Old 02-10-2013, 10:59 PM   #4351
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We have a rule that people taking care of the new post-ops can't also take care of patients with certain infections, so that's good. We have no post-ops right now though. By the end of the month we'll have three with brand new spinal fusions. I always feel bad for those kids - our PT and a few of our nurses have a big issue with not wanting them "addicted" to pain meds, so will start weaning them to plain Tylenol at 3 days post-op. 3 days?!? I had a pretty minor wrist surgery and took Vicodin for a week!
It's a great infection control practice. I know there are times when it is just not possible. What if there are more patients on isolation? It's hard to manage and we do a pretty good job with compliance. Some cases are more vulnerable than others-- but it should be standard practice.

I can't stand it when health care workers decide to manage pain based on addiction fears. It's not right, it's not good practice, and it doesn't make any sense. Everyone knows that unmanaged pain leads to poor recovery. A person in pain will not move. Our PTs will even ask the nurse to medicate for pain prior to working with the patient. We even medicate our sedated and ventilated patients utilizing a pain assessment tool for that population based on: rigidity, guarding, moaning, facial expression, etc.

Grrrrrrr it makes me mad. If you think there is pain-- I am sure you say something.
 

Old 02-11-2013, 11:47 PM   #4352
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It's a great infection control practice. I know there are times when it is just not possible. What if there are more patients on isolation? It's hard to manage and we do a pretty good job with compliance. Some cases are more vulnerable than others-- but it should be standard practice.

I can't stand it when health care workers decide to manage pain based on addiction fears. It's not right, it's not good practice, and it doesn't make any sense. Everyone knows that unmanaged pain leads to poor recovery. A person in pain will not move. Our PTs will even ask the nurse to medicate for pain prior to working with the patient. We even medicate our sedated and ventilated patients utilizing a pain assessment tool for that population based on: rigidity, guarding, moaning, facial expression, etc.

Grrrrrrr it makes me mad. If you think there is pain-- I am sure you say something.
Oh hell yes. In fact a couple of rather loud disagreements with some of the nurses - in particular my mom. She's very anti-pain med, wouldn't even take anything stronger than Tylenol when she had shingles. There is a definite issue with bowel motility in our patient population, most are completely dependent upon elim aids on a good day. So of course narcotics make them more prone to obstructions - I get that. But balance, right? They're very liberal with their use of acetaminophen, but when it comes to the narcotics they panic.

I'd be good with your sedated patients - my patients are (almost) all nonverbal, so facial expression, guarding, etc. are all I ever get for pain indicators. We probably officially use the same scale, but we're really encouraged to go with our gut feelings.

I have to say though, when it comes to really severe chronic pain our staff do step up. We're taking one patient to multiple specialists right now - he's clearly in severe pain, just had hip surgery about two months ago and basically hasn't stopped screaming since. His surgeon says there's nothing wrong. We're on the fourth opinion now.

Also our docs are pretty good about throwing fentanyl patches at the long-term patients with chronic pain, despite the giant pain in the ass of keeping track of them. (Missing fentanyl patch+ward full of patients with PICA=chaos.) One of our attendings firmly believes that a patient who really needs pain meds can't become addicted. I have to say, I disagreed for a long time, but for a couple of months prior to my wrist surgery I was taking a staggering amount of Vicodin every day, and one week post-op I quit cold turkey, and never once had a craving or sign of withdrawal. Consider me a believer.

I spent my first real day of vacation reading a trashy novel on the couch with a pot of tea and my dogs. Heaven!
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Old 02-12-2013, 01:54 PM   #4353
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I am glad you are enjoying your days off! I have a five in a row off stretch coming up soon. I would really like to restore order to the house.

The hardest part is figuring out where to start. I need to create a detailed care plan with goals that are achievable. I am going to apply the nursing process to my life. I am going to nurse the house. I will graft the hole in the kitchen ceiling. I will untangle the wires of the life monitor. I will isolate room by room. I will pack away unnecessary supplies and linens. I will turn, water and feed myself. I will crack the Nightingale window and let some fresh air in. I will caulk up the holes like wound packing. I will arrange important documents into my own chart. I will get creative. I will utilize my resources. I will delegate some things so I donít tire out.
 

Old 02-12-2013, 03:49 PM   #4354
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I recently had the unfortunate chance to see how things are done at another facility. I am still befuddled as to why it was a better idea to move an elderly, disoriented patient out of his bed, to a gurney from the 60's (ok maybe 70's) to send them to radiology for CT and MRI. The patient was unwilling and unable to help move himself from his bed. It would have been safer and made much more sense to wheel him to the dept in his bed, but what do I know.

No one took the time to consider that the patient has to be very still during a CT and MRI and maybe Just Maaaybe he should have been sedated? No, this thought didn't occur to anyone until AFTER he was moved to the decrepit old gurney so he had to flail about there while the staff contacted the doc for the order. Add to this, this patient should have been in a private room with a HUC or CNA assigned to him due to his condition because he was too 'out of it' to be alone, and not be a disturbance to the other patient.

Honestly, it was not a good experience. My family member was the one sharing the room with this person and I had to go speak with the nursing supervisor to get my family member moved. I swear I had to make a conscious effort not to roll my eyes when she asked If I thought one or the other patient should be moved. You could hear the ruckus from the other pt loud and clear from 60 feet away and she somehow thought that was a good thing to have another pt around? I am still trying to decide if a letter to the admin is in order.
 

Old 02-12-2013, 04:45 PM   #4355
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I am still trying to decide if a letter to the admin is in order.
If you are looking for opinions, I'll throw mine in free of charge.

Write it. They can't fix a problem if they don't know about it.
 

Old 02-13-2013, 03:14 AM   #4356
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I am glad you are enjoying your days off! I have a five in a row off stretch coming up soon. I would really like to restore order to the house.

The hardest part is figuring out where to start. I need to create a detailed care plan with goals that are achievable. I am going to apply the nursing process to my life. I am going to nurse the house. I will graft the hole in the kitchen ceiling. I will untangle the wires of the life monitor. I will isolate room by room. I will pack away unnecessary supplies and linens. I will turn, water and feed myself. I will crack the Nightingale window and let some fresh air in. I will caulk up the holes like wound packing. I will arrange important documents into my own chart. I will get creative. I will utilize my resources. I will delegate some things so I donít tire out.
That's not a bad idea. I have housework to do, I just haven't started it yet. I find it funny, my own house looks like a tornado went through it, yet my patients' rooms are tidy and spotlessly clean. My therapist is trying to get me to focus on self-care. Not easy for me.

I got a really cute new haircut today, and had a great lunch with my mom. Fortunately they seated us away from other diners - our first topic of conversation was vomiting. While we ate lentil soup. You know you're in health care when...
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Old 02-13-2013, 07:26 AM   #4357
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That's not a bad idea. I have housework to do, I just haven't started it yet. I find it funny, my own house looks like a tornado went through it, yet my patients' rooms are tidy and spotlessly clean. My therapist is trying to get me to focus on self-care. Not easy for me.

I got a really cute new haircut today, and had a great lunch with my mom. Fortunately they seated us away from other diners - our first topic of conversation was vomiting. While we ate lentil soup. You know you're in health care when...
HAHAHA! Dinner conversations with health care workers! It's always hilarious when a bunch of us from work get together - especially if our SOs are with us. I feel sorry for them!

Hmmm. that raises a question. I wonder if there's ANY topic of dinner conversation that would gross out a nurse. I can't think of anything off the top of my head. Hell, I worked in the OR for 15 years and endoscopy for >10. I can be up to my elbows in somebody's belly and try to decide what I'm having for lunch. I even assisted on a food bolus impaction once; someone had sushi stuck in their esophagus. During the case, I muttered, damn, I'm starting to crave sushi now. The gastroenterologist, anesthetist, and circulator all turned a lovely shade of green. hehehe

And why is self-care so difficult for nurses? We teach that all day long. Caregiver, don't forget to take care of yourself too. But for us? We seem to struggle with that more than the general population.
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Old 02-13-2013, 08:58 PM   #4358
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HAHAHA! Dinner conversations with health care workers! It's always hilarious when a bunch of us from work get together - especially if our SOs are with us. I feel sorry for them!

Hmmm. that raises a question. I wonder if there's ANY topic of dinner conversation that would gross out a nurse. I can't think of anything off the top of my head. Hell, I worked in the OR for 15 years and endoscopy for >10. I can be up to my elbows in somebody's belly and try to decide what I'm having for lunch. I even assisted on a food bolus impaction once; someone had sushi stuck in their esophagus. During the case, I muttered, damn, I'm starting to crave sushi now. The gastroenterologist, anesthetist, and circulator all turned a lovely shade of green. hehehe

And why is self-care so difficult for nurses? We teach that all day long. Caregiver, don't forget to take care of yourself too. But for us? We seem to struggle with that more than the general population.
Mom and I are strictly forbidden from talking shop at family dinners. My dad and sister are pretty much used to it, but sis's hubby is VERY easy to gross out.

My favorite though: one of our social workers had decided to slum it with us for lunch one day in the unit break room. The cafeteria was serving chili, which most of us had, and the topic of discussion was the unique smell and appearance of the stool of a patient with an active c. diff infection. One of our attendings had brought up earlier that day that he thinks we spend far too much money testing for it - if a nurse or CNA says it's "the diff" (his nickname for it), 9 times out of 10 the test will be positive. A new CNA wasn't sure what he was talking about, so we were trying to describe it to her.

Another one that made me laugh: I was eating lunch in the break room, and a brand new nurse, fresh out of college, came in to ask me where we keep our bibs, a patient was drooling. She then apologized for bringing up drool while we were eating. Everyone in the break room just about died laughing. Drool? Really? (She's been around almost a year now, and has become bulletproof like the rest of us.)

I think I can talk about anything and not be ill, but I cannot look at pus (even on TV) and continue eating. I learned this one night watching "Tosh.0" on TV while eating dinner. Anything else I'm fine, just not pus.
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Old 02-13-2013, 09:12 PM   #4359
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Mom and I are strictly forbidden from talking shop at family dinners. My dad and sister are pretty much used to it, but sis's hubby is VERY easy to gross out.

My favorite though: one of our social workers had decided to slum it with us for lunch one day in the unit break room. The cafeteria was serving chili, which most of us had, and the topic of discussion was the unique smell and appearance of the stool of a patient with an active c. diff infection. One of our attendings had brought up earlier that day that he thinks we spend far too much money testing for it - if a nurse or CNA says it's "the diff" (his nickname for it), 9 times out of 10 the test will be positive. A new CNA wasn't sure what he was talking about, so we were trying to describe it to her.

Another one that made me laugh: I was eating lunch in the break room, and a brand new nurse, fresh out of college, came in to ask me where we keep our bibs, a patient was drooling. She then apologized for bringing up drool while we were eating. Everyone in the break room just about died laughing. Drool? Really? (She's been around almost a year now, and has become bulletproof like the rest of us.)

I think I can talk about anything and not be ill, but I cannot look at pus (even on TV) and continue eating. I learned this one night watching "Tosh.0" on TV while eating dinner. Anything else I'm fine, just not pus.
I joke that I can diagnose C. diff, GI bleed, and DKA - from the hallway, without even entering the room, just by smell alone. Furthermore, I can tell from the smell if that GI bleed is from a bleeding tic, Ca, or rrhoids. I used to bet the GI guys at work what we'd find when we did the colonoscopy, but they quit betting me because it cost them too much in lunches.

LOL @ drool. I worked with one endo tech who freaked out if we started talking about pea soup during colonoscopies.

Pus doesn't bother me at all. Only 2 things gross me out - a gangrenous colon or any kind of amp. When we did toe amps, the surgeons used to put the specimen on my Mayo stand. I threw such a fit that they quit doing that; they just handed it straight off to the circulator instead. I don't know why, but the sight of just a toe with a towel clamp attached to it laying on my Mayo stand damn near sent me into vomiting convulsions. "GET THAT GODDAMNED THING OFF MY MAYO STAND!" If I had to scrub on a colon resection for gangrene, I turned the OR upside down to find the Oil of Wintergreen before I went into the room. That is one god-awful smell!
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Old 02-13-2013, 10:36 PM   #4360
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Mom and I are strictly forbidden from talking shop at family dinners. My dad and sister are pretty much used to it, but sis's hubby is VERY easy to gross out.

My favorite though: one of our social workers had decided to slum it with us for lunch one day in the unit break room. The cafeteria was serving chili, which most of us had, and the topic of discussion was the unique smell and appearance of the stool of a patient with an active c. diff infection. One of our attendings had brought up earlier that day that he thinks we spend far too much money testing for it - if a nurse or CNA says it's "the diff" (his nickname for it), 9 times out of 10 the test will be positive. A new CNA wasn't sure what he was talking about, so we were trying to describe it to her.

Another one that made me laugh: I was eating lunch in the break room, and a brand new nurse, fresh out of college, came in to ask me where we keep our bibs, a patient was drooling. She then apologized for bringing up drool while we were eating. Everyone in the break room just about died laughing. Drool? Really? (She's been around almost a year now, and has become bulletproof like the rest of us.)

I think I can talk about anything and not be ill, but I cannot look at pus (even on TV) and continue eating. I learned this one night watching "Tosh.0" on TV while eating dinner. Anything else I'm fine, just not pus.
Very similar to cop humor. You HAVE to deal with it, so you use humor to insulate your emotional reaction.

Because of the Dorner situation, I'm sure every police station is saturated with variations on the old joke "When they found him, he was wearing a smoking jacket and charcoal pants."

Hard to go to a barbeque after one of those cases.

What really broke me down was trauma to children. I just couldn't find a way to insulate myself from it. Still have bad dreams about those.
 

Old 02-14-2013, 06:27 AM   #4361
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Very similar to cop humor. You HAVE to deal with it, so you use humor to insulate your emotional reaction.

Because of the Dorner situation, I'm sure every police station is saturated with variations on the old joke "When they found him, he was wearing a smoking jacket and charcoal pants."

Hard to go to a barbeque after one of those cases.

What really broke me down was trauma to children. I just couldn't find a way to insulate myself from it. Still have bad dreams about those.
I think that's why nurses and cops get along so well together. We understand each other's senses of humor. A close friend of mine is a cop. Our conversations are beyond weird. Most people would cringe if they overheard us, but we think it's hilariously funny.

Children, as you say, are another story altogether. In nursing school, I took care of a 4 month old who was in a body cast from physical abuse. That baby broke my heart. I didn't put her down the entire shift except to go for lunch and to change her diaper. I held that baby all day long and just loved on her. I suspect that was the most loving she'd gotten in her entire 4 months. I just wanted to bring her home with me. If she's still alive, she's a toddler by now. I think about her often and wonder if she's in a happier place.
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Old 02-14-2013, 05:07 PM   #4362
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I think that's why nurses and cops get along so well together. We understand each other's senses of humor. A close friend of mine is a cop. Our conversations are beyond weird. Most people would cringe if they overheard us, but we think it's hilariously funny.

Children, as you say, are another story altogether. In nursing school, I took care of a 4 month old who was in a body cast from physical abuse. That baby broke my heart. I didn't put her down the entire shift except to go for lunch and to change her diaper. I held that baby all day long and just loved on her. I suspect that was the most loving she'd gotten in her entire 4 months. I just wanted to bring her home with me. If she's still alive, she's a toddler by now. I think about her often and wonder if she's in a happier place.
I do just fine with the little ones who were "born that way" - chromosomal problems, accidents at birth, cerebral palsy, etc. I'm even OK with the ones with accidental injuries (like drowning, which we see WAY too often). But yeah, the kids who had perfectly normal brains until some asshole spent quality time with them? Those hurt. We get a fair number of shaken babies, suffocations, and other "non-accidental trauma" cases. The hardest one lately was a kid who was held by his ankles and swung like a baseball bat into the kitchen cabinets. The POS who did it only got 8 years, partly because the kid's mom testified as to what a good person he (her boyfriend) is. 8 years (less with parole), when the kid will spend the rest of his life unable to walk, talk, or feed himself; will have to wear diapers and be bathed by somebody else; and will never get to live on his own or do any of the other things we take for granted. Even worse, once the boyfriend was in jail, he was returned to his mom's custody. My only consolation in that is that the asshat is going to the same prison where Jeffrey Dahmer met his end, hopefully the other inmates will take care of him. (In my fantasy, there is a lot of rectal trauma involved.)

Sometimes I really envy the people who get to go through life blissfully unaware of this kind of evil...
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Old 02-14-2013, 05:25 PM   #4363
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Sometimes I really envy the people who get to go through life blissfully unaware of this kind of evil...
Very well said.

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Old 02-14-2013, 05:31 PM   #4364
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I do just fine with the little ones who were "born that way" - chromosomal problems, accidents at birth, cerebral palsy, etc. I'm even OK with the ones with accidental injuries (like drowning, which we see WAY too often). But yeah, the kids who had perfectly normal brains until some asshole spent quality time with them? Those hurt. We get a fair number of shaken babies, suffocations, and other "non-accidental trauma" cases. The hardest one lately was a kid who was held by his ankles and swung like a baseball bat into the kitchen cabinets. The POS who did it only got 8 years, partly because the kid's mom testified as to what a good person he (her boyfriend) is. 8 years (less with parole), when the kid will spend the rest of his life unable to walk, talk, or feed himself; will have to wear diapers and be bathed by somebody else; and will never get to live on his own or do any of the other things we take for granted. Even worse, once the boyfriend was in jail, he was returned to his mom's custody. My only consolation in that is that the asshat is going to the same prison where Jeffrey Dahmer met his end, hopefully the other inmates will take care of him. (In my fantasy, there is a lot of rectal trauma involved.)

Sometimes I really envy the people who get to go through life blissfully unaware of this kind of evil...
Hell isn't hot enough for people that do such horrendous things to helpless babies.
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Old 02-15-2013, 07:26 AM   #4365
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Hell isn't hot enough for people that do such horrendous things to helpless babies.
How do you let go? I donít think I would be able to emotionally handle and nurse a child hurt. I donít think I could take that home with me and remain intact.

During newborn rotation in nursing school there were babies born growing in the nursery that were in drug withdrawal. The ones withdrawing from heroin were given Phenobarbital. It seemed to soothe them. The babies born to mothers who smoked crack cocaine screamed, and screamed, and screamed. They were inconsolable. Even when picked up their bodies became rigid and they arched their backs as if holding them hurt them.

During pediatric rotation in nursing school there were children that ranged from sweet, stay with me, play with me types with no parent around, to one that sat in his chair throwing food on the floor and told me: Bitch! I think I said to the child: Letís work on your ABCs before using words like that.

During labor and delivery I stood in the corner of an operating room and watched a surgeon deliver a fifth baby to a poor single mother. The surgeon rudely said to the awake mother on the table: Can I tie these tubes yet, or what? All while he pulled her insides out pointing out anatomy to all the students. I thought it was disgusting the way he treated her.

I knew from that year in nursing school that across the lifespan, I would have nothing to do with serving the population in the range of birth through adulthood. I canít do it. Those are my limitations.

In fact the only reason why I donít pick up extra work in critical care transport, something I always wanted to do is because: I donít want to get certified PALS, and I donít want to transport kids.
 

Old 02-15-2013, 07:30 AM   #4366
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I joke that I can diagnose C. diff, GI bleed, and DKA - from the hallway, without even entering the room, just by smell alone. Furthermore, I can tell from the smell if that GI bleed is from a bleeding tic, Ca, or rrhoids. I used to bet the GI guys at work what we'd find when we did the colonoscopy, but they quit betting me because it cost them too much in lunches.

LOL @ drool. I worked with one endo tech who freaked out if we started talking about pea soup during colonoscopies.

Pus doesn't bother me at all. Only 2 things gross me out - a gangrenous colon or any kind of amp. When we did toe amps, the surgeons used to put the specimen on my Mayo stand. I threw such a fit that they quit doing that; they just handed it straight off to the circulator instead. I don't know why, but the sight of just a toe with a towel clamp attached to it laying on my Mayo stand damn near sent me into vomiting convulsions. "GET THAT GODDAMNED THING OFF MY MAYO STAND!" If I had to scrub on a colon resection for gangrene, I turned the OR upside down to find the Oil of Wintergreen before I went into the room. That is one god-awful smell!
I think I feel a little sick. I should eat some toast.
 

Old 02-15-2013, 07:34 AM   #4367
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I do just fine with the little ones who were "born that way" - chromosomal problems, accidents at birth, cerebral palsy, etc. I'm even OK with the ones with accidental injuries (like drowning, which we see WAY too often). But yeah, the kids who had perfectly normal brains until some asshole spent quality time with them? Those hurt. We get a fair number of shaken babies, suffocations, and other "non-accidental trauma" cases. The hardest one lately was a kid who was held by his ankles and swung like a baseball bat into the kitchen cabinets. The POS who did it only got 8 years, partly because the kid's mom testified as to what a good person he (her boyfriend) is. 8 years (less with parole), when the kid will spend the rest of his life unable to walk, talk, or feed himself; will have to wear diapers and be bathed by somebody else; and will never get to live on his own or do any of the other things we take for granted. Even worse, once the boyfriend was in jail, he was returned to his mom's custody. My only consolation in that is that the asshat is going to the same prison where Jeffrey Dahmer met his end, hopefully the other inmates will take care of him. (In my fantasy, there is a lot of rectal trauma involved.)

Sometimes I really envy the people who get to go through life blissfully unaware of this kind of evil...
I am a firm believer in jailhouse justice.
 

Old 02-15-2013, 07:55 AM   #4368
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I couldnít sleep last night. I got very close to a patient. At one point during one of the many shifts with him, I hit him with a pillow. And we laughed. It was mildly inappropriate.

I can still see him jumping out of the bed screaming: I canít take it anymore! And thatís when I hit him with the pillow and told him to get back in the bed for the dressing change. He was dripping blood all over the place.

On day one he was angry, he yelled at me. On day two he cried, on day three I almost cried. On day four he asked for me. It was so much work.

And saying goodbye was the hardest. And then we laughed some more as we talked about day one.

And because of my own conflicted emotions I forgot to tell him that even though I was leavingóhe was being left in very competent and caring hands, but I am pretty sure he knows that by now.

He will be in the book. I will never forget, and itís a good outcome. An outcome I didnít believe could exist. I cut my loss on day one but with persistent care, he got better.

And how do we let go? He said: And just like that I will never see you again? After everything you did for me?

And itís my job. I donít have all the answers. I know there are boundaries that must be maintained.
 

Old 02-15-2013, 02:32 PM   #4369
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And how do we let go? He said: And just like that I will never see you again? After everything you did for me?

And itís my job. I donít have all the answers. I know there are boundaries that must be maintained.
One of the things I like best about my job is that I usually do get to see them again. Most of them come in every 6 months to a year. It's been interesting to watch my mom in the last couple of months - she will be retiring in April, after 41 years as a nurse, 32 at this facility and 16 of those in the same unit. She has been working with many of the patients for all 16 years. The hardest part for her has been saying goodbye one last time to the parents/guardians/foster parents. Hard for them, too.

Sometimes it makes it even harder to maintain those boundaries.
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Old 02-16-2013, 01:44 AM   #4370
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I am a firm believer in jailhouse justice.
There are a few problems with jailhouse justice.

One, it empowers the inmates.

Two, it is usually administered without a shred of proof. Very similar to the French Revolution: "J'accuse!"

Three, it is a misnomer. It is not justice, it is extrajudicial murder.

I could go on, but you get the idea.
 

Old 02-16-2013, 05:03 AM   #4371
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I don't have all the answers either, hon. I'm not used to getting attached to my patients; I worked most of my career in the operating room where we don't have time to get attached to them. I find it absolutely amazing how quickly I get attached to the little old ladies. So far, I haven't had a problem letting go, but they'll always hold a soft spot in my heart.

The baby that I spoke of earlier - I cried for that baby for weeks, if not months. I know DCF was on the case, so I can only hope that she's in a better home now. I hope to God her mother's boyfriend got prison time for what he did to her. I learned my most valuable lesson from nursing school that day. Sometimes my job as a nurse is simply to make the patient's life better - even if it's just for the 12 hours I'm with them. Unfortunately, as an RN, I don't usually have time to spend with them. I TRY, but I'm usually so rushed it's all I can do to just do my job.

On a more pleasant note, I had a patient the other day who'd been assigned to another RN. The patient didn't like her, so she asked for another nurse. They gave her to me. She was so sweet and appreciative; I only had her a few hours before I discharged her. On her way out, she stopped at the desk and gave me one of the flowers out of her bouquet. I taped it to my computer monitor for the day. I drove that COW around all afternoon with a bright yellow flower sticking up from the corner. It's patients like that who make me glad I put up with the bullshit of the job.
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Old 02-16-2013, 11:12 AM   #4372
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One of the things I like best about my job is that I usually do get to see them again. Most of them come in every 6 months to a year. It's been interesting to watch my mom in the last couple of months - she will be retiring in April, after 41 years as a nurse, 32 at this facility and 16 of those in the same unit. She has been working with many of the patients for all 16 years. The hardest part for her has been saying goodbye one last time to the parents/guardians/foster parents. Hard for them, too.

Sometimes it makes it even harder to maintain those boundaries.
That is a lot of years-- I can't even imagine. It is hard for me to even comprehend how she holds all of that inside of her.
 

Old 02-16-2013, 11:14 AM   #4373
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There are a few problems with jailhouse justice.

One, it empowers the inmates.

Two, it is usually administered without a shred of proof. Very similar to the French Revolution: "J'accuse!"

Three, it is a misnomer. It is not justice, it is extrajudicial murder.

I could go on, but you get the idea.
You are right. I almost forgot about the patient that got beat to near death in-house. I was horrified by the pumpkin head. It didn't look like a human head.
 

Old 02-16-2013, 11:35 AM   #4374
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I don't have all the answers either, hon. I'm not used to getting attached to my patients; I worked most of my career in the operating room where we don't have time to get attached to them. I find it absolutely amazing how quickly I get attached to the little old ladies. So far, I haven't had a problem letting go, but they'll always hold a soft spot in my heart.

The baby that I spoke of earlier - I cried for that baby for weeks, if not months. I know DCF was on the case, so I can only hope that she's in a better home now. I hope to God her mother's boyfriend got prison time for what he did to her. I learned my most valuable lesson from nursing school that day. Sometimes my job as a nurse is simply to make the patient's life better - even if it's just for the 12 hours I'm with them. Unfortunately, as an RN, I don't usually have time to spend with them. I TRY, but I'm usually so rushed it's all I can do to just do my job.

On a more pleasant note, I had a patient the other day who'd been assigned to another RN. The patient didn't like her, so she asked for another nurse. They gave her to me. She was so sweet and appreciative; I only had her a few hours before I discharged her. On her way out, she stopped at the desk and gave me one of the flowers out of her bouquet. I taped it to my computer monitor for the day. I drove that COW around all afternoon with a bright yellow flower sticking up from the corner. It's patients like that who make me glad I put up with the bullshit of the job.
Maybe that is why the attachment took me by surprise. Many ICU patients are so sick that they are sedated and ventilated-- and then when they get better we ship them out. I had lots of time with this patient. He was only one of two, all those shifts. And believe it or not he was more work than the sedated: turn-water-feed patient. It was emotionally draining. I put so much into the care-- I cared so much. And when the injury got better and better, my happiness increased so much. This is a risk-- I crossed the emotional line, what if it didn't get better? I would have been destroyed.

Did I mention he was big and strong, funny, and easy on the eyes?

And of course I backed away in the room. I maintained professional integrity (except when I hit him with the pillow.) That's not part of any legitimate care plan.
---

I am glad you mentioned the 12 hour job aspect: because I need to remember that. The last month has been full of take home tears, and it's not good for me. We lost a young victim recently and I cried so much. I even looked up the incident in the newspaper, something I never do.

Yes, there are people that make the job worth the suffering, the struggle. The people that remember us, even if they forget our name. And the families too, the ones that bring us coffee and sweets-- that's always so nice.
 

Old 02-16-2013, 03:20 PM   #4375
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I think to some extent, we have to care for our patients. If we don't, are we really any good to them? I see burned out nurses all the time; I don't want to become like that.

I think all of my patients take a little piece of my heart with them, but then, they give me a little piece of theirs too. I have yet to meet a patient that hasn't taught me something - about being a better person, a better nurse, or a better family member. Even the worst patients teach me something - what I don't want to be.

I'm not sure it's even possible to flip a switch and turn off our jobs at the end of the day. It's too much a part of who we are instead of being just a job.
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