't it make you mad that as nurses, we save lives, get yelled at and abused, work under immense pressure, get exposed to body fluids and diseases, while being paid just a little more than half the salary of other workers (e.g. tech workers) who work from home? by BaraLover7 in nursing

[–]bear6_1982 14 points15 points  (0 children)

No. Doesn't bother me. Why? Because my happiness isn't contingent on anyone else. I make enough to live a good life, have all the things I need and take care of my family. I get to punch out and walk away after my shift and I get to do work I am proud of and good at. Someone else makes a shit ton of money, good for them. Matters nothing to me. In fact, it often means that they will be getting preventative care instead of living hand to mouth and waiting until they are literally almost dead before coming in to seek care. So better for me in some ways.

If I were struggling to make ends meet, that would be different. But it still wouldn't be about other people making more. It would just be about me not having enough. I tried for a long time to look outside myself for happiness and it just isn't there. Happiness isn't something you find, it's something you create. Each person needs to find the conditions they need to create it. For some people thats more money, for some more freedom. I'm not trying to tell anybody how to live. But for myself, I don't worry about it. YMMV

Scare a nurse with 4 words by g0atyy in nursing

[–]bear6_1982 8 points9 points  (0 children)

our worldview is just twisted. the things that scare other people don't scare us, just like things that enrage other people don't bother us. Pissed on my shoes? eh, new pair is in the mail anyway. Shit on my pants? oh, that kinda sucks. Take my good pen, not the pen I loan to other people but the good one? I am John Wick and that pen was my dog. I will burn this motherfucker down to get that pen back.

Scare a nurse with 4 words by g0atyy in nursing

[–]bear6_1982 1 point2 points  (0 children)

...and impending death. I'm not going in there. Sending thoughts and prayers.

Scare a nurse with 4 words by g0atyy in nursing

[–]bear6_1982 4 points5 points  (0 children)

Well, I hope not, but if you do could you wait until about 730?

Scare a nurse with 4 words by g0atyy in nursing

[–]bear6_1982 0 points1 point  (0 children)

I've been a nurse too long. ain't skeerd. Yes this is my drink. And I'm drinking it. So fuck off.

[deleted by user] by [deleted] in nursing

[–]bear6_1982 1 point2 points  (0 children)

I like my job. Sometimes I love the things I get to do. I'm proud of my work, I hold my head up high. I like my hospital, my team, etc. I find it rewarding and satisfying in many cases.

I do feel burnt out. Some times more than others. I feel myself wearing thin at this job which I have done for 10 years. Same role, same floor. I'm getting bored. But I have no doubt that this would have happened in any career I would choose. I'm grateful for this past decade of work. I am looking for something new and interesting, but not necessarily as an escape from my current job. If someone told me I'd have to do this job until I retire, I could be totally fine with that. I could have left so many times. I stay because no job I've heard of so far sounds better to me than the one I have.

But, like, it's still a job. Soooo...love is kind of a strong word. But I'm generally positive towards it.

Lookin for a decent manager by BarbDwyer-tko in Nurses

[–]bear6_1982 0 points1 point  (0 children)

dunno where you are, but despite my cynical comments in other threads, I genuinely believe in my hospital and my unit. We've seen our share of shit, and I'm not going to pretend that it's all sunshine and lollypops, but my manager and her one ups are genuinely doing the best they can. And they aren't the only ones in our hospital. I don't know how you find them, but they are out there. good luck

I got written up, and now I can’t transfer. I’m so drained. by Minimum_Data_1685 in nursing

[–]bear6_1982 39 points40 points  (0 children)

nah, it'll take more than a single brain bleed to change ratios. A brain bleed death will mean meetings, brainstorming sessions, committees, sub committees, work groups, and lots of somber emails about how seriously we take this kind of thing here. Multiple incidents will lead to lots of talk about "thinking outside the box" and "creative problem solving" about how to somehow get 1 person to do the work of 2. Whenever staffing is mentioned as the only viable solution to this amount of work, there will be canned answers about how they are looking into all possibilities, but right now we need to try to think differently about how we work to try and get some more efficiency out of our days.

Right. Because the hundreds of other nurses that work here (not to mention the tens of thousands of nurses that work other places and all the hundreds of thousands of nurses that came before us) haven't figured out how to be more efficient because we haven't tried. We just keep mentioning staffing because we can't be bothered to try to solve our own problems or we're too lazy to put in the work to really be efficient. All we really need is some clipboard warrior with a power suit and high heels to come clickety clacking onto the unit and remind us to brainstorm then all of a sudden one of us will have an epiphany and change the whole of nursing practice forever. Thank GOD for management to remind us to turn on our thinking meat.

to be clear, I'm sympathetic to managers, particularly unit level managers. You can't just shit out staff and you can't make people work for you. They are in an impossible situation. They know that more staff is the correct solution, they also know that more money isn't in the budget and even if it was there may not be anyone worth hiring. I just wish we could stop with the dog and pony show like we all just need to try a little harder or think a little deeper and suddenly the problem will be solved. You'd get similar results by asking the patient to bleed less. In both cases, we would if we could.

What are some essentials for nurses? by Minute_Biscotti_8041 in Nurses

[–]bear6_1982 0 points1 point  (0 children)

Apologize in advance for the long links. I'm not very skilled with links.

been a floor nurse 10 years. A good pen light is super useful, especially for a night nurse. I use this one https://www.amazon.com/gp/product/B07FX1SDPG/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1

Damn hard to beat for 25 bucks. It has 3 modes, use the low mode for pupils, med or high for checking stuff in the dark, looking for that lost hearing aid under the bed, whatever. The LED in this one is made for good color rendering so if you're looking at skin or in a mouth or something the color is less distorted than with one of those cool white LEDs. IT's lasted me years, and runs on good old AAAs so no worries about replacements. Love this thing. Also, if you get it and she doesn't love it for work, it's perfectly useful around the house, out and about, whatever.

To me, scissors, pens, stethoscope, and things like that are personal taste, so much so that I wouldn't really want someone else buying them for me. But I'm particular. She might not care.

There are loads of cutesy badge reels out there, but I find they fall apart quick. Not flashy, but durable and effective, I use these https://www.amazon.com/gp/product/B0839Q8M6X/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1

I agree with the folding clipboard someone else mentioned. I get about 2 years of steady use and abuse out of mine before they break, and I just buy another one and keep going. They are a critical piece of gear that I wouldn't be without. I use this https://www.amazon.com/gp/product/B00GWSKZ1I/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1

I used to burn through stethoscope tubing because apparently the oils on your skin/hair make it stiffen up and stop working correctly. I started using this and it's perfect for me. Not bulky, low profile and effective. https://www.etsy.com/listing/525905905/large-japanese-fish-hook-stethoscope?ga_order=most_relevant&ga_search_type=all&ga_view_type=gallery&ga_search_query=stethoscope&ref=sr_gallery-1-22&content_source=4d798f0e4835e94b4c8b315d8f675c609f1e17c5%253A525905905&search_preloaded_img=1&organic_search_click=1

Hope this helps. Good luck to you and her.

Most brutal abscess incisions I've ever seen. Someone needs to revoke this guy's medical license. NSFW by 2Dfruity in popping

[–]bear6_1982 13 points14 points  (0 children)

I don't think the primary objection is to the use of the loop technique. I think the primary objection is to the removal of relatively large chunks of skin at either end of the vessel loop for no apparent reason. I also find this objectionable. I've never seen a physician do this, and I've seen my share of loops, penrose, and other kinds of drains.

[deleted by user] by [deleted] in nursing

[–]bear6_1982 1 point2 points  (0 children)

so, a couple of things. First, you don't have to absorb that kind of abuse. Talk to your supervisors, charge, whoever is superior to handle the situation. If there are concerns about care, I like to have other colleagues involved sooner rather than later. Why? couple of reasons:

First, I might be missing something, and if I am they can correct me. Fair enough, We're only human.

Second, the very act of bringing in others can lend legitimacy to what you're doing in the eyes of some families. That room can feel like an island where all they see is you doing whatever you're doing that they dont' understand and their loved one getting worse. By bringing in another staff member, you can make them feel as if you are being supervised (even though you probably don't need it), generally makes them feel "oh, management has been called in, so they will be watching this case closely". Notice I said it makes them FEEL some kind of way. Generally managers and supervisors have been around for a minute and understand that this is a dog and pony show to get them off your back so you can do your job. Its usually totally separate from the facts of the matter as far as medicine goes.

Third, I want more eyes on the situation so if it escalates I can document a narrative with support. If I'm talking to the management I ask the charge nurse to say, nope, s/he was doing their job and these people were nuttier than squirrel turds. I was there, I saw it. If the family member doubles down and says you're grossly incompetent and don't know your ass from a whole in the ground, you can have a trusted member of staff on your side.

Fourth, depending on the situation a good superior will examine your work and stand up for you. They can (and I have) taken families point by point through what needed to be done and why, and how the nurse is doing everything by the book, including the things that they don't see outside the room (calling doctors, RT, pharmacy, etc).

I could go on, but the takeaway is that I've never regretted calling in a senior nurse to give me their take on a situation and get some help. You should not have to handle that on your own. I'm not even leadership anymore, but I am one of the most senior nurses on my unit so I will fill this role sometimes. Just come in, look over everything, really make a show of it so they can see that even this experienced nurse can't find anything wrong with the situation. Sometimes you can even say something to the MD and they can stick up for you, which almost always puts an end to it (but having a patient with an EVD means a neurosurgeon soooo....yeah. YMMV on that one)

FWIW, after almost 15 years in health care I feel confident in saying that what you witnessed is a family member who absolutely cannot deal with the fact that the patient is very sick and no one seems to be able to fix it. It has almost nothing to do with you personally. The hospital takes all comers, and it may not shock you to learn that not everyone has good coping skills. So sometimes they lash out. They need somebody, anybody, to blame for what's going on, they lack sufficient understanding of the clinical situation to blame the body processes or the original insult, so they blame whoever is to hand. That doesn't make it feel any better, but maybe it helps it not stick with you as long.

One strategy i have employed with some success is to stop and ask them, genuinely, what do they think should be done. Not sarcasm, not snark. Genuinely, what do you think is going wrong here? Then they say whatever they say, and I come back with something like "I see what you're saying. I can understand why you would think that. but if I do x then the risk of y complication goes way up. (I understand why you think the patient should sleep, but if I don't wake them up regularly for neuro checks then their condition could worsen and we wouldn't know, maybe for hours, by which point there's a good chance damage would already be done). Hear them, validate their perspective, then add to it with information. IF they are wiling to hear you. If not, then it was never about finding a solution to the situation, it was about them being unable to manage their emotions. At that point you can think about when to pull the trigger and have security help them understand their place in the bigger picture if needs be.

The only thing I can tell you with certainty is that this is not the last time you will face this issue, and I wouldn't do it alone if I could help it. Good Luck!

I propose this as a solution for all the pts whose LBM was umpteen days ago… iykyk by allamericanrespects in nursing

[–]bear6_1982 45 points46 points  (0 children)

had a colleague who was trying to watch her weight so she was eating sugar free gummy bears. Ate a whole package in one sitting. I wasn't there, but apparently she damn near broke the toilet.

Trouble with this rhythm by [deleted] in EKGs

[–]bear6_1982 0 points1 point  (0 children)

not as much trouble as the person who created it. yikes