I've been a nurse for over a year now and already I'm shaking my head at "the new nurses."
It's one thing to make a mistake, but it's another to not listen to others when they try to teach you.
"Oh sing unto the Lord a new song: sing unto the Lord, all the earth." Psalm 96:1
Sunday, August 4, 2013
Monday, July 8, 2013
Stop Whining
Heard this conversation the other day between a patient and a nurse.
"Time to go to your CT scan."
"Uhhhh, my tummy, don't turn me that way. It hurts."
"You drank all that contrast already, so really need to go to this CT scan."
"But my tummy, my back."
"Stop whining. You have to get this CT scan. Uh, I mean *kiss on the patient's forehead* we're going to move you over to the stretcher, you'll get the CT scan, then you'll be back, and we'll get you all settled for the night."
"And when the people complained, it displeased the LORD: and the LORD heard it; and his anger was kindled; and the fire of the LORD burnt among them, and consumed them that were in the uttermost parts of the camp." Numbers 11:1
"Time to go to your CT scan."
"Uhhhh, my tummy, don't turn me that way. It hurts."
"You drank all that contrast already, so really need to go to this CT scan."
"But my tummy, my back."
"Stop whining. You have to get this CT scan. Uh, I mean *kiss on the patient's forehead* we're going to move you over to the stretcher, you'll get the CT scan, then you'll be back, and we'll get you all settled for the night."
"And when the people complained, it displeased the LORD: and the LORD heard it; and his anger was kindled; and the fire of the LORD burnt among them, and consumed them that were in the uttermost parts of the camp." Numbers 11:1
Cigarettes
My patient called me a bitch last week.
She was angry because I was keeping her from her cigarettes.
Cigarettes.
Reason #2687 to not smoke.
"And the smoke of the incense, [which came] with the prayers of the saints, ascended up before God out of the angel's hand." Revelation 8:4
She was angry because I was keeping her from her cigarettes.
Cigarettes.
Reason #2687 to not smoke.
"And the smoke of the incense, [which came] with the prayers of the saints, ascended up before God out of the angel's hand." Revelation 8:4
Wednesday, May 8, 2013
Fluid Restriction
On a scale from 1 to 10, do you want to know how much I care about your fluid restriction? With 10 being the most care I can muster.
Zero. Z. E. R. O. Zero.
You want coffee this early in the morning? You go right ahead and drink what ever you please, even if it is over your fluid limit for 24 hours, you know the risks of drinking more than your prescribed ml's of fluid a day, but I'm not in the room 24/7 watching what you put in your mouth. Stop harassing the CNA, she is doing her job by asking you what you drank/ate. And yes, yogurt is a fluid. Yes, I had to Google it, but yes, it's a dairy product that melts, similar to popsicles and sorbet and ice cream and coffee creamer. You, the patient, must care about your body more than anyone else. I'll educate you, but I am not going to be your mother.
Do you need anything else? Are you all set? Is there anything else I can do for you? *smile* Okay, you call me if you need anything. You have your call bell. Okay good. Call me if you need anything. I'll be back to check on you soon.
"Now we exhort you, brethern, warn them that are unruly, comfort the feebleminded, support the weak, be patient toward all men." 1 Thessalonians 5:14
Zero. Z. E. R. O. Zero.
You want coffee this early in the morning? You go right ahead and drink what ever you please, even if it is over your fluid limit for 24 hours, you know the risks of drinking more than your prescribed ml's of fluid a day, but I'm not in the room 24/7 watching what you put in your mouth. Stop harassing the CNA, she is doing her job by asking you what you drank/ate. And yes, yogurt is a fluid. Yes, I had to Google it, but yes, it's a dairy product that melts, similar to popsicles and sorbet and ice cream and coffee creamer. You, the patient, must care about your body more than anyone else. I'll educate you, but I am not going to be your mother.
Do you need anything else? Are you all set? Is there anything else I can do for you? *smile* Okay, you call me if you need anything. You have your call bell. Okay good. Call me if you need anything. I'll be back to check on you soon.
"Now we exhort you, brethern, warn them that are unruly, comfort the feebleminded, support the weak, be patient toward all men." 1 Thessalonians 5:14
Coping With Patient Deaths
I read an article about how nurses cope with patient's deaths.
It was really good, I teared up a little relating to their stories. Until I got the the last sentence. "I have never let a patient die alone."
This really frustrates me. Actually it enrages me.
I have heard/read this exactly thing before two of my patients died two weeks ago, on the same night. Before two weeks ago, just thinking about letting a patient die alone was a horrible thought. As if letting a patient die alone would be failure of mine. Or it would be not caring. Or some other word that would mean I was a bad nurse.
Where I work, we do a fair amount of comfort care for dying patients. We were "joking" this week that we should rename our unit to the Hospice unit, instead of GI, because of how much comfort care we do. I have come face to face with death more often than I expected. Months ago I remember asking the charge nurse if I was supposed to spend my whole night in a comfort care patient's room because her family wasn't there and I "don't want her to die by herself." She told me I could, but that it wasn't necessary because I was busy with my other patients.
And who comes first? The patient who the doctor says has 12 hours to live, or the ones who will be going home tomorrow to fill out satisfaction scores?
My first patient died alone. I checked on her every 30 minutes. The CNA checked on her often as well. I called her family to see if they wanted to come in; they didn't. I medicated her to keep her comfortable. But I didn't hold her hand. Actually, her emaciated, cachectic body freaked me out.
Was I a bad nurse for not holding her hand as she died? Did I fail? Could I have done something differently to be in the room so she would go into eternity with someone at her side, with a Christian at her side? Should I have ignored my other patient to be with her? No. Just no. No to all of it.
There was no emergency contact for my other patient. He opened his eyes for a moment when I first got on duty, and I told him my name, told him not to be afraid, that I was going to take care of him, and he wouldn't be in pain. He never opened his eyes again. Late in the night, a family member showed up, and an hour and a half after she got there, he died. I watched him take his last breath. If you can even call that last inhale a breath. And that was it. He was dead.
At least I don't have to work through administering morphine with a "double effect." Double effect is where you give someone morphine (or any other medication) to relieve someone of pain and suffering, knowing that the effect of respiratory suppression and lowered blood pressure would directly lead to their death.
Where do these people work where they have time to hold patient's hands as they die?
This is a hard job. Don't do it if you don't have a strong stomach and a strong constitution.
"He will swallow up death in victory; and the Lord God will wipe away tears from off all faces." Isaiah 25:8a
It was really good, I teared up a little relating to their stories. Until I got the the last sentence. "I have never let a patient die alone."
This really frustrates me. Actually it enrages me.
I have heard/read this exactly thing before two of my patients died two weeks ago, on the same night. Before two weeks ago, just thinking about letting a patient die alone was a horrible thought. As if letting a patient die alone would be failure of mine. Or it would be not caring. Or some other word that would mean I was a bad nurse.
Where I work, we do a fair amount of comfort care for dying patients. We were "joking" this week that we should rename our unit to the Hospice unit, instead of GI, because of how much comfort care we do. I have come face to face with death more often than I expected. Months ago I remember asking the charge nurse if I was supposed to spend my whole night in a comfort care patient's room because her family wasn't there and I "don't want her to die by herself." She told me I could, but that it wasn't necessary because I was busy with my other patients.
And who comes first? The patient who the doctor says has 12 hours to live, or the ones who will be going home tomorrow to fill out satisfaction scores?
My first patient died alone. I checked on her every 30 minutes. The CNA checked on her often as well. I called her family to see if they wanted to come in; they didn't. I medicated her to keep her comfortable. But I didn't hold her hand. Actually, her emaciated, cachectic body freaked me out.
Was I a bad nurse for not holding her hand as she died? Did I fail? Could I have done something differently to be in the room so she would go into eternity with someone at her side, with a Christian at her side? Should I have ignored my other patient to be with her? No. Just no. No to all of it.
There was no emergency contact for my other patient. He opened his eyes for a moment when I first got on duty, and I told him my name, told him not to be afraid, that I was going to take care of him, and he wouldn't be in pain. He never opened his eyes again. Late in the night, a family member showed up, and an hour and a half after she got there, he died. I watched him take his last breath. If you can even call that last inhale a breath. And that was it. He was dead.
At least I don't have to work through administering morphine with a "double effect." Double effect is where you give someone morphine (or any other medication) to relieve someone of pain and suffering, knowing that the effect of respiratory suppression and lowered blood pressure would directly lead to their death.
Where do these people work where they have time to hold patient's hands as they die?
This is a hard job. Don't do it if you don't have a strong stomach and a strong constitution.
"He will swallow up death in victory; and the Lord God will wipe away tears from off all faces." Isaiah 25:8a
Monday, April 22, 2013
Death x2
Two of my patients died tonight.
Both DNR. Both comfort care. Both in their fifties.
Today was the first ever day I had a patient die while I was there, and I had two patients die.
It is really intense seeing someone's very last breath.
I did not keep them alive 'til 7:05.
Instead of trying to stay awake and do something productive this morning, I took a shower and went straight to bed. Then I woke up and went to lunch/dinner with a friend and bought myself flowers.
Just trying to remember the song: "Great is thy faithfulness, great is thy faithfulness. Morning by morning new mercies I see. All I have needed thy hands have provided. Great is thy faithfulness, Lord unto me."
"Oh death, where is thy sting? Oh grave, where is thy victory? But thanks be to God, which giveth us the victory through our Lord Jesus Christ." 1 Corinthians 15:55,57
Both DNR. Both comfort care. Both in their fifties.
Today was the first ever day I had a patient die while I was there, and I had two patients die.
It is really intense seeing someone's very last breath.
I did not keep them alive 'til 7:05.
Instead of trying to stay awake and do something productive this morning, I took a shower and went straight to bed. Then I woke up and went to lunch/dinner with a friend and bought myself flowers.
Just trying to remember the song: "Great is thy faithfulness, great is thy faithfulness. Morning by morning new mercies I see. All I have needed thy hands have provided. Great is thy faithfulness, Lord unto me."
"Oh death, where is thy sting? Oh grave, where is thy victory? But thanks be to God, which giveth us the victory through our Lord Jesus Christ." 1 Corinthians 15:55,57
Thursday, March 21, 2013
Two Funerals
It's been a long week. Two funerals in less than 10 days.
I've never seen death like this before. So fresh. So painful. So raw.
I'm glad to be family.
I called off work for the first time yesterday, after working at my job for 8 months, for the funeral.
I don't feel like going back to work today.
I'll get off my butt and get ready soon though. Pack a lunch. Wash my face. Put a smile on. And get back to life....
"To appoint unto them that mourn in Zion, to give unto them beauty for ashes, the oil of joy for mourning, the garment of praise for the spirit of heaviness; that they might be called trees of righteousness, the planting of the LORD, that he might be glorified." Isaiah 61:3
I've never seen death like this before. So fresh. So painful. So raw.
I'm glad to be family.
I called off work for the first time yesterday, after working at my job for 8 months, for the funeral.
I don't feel like going back to work today.
I'll get off my butt and get ready soon though. Pack a lunch. Wash my face. Put a smile on. And get back to life....
"To appoint unto them that mourn in Zion, to give unto them beauty for ashes, the oil of joy for mourning, the garment of praise for the spirit of heaviness; that they might be called trees of righteousness, the planting of the LORD, that he might be glorified." Isaiah 61:3
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