Friday, February 28, 2014
Five, most powerful words, ever uttered...
They can answer any question posed!
I actually struggle using them.
Most answers, always have a "yet."
Then there are the false questions... those that are asked, in order to not ask...
So, to answer your questions:
Yes.
No.
I don't know.
Yet...
Wednesday, February 26, 2014
Tuesday, February 25, 2014
Monday, February 17, 2014
Fired.
I got fired by a patient once, as their nurse. A friend recently did as well. Talk about staffing nightmares!
My situation was totally my own. Seems one's comments should be kept to oneself.
Yet, if you puke on the floor, spraying vomit every where, my first action will always be to go get a bath blanket, to start cleaning up. One already demonstrated that a pink tub would have been useless. And I understand fully the concern for dehydration... yet every time one takes a sip of Gatorade, and there is vomit... perhaps one should stop the rehydration attempts.
Although, I do appreciate when it occurs in a lobby. Not only do I get a few bath blankets, I grab some of those self-supporting yellow signs as well!
My friend's issue was cultural. Seems she was insensitive to her patient's family.
Who knew that a pregnant woman was taboo and could not care for someone critically ill...
My situation was totally my own. Seems one's comments should be kept to oneself.
Yet, if you puke on the floor, spraying vomit every where, my first action will always be to go get a bath blanket, to start cleaning up. One already demonstrated that a pink tub would have been useless. And I understand fully the concern for dehydration... yet every time one takes a sip of Gatorade, and there is vomit... perhaps one should stop the rehydration attempts.
Although, I do appreciate when it occurs in a lobby. Not only do I get a few bath blankets, I grab some of those self-supporting yellow signs as well!
My friend's issue was cultural. Seems she was insensitive to her patient's family.
Who knew that a pregnant woman was taboo and could not care for someone critically ill...
Sunday, February 16, 2014
I survived!
The cold snap was short lived! Got into the upper 80's the past few days!
And to think, I was prepared to brush the slush away with a side-swipe of my boot...
And to think, I was prepared to brush the slush away with a side-swipe of my boot...
Friday, February 14, 2014
Cold Snap!
It was below 60 degrees, when I braved the elements to take this picture...
I will need to shovel this morning to get out of the motel parking lot!
I will need to shovel this morning to get out of the motel parking lot!
Wednesday, February 12, 2014
Perspective
As an ED Nurse, I deal with everything.
It is not a glamorous job. There are highs, and there are lows. And the in-between...
Solace!
It is what it is.
I can not change one's perspective. The best I can do, is to explain, demonstrate, educate, and show. It is up to the individual to choose.
It is not a glamorous job. There are highs, and there are lows. And the in-between...
Solace!
It is what it is.
I can not change one's perspective. The best I can do, is to explain, demonstrate, educate, and show. It is up to the individual to choose.
Saturday, February 8, 2014
My niche...
I have found it interesting, throughout my career in medicine, that I always seem to fill a niche. Now it does vary from time to time, and sometimes from person to person, even during a single shift... Yet, I seem to be "the go to person" for a few select things, more often than not.
Although, there are several of my peers, that I consider my "go to person" for few things as well...
Last night, a new Nurse (recent-grad) was being precepted by an experienced Nurse. The new Nurse, came up to me and asked if I was "Ray?" Then stated that another nurse, the preceptor, was asking for me to help with something. It ended up being a difficult IV start. Three Nurses, six attempts already. I am one of a few Nurses that can and will use Ultrasound to start IV's... this is what they were thinking, as they said as much when I entered the room.
One of the ice-breakers I use with patient's, especially after they have had a few attempts and tell me that they are not going to watch is, "You can close your eyes... I'm going to!" Which, by the time it registers, and they react, I am done. IV started and blood being drawn. I also like when a patient tells me to warn them, so I say, "OK, on the count of three. One (needle already in), two (flash of blood), three (needle out, IV started)." It is when I say three, that about 90% tense, preparing... only to realize, that I am already done... and actually, quite a few begin to laugh.
I also seem to be called upon for "difficult" patients. Asking for a male to be present is not being stereotypical, nor is it out of the norm. There are some situations, cultural considerations, etc., that a male standing in the doorway observing, will de-escalate certain situations. Likewise, when a patient does start to get out of line, and there are four guys suddenly present... it's like a splash of ice-cold water! Most 'bravado' will quickly shrink!
I guess it connects to my no-BS approach. It's not illegal to be crazy. It is also not, always, illegal to be intoxicated. As a RN, I will protect myself and co-workers first, then the patient. Respect for each other, abide by the rules, cooperate in the process. It makes a big difference in how a visit unfolds! I am more than willing to report a felony assault on a healthcare worker, and send someone to jail, just as fast I am I requesting that restraints (hand-cuffs/leg-irons) be removed. I am also willing to physically and chemically restrain a patient if they are a clear danger to themselves or others! A "B52" will give just about everyone a blissful eight hours of sleep. The occasional "Big 10-4" is indicated.
And, if you claim to be a biker, and become difficult, threatening, or God forbid violent... all of my peers (both Nurses and Doctors) know, if you are not under the influence of something, and I am working and available; one of two things will occur if I become involved. Both will result in an immediate attitude adjustment.
And my secret weapon, for both kids and adults...
Popsicles!
I can get any kid to take ibuprofen or tylenol, with the promise and delivery of a popsicle! Even adults, who do not want to try a PO fluid challenge (fluids by mouth), will take a popsicle! Although, I held a Cherry Popsicle in my hand, and as it was melting, encouraged a 10 year old to take some liquid ibuprofen the other night. The pained look on their face... yet, it still took them over 5 minutes to drink 20ml, a mere four teaspoons! They got their popsicle... at least 95% of it!
The best, and by far my most favorite:
Is when someone asks for a second look at something; an independent review of the facts, results, physician orders, etc. Myself included! This is true collaboration. Whether it be trouble-shooting an Arterial-line, a ventilator, reviewing lab results, or just assessing a patient to confirm a concern.
And when mid-level providers (PA's and NP's) as well as some of the Doctors ask for my opinion/input... No-BS.
I do not go to the Doctor for every little thing. Most I work with know, that when they see me standing there, time to take pause and listen to my concern/question. I was actually talking to a friend last night in the hallway, the doctor walked out of a patient's room, and stopped in front of me (because I was standing there), to ask me if I needed anything. This same individual has learned, through experience, that I can think critically, respond to immediate situations, and only seek their input for 'critical' and 'narcotic' decisions.
I should go back to school.
Although, there are several of my peers, that I consider my "go to person" for few things as well...
Last night, a new Nurse (recent-grad) was being precepted by an experienced Nurse. The new Nurse, came up to me and asked if I was "Ray?" Then stated that another nurse, the preceptor, was asking for me to help with something. It ended up being a difficult IV start. Three Nurses, six attempts already. I am one of a few Nurses that can and will use Ultrasound to start IV's... this is what they were thinking, as they said as much when I entered the room.
One of the ice-breakers I use with patient's, especially after they have had a few attempts and tell me that they are not going to watch is, "You can close your eyes... I'm going to!" Which, by the time it registers, and they react, I am done. IV started and blood being drawn. I also like when a patient tells me to warn them, so I say, "OK, on the count of three. One (needle already in), two (flash of blood), three (needle out, IV started)." It is when I say three, that about 90% tense, preparing... only to realize, that I am already done... and actually, quite a few begin to laugh.
I also seem to be called upon for "difficult" patients. Asking for a male to be present is not being stereotypical, nor is it out of the norm. There are some situations, cultural considerations, etc., that a male standing in the doorway observing, will de-escalate certain situations. Likewise, when a patient does start to get out of line, and there are four guys suddenly present... it's like a splash of ice-cold water! Most 'bravado' will quickly shrink!
I guess it connects to my no-BS approach. It's not illegal to be crazy. It is also not, always, illegal to be intoxicated. As a RN, I will protect myself and co-workers first, then the patient. Respect for each other, abide by the rules, cooperate in the process. It makes a big difference in how a visit unfolds! I am more than willing to report a felony assault on a healthcare worker, and send someone to jail, just as fast I am I requesting that restraints (hand-cuffs/leg-irons) be removed. I am also willing to physically and chemically restrain a patient if they are a clear danger to themselves or others! A "B52" will give just about everyone a blissful eight hours of sleep. The occasional "Big 10-4" is indicated.
And, if you claim to be a biker, and become difficult, threatening, or God forbid violent... all of my peers (both Nurses and Doctors) know, if you are not under the influence of something, and I am working and available; one of two things will occur if I become involved. Both will result in an immediate attitude adjustment.
And my secret weapon, for both kids and adults...
Popsicles!
I can get any kid to take ibuprofen or tylenol, with the promise and delivery of a popsicle! Even adults, who do not want to try a PO fluid challenge (fluids by mouth), will take a popsicle! Although, I held a Cherry Popsicle in my hand, and as it was melting, encouraged a 10 year old to take some liquid ibuprofen the other night. The pained look on their face... yet, it still took them over 5 minutes to drink 20ml, a mere four teaspoons! They got their popsicle... at least 95% of it!
The best, and by far my most favorite:
Is when someone asks for a second look at something; an independent review of the facts, results, physician orders, etc. Myself included! This is true collaboration. Whether it be trouble-shooting an Arterial-line, a ventilator, reviewing lab results, or just assessing a patient to confirm a concern.
And when mid-level providers (PA's and NP's) as well as some of the Doctors ask for my opinion/input... No-BS.
I do not go to the Doctor for every little thing. Most I work with know, that when they see me standing there, time to take pause and listen to my concern/question. I was actually talking to a friend last night in the hallway, the doctor walked out of a patient's room, and stopped in front of me (because I was standing there), to ask me if I needed anything. This same individual has learned, through experience, that I can think critically, respond to immediate situations, and only seek their input for 'critical' and 'narcotic' decisions.
I should go back to school.
Thursday, February 6, 2014
Riding... as opposed to owning...
A few days ago, I interacted with an individual that was a big, burly, biker kind of guy.
He had all the bling. Everyone else thought as much.
As the bravado escalated, perhaps it was that I was the only "male" in the proximity... perhaps it was that a few knew I also rode... I was asked to intervene.
It quickly de-escalated.
Do not underestimate my peers! They will call upon resources to make things happen!
I ride. There is a code.
Do not ever confuse owning, with riding.
He had all the bling. Everyone else thought as much.
As the bravado escalated, perhaps it was that I was the only "male" in the proximity... perhaps it was that a few knew I also rode... I was asked to intervene.
It quickly de-escalated.
Do not underestimate my peers! They will call upon resources to make things happen!
I ride. There is a code.
Do not ever confuse owning, with riding.
Saturday, February 1, 2014
I have met my Nemesis!
The relationship has evolved over time. However; it recently become apparent to me that this conflict was approaching near "battle" proportions.
It was not a battle I wished to enjoin, so I have been attempting to diffuse the situation. Unfortunately, to no avail.
The other night, I was forced to draw my sword. My position was made clear. I stood my ground.
When you go toe-to-toe with someone, one better be sure of their position!
Being humbled is difficult, I can both sympathize and empathize. I have experienced it many times myself.
It was not a battle I wished to enjoin, so I have been attempting to diffuse the situation. Unfortunately, to no avail.
The other night, I was forced to draw my sword. My position was made clear. I stood my ground.
When you go toe-to-toe with someone, one better be sure of their position!
Being humbled is difficult, I can both sympathize and empathize. I have experienced it many times myself.
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