sothisisnursing - Tumblr blog

[sothisisnursing]

Or an accurate depiction of nursing school...!

[sothisisnursing]

When you pick up for 4 hours and get an assignment of 2 discharges and an admission...

[sothisisnursing]

When the head hospitalist starts yelling congratulations in the hall and gives you the biggest high five ‘cos you got into your first choice DNP program

[sothisisnursing]

We tape report. Everyone has their own process but mine goes something like:

name/room/hospitalist covering/age/gender/code status/precautions/allergies

when and why they came in and a little about their home situation (esp. if nursing home etc)

what we did for them in the ED/ICU; any major labs/measurements of note when they came in

imaging/testing they had and any significant findings

what their major treatment points are now (eg. COPD exacerbation - IV steroids, nebulizers, inhalers… Pneumonia - IV Rocephin…)

consultants they are followed by

mobility and safety status (walker? bed alarm? desat when ambulating on RA?)

toileting status

diet and tolerance

ASSESSMENT - orientation, how they take pills; lung sounds, heart sounds, abdomen & last BM, edema/pedal pulses (plus any significant skin issues etc)

IV access

DVT prophylaxis (if any, or why contraindicated)

VS/abnormals

significant labs from that day and any repletions

overall plan for the patient (STR? home when ready?)

whether I am back in the morning

THANK YOU AND HAVE A GREAT NIGHT!

Usually around 3-5 minutes per patient. Taping is awkward but it means you don’t have to track people down/wait around to give verbal report.

Also if we know a patient from the day/night before we just tape updates. :)

Hope that helps!

So I’m kind of Curious how does everyone get report?

On my floor we get a verbal report and then pass an SBAR from shift to shift rewriting it as need.  I know when I’ve floated to our Ortho unit they have partial filled out SBARs in the patients chart with things like the diet and activity levels left blank as they can change so quickly.  So if you get report differently leave a comment.  I’d like to know what to expect whenever I decided to venture to a new hospital.

[sothisisnursing]

Dedicated to the MD who called us hospital nurses “glorified babysitters.”

[sothisisnursing]

When you think you hear call lights when you’re at home

[sothisisnursing]

Vfib, basically. 😂

[sothisisnursing]

You’ll like this.

[sothisisnursing]

Would I chose it again? In a heartbeat.

Am I happy? I have my moments but overall there is just about nothing I'd rather be doing.

hi there! i am considering careers, and i need to know, please. 

nurses, would you choose your profession again? are you happy?

[sothisisnursing]

"Just a nurse"

I am not just a nurse. I am YOUR nurse.

I will sit beside you and hold your hand when you vomit so hard that your TMJ gets dislocated and has to be reduced so you can close your mouth all the way, when you're screaming at your family to get out of the room because you don't want them to see you like this.

I will stand with a smile on my face (and only roll my eyes a little..!) when you take over half an hour to take your morning medication because each half pill needs multiple sips so you don't aspirate, and you're screaming at me that you "don't remember taking all this shit at home".

I will suck it up and page the hospitalist I dread working with because you've had a change in status and need further interventions NOW. I will stumble through my tentative SBAR to get you what you need.

I will spend an extra half an hour on the phone with your health care proxy after I discharge to make sure you will get the follow-up care you need and that someone will be home when you get there and that your discharge medications will be picked up.

I will think critically about your orders and NOT automatically give you medications that aren't indicated and advocate for orders that make sense (... Like MiraLax that's PRN and not standing order which takes up half your fluid restriction allowance for the day. One of the renal docs was like "see?! You're smart and use common sense").

I will be moved almost to tears when you tell me what a good job I did taking care of you, and that I'm a great nurse (and laugh with you when you add "and didn't take any BS..!").

This job is a privilege.

I will remind myself of that in those moments when it feels too heavy a burden to carry.

[sothisisnursing]

Pagealese

Intern (from Germany): *gets paged: 'pt soandso dtr here'* *looks up confused*. What does DTR mean?

Med student: Deep Tendon Reflexes

Resident: Daughter

Attending: Define The Relationship

[sothisisnursing]

5 by 5 rule. If it’s not gonna matter in 5 years, don’t spend more than 5 minutes upset by it.

Saw this & had to share (via wantyourgayromance)

OH I like this!!! Perspective!!

[sothisisnursing]

I was not the nurse I wanted to be today. I was not the coworker I wanted to be today. I got overwhelmed, and let the stress get the better of me. I felt the demands on me - on my time - too acutely.

It never comes from a malicious place. It comes from an “I want to do a good job and not leave a mess for the people who come after me” place. It comes from an “I don’t want to have to bug people and ask for help multiple times” place (though don’t worry, I ALWAYS will). It comes from an “I have high expectations of myself” place.

I could have articulated clearer. I could have kept myself together more. I could have asked someone else sooner. I am not perfect. I need to be okay with not being perfect. But I still want to learn, and grow, and do better than I did today.

[sothisisnursing]

When they ask you to be a unit rep on the hospital’s nursing practice council

[sothisisnursing]

Hard to tell from the image... *turns laptop on side* -- Wenkebach or 3rd degree..? I think Wenkebach... 

If R is far from P then you have a First Degree.

Longer, Longer, Longer DROP! Then you have a Wenkebach.

If some P's just don't get through, then you have a Mobitz II. 

If P's and Q's just don't agree, then you have a Third Degree.

Answers later.. ;) What block is this?

[sothisisnursing]

Wait, you guys can give Tylenol PO??! I think that's restricted to peri-op and L&D in my hospital. No wonder I've never seen it on the floor... 😁😂

Come to the ICU & I will give you a life-saving Tylenol!

Got a transfer to the ICU from Medical for “fever & possible sepsis”. Patient was tachycardic, hypertensive, & temp was 102.8 F. Checked when he had his last dose of Tylenol & it was 15 hours before he came to me. Gave him 650 mg of Tylenol & his fever broke an hour later. Patient was transferred out of ICU less than 10 hours later. Family thanked me for “saving his life” & doctors said “I did a good job”.

[sothisisnursing]

When your patient jumps up and starts sustaining in the 180s/190s and all you have for them is a PO Cardizem x1 😁 (and the hospitalist messed with their regimen that morning 😡)