Drama at work

Watching drama unfold as your patient’s wife comes to visit your patient when his concerned girlfriend is already at bedside. All your thinking is ” crap, do I have to call security soon?”

It turns out I didn’t have to call security, because the ladies were aware of each other. The girlfriend just went over her allotted time. Yeah, are you shocked over the girlfriend part or the allotted time part?

This is why when I see multiple people in a patient’s room, I never assume it’s a girlfriend, wife or friend. I just ask ” are we family?” And let them tell me what the relationship is.  Sometimes its easier if the answer is provided for you.

images via Giphy

Nurse brain please turn off

Once a nurse, always a nurse.

So once your a nurse, you develop a “nurse brain.” A nurse brain consist of critical thinking, time management and attention to detail. Because of this, a nurse brain never takes a break even when the nurse is off duty or on vacation.

I know what your thinking “what is she talking about??”

Let me give you examples:

1. Instagram– A picture of a pretty girl sitting on the street, curb, side of a building or a brick on the parking lot. Her $3,000 purse perfectly positioned for the camera to see the label.

A regular person will think – wow she’s pretty, #goals, I want that outfit, I want that purse.

A nurse would think – WTF, is she doing. The street, curb, side of the building is filthy and full of germs. I hope she brought some disinfecting wipes to wipe the bottom of that $3,000 purse down.

I would also be thinking “holy shit $3,000 purse!!”  To be honest, I would love to have that $3,000 purse so if someone would like to give me a $3,000 purse. I will gladly accept it! I have a couple of Louis Vuitton purse, but I had to save up for that. I had buyers remorse for a couple of days because that amount of money could be sitting in my savings account accruing interest. But I figured I work hard, it’s my birthday so I’m going to treat myself to a Louis Vuitton purse. But you can bet that my Louis Vuitton would not be laying on the nasty concrete. Hell no! And it has a Bath and Body sanitizer gel hanging on it. You know the rule, foam in /foam out/ foam everything.

Remember Microbiology class when you went all over the school to swab door knobs, bathroom area and water fountain to see what kind of bacteria will grow into a petri dish. That was an eye opener.

How do you know when your nursing life has rubbed off on your children?

When they are using a public restroom, they use a paper towel to turn off the water and a paper towel to open the door. Oh, so proud. #mymomsanurse. lol.

2.  A good looking shirtless man
– a regular person would be drooling over that eye candy, looking at his bulge through those jeans.

A nurse would think ” that’s a good looking man, I can definitely hit that…..vein!” “Look at that vein bulging, I wouldn’t even need a tourniquet for that!”

Yes, thats how dirty a nurse mind works. We can’t help but look at the vein on a random man, when everyone else is looking at that body. Okay, nurse looks at hot bodies too. We also look at random people’s vein at the grocery check out line.

3. Diagnosing strangers– When a stranger walks around with red, inflamed lower extremities.

A regular person would think your rash is terrible, you should see your physician.

A nurse is thinking “crap, you have some bad cellulitis going on buddy.” Every nurse is guilty of practicing out of our scope of practice and tries to diagnose random people we see. We can’t help it, because our nurse brain doesn’t shut off.  I’ll be on a cruise and see someone with beet red legs and I’m trying to diagnose him. I see a lady with a productive cough and I’m trying to debate what kind of diagnosis I should give her. I see erratic behavior and I’ll try to debate if it’s alcohol consumption or diagnose her with a mental disorder.

It doesn’t stop, I can relate almost everything I see to my nursing field.  If I hear butterfly, I think butterfly needle before I think of a butterfly creature.

I think I just need to vacation more. Yep, thats my reasoning and I’ll share that with my husband.

Here’s my shitty nursing care plan:

Nursing Diagnosis Assessment Nurse planning Intervention Rationale Evaluation
Decreased fun output related to increased mommy workload. Patient exhibit:

Restlessness

-Excessive cleaning

-Fun scale 6/10

-Sleep disturbance

-Irritability

-Constipation

The patient will express increase in fun scale. -Massage

-Facial

-Mani/pedi

-alcohol consumption

-laxative

-cruise vacation

-Prevent fatigue/irritability

-To improve fun scale

-Decrease sleep disturbance

Patient will be free from stress, demonstrated by decrease irritability and produce a bowel movement.

I hated care plans in nursing school. Now we have electronic care plans that I click on at work. I can’t escape them.

Nurses if you know how to turn off your nurse brain, please share.

 

Nurse, I have chest pain

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When my patient reports he has chest pain.  Yeah, we got this shit!

I can’t say it enough that I love my unit. We work well as a team and we are a great work family. Competition is good when it drives you to make positive changes. Competition is bad when nurses undermine one another.

We continue to challenge each other and encourage one another. That’s why nursing is a great career.

Over the weekend, my patient reported he had chest pain. It never fails someone will have chest pain when you are crazy ass busy. I am thankful my coworker offered to do my EKG while I finished up with another patient.

Ahh, no EKG changes.

Patient already has oxygen on.

One tablet of nitroglycerin sublingual given.

Pain resolved after one tablet.

Patient is awaiting for his heart cath this week.

 Boom! moving on to the next patient.

Are nurses hypocrites?

Are nurses hypocrites? Yes, we are! Not only do we educate our patients about medications, but we also educate them on healthy living, diet, staying active/exercising and smoking cessation. How many nurses educate their patients about the importance of smoking cessation, but continues to smoke themselves? We all know smoking causes vasoconstriction, increase coronary vascular resistance, decrease coronary blood flow, risk for cancer and so much more.

We should know better because we see the effects smoking has on the human body. Don’t you dare be the nurse that is religiously exercising, eating healthy, counting steps, but then continues to smoke. Come on! Your doing good one way, but hurting your body by smoking. Quit smoking!

No, I’m not on a high horse because I’m just as bad.  I don’t smoke, but I don’t exercise as much as I should and I should eat healthier too. I work 3  shifts a week (maybe 4 if overtime is available), so that leaves me with 4 days off. I’ve been working out once a week because I’ve been busy, exhausted and just want to sleep.

For me, I need to get off my ass and drag myself to work out more. I want to work out at least 3x a week. I just need to block time on my days off to go to the gym and work out. I know I would feel so much better and I’ll have those natural endorphins. So thats my goal-working out 3x a week.

There you have it. My name is Kat, I’m a hypocrite and I need to work out more frequently and eat healthier.

When I told my friend I needed more workout pants. She goes “why? your sweaty ass is still going to stick to whatever pants your wearing.” Okay, well the plan is to find some workout pants that will wick the moisture so my sweaty ass won’t stick to the fabric.

bottoms:


tops:

Stay active my friends.

We’re medical professionals, please use your words

Respiratory therapist (RT): I have to go the EEERRRR, can you take the patient off their treatment?

Me: [WTF look on my face] where are you going?

RT: EEERRR

Me: [WTF look remains] okay [ I replied because wherever she was going, I’ll still take my patient off their respiratory treatment.]

I sat there in silence trying to figure out what the hell RT was saying, then a light bulb went off or maybe it was a patient’s call light.  She was referring to the emergency department, otherwise known as ER. Or if you watch Grey’s Anatomy, the pit. But now were not even using acronyms because that’s too difficult to say. We’ve resorted to using sounds now?

Okay, I’m guilty of saying MRSA instead of M.R.S.A, but “EEERRR” is just stupid. Your not a pirate.

We’re medical professionals lets use appropriate medical terms and acronyms, if you came up with cool new words with your colleagues, don’t assume everybody knows what your talking about. If it’s a haha inside joke, then keep it inside, because I don’t know what your talking about.

However, if you enjoy seeing the “WTF are you talking about” look on everyone face,then continue using sounds no one understands.

images via Giphy

Great products for nurses

I found this little gadget on Amazon and I had an “aha” moment, like why didn’t I think of this.  It’s a tape holder that you place on your stethoscope. There have been numerous of times when my tape will slide off my stethoscope when I open the ear piece to auscultate lung sounds. Luckily, it has never flew out and hit my patient.

The tape holder is made by  StatGear. You simply attach the device to your stethoscope and place the hospital tape over it. The device holds it in place so no more sliding. Yeah!


These are so cute.  EKG design compression socks for a cardiac tele nurse. Perfect!

Do you wear compression socks? I do. With our mandatory scrub color at my hospital,  I tend to have fun with my compression sock choices but you also have to look at pressure gradients and materials they are made out of.

Reason why you should wear compression socks:

1.Alleviate stress and discomfort on your feet for starters and after work ask your significant other for a foot massage to further alleviate stress and discomfort

2.Increase circulation and blood flow that will aid in muscle recovery time because good chances your working tomorrow too.

3.Reduce edema because who wants kankles? No one. With all the standing nurses do, that extra squeezing helps.

4.Help prevent/minimize varicose veins. Nurses stand for long periods of time  and blood will pool at your lower extremities and enlarge those veins. It’s better to prevent it now and keep your legs sexy because we all know your hands are dried and crusty from all the foam and hand washing.

5. Reduce incidence of blood clots. I know everyone thinks “sedentary” when they hear blood clots, but that’s not true. Other causes can be smoking, repetitive motion, birth control, blood disorders.

 I usually buy 20-30 mmHg compression socks, it provides enough compression with all the physical activity that nurses do. For starters, if your new to compression socks don’t jump to 30-40 mmHg(extra firm compression) because it will be uncomfortable.

I know there are quite of few people that wear compression socks during travels too. My airplane rides are usually 1-2 hour long, but I think I should look into buying or wearing compression socks for travel too.

Nurses which gradient pressure do you wear when you travel?

As for the material, I always make sure mine are antimicrobial. I think that is ingrained into any nurses brain. Antimicrobial, antibacterial, foam in/foam out and wash your hands. I think we’re the only profession that washes their hands before using the restroom and of course after.

I remember in nursing school we were instructed to put our compression socks on before getting out of bed because your legs have less edema. I always put them on when getting ready in the morning. Something I can improve on. However, I don’t think my husband will approve of me wiggling in bed at 4:30 in the morning trying to put my compression socks on. haha.

Editors note:  Post was written while catching up on Housewives of Beverly Hills and maybe a small glass of wine. This is definitely not research material or in APA format. 

Pyxis is the “water cooler” spot for nurses

 

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It’s Monday, everyone congregates at the water cooler and talk about the fun weekend they had or the new sushi place they tried out. For nurses, we congregate at the pyxis. We do our bedside report, look up labs, read notes then start our vital signs.

We’re not going to have any abnormal labs or elevated blood pressures until I’ve consumed my coffee, okay.

Ah, now it’s time to pull meds at the pyxis and catch up with each other. Did you do anything fun on your day off? How was your vacation?
The upside- we’re actually standing at one place so we can have short conversations. Downside- increase chances of med errors. Sure, we still have to do our 5Rs.

  • right patient
  • right medication
  • right route
  • right dose
  • right time

But when we’re distracted we can grab a medication from the wrong med pocket. It’s a hassle coming back out of a patients’ room to grab the medicine from the correct pocket when you should of done it in the first place.

Some units are even going so far as to applying a yellow tape around the pyxis as “quiet zone” kind of reminds you of riding the school bus as a child. “Stay behind the line!”

pyxis etiquette:

    1. If  your coworker is trying to count the pills. Don’t distract her. Wait until she’s done. Please don’t shout out numbers to throw off her count. I will not confirm or deny I’ve done that before. lol.
    2. If someone needs to pull a prn, be nice let them cut. Because the next time you need to cut the line, your coworker will let you. Or it might be because she can hear your patient yelling “I need my dilaudid for my paper cut!!”
    3. If you tell me your gonna pull a quick med for a patient, do it quick. Don’t pull that one pill, then pull 5 more without telling me first especially if I let you cut the line.
    4. Make your patient list in the pyxis in the morning and only pull meds for a certain time frame. I do not want to be standing behind a nurse that pulls her 0700-1800 meds when it’s 0700. Please just do 0700-1100.
    5. If a physician calls to speak to the nurse that is currently pulling her medications, offer to finish pulling meds for her so she can speak to the physician. Of course when she’s in her patients room she will still do her 5 rights regardless if you helped or she pulled them herself.
    6. Do not drop a Norco between the pyxis. I do not have time to move the pyxis out of the corner with you to retrieve a pill.

Nurses, wouldn’t it be easier if we can just have a plain water cooler so we can gossip and chit chat like they do in the movies? The closest thing to a water cooler is the ice machine and it is loud.

 

image via webstaurantstore.com

Just for laughs, how many times have you witnessed patients or visitor use the ice machine and they start yelling ” how do I make it stop?!!” And you politely say “move the cup away from the sensor.” ALL THE TIME.

I was skeptical about these Swell bottle keeping your drinks cold. But it actually works. I like how it doesn’t have the condensation. I used to have to put napkins underneath my water bottle when I’m at work.
 

Have a good Monday!

 

Nurse, please take a look

Patient with a foley catheter presses the call light: Can you send the nurse in. I need her to look at my penis.

[I ask a PCT to accompany me]

Patient: Something is wrong, my penis is bigger than usual. It’s swollen.

Me [I kindly take a look]  are you telling me your penis is swollen?

After some investigation, foley catheter was removed. Patient urinated without any difficulties and patient states his penis feels fine.

PCT and I

Rest assure no penis was harmed in this story.

images via GIPHY

 

Seven interview tips that will help you land the job

I hate interviewing for a job. I get nervous and start talking really fast. Luckily for me, my managers liked my personality and I got the job. Woohoo! It doesn’t matter if your a baby nurse or experienced, it’s always nice to be prepared for your interview and the questions.

As a charge nurse, I often will give the prospect candidate a tour of our unit and introduce her to  coworkers. It’s a good idea to ask the charge nurse questions too. It’s less stressful and it eases your nerves so you’ll be prepared for the interview. I’ve also gotten the opportunity to sit through interviews with my manger and ask questions. Managers will often ask us, how do we feel about the prospect candidate and we will give our opinions.

Few tips:

  1. Be yourself, unless you can be a unicorn. Then be the unicorn. lol. I read that somewhere, probably on my daughter’s tshirts. All kidding aside, relax. Talk and laugh, let them see your personality. You will here”tell me a little about yourself?” Here’s the chance to brag a little bit about yourself
  2. Be prepared have a folder of a copy of your resume and certification handy. Most hospitals now utilize a nursing recruiter that will handle all the paperwork and you do not have to bring anything.
  3. Do your research on the company/hospital you wish to join. What is it about the hospital that stands out? Look for the hospital’s promise or mission statement online. Do you see yourself living the workplace promise?
  4. What are your strengths and weakness? I feel this is the one most people stumble on. It’s easier to answer the strength question oppose to the weakness, but it’s important to have both answers prepared. Strengths-are you a hard worker,  believe in team work,  a quick learner?  Your weakness cannot be your strength. If you don’t voice a weakness, you will appear over confident. Everybody has a weakness because there is always room for improvements. For example, I would say ” my weakness are cardiac drips, I feel confident in starting diltiazem or amiodarone drips that I see more frequently, but dopamine drips make me nervous because of the calculations, I want to continue to improve in that area.”
  5. Goals. Where do you see yourself in 2/5/10 years? You always have to move forward in your career. Make sure your goals are realistic and attainable.
  6. Be proactive. participate in committees and volunteer.
  7. Ask questions verify nurse/patient ratio, scheduling, mandatory holidays. Make sure the prospect unit is where you see yourself. Ask about the culture on the unit. It’s amazing to see a culture of friend/family bonding and strong teamwork while you can step onto another unit and see a “swim or sink” mentality.

I hope these tips were helpful and you land the dream job.

How a nurse will describe a workday

@0620 coffee is mandatory

@0630 When you see your favorite nurses.

@0700 Someone doesn’t show up for work and you have to take an extra patient.

@9am you started the IV on your patient that insist he’s a hard stick because he’s vein always roll.

@1100 Confused patient that insist he’s at Walmart decides to sneak out of his room while his family member naps.

@12pm helping your patient shower

@1pm lunch break

@3pm Your patient that has been threatening to go AMA (against medical advice) finally leaves.

@5pm trying to chart like crazy

@7pm time to clock out and go home to my family. Peace out!

 

images via giphy