Monday, April 30, 2012

Have Nurses Become Spoiled?


 I know what you are saying, why on earth would I write such a thing? Nurses work hard and are often under appreciated for everything they do! Hey I know this and agree, to a point.


  Just recently we received a memo at work letting us know that the company as a whole will temporarily be suspending the education reimbursement program and that no merit raises would be given this year due to financial issues. The nurses went ballistic, for the next week every night I worked all I heard was how lousy our company is, how they don't care about us and how everyone was going to start looking for new jobs. I was constantly told stories about "the good old days" when a hospital would pay out huge signing bonuses to nurses taking positions in high need areas, and alas now there is none of that to be seen. How the employer used to pay for 100% of our medical benefits and now we have to pay for a portion, how cheap of them!


  I kept my mouth shut and have up until now, but honestly I am pretty bothered by what I hear. So let me air this out and perhaps help some people see things from a very different point of view. 


  Honestly I feel pretty damn lucky right now. I have a full time job that pays pretty darned good for a entry level position. My husband has a Masters degree and just completed another Bachelors, he moved into a new field and makes less than I do as an entry level database manager. Let me put this in perspective, I don't even have a Bachelors and I make a decent bit more than he does with two degrees! 


  I have pretty good health insurance that covers me from head to toes, which is more than 48 million Americans can say. Yep last year approx 26% of Americans age 19 to 64 had NO health insurance. That's not including children and the elderly. So I have to pay $25.00 a paycheck to cover myself, it could be worse I could be have no coverage, or have to pay WAY more. I've been uninsured in the recent past and don't want to go there again, ever!


  I do remember the "good days". As a student I remember seeing the banners and ads in the newspapers that promised signing bonuses of $1000 for nurses willing to take a position in critical need areas. I remember the days when the it seemed that a new nurse was being courted by every hospital in town. I remember when hospitals even funded programs that would pay for nursing school and guaranteed the graduates a job upon graduation. But ladies and gentlemen the golden days are over. The economy has flatlined, every one in the US is willing to admit that, so why aren't nurses willing to admit that their expectations of what an employer has to offer you is just flat unrealistic?


  With the economy down politicians are cutting funding to Medicare and State funded programs by the billions of dollars. Unfortunately for hospitals a large majority of our patients depend on this funding and we depend on it to get paid. On top of that with widespread job loss many Americans no longer have private health insurance that will cover the cost of their medical expenses. Hospitals cannot simply close their doors to the under or uninsured, EMTALA ensures that by law people who need emergency medical attention are seen. Now I'm not saying that I'm not in favor of this law, I think all people needing medical attention should get it. But I am asking you to think, if they have no way of paying for the treatment received, who eats the cost? And with more and more people who have no health insurance, what do you think is going to happen? There are more and more people coming through the ED doors because they couldn't see a PCP and things spiraled out of control. I'm seeing it more and more, what about you?


  I'm not setting out to blame anyone, I just want to help nurses see that our employers are also in a tight spot. They can cut back the "extras" like tuition reimbursement, bonuses, raises and free health insurance or they can start cutting back on jobs. Personally I would prefer to keep my job, collect a paycheck and still have affordable health insurance available to me than be in constant fear of losing my job, with all the perks.


  With the economy still floundering, and less and less money being allocated to Medicare and State aid the hospitals are still being held to a providing a high standard of medical care with little promise of being reimbursed in full. Perhaps it's time was as nurses took a stand and made our voices heard to our government and make them aware of the situations they are creating. If not, lets at least pull together, we are the heart of every hospital, so why not stand together and tough out a hard time instead of pointing fingers.


  I don't know maybe I am a real newbie and the rough job market for new grads has made me soft and all Pollyanna eyed. But I am thankful that someone had some faith in me and gave me a job.  I always admired JFK for addressing a troubled country with his now famous quote "Ask not what your country can do for you - ask what you can do for your country" Perhaps we should all take it to heart, in everything we do. Are nurses spoiled? I'm not sure. We work pretty darned hard and yes I think some of the benefits are ways of saying thank you. But when we come to expect them, then perhaps we're acting a little like Veruca Salt there.

Friday, April 27, 2012

Days vs Nights


  The eternal question when looking at jobs in nursing, days or nights? That's the wonderful thing about the healthcare industry, we are 24/7. This can lead to amazing flexibility in when and how often you work. In very few jobs can you say you work full time and only work 3 days in a week.  Yes I know it can be frustrating because we do not always have the option to have major holidays off to be with our families, but in truth nursing offers some of the most flexible scheduling options. 

  Think about this. Some hospitals will hire nurses only for weekends due to a lack of staff interested in working these days. If you work the ER there are a number of different shifts up for grabs, your traditional 7-7, 12-12 even 10-10. If you think you would like a regular 9-5 five days a week kind of job then you may love working in a doctors office or outpatient surgery. The options are really endless. The first real question that you need to ask yourself is days or nights?

  The majority of society works during the daylight hours, so it is pretty normal to know how things are going to work out. For many people nights is a very alluring possibility, the shift differential, the lack of round physicians, and less need for child care. These are all good reasons to think about trying night shift, but many people wonder can they survive? 

  That is a very hard question to answer. Personally I was born for the night shift, literally. My parents tell stories about me as a baby being up all night and sleeping all day. To this day I am a night owl and would rather be up prowling around at 2am then waking up at 6am to face a new day. A friend of mine asked me the other day how you know if you are just NOT cut out for nights as she was thinking about switching because she could really use the extra money. So I sat down and thought about all the people I have seen try to switch to night and what made them fail or succeed. Here's what I cam up with.

  Do you have a circadian rhythm? Are you one of those people that starts yawning the minute the sun goes down and jumps out of bed at sunrise? If you are the night shift may not be for you. It's very hard to break that natural rhythm. One fellow who started working at the same time I did was that type and within 2 months was desperately looking for a spot on days. He just could not break his body of that rhythm. It was so bad that when the sun began coming up earlier, he could not sleep when he got home.  

  How do you sleep? Are you very particular, do you need silence, the room to be dark, for it to be cold? These are things that very few people take into account and begin to notice as they try to adjust. People forget that during the day there is so much more activity taking place that you may find the general everyday noise to hinder your sleeping. Me, I sleep a coma, dead to the world, no word of a lie but I slept through an earthquake once. The noise doesn't bother me, but if you are used to sleeping at night when most of the world is in bed you may find the amount of noise to be earth shattering.

 Can you sleep with the lights on? Personally I think there is nothing better than curling up in bed with a sunbeam on my face, me and the cat often fight over napping spots. But a lot of people find that little spot light obnoxious. Think it over carefully, blackout curtains only work so well. My suggestion is think about if you nap well during the day, and if you do nap where and for how long you do. Ask yourself do you sleep deeply or just drowse? Remember the quality of sleep you get will be a huge factor in how you feel deep into your 12 hours.

  What kind of a nurse are you? Are you very task oriented, do you prefer to have everyone leave you alone? I hear it over and over, the differences in nurse on days versus nights is well like day and night. This is very true, don't listen to the lies that one is easier than the other, because they are not, but they are hugely different. Knowing yourself is key to finding a good fit. Having worked both shifts I will say this...

  Day shift tends to be very task oriented. Take your patient to CT scan, then PT, then speak with the rounding physicians and participate with Case Management etc.  If you like a lot of structure to your shift, days is an excellent place for you. On days everyone is around, doctors are constantly in and out along with all the other departments, if you like to influence and take a very active role in your patients care, you will do great on days.

  Nights is a whole different kettle of fish. Doctors rarely round on nights, in fact you rarely see anyone in the evening, meaning it's just you and your compadres. If anything goes down, it's up to you to figure out how to deal with it. If you work nights you will need to be comfortable knowing that you call the shots. You need to be able to work independently and have a high level of critical thinking, it's up to you to decide when to call the Doc for orders, or ask the Hospitalist to come and actually look at the patient because they are heading south. You will need to be ok with getting yelled at when you wake up a Doc in the middle of the night and they do not agree with your assessment of the situation, and you will need be strong enough to stand up to the Doc who doesn't want to leave the sleeping room to come see your patient, but you know they need to.

  In the end sometimes all you need to do it try it. There have been many people who have though they had no business being on one shift or the other and found their niche. And in the end if you really can't take it you can always transfer when an opening arises!


Thursday, April 26, 2012

Fibers Nurses Week 2012 T-Shirt Design Contest

  Nurses Week is coming and Fibers is starting the celebration early. 
They are holding their 3rd Annual Humerus T-Shirt Design contest in celebration. 
Up for grabs are some really cool prizes, including an iPad3! 

  Naturally I decided to join in the fun and whipped up my own design.
I thought this was a pretty funny and appropriate since every NOC Nurse lives off coffee.
I would ABSOLUTELY love it if you voted for my design.
All you have to do is follow this link.
It will ask you to join Fibers, but don't worry you won't be charged 
and they don't spam your mailbox.

Even better,
why don't you head on over to Fibers and create your own design.
Who knows you might win a prize!


Monday, April 23, 2012

You Know You're A Nurse When....

  You know you are nurse when you are cleaning up a scratch on your own leg and begin looking around for a pair of gloves to put on when you are going to throw away the bloody gauze you used to clean the scratch and you have to remind yourself, 


"Hey that's my blood, it's OK to touch it"


 And you still pick it up like you're going to catch something from it.


Good habits die hard huh?

Saturday, April 21, 2012

Dreaming

  Has anyone else had this happen to them? The last couple of nights I'll dream that I am at work, the ED is overflowing and someone is trying to give me report on a dozen patients that are coming in while I am lying in a bed dozing somewhere. Then they get really mad and yell, at which point I wake up. It always takes me a couple of minutes to realize that I am at home, in my own bed and it's my night off! I actually have to take a second to mentally tell myself it was all a dream and try to relax and go back to sleep.


  What the heck? My husband thinks this is weird and so do I. I've always been a great sleeper and never had problems working the night shift then flipping back to a normal schedule on my days off. I don't like to use medications but this is getting silly. Any suggestions nurse sisters and brothers?

Friday, April 20, 2012

BzzAgent Review of Garnier Miracle Skin Perfector BB Cream: Follow Up


  As promised I am following up on my experience with Garnier's Miracle Skin Perfector B.B. Cream that was sent to me from BzzAgent to review. I have been wearing the B.B. Cream exclusively now for about about a month, I use it in place of a moisturizer when I get up and instead of the mineral powder that I had previously used as a foundation.

  Here are the photo's that I uploaded at the beginning of the campaign, before I began using the BB Cream. My biggest complaint at the time was that I felt a little uneven in tone and there are some slight discolorations on my cheeks. 

    After using the B.B Cream for a little over a month I have begun to notice that my skin looks better even without wearing it. Take a look for yourself, I took this picture today with no make up on (the things I will do to prove a point!)
  I think that overall the tone of my skin is more even, with less of the discolorations across the cheeks. I also noticed that my skin looks smoother and when I get close up to the mirror the pores look smaller to me.

  The biggest difference that I notice now is that I have had way less breakouts. I used to forever have blackheads across my forehead and chin and big red zits on my cheeks.  I was worried that the BB Cream would add to those problems but instead it seems to have evened out my skin. Now I get the occasion blackheads on my chin and forehead if I don't wash well but very few on my cheeks. 

  From a nurse's stand point this is a fabulous product. It takes the place of my moisturizer and foundation, which means it is one less thing to worry about when getting ready for work. The B.B. Cream has stood up to numerous 12 hour shifts without smudging or rubbing off despite crazy hectic nights of running around and sweating, I noticed in the morning I still look the way I did when I started my shift.

  I did a little research on the prices of the designer end BB Creams and found that in most cases the Garnier BB Cream is less than half the price and is available anywhere Garnier products are sold, saving me not only a large chunk of change in the price but the gas money that is required to head over to the specialty store that sells the others.

  After a month of use Garnier's BB Cream gets my stamp of approval and will be a staple in my beauty routine, allowing me to get rid of a ton of stuff in my cupboard. I highly suggest that you try it out!

Legal stuff: I was provided with this product compliments of BzzAgent for testing and review purposes. The opinions contained in this blog about said product are solely 100% mine 














Thursday, April 19, 2012

Look Ma! I'm an ED Nurse

  Census has been low in the ICU again so I spent my last three shifts in the ED.  Not that I am complaining, I have always been fascinated with the ED. It has always seemed like controlled chaos to me. Tons of people running around, doctors always available and lots and lots of patients coming and going.


  Well after three nights working there I have come to a number of conclusions. First, there is no illusion the ED really is carefully run chaos. Nurses have a lot more independence there and ability to make judgement calls, and they work much more closely with the doctors. Second it is a fabulous place to brush up on skills that you may not have had a chance to practice while in clinicals. I think I put in about three times the number of IV's in three nights than I did in all of my two years of school. Never got a chance to do much in pediatrics? You'll get a chance to straight cath a baby PLUS give an injection all in one fell swoop. I did!


  My suggestion to any students reading this, is that if you have an opportunity to hang out in an ED during clinicals do it. Do it even if you have no intention of being an ED nurse, it gives you a great chance to brush up on skills you maybe lacking and you will get plenty of chances to practice you assessment skills.  To all you new nurses out there, if you can talk someone at work into allowing it, go float for a shift in the ED. It gives you a whole new appreciation for what goes on down there when you have been part of it. Not to mention you will always have a few patients who came through the ED and ultimately end up with you. It is smart to know what your patient has gone through before they came to your unit. 


  The last conclusion that I came to is that the ED is not for everybody. It really does take a particular type of personality to work there, and I think I may have it. At the end of my three nights I had a number of the nurses there asking me if I was going to transfer to the ED and leave the unit behind. When I told them I was just helping out they asked me to come back and play with them soon. I'll take that as a huge compliment.

Saturday, April 14, 2012

7th Heaven Bar Recipe

  I'm a total disaster when it comes to baking. I can handle coding a patient and I keep my head in the craziest of situations at work but ask me to make a muffin and beware! Because of this I am always on the look out for easy recipes that impress. No one at the potluck needs to be the wiser about my ability to turn chocolate chip cookies into chocolate studded pucks that could kill someone.

  I found this recipe ages ago, they go by a number of names "Better Than Sex Bars" or "7 Layer Cookie Bars". I call them 7th Heaven Bars, mainly because the recipe is literally layering seven ingredients then baking it.  This is a fool proof recipe and takes less than 30 minutes total to prepare.  If I need to make them to take to work I literally throw it together, shove it in the oven, and then get ready for bed. By that time I can pull them out of the oven and let them cool on the stove while I sleep.  Then when I take them in to work, everyone thinks I'm Betty Crocker!

 So here you go, whip up a batch and see how easy it is!

7th Heaven Bars
  • 1/2 cup butter
  • 1 1/2 cups of graham cracker crumbs
  • 1 can sweetened condensed milk
  • 1 cup chocolate chips
  • 1 cup butterscotch chips
  • 1 cup nuts (I used a mixture of pecans and walnuts)
  • 1 1/2 cup shredded coconut

- Preheat oven to 350 degrees
- Melt butter in the microwave then pour it into a 9"x13" pan. Tilt the pan and ensure an even coating. 
- Sprinkle graham cracker crumbs evenly over the butter and pat down lightly, like you are making a cheesecake crust.
- Pour the can of condensed milk over the graham cracker crumbs to cover evenly.
- Sprinkle chocolate chips on top
- Sprinkle butterscotch chips on top
- Sprinkle nuts on top
- Sprinkle shredded coconut over top and gently press down.
- Bake for 25 minutes. Remove from oven and let cool then cut into squares.
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  Make sure you let these squares cool completely, they are molten hot when they come out of the oven. Do not try to sample them until they are totally cool unless you feel like an ED visit!

Update 4/21/2012
  Took these bars with me while being floated to the ED. Food is always a good way to make friends there. The bars were a huge hit with the other nurses who have now nicknamed these bars "Crack Bars" because of the hugely addictive quality.

  


Friday, April 13, 2012

Lost in Translation

  
  I floated over to the ED yesterday to get a quick orientation to the area since they are low on staff the ICU nurses will be lending a hand. They sent me over to fast track which is mostly handing out Tylenol, assessing sick babies and looking at weird rashes. 


  Since I was just getting my bearing they gave me the easiest of all things to do, discharge instructions. Basically take the printed papers, prescriptions and discharge papers to the patient run through them and walk them to the window. Easy right?


  One of the patients I was sent to discharge only spoke Spanish which is a bit of a problem since I speak about 5 words. But what the heck I'm always willing to give it my best shot. Armed with Spanish instructions I headed in and gave the fellow his papers. He glanced over the instructions and nodded in understanding. 


Great. 


  Now for the prescriptions, I hand him those and tell him to take them to his " farmacia ". I must have the worst accent in the world because the fellow looked panicked and says " Por que Policia?"


  Poor fellow thought I was sending him and his scripts to the police. Yikes. I quickly cleared up that misunderstanding by explaining it was a script for his "medicina" He got it eventually, but it looked like he left in an awful hurry, not that I blame him.


Everyone had a good laugh at me that night.

Thursday, April 12, 2012

5 Minute Salsa Recipe

  We night nurses love to potluck. What can we say, when the cafeteria isn't open and your options for dinner is Dennys or organizing a small feast of home made goodies I can tell you what wins every time!  But that does mean that you have to actually cook, if you are just coming on after a couple days off you have plenty of time. If you are not you may be scrambling for something that you can whip up in five minutes so you don't look like the looser who ran to Costco on the way to work.


  I found this amazing salsa recipe on Pintrest,  I cannot claim any kudos here it is not mine, but I will accept love and adoration for sharing it. The recipe comes from Mountain Mama Cooks, so if you love the recipe please take a moment to pop over and let her know.  This salsa is more of the blended type you get at real Mexican restaurants, and the best part is you can literally whip this up in about 5 minutes in a blender. The only change I made to the original recipe is that I left out the teaspoon of honey and add a touch more cumin.


  This has been field tested and my co-workers demolished the entire batch I made, this recipe makes about 3 cups of salsa.


5 Minute Salsa

Ingredients:

  • 1- 14 oz can diced tomatoes
  • 1- 10 oz can orginal Rotel
  • 1/2 small onion, roughly chopped
  • 1 clove garlic, peeled and squished
  • 1/2-1 jalapeno, seeded or not (depends on how spicy you like it)
  • 1/2 teaspoon salt
  • 1/4 teaspoon ground cumin
  • small to medium size handful of cilantro, washed
  • juice of 1 lime

Directions:

Put all the ingredients in the blender and whiz for 30 seconds or so until all the ingredients are finely chopped and salsa is desired consistency. Taste for seasoning and adjust to taste. Serve with chips or over tacos.
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 This really is a dummy proof recipe, you can play with the spicing to your taste. I tried a can of Rotel with Cilantro and Lime and it gave it a more piquante flavor. Also if you are a little more health conscious use tomatoes that have no salt added, I did this with the batch I took to work and no one was the wiser.





Monday, April 9, 2012

Runners VS "Nursing" Shoes


  If there is one thing that I have noticed nurses are highly opinionated about it's what they wear in their feet.  Talk to any nurse and eventually the conversation will inevitably turn to what shoes they are wearing and how fabulous they are, guaranteed. Don't believe me? Go ask a nurse to recommend you a brand of shoes in front of the nursing station and then step back and watch the debate rage.

  Personally I have always worn runners, not because I particularly like them, I don't think anyone with any fashion sense can say they really like  runners, but because it was always easy to find cheap, white runners that could pass dress code in school. I had briefly looked at a pair of white leather clogs but the price was a huge deterrent for a starving student. I have continued wearing my white runners only because I really haven't had the time to indulge in a proper shoe shopping trip to a store that carried a variety of "nursing shoes".  

  Saturday ended that excuse. I made a trip to my local scrub store for the first time since being hired. I have been living off two sets of scrubs and finally got tired of waking up to bad dreams that my scrubs were not dry in the evening. I picked up another set of the same navy blue scrubs that have become my staple, a couple pairs of socks and then I spied it, the clearance table! I saw a sweet pair of mary jane styled Dansko clogs in brown, on sale, in my size. I hummed and hawed until Mr. took a look at the price $30.00, he silently picked them up and added them to my pile. When I began to protest he simply said, "You make a living off being on your feet, may as well be good to them." Have I ever mentioned that when shopping with Mr I tend to leave with WAY more stuff then intended? 

  So now I own both a pair of runners and a pair of "nursing shoes" having worn both, let me be true to nursing nature and tell you all about what I wear on my feet.

Verona Supreme 2 by Reebok
  Let's start with the caveat that all runners are not...well runners. Call them what you will sneakers, running shoes, athletic shoes, whatever we all have a pair in our wardrobe and most of wish there was some way to incorporate they comfort they afford into a much more stylish appearance.  Back to my point. Not all runners are made the same, if you go for a walk down your local shoe department you will note that there are a number of different categories, cross trainers, walking shoes and running shoes. So whats the difference?

  • Running shoes are made for, well running. This means the shoes are designed to cushion the shock of feet pounding as you run. What this means for you is that a running shoe will have more cushioning in the heels then other styles of athletic shoes, you may also notice that many brands of running shoes have extra cushioning in the soles as well. Some people find the built up heel to impede the roll through of the natural walking motion.


  • Cross Trainers are kind of your multi-purpose athletic shoe. The ankles come up higher to provide more support around the ankle, which can tend to roll. You can run for short distances in these, but don't make a habit out of it as your heels may start to notice it as there may be some cushioning there but not the amount needed to take the force produced from running. These are your jack of all trade kind of shoe that you often see at the gym. 


  • Walking shoes have the most flexible soles of the three types. This is to promote the natural roll through motion of your foot. This also means that they have the thinnest soles and the least cushioning, also making them the lightest and often the most breathable.


  If you haven't found a pair of runners that work for you don't despair! Try on a number of different styles and types of runners you may find that while Cross Trainers don't work walking shoes do. I have found that true running shoes work the best for me as I have a tenancy to walk very heel to toe and need the cushioning.  

Sally by Dansko
  Nursing shoes have in the past had a bad rap as being ugly, thick, unwieldy looking clod hoppers of shoes, but lately companies have been trying to move away from that stereotype.  There are a huge number of manufacturers now making "nursing shoes" Dansko, Crocs, Allegria, and Nurse Mates just to name a few.

  What most of these shoes have in common is a solid construction in the sole of the shoe and a firm built up arch support. My Dansko's are no exception to this rule, the arch support is quite firm and the foot bed has very little give to it, very unlike my runners.  Nursing shoes have thick soles for support, they are there to provide as barrier between your feet and the hard, hard floors, creating a thick layer to absorb the pressure of standing on your feet all day and redistribute it. 

  Nursing shoes are also designed with the thought that you are NOT going to running a marathon in them, but instead putting lots of time in standing or walking and give your arches the support needed to put up with that for 12 hours a day.

  While there is more and more though going into the look of nursing shoes you will notice that all of them save for Crocs are solid design. This is mainly due to the thought that nurses deal with a number of hazards in a shift including bodily fluids and falling sharp objects. The thick, solid leather is designed to save your feet from all such hazards, where many runners have mesh insets to allow feet to breath.
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  In the end there is no one who can really help you make a decision as to what is "best" to wear to work. That depends on you and your feet, but here are a few tips that can help.
  • Try on a number of different styles including the ones that you don't think will work. Experimentation can often lead to the best shoes you ever met
  • Keep in mind that the weight of the shoe can affect your feet, knees and hips. 
  • Think about where you work, if you are running, literally, all night then perhaps backless shoes are not the best idea.
  • You know you best. If a pair of shoes just feels bad, don't convince yourself they will feel better after 12 hours on your feet.
  • Don't be afraid to take your time, let the sales person huff and look pointedly at the clock all they want. Make it all about you for once!
  The best piece of advice I got was from a former instructor, she told me that she never wears the same pair of shoes two nights in a row. She often swaps between runners, nursing shoes and Cros depending on how she felt and what her night looked like. She even kept a second pair of shoes in her bag at work in case things changed.

  I guess Mr is right, we make a living on our feet, it's best we take care of them. Call it protecting an investment!




Friday, April 6, 2012

To Restrain or Not To Restrain


 Last night I kinda got into it with a co-worker, one of the RT's.  She decided to pick a bone with me about one of my patients from last week. The fellow was intubated and lightly sedated but able to follow commands and was pretty alert. According to my orders I was not to sedate him any further nor could he take it hemodynamically, when they increased sedation he would brady down into the 40's.


  Anyhow the bone the RT had to pick with me was the fact that my patient spent the entire night unrestrained and in the morning extubated himself about an hour before shift change. Her point was that EVERY intubated patient should be put in restraints and thus my patient should have been in two point soft restraints.


  My issue with her point of view was this, the fellow never made a single move for that tube all night. In fact he acknowledged that he understood the purpose of it and even kept his hands at his sides or crossed across his tummy. I always understood that to initiate an order for restraints your patient had to be actively pulling at stuff or demonstrating in some way that he is going to yank at something. I don't have a problem restraining patients, when it is warranted, and I didn't think that being intubated and vented is an indication for restraints otherwise every order set for my intubated patients would include a restraints order.


  Well anyhow the talk I had with her didn't really get much past how she was right because the guy did extubate himself and that I was stupid to think that he didn't need to be restrained. I personally feel that I did the right thing ethically and legally to not restrain him as he gave me no evidence to believe it was necessary, it's not to say that I didn't go home that morning and cry my eyes out feeling like a total failure. I had a few days to deal with it and then I get this...a whole fistful of salt in the wound. Great.

Thursday, April 5, 2012

Cardiac Review Packet


  Here is another review packet I found in my Nursing Folder on the Cardiac System. Basically they were passed on from "generation" to generation of Block Four (last semester) students. They contain study material that is broken down by system and contain a ton of information about the diseases, medications and interventions that you need to know. Each generation of students have added on to it, making it a great resource. 


  Since I no longer am in need of these I am happy to pass them along to any of you nursing students. Please follow the tradition and pass them along and edit or add any relevant information.  As always this packet comes with the caveat that I make no guarantees that information contained in the packet is up to date or correct, so please do not take it for gospel and do not come back screaming at me if you find any inaccuracies.


Practical Nurse

Whats wrong with this picture?

  I know what you're thinking, what the heck is a roll of Coban doing in the garden? It doesn't belong there. Well how many times has this happened to you, you get home and begin unloading your scrub pockets only to find you have a brought home something from work, a roll of tape, a couple alcohol swabs, or a roll of coban. We all do it, and nine time out of ten those sundry items end up hanging around in a drawer or even worse being tossed out.  We don't mean to do it, but it happens.

  I hate wasting anything, so I have a collection of odd things that happen to ride home with me. Don't get me wrong I will keep things like rolls of tape and alcohol in my nursing bag and take them back with me, but this roll of coban was almost done and there wasn't even enough to wrap an arm with. So instead of throwing it out I decided to give it a new purpose.
Did you know Coban is awesome in the garden?

  Yep, I use it to stake my peas instead of string or those expensive twist ties. I like the coban because it is wider and you have less chance of it accidentally snapping the tender shoots you are trying to train.  It's also WAY easier to use, stretch, wrap and leave it. I happen to cut it in half because I didn't need all that much width, as you can see it does an awesome job.
Anyone have any great tips on what to do with odd nursing 
items that they would like to share?


  

Monday, April 2, 2012

R&R

  I feel kind of guilty admitting this but I REALLY enjoyed being called off on Thursday. Even though I slept all day it meant that I could actually enjoy my Friday off like a normal, awake-during-the-day kind of person instead of sleeping till noon and then stumbling around until 10pm like a zombie for my first day off.


 It was the Mr.'s birthday weekend so we had dinner with the family on Friday night. Saturday his request was "to do something fun", so I decided that we would drive an hour out of town and see the Renaissance Festival as it was in it's last weekend and Mr had never been.  Of course I happened to pick what has been the hottest day of the year so far, it reached 92 degrees!


  A great time was had by both, we watched the shows, ate giant turkey drumsticks and drank mead. The shopping was way too much fun and I some how ended up with a pair of earrings. Funny how that happens, but when with the Mr at a festival jewelry tends to end up in my purse. 


  We even tried our hand at old fashioned games,
 I guess back then they didn't have water guns so a bow and arrow it is!
Those targets look kinda nervous!
Mr. has apparently done this before.
I however had not,
 but was game to try with a good deal of coaching
from my part time Robin Hood.
While I have no pictures to prove it, I did manage to stick a couple of the targets very nicely.

After that it was on to another harmless game,
Knife throwing!
Yes this is a very family friendly fair!
I just joked that it keeps me employed to have games like this.
While I'm sure these were dulled versions of the real thing they were heavy enough
to actually stick in the wood boards when thrown correctly.
I decided to join in the fun and took a stab at it.
(pun intended)

 Once again I have no photo's to prove it, so you will have to take my word for it, I managed to throw four out of the five knives into the wall grouped about 4 inches from the center of the target (I really wanted the prize). This apparently scared a couple of the on lookers enough that one fellow told the Mr to watch himself if his wife could throw a knife that well who knew what else I could do!  I like to keep people a little off balance, and now that I think of it I have no idea what the prize was for a bulls-eye, I just wanted it.