In the news

It's not Wednesday, but it's pretty close, so here are a few things I've encountered so far this week in my meanderings around the internet.

Should you be sincere?
Maybe not according to this CNN article.

Goals
Sometimes you just need a big, hairy, audacious goal to get you going where you want to be (from LinkedIn).

Tips from Harvard
As an escaped business student, I've read the Harvard Business Review for years. Despite the cases, they have some exceptional tips on management and growth. 

It's short and sweet, but Make a plan for professional growth will get you started.

Pearls of wisdom
This article was very appropriate for a couple of folks at the Hotel who just happen to be agitated on the evening shift.

Enjoy!

So, so wrong

Driving through the tree-lined lane on my way home, as I'm admiring the fall colors, I see one of the Hotel patients. (I know Mr. X pretty well because I admitted him on his previous trip.)

At this point, he's nearly a mile from the Hotel, with his wheelchair loaded up with shopping bags. To add to the fun and excitement, there is no sidewalk and no shoulder. If a car comes, he's in trouble.

I call the unit and they must be busy, so no one answers the phone. I get the pleasure of bouncing to the on-call doc. The boss is the doc of the day.

So glad I don't work those evenings anymore...

In the dark

It's been interesting lately. It always is when you work the evening and night shift. Most of your life actually happens in the dark.

First, you confide in your coworker who's sitting just outside in the darkened hallway of what you see around you. She's been a nurse forever (since dirt, she likes to say) so she tells you about life in other places, and it ain't like the soap opera of the Hotel, either! Yes, sistah!

Next, you eventually turn down the lights in the rooms so people drift off to sleep. Sometimes, they don't drift too quickly. They fear the dark, sleep apnea, and the doctor showing up tomorrow. They vent in the dark--"Why didn't Dr. X tell me why I had to have so many blood draws?", "How come I have this IV?" or "No one told me I had xx bug."

One of my patients confided a lot of firsts to me recently. First person he knew to become injured. First person in his family to have cancer. First one in his family who controlled his type II diabetes effectively. First one in his family not to have a heart attack. Now his cancer has caused his recent mayhem. He's going back and forth on a pendulum he did not choose--surgery here, treatment there, back to us, and the cycle swings back again.

He does have a little consolation. His siblings bought him a computer. While the internet's not working yet for him, he does play games, which keeps him occupied. One of these days, he says, he'll beat that computer in chess.

And off I go in the dark, for the next round of confidences and consolations.

More to come...

I keep telling myself

I love evening shift, I love evening shift, I love evening shift.

Even if I don't. I know it's not nights, but I'm still tired!

A night out with the big men

No, I'm not going out with Dahey and Bubba, nor am I partaking in that festival of festivals called the NCAA tournament. (although a few of my patients will be glued to the TV). No, I'm working at the Hotel again. People come in, and people go out, and when I get in, we'll see who's left.

Lately, it's been placid, but that tends to change when 1) the moon does (the Storm Moon is coming Monday) and 2) the drama mamas come to work.

I'll just hang with the big men, thank you very much!

Stay tuned!

I get to rest...

On the evening shift. Yes, it's true. Days can be rough and today was no exception.

I got the characters I had on evenings last time. Joy. No one else wants one or both, so I get stuck in their room. When no one is anxious, all is good. When there's anxiety for them, there's lots of work for me.

Tomorrow will probably be different, though. One leaves early for his weekly appointment off-site. The other's got issues, and if that resident doesn't fix them tonight, he'll be going out with the last guy who was really perturbed that he was on bedrest all weekend. Alas, we'll see what happens.

More to come...

Friday the 13th...

And for me, it's evenings again. Last night, there was nothing unlucky about it. Yes, I did end up with the med wagon again, but I had three patients who were relatively easy to take care of, so all went off without a hitch. It also helped that the schedule was stacked with more RNs to the rest of staff, so it makes the load lighter. (Not that I don't like the LPNs and NAs, they just can't do everything...)

I had one patient I'll call DQ (that's for Drama Queen). Every time he goes into some rant, I just want to stand outside the room, applaud and yell, "Bravo!" for his Oscar/Emmy/Golden Globe performance. I told the MD about his gentle rant (no one on either side of the hall in the other rooms complained about this one...) yesterday at the beginning of the shift. Since he's not going with the bowel program (which is a big, big problem on our unit), she told me to give him this message, "If the bowels are plugged, I'll just have to drop the pain meds." We'll see what actually happens. Hopefully, he'll be reasonably good again on my shift.

We expect to have a discharge today, but we'll probably get one or two people to take his place. It really depends. Since the Hotel is pretty much to capacity with isolated patients, it's getting more interesting to find places to put people...especially the ones who aren't on isolation. My favorite charge worked with us last night (which she normally doesn't do) and her take is, "we always get extra people in on our weekend." The scary part is that she's usually right. We don't take people back on the weekends, but on Fridays, if any of our folks are at Washington and nearing discharge, they're pleading to come back to us before nightfall. Ahh, isn't it great to feel loved? Hmm....

I'm not too superstitious, but I'll be hoping I'm lucky enough to have another night like last night, which was not too crazy.

More to come...stay tuned!

One to go...

Ahh, I really like Mondays when I know that I'll be finished with my five-in-a-row schedule. Sure, I only get one day off and then I'm back until the end of the week, but one day off after five on is better than nothing!

I still feel like I'm hanging on to that random Christmas virus I got. A little nose running, a little hacking cough, a lot of perturbed nurse, who's been trying to rest and beat it. Well, we shall see how it goes!

The last few days I've had pretty much the same assignment--two patients and the med wagon again. Even with LPNs on most of this weekend, I haven't lost that. I don't mind really, since I have an easy area to deal with, and I know pretty much what they want after dealing with them all this time.

Bubba has his birthday this week, so I'll be busy getting ready for the party this weekend. We had a little craziness here with the weather, so that messed me up a bit, but now I'm getting all my stuff going. I'll be really busy tomorrow! I'm glad it's my day off!

More later...

Nuggets for January 15

Well, it's back to work today, and I still have a bunch of stuff to do before I go. Here are a few things I've found while traversing the internet and various blogs.

My Own Woman has a great post for new nurses. Read it and live it. (I'm not brand new, but I'm still new at nursing and it really made me think.)

Tex from Weird Nursing Tales always has a great sing-a-long on his site. The latest, describes what I get to deal with on evening shift.

As a student nurse, I really enjoyed my trips to OR land at PrivateU's hospital. I almost considered going that route after getting my degree. If you're interested in the jobs of the OR nurse, check out UnsinkableMB's post on life as an OR nurse.

Jeepgirl has one of the reasons why I'm happy there's no full moon this weekend. Some of our people will just be crazy, anyway. All I can hope for is that a few more of them make it out by Friday, so the census comes down a bit before the weekend!

Nuggets for December 6

Happy St. Nicholas Day to all! It's been a busy week at Hotel Madison, but it's been fun.

Evenings is always a blast of a shift to come back to if only for the havoc we sometimes have with staff. (One was a no-call no-show last night.) Patients are generally good, unless of course, they're busy sundowning. Last night was decent enough, so I am happy for little things. Our shift missed the annual holiday party that our manager has, so said manager sent pizza.

In addition to all of the early in the shift hubbub, we had a TV crew show up to talk to one of our patients. Nothing like having hospital PR staff, the nursing staff and TV people on your floor roaming around just before the craziness of dinner time.

Here are a few of the interesting topics I've encountered recently.

One of my patients I noticed was taking Demeclocycline. I thought it was an odd antibiotic to use until I read this article about SIADH.

Last night, our charge nurse and I were talking about one of our patients who has a tenodesis splint and one who needs one. Another option for this problem: one of our docs talked to a patient this week about getting tenodesis surgery to improve his pincer grip.

Finally, I saw a drug I haven't seen in a long time at our place...good old hydralyzine show up for one of our new patients on the floor. This patient was a character. He looked exactly like a famous criminal and when I checked him to give him the hydralyzine and told him what it was, he denied hypertension. (Surprise, surprise.) He's with us only for a short visit, so he'll easily be home by Christmas.

More later...

Happy Monday!

Reasons I'm happy:

1. It's my last evening shift this week...today! Hopefully, when I get back later in the week, I'll get some new people. I've had a doozy this week, but it's not his fault. When you're a trainwreck, you're gonna have issues.

Thank goodness for therapeutic communication (and some very understanding coworkers) or I'd have jumped out the lunch room window by now.

2. My turkey is thawing. I'll be cooking for my family Thursday, which means Wednesday night will be a late one prepping, chopping and baking some stuff.

3. I am feeling good. So many people I work with are getting colds, etc., and feeling crappy. I went back to sleep this morning and I feel much better. It's amazing how sleeping works!

4. I'll be hosting CoS (Change of Shift) also on Thanksgiving. Another reason to stay up late on Wednesday.

5. Finally, if you're feeling ambushed, check out Jo's latest post at Head Nurse. It made me laugh so hard. My, how people infer things from these blogs!

More later, stay tuned and stay well!

Working the weekend

It's been very busy outside of work this weekend, so I'll be back later for more posting fun.

Meanwhile, the evening shift continues along swimmingly....stay tuned!

How to know the moon is full

Listen up, all you nursing students, although you may have thought meteorology has nothing to do with nursing outside of being listed before it in the class schedule, the full moon can make a difference on your unit.

In my short time as a student and so far as a nurse, I've heard from psych to labor and delivery to LTC nurses that the change in the phases of the moon brings out the strange and unusual more than you'd think.

Well, since yesterday was the full moon, here's a few of the fun things that happened at Madison.

1. The crazy people get crazier. Yes, lil' ol' Mr. K. keeps forgetting he's a quad, even when he's reoriented, and in between, he even acts lucid. Last night's installment: he kept wanting to put on his pants and get up, so he kept ringing his call light. Not even the two Pepsis (he loves Pepsi so much they could use him in ads) I brought in as a bribe kept him quiet.

I'm starting to like the idea of aerosolized Haldol for not just patients, but some of my coworkers.

2. Your coworkers get edgy. When I asked about Mr. K. and his light buzzing, I remarked, "Wow, has he been quiet all night?" since Mr. K. did not buzz once while I was sitting at the nurses' station (which was not long). The Slug, true to her pain in the backside self replied, "You've been smoking crack."

Nevertheless, I blew her off, since I spent most of my night actually on the floor with patients, while she sat by the phone and played secretary in between her med passes. It's actually better for her to sit by the phone because whenever you work with her, because you'll get about 20-25 calls a night and 99% will be for her. It's just a whole lot easier not being at the desk so you don't have to be her secretary.

3. The normally quiet people decide they need something...now! Mr. H. decided to do this last night before the end of shift. I guess he got tired of me going into his room and always giving his roomies their PRN pain meds. I've delivered meds on his hall for a while and this was the first time I've ever given him a pain med.

One of his roommates is a basket case. He's taking every psych drug, pain pill, and sleeping pill we'll give him. That's what happens when you can't deal with the life you've created on the outside. The roomie is having problems with his wife and infidelity again. The story gets better and better--he was with the other woman when he was injured and she is having his baby. Other Woman decided to let the wife know once he was injured. Said wife was really perturbed when he visited Labor Day weekend.

With real-life stories like this, who needs to watch a soap?

4. Although it's not related to the full moon here in our neck of the woods, the weather's been crazy. Ike's remnants flew through the midwestern US and left us with a whole bunch of water. Lots of low-lying areas around here that don't normally flood filled up really fast. We had fun taking not one but two detours to get to a family reunion yesterday. After the second one, I told Dahey to just go back home and take the route closest to our house, since that doesn't normally flood and it worked out well. I just wish we could have stayed longer at the reunion. It stunk having to leave and go to work.

One more evening, then back to days. Stay tuned for all the excitement.