What not to do: Happy Graduation 2016 edition

Congratulations graduates! You worked hard and now you're prepping for that NCLEX. Some people say it's the hardest exam they've ever taken. You may get nauseated (I did) before it's done.

Please, grads, don't find your way into your state's Board of Nursing (BON) newsletter for getting a ding or losing your license. Trust me, keep it clean and shiny. You are worth it!

Here are some of the things I noticed in this edition:

1. Use respectful language.
Yes, believe it or not, one RN was censured due to this little problem. They just keep piling on the issues, too, as they did for this nurse, if you're really a pain (unauthorized record access, changing orders, etc.)

Just say no.

2. For all of you nursing instructors out there, don't dope slap your nursing students.  
One RN did and she was written up in this BON newsletter. One word: priceless. I think some of my nursing instructors may have thought it, but no one ever did it.

3. Don't steal a resident's purse, then get something from the med room and shoot up.
This nurse did. She obviously forgot the video cameras reported her every move.

4. Don't ask nursing students to do the wrong thing.
Telling your student to give a patient normal saline instead of Dilaudid is a perfect example. Someone will notice. The patient did and reported the nurse.

5. If you forget a specimen, get it to the lab. Do not take it home.
Yes, someone actually took a specimen from a procedure home, since the nurse forgot to send it along. A technician found it when cleaning the room. Admit your mistakes, but get it to the lab!

6. Drug testing is not optional.
Just remember: your facility policy is not optional. Compliant is a lot different than "slightly compliant".

7. Do not forget to document drug wastes.
Always, always, always waste drugs per your facility policy (we have special containers for various classes of drugs) and make sure you document appropriately. Your license really does depend on it.

Many happy returns and best wishes for a long nursing career!

A Wayne and Garth moment

"We're not worthy", I wanted to shout, complete with bows, but I took it all in stride.

My advisor from PublicU contacted me today about talking to her students in a conference about what I do in the SU.

Priceless.



I love you two, but I AM worthy. Three words: Bring it on!

 Stay tuned!

I survived!

My stint as an adjunct instructor at MegaCorp College is over. Hooray!

What did I learn?

1. Some people are just not motivated.

2. Some people don't really listen. I only told my students (orally and in writing) that all the written homework was due the day before the final.

I still had one goof say, "What? We can't turn in any homework tonight?"

Yes, Doofus, that's right. Working on your schedule at Taco Bell instead of finishing your uncompleted work was really not a good thing. Miraculously, he passed the course...with a whopping D.

3. Flunking students is not fun, but sometimes you have to do it. I had to flunk the one student in my course who would like to go on to the nursing program.

As Dahey says, if she can't hack it now, maybe she should be doing something else.

Unearthing myself

Yes, I've been buried. Being an instructor at MegaCorp College really is a lot of work (even if it's only one class.)

Besides my seven login accounts, I got surprised with advising duties recently. Yes, I know, most smart schools only allow the crack, full-time professors to advise students, but since MCC is a check the box kind of school, I got tasked with "advising" students.

What, you ask, did I have to do?

1. I decided to read my e-mail before class and I found out I had to complete this task by the end of the week. Since that was the last day of my week, it became a priority.

2. When I discussed it with a student who came early, and showed her the form, she had never seen it.

3. I showed each student their grade to date in the learning management system. The midterm was ugly. Had I not used the analysis to throw out questions, I would have had even more Fs.

4. With the analysis, I just had more work (adding points back). Depending on the student, I had the potential to add back 36 points out of 200.

5. Thankfully, most of the students came back after the midterm. Still have a couple of stragglers. Will see how that goes.

Thanks for listening. I'll be escaping (literally and figuratively) to a remote town known only to famous authors. I'll be hiding out doing nothing, except enjoying some time with Dahey and Bubba. It should be fun.

Until next time...stay tuned  for more educational adventures.

In the news: Byproducts edition

One of my friends posted recently, "I just got hit by C-diff and VRE all at once." Yes, the gross part of being a nurse sometimes stands out more than others.

Note to new nurses: always know where you can get an extra set of scrubs. If you have a good sized locker, this is something you may want to stash, along with an extra pair of underwear and socks. It's good for those gross days, as well as for those times when you have local emergencies, due to snowstorms (as we did recently.)

Blow up
Yes, if you have enough methane in the form of gas and belches, you can indeed cause an explosion, as these folks in Germany found out recently (thank you BBC).

Tales from the ER
I really enjoyed this post from Florencenightnday about gross stuff in nursing. Yes, the trick is really: don't breathe through your nose (sometimes you have to limit how much you breathe through your mouth, too.)


Take a picture
Someone did here. Yes, it's gross, but this is the holy grail of rehab nursing.

Not a nurse, but worried about caregiving?
The Visiting Nurses of New York have this article for you. Don't worry. They won't gross you out too much. 

Last, but not least
Probably one of the mother of all poop posts you can find on the internet from jo at Head Nurse. Read the comments, too, they are valuable.

Rehab nurses sure know it!

While I'm resting on my break (i.e. meaning I'm done with heavy lifting for a few minutes), I noticed an interesting e-mail.

I like to tell the nursing students who come to our unit at the Hotel that rehab nursing is really about bowel, bladder and skin (the physiological part).

Needless to say, I'm glad I was done drinking my Hefeweizen when I got this e-mail:

You have a new follower on Twitter

Kegel Universe

@kegeluniverse

We promote and support Kegel exercising! Our main purpose is to educate and remind individuals of the benefits of Kegel Exercising!
United States Of The World

Never a dull moment with us at the Hotel. Hope you enjoy!

Bwahaha!

Take that you lazy Slugs who tell people who do a good job that they're just lackeys. (Especially our newbies and students)

You won't get anything posted on a major specialty nursing organization's website with that horrific attitude. Lateral violence WILL come back to bite you, dearies.

Nyah!

More later...

Ah, those were the days...

I felt a lot of relief when I finished nursing school. To date, it has been one of the hardest things I've ever done, childbirth included.

So tonight, I raise a glass to all the graduates of PrivateU, my alma mater, who are getting ready for all the festivities coming up. If I were in charge of the nursing school commencement, here's what I'd tell you all, nurse to graduate nurse.

1. Enjoy waiting for your ATT (Authorization To Test). It'll get there when it's darned good and ready.

2. Take an NCLEX prep class with a guarantee if you can afford it. If not, plan on studying full-time for at least three weeks (Monday through Friday like an 8 hour job). Enjoy the weekends to digest everything.

3. Follow the instructions exactly when taking the test. Know where to go and get there a little early.

4. Breathe and count to 10 if you get the question from hell.

5. Do the same even if you get the TV commercial Viagra (Cialis, fill in your drug of choice) slam dunk easy question.

6. Do not throw up when you're done taking NCLEX. Relax and enjoy. You'll have to wait however long no matter what for results.

7. If you have a job, work hard and realize, yes, you really do need to keep studying those things you don't know on your own time. You need to do them at work.

8. If you don't have a job, make your search your full-time job, Monday through Friday, eight hours a day. Three words: network, network, network. Join a nursing organization if you have to (many have new nurse discounts) and volunteer if you can. Don't despair. Been there, done that, many moons ago (and waited over a year for a full-time degree-appropriate job).

9. Use every resource available to alumni of your institution for your job search. Register with them (if needed) even if you have a job. You never know when you'll look for another one.

10. Nursing is hard and there is a reason why (you'll soon find out) many new grads (somewhere around 50%) quit nursing after one year. Think of it like Survivor. Learn to outwit, outlast and outplay whatever madness comes your way. Always wear good shoes and use the rest room whenever you can.

And finally, make time to have a life. Have friends you can count on, in nursing, and outside nursing. Have family relationships of value. And most of all, take care of your physical and mental well-being, even if it means you get your toes pedicured once a month, get that monthly massage, or have that lunch with a friend monthly. Live so that you may have something to give to your patients and your coworkers at work and to the people you love when you get home.

This is just the beginning. Enjoy the trip. Congratulations!

Firing on all cylinders

Yes, it was a little strange, but it was a decent day. My patients got rolling and I got them out and going.

I had students to work with again today and it was a joy. I sent one on a field trip to the SU after I called my buddy Sue. She had loads of patients for procedures and she was happy to have the student. The doc was very complimentary. I think he just likes the nursing students better than some of the residents.

The end of the semester keeps the students hopping, and thankfully, we have lots to do at the Hotel. I got to instruct one on how to change a suprapubic catheter, then have him/her do it with my instruction and standby to help (this was a large patient and he/she really needed someone to hold the pannus).

Next, I helped to hang blood for another patient and brought another student along so he/she could learn how that's done. It was pretty satisfying.

Finally, I calmed one of the worried rascals who was dropping one too many f-bombs. I calmly asked him to stop, and he complied. The other nurses were pretty happy, too.

And now, it's back to homework as the semester winds down. I can't wait! More later...

Boys will be boys

And idiots sometimes. You could tell the moon was full recently, since we had so much juvenile antics lately.

Scenario #1
Patient X doesn't like Patient Y. Patient X decides to duke it out with Patient Y in front of the table in the dining room. Security is called. Patient X gets a ticket, and will be considered for discharge soon. Patient Y fell down, so this causes tons of paperwork mayhem for Ella, our harried night charge nurse, who is late giving report, since she's filling out incident reports, info for security, fall reassessments, patient assessments, and calls to the on-call MD. Word spread fast around the unit, since one of our characters says to Mr. Y. when he saw him today, "I heard you had an exciting time earlier."

Scenario #2
Patient Z, one of our resident COPDers was scheduled for discharge recently. Patient Z likes it at our place, so he turns off his oxygen to make us think he's "sick". Try as he might to sabotage his discharge, we figured out that Z could indeed reach the oxygen valve from his perch in bed, and yes, he did turn it off. He got crazy, so the chiropractor came down at the boss's request and gave him a mini-adjustment, the specialist gave him his specialty consult, and finally, three hours late, his transportation showed up.

Scenario #3
Patient A tells our student nurse, who's doing an assessment for her master's program, that, yes, he is indeed still smoking weed. Despite everything, we have to keep him for a while. Patient A has developed a new problem and we cannot simply discharge him for non-compliance. So far, no one's found his stash.


So needless to say, I was happy, happy, happy to be going home after a long day. Stay tuned for more excitement. You never know what will happen at the Hotel Rehab.

Just because

Just because I could...

I got one nurse's assignment changed, even though I wanted to him/her suffer, since the lazy a$% is off the next two days. Why? Because I like the patient, and he asked nicely. Slacker Nurse was really a pain over the last few days, and even though he/she had a lower acuity assignment, he/she was perturbed about not texting friends every 10 minutes or so per usual.

I helped one of our students (Student 1) find some research articles related to a patient. And yes, kids, this is considered business-related use of the internet at the Hotel. Student 1 said, "I always feel weird doing that. What if a call light rings?"

"Go answer it and come back to your research when you have time, " I said. Simple. Patients always come before any research. Period. Besides, most of those happy patients didn't ring the light much the last night when I worked with you.

I got Student 2 some networking info from a nurse I never met in another state. Connection? A national  nursing organization and Facebook. Since the job market is so crappy, I don't mind paying back the help I got myself when I was a Almost Done Nursing Student. (Thankfully, the market was great way back then!)

I got one of our patients his/her favorite snack. I brought it in myself.

I got everyone's care done in a timely matter one night recently. Why? I wasn't herding cats that night, i.e. dealing with primadonna doctors and nurses, as well as crabby patients.

Just because, I like to do the unexpected. It really messes some folks up. At least, it keeps them on their toes.

Stay tuned...