We never stop learning around here in this business we call healthcare, I guess that is why I like it so much. I get to be a forever student and I do not have to rationalize it to anyone! A few months ago this blogger told me about a procedure demonstrated in the above picture: the precordial thump! At first I hardly believed it although it kinda makes sense I mean a fist can pack some energy. So I looked it up and found some articles and I guess it is used if there is no defibrillator in sight and you witness a cardiac arrest. I doubt that I would ever try it: unless I am in the middle of the desert, or the jungle, or lost in the mountains, and sure that EMS is not going to roll up and rescue and take over; I suppose in those situations I would give it a good whack, I mean thump and hope that I could end a lethal arrhythmia with my fist. In my pursuit of finding out about this method I also found some other outdated medical procedures such as inserting mercury to break down a bowel obstruction! Read it all here. if you feel like it.
Anyway it is good to have an open mind and be flexible, or “teachable”. I happen to fit into that teachable flexible type. I want to know if there is a better way, I want to know why we do the things we do as nurses. Things will just get into my mind and I have to know the answer. For example now I find that I am still perplexed over the purpose of infusing half normal saline. I just do not get it and as soon as I finish this post I am going to seek and destroy all useful materials till I find the answer. I guess it is something I should know the rationale for already right? Maybe I just like normal saline because it helps to raise the blood pressure in the sinking, dehydrated, patient. I get jollies from that cause I am a nerd. And because of my fondness for normal saline all other salines can hit the road.
Seriously though, some nurses tend to get stuck in their ways of doing things that they just can not get past any other way. I was told by one experienced nurse who noticed that every week I handling report with one particular night nurse more often than with other night nurses, that it was not healthy because a relationship develops, or you might trust her too much, or things might get missed. This had been planned by me and this night nurse because we worked the same days and it became extremely convenient. Well, I found out that it was true and this nurse has become a nightmare for me, an unhealthy work relationship; I tend to take things personally. Her anxiety level is so high I am not sure how she handles her job the way she gets so worked up over everything. I try to placate her, but her negativity has striked an all time low lately and I have decided to sever this relationship with her for both of our sakes. And she also suffers from nurse who thinks she is a doctor and I think that is where all of her angst comes from, that and working on night shift she does not realize that all the physicians have assessed the patient, looked at their labs, adjusted medications, and so on, she just does not see the picture. She starts out every night with negative verbiage like: Am I transfusing blood again? And I respond like, no but if the patient needs a blood transfusion that is your job. And she will greet me in the morning with some negative crap like: Your patients were pooping all night, why did you give this to me? And I respond like, they are “our” patients not “my” patients and sometimes people are sick and poop a lot. Her last meltdown was over the usage of a flat sheet versus a fitted sheet over an air mattress on a patient that has skin breakdown on the back already. Now I am not sure where I learned that a flat sheet is better, I just knew that probably from orientation but it does not really matter in the end really. I advised her if she did not like the sheet that I used she was free to change it. She did not like my response very much and flipped out and even cursed at me telling me to show her the policy and evidence of utilizing a flat sheet. Of course I could come up with no such piece of paper to please her outraged mentation so I just ended the conversation and made sure that every single patient that we had on an air mattress had a flat sheet over it so she could become enraged after I was out the door and in my warm car, to safety. I did not flip out on her when she handed me a patient that had an occluded lumen on the PICC line that she was infusing antibiotics via the other lumen when the hospital policy clearly states that the lumen should be cleared before infusing anything. I mentioned it to her briefly that we should tPA the line, and that is what I did after she was gone, spoke with the physician about the occluded lumen and tPAd the line. I do not want to drag this out anymore, I really did get it out of my system last week ranting and raving about her unprofessional behaviour and luckily I obtained the support of colleagues. I just do not want end up like her one day: negative all the time.
I am back to studying for PCCN certification and I applied to a university to start the work for a BSN, I hope to start this semester one class at a time and I have no excuse not to. I am secretly contemplating writing a novel, but this is not the time to show my hidden talents.
Happy late New Year! Maybe some time I will have the time to fix this blog up, it looks kinda plain to me lately.