May 23, 2017

It's that time again...

ACLS renewal time.  Time to get the latest guidelines out and remind myself what third-degree heart block looks like.

I am 0 for 4 on my patient surviving megacodes, because I am 4 for 4 on getting the asystole megacode.  Something about me must tell the instructor, "give this one the flat liner." Perhaps it's because I'm usually the only psych nurse in the class, probably the only one they see all year.

I am a pro on the asystole megacode.  The problem is that most patients are not pros at surviving asystole.

I did get a chance to run a second megacode during one renewal--it was supraventricular tachycardia, and that patient did make it.  But as it was after my official (asystole) megacode for the class, and the instructor did it to give other students a chance to perform in different roles, it doesn't really count.  Though since it wasn't asystole, I wasn't used to the fact that my patient was actually responding to treatment, and it kind of threw it wasn't my smoothest megacode performance to date.

Anyhow, here's hoping I get a megacode with a shockable heart rhythm this year.   Then again, being 5 for 5 on getting asystole megacodes is kind of a bragging right in itself.

May 22, 2017

Surgery stuff

Recovery will be up 2 weeks, so that's what I'm putting in for.  This is going to run into the Labor Day holiday, but I can't help that.   I would like to try to be back on Labor Day so I can get a day of holiday pay, but that's up to the MD.  I have to get the paperwork in June and get the process started.

May 15, 2017

The bane of my existence...

In the last week, I attempted 23 IV starts.  The one I managed to get in was later determined by the MD to be not good enough for his essentially, I batted .000.  I did get one successfully started the week before, and on a psychotic hallucinating patient, no less.  So for the whole month, I'm 1 for 24, or 4.166% percent successful.

My IV skills are not improving despite hell AND high water.

I decided that it's time I broke down and took a LVN IV Therapy course.  So I went to the BVNPT website and found local approved course providers, and messaged them for more information.  I suppose since I'm not going for BVNPT certification, I could take a course that wasn't approved by them.  But I consider the fact that a course has BVNPT approval as meaning that the course content is up to snuff.

That is the downside to working in psych:  we almost rarely start IVs.   Psych-medical sees more IVs than the rest, but even then, it's nowhere as many as you'd see on your typical med-surg floor.

IMs are no problem:  I can give an IM to a patient under pretty much any conditions.  And have.

So while I wait to hear back from the courses about enrollment, I'll be pulling out all my IV books and reading them...again.   I wish they sold an IV practice kit that didn't involve a human body part.

May 4, 2017

Typing this while wearing high heels

I have a social event to go to in a few days, so I finally bought a new pair of party shoes.  The last pair of high heel shoes I have is more than 20 years old--they're still in good condition since I wear them so infrequently.  I just can't find them, so I decided to get a new pair.  I'm currently wearing them over a pair of red wool socks to break them in.  The following day after the social event is a work day, and I want to minimize the inevitable blisters.

I don't usually wear high heels as gracefulness is not one of my strong suits.  That, and wearing high heels puts me into the "rather tall female" category.  I also don't usually wear dresses but I will be that day, and I am now debating whether to get some Dermablend to conceal the leg ink.  I'm not ashamed of my ink, but I also don't want to commit a social faux-pas.

24 pounds down.  Some of our long-term patients have commented that I've been losing weight.

I don't really see it, though.  I mean, I can tell from the fit of my clothing that there's less of me.  In fact, I had to break down and order some smaller scrub pants, since a lot of the ones I own were unable to be cinched tight enough at the waist (I'm all about the drawstring) to prevent them from dragging on the floor.  But I don't look at myself and say, "you know what, I do look thinner!"  I guess because I look at my face and body every single day so I'm not noticing the subtle changes.

Anyhow, this loss means I'll have 22 pounds to go before I hit my minimum ideal weight--27 until I hit my maximum.  145-150 looks good on me; any less, and I start to look ill.

I'm hoping to lose the rest, or at least most of it, before the eye surgery in August...yes, a date has been set.  Late August.  I have already informed my manager that I will be having some minor surgery (didn't say for what) and will be off work for up to 10 days.   I asked if I should put in for time off now, or just wait and see.  No response yet and it's been a couple of weeks...I think I need to remind them that I will be off for surgery starting on that day regardless of what they say.