insultmom

[insultmom]

Life interrupted

So, I'll try to keep this brief. Things have been rough. I recently started a new medication for depression and anxiety. I believe mental health shouldn't be a stigma, and shouldn't be something that is just pushed under the rug, which is why I am writing this.

Anyway, I started Effexor. Went on vacation with my mom and had a wonderful time, we went to Key West. By the day that we returned home, I had been on the medication for 6 days and was starting to feel weird. I couldn't really even describe how I felt, except to say it started to feel like an out of body experience. I went back to work the next Monday and started my week. Day by day, the feeling got worse. My anxiety was so bad, I couldn't even sit down to relax when I wasn't working. So... I pretty much worked 24/7 for several days because I did on-call at night several days that week. By Friday I was a mess and needed to leave work because I couldn't even concentrate. I was anxious and I was getting paranoid on top of everything else.

I got home, couldn't even sit down because I had so much on my mind. I talked at length to my step-dad about work and he had some good advice for me and told me he thought I was overthinking things, which I definitely was. Mom got home soon after and had picked up my son for me, and we all went out to dinner that night. I don't remember much about dinner, but mom said I was just staring a lot and seemed "out of it." I stayed up late that night talking to my son, and things just got worse. He went to bed, and I was suddenly paralyzed with the thought that he was going to die. I was worried he would take pills I had in the bedroom, even though I had no basis whatsoever for my fears. I kept going in to check on him and make sure he was still breathing. This went on all night...

By morning, I was a mess. Mom got up and we were just having coffee and chatting, and all of a sudden I just looked at her and said, "I need to go to the hospital."

The drive to the hospital was quiet... we talked a little bit, but I was at the point that I couldn't put together a coherent thought. My mind was too scrambled. I tried to explain, that it's not that I want to kill myself, or that I want to die. It's that I feel like I won't be able to stop myself from hurting myself, and I'm convinced already that somehow, someway, I'm going to die today. It's hard to explain, and even harder to understand I imagine if you've never been in that dark hole.

I don't remember much after that. I know they ran a bunch of tests, I know at one point, which was heartbreaking for my mom and son, I tried to get up and leave and they held me down. It was awful... I wouldn't wish this experience on anyone.

Next thing I know, I'm at a psychiatric facility. It's not pleasant, I couldn't have my belongings, my jewelry, my cell phone, my pillow, nothing. I was allowed to have certain kinds of clothing, nothing with strings, zippers or buttons. and that was it.

I spent 9 days there. Maybe sometime I'll talk about it, but not now. It's still too real. Too close. Too vivid. My memories of that won't fade quickly I'm afraid.

Anyway, I'm home now. I'm getting better every day. I'm going back to work this week. After some significant medication changes, I'm feeling back to myself and the way I used to feel, which is good.

There shouldn't be stigma to mental health. There still is, and that's a shame. Whether or not Iikes for writing this doesn't matter to me. I just needed to get it off my chest and put it out there. I need to release it and let it go, and this helps.

#mental health #mentalwellness #stigma #psychiatry #mental wellbeing #therapy

[insultmom]

It’s been some time… I know. I’ve been through a lot in the last however many years it’s been since I posted. Some mental health struggles, thyroid cancer and a total thyroidectomy and resulting adjustments, failure of a long term relationship… and the list goes on. But, I’d like to get back to writing again.

Also, big news. I changed specialties and have been doing hospice nursing for the last year!! I have all kinds of stories about my change in specialty, so stay tuned for that! Life has happened in the meantime, so I’ll update on that too when I have a chance.

[insultmom]

"Just a Nurse"

I didn’t catch the Miss America competition this weekend, as it was my weekend to work. Not that I would’ve watched anyway, I’ve never been much of a “girly girl”. I suppose that’s why Emergency nursing attracted me. I knew I could do things in the Emergency Department that I would never do anywhere else. Not to mention the autonomy I have there. We are respected by our physicians as the best of the best. So, while the Miss America pageant was broadcasting, I was starting my second 12 hour night shift. I was running a Level 1 Trauma center Emergency Department, as the charge nurse. I was assessing patients coming in by squad with my nifty “doctors stethoscope” and being gatekeeper to the unending lines of squads and patients checking in.

After my 36 hours in the Emergency Department this weekend (what did you do with your weekend?), I slept most of the day Monday. My sleep was broken by the myriad of daytime noises… kids playing, lawn mowers, cars coming and going from the neighbor’s, and our two cats meowing, wanting my attention. When my boyfriend finally called and woke me at 4pm, I felt like I had wasted the entire day, yet only gotten a couple hours of broken sleep. I stumbled to the shower, hoping I could at least salvage the evening.

I spent that evening having dinner with a colleague, an advanced practice nurse with two masters degrees, and my wonderful boyfriend, who listened to us bitch endlessly about the bullshit we put up with just to do our job properly. He has the patience of a saint, not to mention he respects my work. Doesn’t hurt that he’s in love with me either. 😉

Tuesday, I woke up bright and early, ready to accomplish something with my only full day off. But, a morning doctors appt quickly turned into a specialists visit and minor surgery for my boyfriend. He picked me up and I went with him so that I could drive him home afterward and decifer any home going instructions he received. Plus, I’m also in love with him, and wouldn’t have wanted to be anywhere else. I was sent to the waiting area while he had the procedure where I sat and stewed… I don’t make a good patient, and I make an even worse patients significant other. I mentally checked off all the things I should be on the look out for… fevers, increased swelling, drainage, bleeding, cellulitis, MRSA, etc. Once we were done, I dropped off his prescriptions at the pharmacy and took him home to rest. But, by the time we made the 30 minute trip, the area in question was already significantly swollen and didn’t look right to me. We called the doctors office, but had to leave a voicemail. Then, I waited. And I got him lunch, and picked up his prescriptions, and watched the area like a hawk, while I waited for the office to return the call. I got him a cold pack to put on it, in hopes the swelling would slow, and worried. We watched movies and I stayed with him all afternoon and evening, because again, I wouldn’t have it any other way.

You see, this girl who is “just a nurse”, doesn’t ever stop being a nurse. Even on my days off, my boyfriend will attest to the fact that I am frequently stewing over a work situation, or a sick patient I took care of, or working on items for one of the many committees I belong to in the hospital. When I’m not doing those things, I’m a mother, a daughter, a sister, a girlfriend and I’m still a nurse. And I take care of the people I love. Even if it’s just to answer a phone call and reassure them they’re not going to die from taking motrin 5 hours apart instead of 6. Yes, this actually happens to us all the time.

My point being, that by Tuesday night, I was finally relaxed enough to scroll through my Facebook feed and catch up on the offensive and appalling comments Joy Behar made on The View about Miss Colorado. You can Google it if you haven’t already heard, but she questioned why she was wearing a “doctors stethoscope” and basically mocked her, calling her “just a nurse.”

Now, I don’t watch much television, I’m too busy for that. So, I’m sure that The View will never miss my patronage, since they never had it to begin with. But let me just say, of all professions to mock, nursing is not the one. With over 3 million nurses in the US alone, not to mention the family, friends and colleagues that love and respect us, you just pissed off the wrong crowd.

Think about this, the very first stethoscope laid on an infants chest after delivery is held in the hands of a nurse. The very last person to hold your hand, or wash your worn out body after you pass from this life to the next, is a nurse. The last person to catch a medication error before it kills you, is a nurse. The person that decides who is seen immediately and who waits in the Emergency Department, is a nurse. The person that watches over your premature infant all night long, and can detect the slightest change in their status, and is responsible for calling in a team to rapidly assess and care for them, is a nurse. When you are critically ill or injured and need flown from a scene or to a hospital with a higher level of care, you are taken by helicopter with a nurse. When you can no longer care for your aging parents, or disabled child, and they are placed in long term care, you rely on nurses. So, when you insult such a large and varied group of professionals, you should know that we will defend ourselves tirelessly for the respect we deserve. Luckily for Joy Behar and her table of witless, intellectually challenged cohorts, the nurses of the world are still bound by law and by profession to provide you with the same care they would their own family member. Unlike Kim Davis, the clerk in Tennessee who is hiding behind her religion as a reason not to do her job, we are professionals, and we will never walk away from someone who needs us, just because we don’t share the same religion, ethics, education, ethnicity, sexual orientation or political beliefs. We are nurses, and we are damn proud of it.

So, Joy Behar, I would like to know what you did with your weekend. When was the last time you saved a life? Have you ever carried a 4 year old to the morgue after they died at the hands of their own parent? Have you ever held brain tissue in your hands after a 16 year old shoots himself in the head? Have you ever picked grass and dirt out of severed limb so that it can reattached to the 8 year old that fell under a riding lawn mower? Have you ever been attacked by a family member of a dead child, after you did everything in your power to save their life? Have you ever left the bedside of your own dying family member to go to work to care for someone else’s sick child? Have you missed out on countless holidays, birthdays and school plays to be cussed at and berated by the people you are bound to care for? Do you lay awake at night wondering if you did enough, worked hard enough or advocated to the best of your ability for the sick and dying? Have you ever done CPR on a coworker? Because I have… and when I get dressed for work tonight and put on my scrubs and hang that “doctors stethoscope” around my neck, please know that will spend all 12 hours working my ass off to save lives, and honor my profession to the best of my ability. And I won’t be losing any sleep over the comments you so carelessly made about me and my colleagues. You sit behind a desk and talk shit about something you obviously know nothing about. Until you’ve walked the proverbial mile in my shoes, you should refrain from ever opening those flapping jowls of yours again with criticism of my profession. You will never have even an ounce of the dignity, courage and professionalism displayed by nurses across the country. You are a disgrace, and I sincerely hope you never speak in public again, unless it’s to offer a sincere and heartfelt apology to nurses everywhere.

Sincerely,

“Just a Nurse”

#joybehar #theview #nursesunite #ernurse #byefelicia #emergency #nursing #suckabagofdicks #abc #media #socialmedia

[insultmom]

I've been a huge fan of Zdoggmd for awhile now, this is the first video he's done that isn't sarcastic and comedy based, and he nailed it. Talk to your family about your wishes, make sure everyone is on the same page and elect a medical power of attorney.

[insultmom]

[insultmom]

In regards to hazing from other nurses what do you do? Do you just threaten them with a report to HR under hostile work environment? Become the hugest C you next Tuesday nurse on the unit to combat the hazing? Shame them for being bullies? What do you do? Cause I went through the enough bullshit in high school, I shouldn't have to worry about my mental and emotional wellbeing when at work in regard to my coworkers (who safe to say should be the nicest people in the world).

So, I'm the type of person that doesn't tolerate bullshit well. Granted, my balls weren't always as big as they are now, but I've found the very best way to deal with this type of behavior is to call it out, right then and there. Stand up for what is right. Don't take it. Plain and simple. Over the years, I've dealt with some super fucking hateful people. They DO NOT like being called out for their behavior. So when someone is trashing another nurse right there at the desk in front of 15 people, I will straight up look at them and say, "wow... I thought we were all more secure with ourselves and our skills. It takes a really insecure person to talk shit about a new nurse that's trying to learn." That will stop someone mid-sentence and put them on the defensive. Then they just wind up looking like an asshole when I mention things like integrity and professionalism. Don't mistake what I'm saying for always defending a new nurse, because I am also the first person to call a new nurse out if I don't think they're pulling their weight, or making an effort to improve, or giving something their best shot. But, I know how to do it in a professional manner, and provide constructive criticism. Now, my other bitch, while I'm on the subject, is the very unfortunate trend I've seen lately of new grads who CANNOT take constructive criticism. They take everything as a personal fucking insult and think we're being mean to them. NO. JUST NO. When I tell you that I feel you need to work on time management and prioritization, I'm not being a bitch. I'm not being mean, I'm not jealous because you're younger, thinner and prettier (yep, I've heard them all), I'm simply giving you constructive feedback in order to teach you. Too many people project their personal emotions and inadequacy onto the situation and turn it into something it's not. I honestly feel that it's something they should focus more on in high school and college. Life is all about learning. When you stop learning, you might as well hole up in your house and get yourself 30 cats and a couple ferrets and just call it a day, because you're done. Sorry, I got off on another subject. It's probably a good time to mention I've had 90 minutes of sleep since getting off at 7a after three 12's. 😉

[insultmom]

Life and Death

The constant tug of war between life and death is overwhelming at times. It seems like there are just times that I feel this struggle more acutely. Months go by without thinking about it at all, and then one day it hits me again like a sledgehammer. I sat holding a baby last night. She was sleeping and had her tiny little fingers wrapped around my index finger. I was staring at her paper thin nails, thinking what a miracle the human body is to create a whole human being in the span of 9 months. There was nothing, and then some cells divide, and there's a life. And I'm holding a little human that I will likely never see again. Our lives intersected for that hour that I fed her a bottle, burped her, swaddled her and rocked her to sleep. And someday (with luck) she'll be a walking, talking, adult with ideas and opinions that I'll never know. And she'll never remember the hour I held her and stared at her little fingers, contemplating life. In the very next moment, I'm watching an 18 year old chronic patient take his last breath. I consoled the parents, and let them crawl into bed with him and hold him in his very last moments on earth. There was no longer any drug or procedure or intervention that was going to fix him, or make him whole again. I stood watching, thinking how unfair it is that some lives are cursed from the beginning. They never even have a chance, and we work our asses off over the years to keep them alive, for what? Because once we're born, we will all meet the same fate. We will all die someday. Just some sooner than others. And it isn't very fair, and there are no guarantees, and none of us are guaranteed another day. I unhooked the monitor, and put some warm blankets on him and leave them to say goodbye to their child. I was present in a moment of their lives that they will never forget. For better or worse. Some days it takes every last bit of reserve to put one foot in front of the other. The constant pull between life and death and where I fit in. I just think about it sometimes...

#lifeanddeath #ERnursing #nightshift #nursing #deepthought

[insultmom]

Repeat this over and over... Go all the goddamn way with what matters. We only get one chance with every moment we're given. Make the most of that moment. Grab life by the balls and make the most of it.

#life #nursing #liveyourlife

[insultmom]

Do you have any tips for drawing blood? At my new job, we have to draw our own labs, and I keep getting a sluggish blood flow... or not hitting obvious veins... and giving the patient big bruises. I've been on a streak where i can't get blood or start IVs and I'm not exactly a new nurse so I'm pretty embarrassed. :(

I've told my new nurses this many times, so I will pass on the same advice here. Try not to let skills define you. We are living in a world where more and more professions are being outsourced, and sometimes replaced altogether by a cheaper alternative. We don't want that to happen in nursing, so we need to consider our most valuable asset our brain, and the ability to critical think and problem solve in stressful situations. But, since you asked, and I do pride myself on being one of the best "sticks" in the hospital, I'll tell you a little about my technique.

First, your number of attempt should always be relative to the situation. Blood drawn for non-urgent reason, then I say 2 sticks and your done. If we're in a trauma or code, we have 30-60 seconds to get a line, or else we're placing an IO (instraosseous line). So what I'm saying is, there are only a few extenuating circumstances where you should ever be sticking more than twice yourself before you find someone more qualified. Now, if you come find me to stick someone that absolutely needs a line for an urgent medication, procedure, or IV fluids, I'm probably going to stick 2-3 times if I need that many attempts. The reasoning behind this is that you should be saving sites for more experienced personnel to attempt. I am that experienced personnel, and if I can't get it, we're going for a central line, or going to IR to have a line placed.

When I do stick, I look everywhere. In pediatrics, that means hands, AC's, saphenous, feet, and head. In adults, hands, forearms, AC's, and upper arms. I will only place a line in a lower extremity in an adult in an emergent situation, or if for some reason the upper extremities have some type of severe trauma. Remember, you can still place an IV through burns, it's just more difficult to tape and requires gauze dressings instead of adhesive. Adults have a high instance of complications from a line placed in lower extremities, so I avoid them unless absolutely necessary. I always explain to the patient or family, if present, that the reason I am looking all over is to find the best vein, for the best chance of success. I will not stick someone just to say I did. If I don't see something I like, I won't stick. End of story. You shouldn't either, however, in the beginning, you will question yourself constantly, so I urge you to try at least once.

I see this happen with coworkers, in other hospitals, even when I have blood drawn myself. Nurses touching a site after they have prepped it. DO NOT TOUCH THE SITE. My only caveat to this is if you are in a critical situation and the chance of the patient dying without IV access is greater than the chance of infection. Why are you touching the site?? You already found it and cleaned it, now stick it. Quit questioning yourself. It's not necessary, it's a nervous habit people develop when they don't believe in themselves.

Next, when you go to enter the skin with the IV catheter, do not go flush with the skin. You also don't want to enter the skin at too much of an angle. This takes time and experience to gauge just how much of an angle you need to compensate for subcutaneous fat, the age of the patient and the site you're accessing. Toddlers tend to have lots of subcutaneous fat, or "baby fat", so you do need a bit more of an angle. Infants have very little subcutaneous skin, as do the elderly. With infants, toddlers, children and young adults, the veins still have significant resistance to them, you'll feel a "pop" when you enter the vein. As we age, the veins tend to relax somewhat, and have more of a stretched out pantyhose type feel to them, so unless they're engorged with blood, you may not feel anything. The elderly have veins like tissue paper, you won't feel anything, you'll be in one side and out the other, and you're site will be blown before you know it, so you have to be extremely careful and trust your instinct of when you're actually in the vein.

You also can't always rely on blood return in the IV catheter. Especially in emergency medicine, my patients can be severely dehydrated, multisystem trauma, comorbidities, etc., and I won't see anything in the catheter, but I know I'm in the vein. It's a combination of instinct, visual confirmation, and the feel of the catheter sliding forward when you're actually inside the vein. I tell new nurses that if they do see blood return in the catheter, to continue to advance the needle another millimeter or two and then slide the catheter off the needle, otherwise the catheter will bunch at the entry site and blow the vein. Next, you want to occlude the vein when you remove the needle, or else it's going to look like a homicide scene. I have a little ongoing challenge to myself not to spill a drop of blood. Depending on my patient, some days I win every attempt, other days, my patient does the alligator death roll and everyone winds up with blood on them.

Once you've removed the needle, at least at my institution, I obtain blood from the catheter, then attach the T-connector. There are several different ways to do this, but if you're obtaining blood culture, it should always be the first blood obtained, and the syringe should be securely attached to the catheter, so as not to introduce contaminates into the sample. Sometimes you need to release the tourniquet to allow the vein to fill again in order to get the appropriate amount of blood. Sometimes it's impossible to get anything, depending on how sick your patient is, and it's best to just save the IV site and worrying about labs later. Don't assume your IV is bad if you don't get blood return.

Here's another little bit of advice... It doesn't matter what size catheter you put in. That's right... You can still save a life with a 24g catheter. Now, if you put a 24g catheter in a healthy adult, I'm likely going to call you a pussy and make fun of you. However, if that's the best you can get, and that 24g catheter is in their index finger, well, I can still work with that. You can push blood (albeit not as quickly) through a 24g, you can bolus fluids through a 24g, and you can push drugs through that same 24g. Use it until you can get something bigger. In adult hospitals, they often won't even attempt with anything smaller than a 20g. I've got news for you, that's not always going to work. Tough shit, swallow your pride, and grab a smaller catheter. The goal is to help the patient, not sooth your battered ego when someone cracks a joke about what size needle you used. We still use a push/pull method with the rapid infuser and 24g IVs. It works, trust me.

Some other helpful hints for placing IV's... in infants, hands and feet are usually the best points of access, if you can't get those, go for a scalp vein. When accessing anything above the heart, you need to point the catheter towards the heart. So if you're accessing a scalp vein, you point the tip of the needle towards the heart. Otherwise you're going the wrong way in the vein and it's going to cause problems. I love a good saphenous vein in a toddler. It's about the only place they don't have that padding of baby fat, and you can sneak right in there without much difficulty. In older kids and adults, the forearm is a great site for access, they don't kink off the catheter with movement and it's a nice, stable vein that will maintain access for days. In people with serious, chronic medical problems, the typical veins you would access are going to be overused and abused. So look for something in a atypical place, the upper arms, fingers, hell, I've put IV's in breast tissue. Go for whatever you think you can hit, and will maintain patency long enough to get another point of access in.

In the end, practice makes perfect. And, prepare for the worst, hope for the best!

[insultmom]

Any words of wisdom for new grad nurses?

My best advice is to keep your mouth closed and your eyes and ears open. That may sound harsh, but I promise you that 5 years down the road, you will say the exact same thing. Take every opportunity to learn something. When you do speak, ask questions. Lots of them. There are no stupid questions except the ones left unasked. Actually, that's a lie... There are stupid questions, but we're all going to have a good laugh about it later, I promise.

Don’t criticize tenured nurses for being jaded, or uncaring, especially when you hear us cracking jokes about patients or situations. You will understand in a few years that humor is what keeps us from going insane.

Don’t ever be afraid of doctors, surgeons or administrators. Hold them to the same standards you would anyone else, and that includes manners. They're kind of like dogs or small children, if you set clear expectations of them from the beginning, then you won't have a problem later. You alone determine how the physicians will speak to you. Don’t be afraid to ask them questions if you don’t understand their orders, or a particular condition. And don’t be afraid to question a particular treatment or medication if it doesn’t make sense.

Remember that a little Narcan never hurt anyone, but a lot of Narcan will throw an addict into acute withdrawal, so be prepared for them to seize. It's a good idea to have suction handy. And Ativan.

Codes always equal Epi. And even after you get them back, better push some more Epi and hang a drip.

The pharmacists are your friends. Likewise, so are the cafeteria workers. Be nice to them if you want drugs or food in a timely manner.

Wear good shoes. I have always worn Dansko’s, but you have to find what works for you. You have to take care of your feet, and if that means shelling out $130 for Dansko’s every year, then so be it. I would spend more money on shoes and less money on a stethoscope. But, as far as stethoscopes go, the Littmann Cardiology III is the best stethoscope for the money. There is no need to get any fancier than that.

If you are sick, take a day off. Don’t be a martyr, no one gets an award for torturing themselves for a job. Take a personal day every once in awhile. I call them mental health days. You will need one occasionally, trust me.

Be nice to the nurses aides. Do your own work when you can, but learn when, and more importantly, how to delegate. Just as nurses can make or break a doctor, a nurses' aide will make or break a nurse. If you treat them poorly, you will pay.

Get and maintain as many certifications as possible. If your hospital pays for you to take PALS, ACLS, TNCC, ENPC, ABLS, and ATLS, take them. And if you can get a specialized certification like your CEN (certified emergency nurse) then by all means, take the test! These also usually entitle you to a small merit increase, my hospital is $0.50/hr. Join professional organizations as well, like the ENA. You get CEU offerings, a magazine subscription and another addition to your resume. Employers look for this information, especially in specialized areas like critical care, emergency nursing and pediatrics. It shows that you value your profession and want to excel.

And finally, learn how to laugh at yourself, find the humor in any situation you can, and have a good time. If you don't enjoy what you're doing the majority of the time, you picked the wrong profession. I still enjoy going to work most days. When I stop enjoying it, it will be time to move on.

#ERnurse ER Nursing101 Nightshift Newgradnursing

[insultmom]

Some days, it takes all the energy I have to get up and shower, eat and drive to work. I come home after 12 hours, and collapse into bed like I've just been waterboarded the entire shift. This woman has been doing this for 60 years!! She is an inspiration, and although I'm sure she probably did her fair share of complaining over the years (we all do), she's had the strength and resolve to continue practicing nursing all this time. That is true commitment and dedication. Take note people... This woman deserves our respect and admiration.

Florence “SeeSee” Rigney, a registered nurse working at MultiCare Tacoma General Hospital in Washington, has been faithfully helping patients for 69 years. On May 8, 2015, she celebrated her 90th birthday.

Her fellow nurses and hospital staff greeted Rigney with birthday wishes and a letter of congratulations from Washington Gov. Jay Inslee, and as she thanked them for the well wishes, she could hardly hold back tears. Inslee recognized her as the country’s oldest working nurse.

“You are all wonderful,” she said. “I know I’m a pain in the you-know-what!” [via]

#inspiration #nursingforlife #nursing #dedication #badass #therealMVP

[insultmom]

STOP WHAT YOU'RE DOING AND DO THIS IMMEDIATELY!! You can thank me later. While you're at it, put some fresh sheets on the bed and sleep naked. I may not leave my bed all weekend...

ALRIGHT MOTHERFUCKERS, TIME FOR SOME LEARNIN SO SIT OUR BITCH ASS DOWN AND GET OUT OUR NOTEPAD

THIS SHIT RIGHT HERE IS SUGAR SCRUB. YEAH I KNOW YOUVE SEEN IT BEFORE BUT YOU DONT KNOW WHAT I KNOW AND THAT WHEN YOU USE IT WITH ONE OF THESE FUCKERS

YOU WILL GET LEGS AND ARMS AND ANY OTHER SHIT YOU WANT THAT IS SO SOFT YOU WILL BE SHOVING IT IN THE FACE OF EVERYONE YOU KNOW AND ASKING THEM TO COMPARE IT TO THE TENDER PINK FLESH OF A NEWBORN

SO GET YOURSELF SOME FUCKING WHITE SUGAR AND SOME CHEAP ASS OIL LIKE CANOLA OR SOME SHIT AND MIX THAT SHIT WITH TWO PARTS SUGAR AND ONE PART OIL( THAT MEANS TWICE AS MUCH SUGAR AS OIL BITCHES I USUALLY USE ONE CUP OF SUGAR AND DO SOME FUCKING MATH TO FIGURE OUT HOW MUCH OIL THAT IS) DROP A FEW DROPS OF VANILLA ESSENCE OR MAYBE SOME FUCKING LAVENDER OIL WHATEVER YOU WANNA SMELL LIKE. MIX IT UP REALLY GOOD MMMM SMELLS LIKE CAKE BATTER FUCK YEAH.

NOW GET YOURSELF GOOD AND NAKED. REAL NAKED. PAMPER YOUR GODDESS-LIKE ASS WITH A BUBBLE BATH. TAKE ONE OF THOSE RAZORS YOU GOT AND SHAVE WHATEVER YOU LIKE TO SHAVE LEGS ARMS VAJAYJAY PITS I DONT FUCKING CARE.

NOW GET OUT OF THAT GROSS HAIRY DIRT WATER AND SIT ON THE EDGE OF THAT THERE BATHTUB. TAKE A HANDFUL OF THAT SWEET GOOP AND RUB IT ALL OVER THAT SKIN OF YOURS(just dont use this stuff on or near your lady bits i put this in lower case because it is really important your love cavern does not like sugar uh uh no way its diabetic) RUB RUB RUB KEEP RUBBIN YEAH YOUR HANDS STARTING TO FEEL WEIRD GOOD BECAUSE ITS WORKING

NOW TAKE THAT CHEAP-ASS DISPOSABLE RAZOR YOU HAVE AND SHAVE OFF THAT NASTY-ASS DEAD SKIN EWW ITS SO GROSS NO ITS NOT ITS YOUR OWN SKIN BUT ITS ALL GREY. RINSE OF THAT OILY STUFF BECAUSE YOUR SKIN AINT NO SLIP-N-SLIDE

GOOD NOW FEEL YOUR NEWFOUND SOFT SKIN THAT WAS ONCE BURIED UNDER LAYERS OF DEAD FLAKES OF YOUR PAST SELF YOUR WELCOME MOTHERFUCKERS CLASS DISMISSED

[insultmom]

Is that a blue raspberry creamsicle?!?! I need that in my life right now.

Here are some dogs enjoying Popsicles. 

#hungry #jealousofadog

[insultmom]

Happy Nurses Week!!! But seriously, I was out super late and I got this from a friend in the night. So when I opened it this morning, I was like, "wow, this is some heavy shit to confess first thing in the morning... Oh wait, it's not literal." Guys. I actually had to look twice at who sent it, because I was really confused. Shit. Fail.

#confessionsofanurse #nursesweek #ERnurse #dontjudge #nightshiftproblems

[insultmom]

Help a girl out...

I really need a distraction this week, and I can't write about what is going on, not yet. So send me your questions, ask me anything you would like and I'll do my best to answer. Or, send me a topic you'd like to see me write about. It can be nursing related, parenting, personal, I don't really care. I just need to distract myself with writing this week. This is my best outlet for stress relief, and I need to keep busy!

#ask me anything #nursing #ER #ERnurse #parenting #life #ipromisei'llanswer

[insultmom]

Just thought I'd let you know I thought your " life is messy" post was so relevant that I shared it with the rest of my nursing class and from what people are saying its really changing their perception of what its going to be like after we graduate, so sincerely thank you :)

Thank you for sharing my writing!! I've gotten so much enjoyment from reading people's reaction to my writing over the last several weeks since I've had more traffic! I love to hear what other people think about it and how it impacts them. I can honestly say, I'm just like any other ER nurse, I just figured out that my best outlet for stress is writing. I have always thought that one of the biggest disconnects in nursing and medicine is the lack of real understanding of what true practice will be like. What is taught in the classroom and what actually happens in real life are two completely different beasts. And there is a very fine line to walk when it comes to knowing when to trash what you've been taught and just go with your gut. For example, I tell new nurses that the biggest thing I want them to learn is how to make that initial determination of "sick" or "not sick". I want you to be able to look at someone from across a triage desk in about 30 seconds and tell me if they can sit in the lobby for 6 hours and be fine, or if they're going to deteriorate if they aren't treated in a timely manner. I don't even care if you can tell me why you think that initially... As long as you eventually learn why you think that way. There are still times that I get a particularly bad feeling about a patient, even though there is nothing outward that qualifies them as a high acuity patient with a significant risk for deterioration. Even after years of experience, I will tell you that I still work with nurses that suck at making this call. It takes a careful combination of book smarts, common sense, and a good gut instinct to really be good at this. But it's what our entire triage system is based on, and it will absolutely fuck up the flow of the ER if you're wrong. Sure, there are algorithms for determining how many resources a particular patient will require, and they work to a certain extent, but a truly good ER nurse can look at 100 patients on any given night and pick out the 10 people that are going to fucking die if you sit their ass out in the lobby, and be right nearly 100% of the time. There could be 15 other people with the same symptoms and vitals, but something makes me uneasy deep down about a particular person, and I can't shake it. If you ignore those patients, they will sit quietly in your lobby and then they will come up to the desk and say something like, "I don't feel so good..." and then they'll drop like a fucking rock and die. And that's a lot of paperwork, believe me. And management gets really irritated when people die in the lobby. You spend a lot of time explaining that shit, and then legal gets involved, and everyone has a bad day. So, I like to avoid all that and just go with my gut from time to time and get a doc to look at them. And if they blow me off, I go find another doc. Sure, I've been wrong, but way more often than not, I'm right. And that is how you save lives... It's not always the guts and glory in the trauma room, and cracking the chest of a patient with a shredded aorta from a bullet. It's pulling someone out of the triage line that has the "circling the drain" look. It's walking into a room and knowing when to hit that "code blue" light, even though the patient hasn't truly coded yet. It's knowing which baby with a fever is septic, versus just sick with a virus. A lot of the time, it's going with your gut instinct. And that is what cannot be taught in a classroom.

[insultmom]

Life is messy...

When I think back to why I started this journey into nursing, I’d like to say that I became an ER nurse so that I could help people, be a healer, be there for people in their darkest hour. In reality, I was just a 17 year old girl that wasn’t sure who I wanted to be when I grew up.

I picked nursing for a variety of reasons, none of which I can remember. Not that they really matter. Because almost every young kid that starts out in the nursing program has a very narrow view of what the world is like, and where they want to go in that world. Life isn’t like they tell you in high school, and nursing sure as hell isn’t what they tell you in nursing school.

I remember how hard I practiced to learn sterile technique. Taking the gloves on and off, never turning my back on my sterile field, always dropping my sterile supplies right in the center, so careful not to get close to the outer edge and the “dirty” zone. We worked on that for weeks in nursing school. And it all led up to a practical test where we had to go into a room with an instructor and demonstrate sterile technique by placing a Foley catheter into one of our lab mannequins.

I know my hands were shaking, I was probably sweaty and stumbling over my words as I explained every step of the process that I had so carefully memorized. I opened my tray and laid out all my supplies. I picked up a glove and carefully slid my hand into it. Then picked up the other glove, and was about to slide my other hand into, when I looked up and noticed my instructor wasn’t even watching what I was doing. She was staring at the mannequin, but I could see in her eyes that she was a million or so miles away.

That instructor lost her youngest child just months earlier to an accident. A babysitter had him at the pool, he could swim, but not that well yet. She turned her back for a second and lost track of him in a sea of bodies in the pool. By the time she found him, he’d been underwater for several minutes. They pulled him out and EMS worked him until they got to the ER I currently work in. They pronounced him shortly after. He was 7 years old. The same age my son is now.

I remember that day, that they came in and got her out of class, and how we could all hear her screaming in the hallway. Most of us just uncomfortable witnesses to her raw emotion. Most of us just wondering how long was long enough to sit there before we got up to leave the classroom after she was escorted out. None of us had any idea what it meant to even have a child, let alone to lose one.

The weeks after the accident, the funeral and her return to school, we mostly tip toed around her, tried to ignore her reddened eyes, her obviously gaunt face and the silence surrounding what had happened. That day in the skills lab, I’d like to say that I stopped what I was doing and hugged her, told her that her grief didn’t go unnoticed. I wish I had told her that it was ok to cry and scream and be mad that her baby was gone. Instead, I continued on with my practical test. I think I even walked out of there annoyed that she didn’t seem to notice, and certainly didn’t acknowledge my near perfect sterile technique. I just got the appropriate “pass” check on my paper with her signature. I was an asshole teenager that had no idea what real life was like.

I had no idea that sterile technique is a fine skill to practice and perfect, but when it all comes right down to it, sterile technique in the ER is relative to the situation. That dropping a foley usually means opening my kit between the patients legs, with blood soaking through the sterile drape, and having to put my gloves on while 10 other people crowd around the patient trying to stabilize them. That maintaining a sterile field in a trauma is a joke, and keeping the tip of the foley sterile is usually my only goal. That all my work practicing sterile technique was a waste of time. That the ideals set forth in nursing school are really only that. Ideals.

Nursing isn’t sterile. It’s messy. It’s sweaty, dirty, heart pounding, anxiety-ridden work. Just like life. Life is messy. And despite our best efforts to live the kind of life we’ve planned out in a journal with a heart shaped lock on during our study hall in high school, life never turns out the quite way we planned.

All those practice sessions for the “test” never quite prepare us for the real thing. You don’t get a second chance in life to get it right. You don’t get to decide when the real test will be, or what that test will entail. Life throws you punches, and you react and deal with them as best you can. Just like trying to maintain sterile technique in a trauma arrest. You do your best initially to get it right and do what you were taught, and sometimes you trash your kit and try to start over. And after a few traumas, you learn that sterile technique is always relative to the situation you’re in.

Sometimes you have time to explain your procedure, and lay all your supplies out on your sterile field, and don your sterile gloves and put the foley in using sterile technique just as you were taught all those years ago. And other times, your kit gets balanced on the patients knees while the attending is placing a chest tube. And just as you’re getting ready to lube up the foley, someone knocks your kit to the floor, and you’re standing there holding the foley with a pissed off look on your face… And you end up placing it anyway. Because what choice do you have but to move forward? To do the best you can. To try and make the right decisions. And to hope you’re not the person screaming in the hallway one day while asshole teenagers ignore your grief.

Why did I choose nursing? I don’t know… But I know now that life is messy, just like nursing. That as much as you prepare, you will likely never be prepared enough. So you do the best you can. And when life gets tough, you push forward. Because what choice do you have?

#life #nursing #ERnurse #grief