Time flies

Geez where did all the time go... I am approaching my last month on orientation (can you guys believe it!?). I can remember Day 1 like it was yesterday.. brushing through those double doors and opening a can of sensory overload..from hearing ventilators alarming to pumps beeping.. it was music to my ears! I observed the flow of the unit starting with AM critical care rounds and the involvement of different medical personnel (dietary, physical therapy, GI, Infectious Dz, Liver transplant..etc) working as a team to better the patient's care. Thinking back to that day, I can say it has truly been a journey.. no it was not easy.. the learning curve was very steep and still is. Yes, it was VERY overwhelming at times.. but with patience, perseverance and dedication.. you can get through it! For those of you who might be new nurses in your area of specialty who have made it over, what I call.. "the struggle hump".. CONGRATS! The worst is over!

 

"Fruit for thought"

ICU Problems

"When you leave your stethoscope on the unit and come back the following week and its right where you left it"

Dear Littman Cardiology II, that is 

purple with  rainbow gold finish..

come to me NOW! lol 

                    "Bright RED bloody stools"

Nor is it a great smell! Actually it is one that will forever be remembered after it burns its way into your nostrils! This was my first GI Bleed but I knew it would not be my last. First things first! I checked the pt. vitals, which were steadily declining (no surprise) but then again he just started his HD treatment..(how's that for clouding the picture)...then I checked his last hemoglobin, which was great--for now at least. I am already anticipating that he will need blood though so before going to the mid-level I check the transfusion data to see if he has a current sample (he didn't) went to the mid-level and told him what happened along with all of the above and we sent a type & cross as well as a CBC. 

                        "Nothing like a fresh OLT"

Sometimes, Orthoptic Liver Transplant (OLT) patients come straight to 

our unit from the OR (depending on how critical they are)..and when they are 

critical... they are usually quite jaundiced AKA "banana-looking'! lol 

Click here to learn more about Liver Transplants! 

                                         "Precisely!"

 And CYA! I'm sure I don't have to explain that acronym! 

(Disclaimer: The clinical suggestions, advice and recommendations described on sicunurse.blogspot.com are based on my personal opinions and are not medical advice. The content is for entertainment purposes only. I, surgicalnurse.blogspot.com, do not own, nor did I create any of the animations above. I did create the captions written above and below them, customizing them to my experiences along with learning tips I have found helpful in my practice.

4th at the hospital

And guess who comes to pay a visit... JACHO AKA Joint Commission on Accreditation of Healthcare AKA 'unit-must-be-perfect-on-this-day"..The Joint Commission accredits healthcare organizations across the United States and are recognized as the symbol of quality. Hospitals aren't told an exact date to expect JACHO in efforts to avoid any special preparation from the unit exclusively for a visit. They visit every three years and provide the organization with any standards that were cited for improvement. To learn more about JACHO and their standards, click here. 

 "When I found out JACHO was on the unit"

We had been expecting them any day now so of COURSE they 

had to come on 4th of July!

"JACHO's here!"

Everyone always acts all "OMG-they're-here-walk-upright-and-smile" when 

they come but we shouldn't act any different..

keyword=shouldn't

      LOL!

 And have a great day!

(Disclaimer: The clinical suggestions, advice and recommendations described on sicunurse.blogspot.com are based on my personal opinions and are not medical advice. The content is for entertainment purposes only. I, surgicalnurse.blogspot.com, do not own, nor did I create any of the animations above. I did create the captions written above and below them, customizing them to my experiences along with learning tips I have found helpful in my practice).

It's the first of the month!

Well it's July 1st AKA 'fresh-new-residents-on-the-unit' day... Every July, medical residents who have just graduated from medical school come to the unit and begin learning how to become safe, competent physicians ((how exciting scary!)). Though I am new as well, I soon learned exactly what that meant! For new residents, there is a knowledge deficit between what was learned the past four year in BOOKS vs what needs to occur in REAL LIFE.. so as the nurse you have much more 'hands on' experience and a much broader knowledge base than a first-year resident so you have to be patient and in some situations, guide the residents.. one might not know how to write an order.. or what to do in emergency situations.. and that is where you step in!!

"How the new residents look walking into a patients room before  morning rounds"

Be that 'helpful nurse' to the resident, not the mean 

'learn how to do it yourself' nurse!

 "When I ask the resident to order a PCA for my fresh surgical patient and they tell me they don't know how to"

No worries! I'll just ask the pharmacist

"When the resident wants me to take restraints off my patient with hepatic encephalopathy 
because they are calm at the present moment"

 It only takes one tug at that A-line OR unbridled DHT 

for real issues to arise.. just trust me, lets not!

"Me: So what do you think we should do about the patient's declining respiratory status?"

                                                                          (Resident)

 Oh okay well take a look at their last ABG.. I think we should intubate STAT!

(Disclaimer: The clinical suggestions, advice and recommendations described on sicunurse.blogspot.com are based on my personal opinions and are not medical advice. The content is for entertainment purposes only. I, surgicalnurse.blogspot.com, do not own, nor did I create any of the animations above. I did create the captions written above and below them, customizing them to my experiences along with learning tips I have found helpful in my practice).