this is just to remind me to write about my absolutely hideous night at work on Thanksgiving! I spent it on the Adolescent Unit with FIVE teen-aged girls. Imagine what it would be like to spend a day with five adolescent girls of the non-mentally ill type...okay, scared you? Now add to that, some pretty severe metal illness issues, one girl who'd just been released from jail for assault, one girl just released from the Juvenile jail for assault, two very depressed younger girls, one of whom her mother promised to visit and never show, AND a girl who could NOT speak more than a sentence without lying....my head hurt that night! LOL
I am doing much better with my crazy fellow nurse: I have realized that part of this is because she now getting laid on a regular basis. LOL Seriously, she has a new bf and is much nicer to be around. She still makes me roll my eyes, but I feel a lot less homicidal toward her. :-)
In other psych news, Medscape has a pretty cool short article called The Year in Psychiatry: Studies Not to Miss From 2011
Some pretty good studies there! :-)
So I worked with two wonderful nurses both named "Bryan" (yes, both spell it with a "y"). I adore these guys. I was working with the co-worker who's annoyed me on Tuesday, and let me just say, she was a completely different person working with the guys. I felt like I was in high school! I would not have been surprised if she'd giggled!
In all fairness, she knows that they are moderate conservatives and not a commie liberal like I am. (Which I really am not, but she perceives me that way as on Tuesday, I talked a bit about gay rights in the context of one of our gay pts.) So I think she thinks she among like-minded people, even though I've seen them roll their eyes at times when she speaks. ;-)
But I do have to say, she was a WAY more pleasant person with which to work! ;-)
First, let me start off by saying, I'm really pretty moderate. I'm definitely a "live and let live" kind of girl. I have friends who I admire who are conservative as well as friends who are way more liberal than I, and pretty much everything in-between.
BUT, I cannot tolerate closed-minded, Glenn Beck-type conservatives. I had to work with one of those tonight and I use the term "work-with" loosely as she did actually very little work. Then, I hear from another nurse, she complained about the "personalities on the shift." PLEASE--my particular shift has been one of the BEST group of people I've ever worked with, anywhere. We work together. We watch each others' backs. We really and truly work as a team, nurses, doctors and PCAs. So to have this person come in and complain about the "personalities" I just want to throttle her!
Okay, I have ranted! :-)
Nothing much thrilling happening today--just a work day. Had a new pt with a very sad psychosis: she believed that she had done something terrible and wrong and that she deserved to be punished. Her family were all very supportive of her. They said other than her depression, she really was a healthy, loving person. But if you tried to explain this to her, she would state, "I just have them all fooled. That's just shows you what a bad person I am."
Delusions are interesting. I am pretty logical person and I can usually be persuaded to change my mind and my belief-set when confronted with evidence that proves I'm wrong. People with fixed delusions can agree that your logic is flawless, the points you make are valid, but still, your conclusion is wrong. They are not capable of being able to follow the logic to a conclusion.
I will probably have this person as a pt again tomorrow. She was med compliant and I am wondering if getting some medications on board will help clear some of her thoughts. She really does seem like a very nice person with a good family that loves her. I'd like to get her back home soon.
Too many family members and co-workers on FB!
Where can I complain about them except in the safety of LJ! AND I need to take a look and see who's still here on LJ who are also on FB and see if I can add more Bronzers to my LJ. :-)
Met my new boss for my adjunct teaching job last night: I believe she is a manic and a little insecure, but she likes me so far so I'll just stay under her radar. BUT I'm teaching a class that they didn't give me all the materials I need. The rubrics don't match the assignments (For example, one quiz on the rundown of assignments says "Worth 50 pts" On the actual test on line, it says "15 questions worth 2 points a piece" and the computer is set so that each question is worth 5 points a piece. I cleaned it up and edited to 10 questions at 5 pts a piece so that the point totals at least agreed!)
Some of my students are frustrated at my disorganization. Well, frankly, I'm cleaning up the class as I go! LOL I just told them, "You know what? Life is not always as organized as you'd like it. And guess what? Working in healthcare is all about being able to adjust to the circumstances as they happen. If you are looking for predictability, maybe healthcare isn't for you.
Thanks for the welcome back!
Now that I'm here--I have no thoughts worth sharing except I was furious at a peer of mine posting this piece of crap:
Just linking it because the ideas are so offensive to me that I don't want to expose people unless they are fully warned.
Excuse me? Many of my pts come in because they have worked all their lives, lost their jobs, lost their families due to financial stressors and don't get mental or physical help until they ARE in an emergency room. Often after they've tried to kill themselves.
Are their people who make poor choices that end up in ER? Of course! My brother, who was an ER doc, used to call them "self-inflicted wounds" as in the pts decided to drink and drive, decided to go to the "bad" part of town to buy drugs, etc. But because some people making poor choices, NO one in need should get health care?
I'll admit: There are "frequent flier" pts that do occasionally give me the wish to sterilize them before they leave. (Dual diagnosis people who are on their 4th child with severe fetal alcohol syndrome and all in the hands of child protective services...) But then I realize, It is not my place to make these kinds of choices for anyone. I can encourage them that getting their shit together might be a better idea than having another baby, or say, hooking up with someone they met on the unit... Simply, people have the right to make poor choices. People have the right to make good choices. And even the best of us, making the best choices we can make, can still end up in crappy places needing help in getting health care.
I've been meaning to come back to Livejournal anyway, and just got a big incentive to now: My mother-in-law in on Facebook now. AND I helped her get there!
Anyway, livejournal's format is really much better for me. I'm certainly more long-winded rather facebook generally allows! ALSO, I have many, many, many work friends on FB, who do not do Livejounal. As much as I really like these folks, the bad grammar kills me at times. I want to scream ""A lot" is TWO words, unless you mean "allot" and by context, I KNOW you don't!"
And I don't have to censor myself as much here as on FB: People here know that I'm expressing my opinion, not dictating the way they should live their own lives. Maybe because I have more words to actually use here, or maybe my Flist is more open-minded here!
So anyway, I'll probably be reading and ranting more here now as I really like my MIL, but I'm not sure if she needs to know every little rebellious thought that pops in my head. ;-)
Okay! Sorry about that, it's been a bit busy around here: I passed my boards and now am a licensed registered nurse! AND I got a job! (this is pretty cool as there are many jobs out there right now) I'll be working as a psych nurse and as my mom said: "How will they know that you are supposed to leave when your shift is over?" LOL
So back to Craig: Craig was put into the hospital overnight. They ran a few tests--his sodium was 123, which is low, BUT his CT scan came back BETTER than it had been. The neurosurgeon said "Actually, if we'd done the surgery and this was the result, we'd have been pleased."
So the good news: Craig didn't have to have surgery, but he was having some gait and other difficulties, so we've been back to PT ever since. They have also decided that he needs to have a leg brace to help him with his "foot drop." My feeling is if he needs an AFO (Ankle/foot orthotic) who cares as long as he walks safely!
So that's where we stand now. My job doesn't start until September 14, so I actually have the summer off to get all the things sorted out that I've let go the last few years--but right now, I'm sitting on my butt typing this and actually not feeling guilty at ALL! (okay...maybe a little guilty...after all, I was brought up Lutheran in the Midwest....)
First, thank you everyone for your warm thoughts! And I've emailed a few folks and it seems that my chartermi.net account is ending up in people's spam email for some reason--so if you were expecting an email from me--check your spam--I could be there!
In January, I started my last semester. It felt really, really strange: While one of my best friends was in the class, it wasn't the people with whom I'd spent the last 3 years. The dynamic was very different. The class was overall younger and there were NO guys. AND the last semester covers areas that frankly aren't my forte: Leadership and Community Nursing, give me blood and guts over making budgets ANY day! I did have an awesome Community clinical--I was working with people who were living independently but who had serious mental illness. I was actually supervising other nursing students who were developing classes for them on various topics from nutrition and exercise to STIs.
On the Craig front, he'd had an MRI in December that showed some residual fluid, but they weren't too worried as they felt it would reabsorb naturally...besides, subdural hematomas only become chronic in less than 20% of the cases.
I noticed that his right side instead of getting stronger, was actually getting weaker, so when we went into the neurosurgeon's for a check up, I was not terribly surprised to hear that his hematoma was not getting smaller but was actually getting bigger again. At this point we had to make a choice: what kind of surgery are we going to do? Are we going to do the full crani again? (craniotomy) Do we do a burr hole and drainage? (Basically drill a hole in his skull and put some drains in for a couple days) or put a permanent shut? I opted for burr hole and drainage. So I'm feeling a little overwhelmed: I have finals, final papers, and try to get all Craig's pre-surgery tests and doctor's appointments. (I had to miss a final and take it later in the day because of a appointment that couldn't be moved.) So we make it through, with Craig scheduled for surgery the Tuesday following my Friday pinning.
What the heck is pinning? In the old days, nurses had a capping ceremony, but now that we know caps can harbor all sorts of crud and germs, we have a pinning where we get pins with our nursing school name and the school crest.
The morning of pinning comes and Craig has a seizure at about 5 AM. He had gotten up to to to the bathroom and I heard the rhythmic "thud thud thud" of someone hitting his or her arm and leg against the wall--In this case, arm, leg and head. I get into the bathroom and quickly protect his head against the floor. It passes and we manage to get him back to bed. Since he is scheduled for surgery, having a seizure isn't that surprising--but when he has another seizure at 8:30, I call the ambulance.
So we take him to the hospital.
(More as I get time)