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"I have been crucified with Christ. It is no longer I who live, but Christ who lives in me. And the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me" (Galatians 2:20). こんにちは, I'm Christabel. I'm a new grad RN, and I love Jesus, Japan, and flossing.

[christaberu]

Day 126.

1. Dentures, hearing aids, medicine: These are reaaaalllly expensive. Make sure you return ALL of the patient’s belongings. Triple check. Get an extra pair of eyes to look. Have the transporter pick-up people also look. Like seriously, I can’t tell you how much grief lost property can cause on errbody.

2. Advocate for your patient. If, for whatever reason, you/the family/the patient doesn’t feel comfortable getting discharged, discuss with the MD! 

3. If your patient is comfort care (has been on a morphine drip) and is gonna go home with hospice or something, make sure you talk with the family and MD about potentially getting the patient off the drip and converting to PO morphine/roxanol/whatevs BEFORE they leave. Ykno, better transition. 

[christaberu]

Day 125.

1. There’s a really neat thing called Surgicel used in the OR that is to stop bleeding. It’s kindof amazing. (And very useful when your newly inserted central line is bleeding.

[christaberu]

Day 124.

1. If you were offered a break but refused, that’s on you. But if you didn’t get your 15 or whatever ‘cause it was just that busy and nobody even offered to break you, make sure you log that. You’re supposed to get paid for the breaks you don’t take.

2. If your patient is known for “knowing” when they’re gonna need bipap or something, you best believe them when they say they’re gonna need it. I mean yeah, try things that’ll help calm them down, but I mean, they know themselves.

3. Some days straight up suck. Like literally everyone is running around like it’s a madhouse and errbody stays late to chart. Yup. Camaraderie, at its finest.

[christaberu]

Day 123.

1. If you’re unsure about anything at all, consult your charge nurse! Chances are your hunch is correct.

2. Apologize for mistakes you actually make, but don’t let the oncoming nurse beat you down for crap you didn’t have control over (like time).

3. Don’t forget to brush up on your cardiac rhythm recognition skills every now and then!

[christaberu]

Day 122.

1. FFP can be transfused heckof fast, like 30 mins fast. Still make sure you observe them for the first 15 mins.

2. You may get rejections a ton when you dish out applications, but just keep at it faithfully. Always seek to improve yourself and your resume and stuff.

[christaberu]

Day 121.

1. If you have time, don’t wait for EVS to come help clean your patient’s room. Grab some bleach or caviwipes or whatever and get the job going! And seriously, patient participation. Encourage that.

[christaberu]

Day 120.

1. When the patient or their family gives you their med bottles or whatever to look at, carefully observe the dose and frequency! If you glaze over it, it’s easy to mistake daily for tid (some days). You don’t wanna give them more than what’s necessary.

[christaberu]

Day 119.

1. Don’t be afraid to let your noncompliant, uncooperative patients aware of leaving AMA. Honestly it sucks to say, but if you aren’t letting people take care of you in the hospital, frankly, you’re taking up space. Really sick people that really want to get better can be in your spot.

[christaberu]

Day 118.

1. Help out your fellow nurses. If one of you is clearly getting slammed, even sparing a moment (if you’ve tended to your patients’ safety first) helps immensely.

2. Hear your patients out. Find out their story. Build that rapport! And obvs it helps with understanding your patient’s case. 

[musicinanime]

Visit Original Link

Rising Hope - LiSA

Anime: Mahouka Koukou no Rettousei

[christaberu]

The soundtrack, picture, colour, everything. So much hype in the 2 intro themes; it’s great. WHERE IS SEASON 2?!?!?

[christaberu]

Day 117.

1. If your patient is hypotensive, (of course) check for symptoms. Are they lightheaded/dizzy/etc. Next! Make sure they don’t have any clonidine patches or nitro paste type stuff on them that can further bring their BP down. If they’re on a PO diet and can swallow great, while you wait for the MD to call back, try to have them drink fluids and stuff! I mean, you’re probably gonna give them an IV bolus anyway when the doc calls back, so you might as well give them a head start.

2. Always check the belongings list before the patient is discharged/transferred. Forrealz, ‘cause surprise surprise, your patient might have like, 6 bag-fulls of meds waiting for them in the pharmacy!

3. I’ve probably mentioned this before, but if your patient is alert and oriented at all but is reportedly “incontinent”, don’t listen to that. Assess it for yourself. Give them a chance! Ask the patient if they’re able to tell when they needa go and then make sure the call light is close enough for them to ask for help! And periodically go into the room to ask if they wanna use the bedpan/urinal. It’ll save both of you the trouble of cleaning up (what could’ve been an easy mess).

[christaberu]

Day 116.

1. Never forget to ask the “Is there anything else I can help you with?” question before you exit the room. It can save both you and the patient trouble.

2. If your patient’s vein is really burning up from the IV potassium, ask the MD if you can replace it with KCl premixed with lidocaine. It hurts less and you’d only need to hang one bag, so it’s a win for everyone!

3. Try not to miss out on your patients’ bowel movements, seriously. You needa know if it’s loose, tarry, black, abnormal in any way.

[christaberu]

Day 115.

1. When you’re assessing your patient, definitely be aware of not only the lung sounds, but also how the patient is breathing. When you get busy it can be hard to remember simple things like that, but yeah. 

2. When you notice wheezing at all, check for prn breathing treatments. If none are ordered, check the patient’s home meds to see if they take anything. Either way, call the doctor and let them know.

3. Even if your hospital protocol says you only need to check your med/surg patients’ vitals every 8 hours, use your own discretion in the frequency. If the patient just got transferred from ICU or something like that, obvs you wouldn’t only check once in the shift.

[christaberu]

Day 114.

1. Discuss the pain control plan with your patient! I mean yes, there are some patients that (without a doubt) are what we call “drug-seekers”, but there are honest-to-God people in pain! Just listen.

2. Fun fact, but apparently abnormal LFTs can affect a person’s lactic acid? Talk about it with the MD to see if you need to consider a sepsis pathway or something.

[christaberu]

Day 113.

1. Just use the translator phone. It’s easier.

2. There’s always a reason for everything. If your patient is there on CIWA protocol or something, don’t just assume they’re an alcoholic. Think of WHY they’ve decided to make the decisions they’ve made. If the patient is a paraplegic and is withdrawn, consider maybe a recent traumatic brain injury that left them paralyzed from the waist down. Never. Assume.

[christaberu]

Day 112.

1. Insurance issues are the probz some of the most annoying. Even though the patient is well and able to get discharge, sometimes they can’t leave just ‘cause insurance still hasn’t approved of a transfer or whatever. /sigh, increased risk for infection wooooo.

[christaberu]

Day 111.

1. If the troponin result has gone up at all, notify the MD, even if it’s just by 0.01. 

2. There’s a special protocol for cosyntropin stimulation tests! Look that business up.

3. No matter how “comfortable” you get at doing your job, you’re still gonna have days where you feel lost. It’s cool.