So, to bring things up to speed a bit...
Graduated with BSN December of 2015
Started Masters of Nursing program May of 2016
Left peds pych for adult medical early 2017, returned to peds psych within two months
Promoted from floor nurse to clinical supervisor early 2018
Graduated Masters program May 2018
And here we are today. Not in school, putting in my 40ish hour week on my peds psych unit at a hospital I love with people I really enjoy working with. I will be honest when I say that the transition from student to non-student has left me in a tailspin, wondering what I should do with my free time? Second job? A clean(er) house? Hobbies?
I've toyed with going back to school for advanced education and or certifications, but honestly at this point I really want to figure out what I am passionate about and what I want to do in the future.
To be continued...
Thursday, January 17, 2019
Friday, January 8, 2016
PALS
Working at a pediatric hospital is great. I truly love the patients I work with and get a warm fuzzy feeling inside when I see patients from other parts of the hospital or I hear a really great "miracle" story from one of the other floors. What terrifies me is PALS.
Before I started at my current job, I had BLS and ACLS certification (I did not know I would be working with kiddos at the time). Well, that was two years ago and it's time for renewal and appropriate certification, a.k.a. PALS.
I've been involved in two codes in my nursing career. Both during clinicals as a student. One was an adult on the ICU unit, and they were not my patient, so I was asked to just stand back and observe as my fellow nursing student was fully participating. The second was a pediatric patient who went into status asthmaticus shortly after we arrived on shift and I was given the job of writing down all the medications that were given to this patient. Thankfully our patient survived, but my heart still aches for the parents that had to live through this episode. Which brings me back to PALS.
Thankfully, if we keep our eyes open we can catch a pediatric patient tanking before they go into cardiac arrest. I went in to do the hands on, skills portion of PALS today and was very nervous. As a psych nurse, I do not deal with the same issues that a typical med/surg unit may deal with on a day to day basis. However, I did surprise myself with what I still know and my ability to bring everything back to our basic training in nursing school, good ol' ABC's. Although I know that I am a nurse, and have the education to prove that I am a nurse, I still need those reminders that regardless of what type of nurse you are, you have the information and skill, you may just need to brush off the dust a bit to find those skills. Yes, psych nurses are trained to save lives too.
Before I started at my current job, I had BLS and ACLS certification (I did not know I would be working with kiddos at the time). Well, that was two years ago and it's time for renewal and appropriate certification, a.k.a. PALS.
I've been involved in two codes in my nursing career. Both during clinicals as a student. One was an adult on the ICU unit, and they were not my patient, so I was asked to just stand back and observe as my fellow nursing student was fully participating. The second was a pediatric patient who went into status asthmaticus shortly after we arrived on shift and I was given the job of writing down all the medications that were given to this patient. Thankfully our patient survived, but my heart still aches for the parents that had to live through this episode. Which brings me back to PALS.
Thankfully, if we keep our eyes open we can catch a pediatric patient tanking before they go into cardiac arrest. I went in to do the hands on, skills portion of PALS today and was very nervous. As a psych nurse, I do not deal with the same issues that a typical med/surg unit may deal with on a day to day basis. However, I did surprise myself with what I still know and my ability to bring everything back to our basic training in nursing school, good ol' ABC's. Although I know that I am a nurse, and have the education to prove that I am a nurse, I still need those reminders that regardless of what type of nurse you are, you have the information and skill, you may just need to brush off the dust a bit to find those skills. Yes, psych nurses are trained to save lives too.
Thursday, January 7, 2016
RN Lead Groups
Our unit recently implemented RN lead groups at work with our patients. With that said, searching the internet for content on how to lead a RN group has brought few results. Maybe it's my search method, maybe I haven't spent enough time searching, but at this point I am turning to creating my own group ideas with the help of my trust nursing diagnosis handbook, online medical references and good old Pinterest for ideas. My group topic parameters were wide open, which is a good thing. I initially thought I could teach the kids about their medications, hygiene, nutrition, etc. I've tried a few of these topics and I've had an epiphany. First, teach the kids on what they want to know. My number one question from the kids is how do they get out of the hospital. This has become my journey group, which, depending upon the group of kids has been fairly successful. Second, teach them about what I know. I've "taken over" the weekly BHT cooking group and have incorporated nutrition (sometimes) in that group with the kids. This group appeals to my foodie side as I love food, but the twist is I have to make an item with what we have on the unit and if it needs to be cooked, I only have a microwave. Challenging? Yes. Impossible? No. Tasty? Believe it or not, we've come up with some great recipes with minimal ingredients. Third, teach what I love, which happens to be being healthy. I've incorporated the benefits of exercise with the fifty-two fitness card game, and tried it out for the first time yesterday. Let's just say I think we picked all high cards in a row and my shoulders and quadriceps are sore today, and I am glad we only went through half the deck. However, the kids stuck with it and enjoyed it until the end.
Monday, January 4, 2016
Happy New Year! With the new year comes resolutions, goals, the changing of ways. Although I am not much of a resolution person, I do have some goals for the coming year:
1. Add new recipes that are delicious, easy and healthy. I'm stuck in a rut on this one.
2. Work towards the run the year challenge. I know I can do this as it is only 5.5 miles per day. However, I have to be careful as I also am doing triathlon training and am prone to overuse injuries.
3. Tweak my own diet routine. I tend to eat really healthy and stay on track while at work and on my days off...until late in the afternoon when I feel like I am starving and need to cave in to each and every snack I see. I am going to try to add in a protein boost in the early afternoon to see if this helps.
4. Stretch more. I have a bum hip which could use a little more love.
What are you working towards in 2016?
1. Add new recipes that are delicious, easy and healthy. I'm stuck in a rut on this one.
2. Work towards the run the year challenge. I know I can do this as it is only 5.5 miles per day. However, I have to be careful as I also am doing triathlon training and am prone to overuse injuries.
3. Tweak my own diet routine. I tend to eat really healthy and stay on track while at work and on my days off...until late in the afternoon when I feel like I am starving and need to cave in to each and every snack I see. I am going to try to add in a protein boost in the early afternoon to see if this helps.
4. Stretch more. I have a bum hip which could use a little more love.
What are you working towards in 2016?
Wednesday, December 30, 2015
Do all things without grumbling...
I have my current favorite bible verse referenced on my bathroom mirror as a daily reminder to do everything without complaint (no one wants to hear it anyway) or as I like to put it, suck it up buttercup. I try very hard to not complain about whatever goes on in my day and to just grin and bear it, however, one thing that tests me time and time again is getting an admission from our own ED at shift change.
As any nurse will tell you, most days have a certain routine. Medications need to be passed, procedures need to be done, rounds with the doctors happen, etc. If you are lucky, this will occur without incident and you are able to pass on report and be on your merry way shortly after shift change and report are over. As a day shift nurse on a psych unit, my goals for the day consist of many things, but in the end, keeping everyone safe has top priority. For many of my patients, transition is a HUGE trigger. Transitioning from the playground, from quiet time, from group time, etc. can be hard on the kids. Transitioning from staff, especially at shift change can be time for mutiny on a psych unit. Hence my frustration with admissions at change of shift.
I am proud of the team I work with and the fact that we have a plan for shift change and how we can make things easier on "our kids." We know that many of these kids cannot trust adults and will test boundaries to the limit when a new adult is present. Our team tries (very, very, very hard) to create a consistent routine, to plan ahead, and to plan with the child what will happen next, in order to maintain calm on the unit. As a day nurse, I work hard to keep the calm at shift change so I can set up the incoming night crew with a good shift since I will likely be seeing them the next morning. This is where my plea to the ED comes in. If I know that your patient is coming to me at 1729, please be prompt and send this patient to me ASAP. Please do not put in the admit order at 1749 and then send the patient at 1915. We are now in report with the night crew and trying to maintain that thin shred of calm on the unit that we have worked hard to maintain and the patient you have sent me is crying, screaming and has nine relatives in tow, who are all on their cell phones tweeting/facebooking/snap chatting, wanting to take pictures of the patient on the psych unit no less, all while demanding water and a "safe" place to put their very expensive handbag. I understand that the ED is not fond of working with "my" kids, but please do not hold "my" kids until 1915 and tell me they need to move now so night shift assignments in the ED can be made. We made assignments as well, and this admit may change how we would have staffed. My unit is different than most. Parents do not stay. Kids are not confined to bed. All are triggered by the smallest upset/noise/change in routine. Although I may grumble when this happens, I will always stay to help the next shift in whatever way I can, I just wish other areas would understand how huge and unsettling shift change is for psych patients.
As any nurse will tell you, most days have a certain routine. Medications need to be passed, procedures need to be done, rounds with the doctors happen, etc. If you are lucky, this will occur without incident and you are able to pass on report and be on your merry way shortly after shift change and report are over. As a day shift nurse on a psych unit, my goals for the day consist of many things, but in the end, keeping everyone safe has top priority. For many of my patients, transition is a HUGE trigger. Transitioning from the playground, from quiet time, from group time, etc. can be hard on the kids. Transitioning from staff, especially at shift change can be time for mutiny on a psych unit. Hence my frustration with admissions at change of shift.
I am proud of the team I work with and the fact that we have a plan for shift change and how we can make things easier on "our kids." We know that many of these kids cannot trust adults and will test boundaries to the limit when a new adult is present. Our team tries (very, very, very hard) to create a consistent routine, to plan ahead, and to plan with the child what will happen next, in order to maintain calm on the unit. As a day nurse, I work hard to keep the calm at shift change so I can set up the incoming night crew with a good shift since I will likely be seeing them the next morning. This is where my plea to the ED comes in. If I know that your patient is coming to me at 1729, please be prompt and send this patient to me ASAP. Please do not put in the admit order at 1749 and then send the patient at 1915. We are now in report with the night crew and trying to maintain that thin shred of calm on the unit that we have worked hard to maintain and the patient you have sent me is crying, screaming and has nine relatives in tow, who are all on their cell phones tweeting/facebooking/snap chatting, wanting to take pictures of the patient on the psych unit no less, all while demanding water and a "safe" place to put their very expensive handbag. I understand that the ED is not fond of working with "my" kids, but please do not hold "my" kids until 1915 and tell me they need to move now so night shift assignments in the ED can be made. We made assignments as well, and this admit may change how we would have staffed. My unit is different than most. Parents do not stay. Kids are not confined to bed. All are triggered by the smallest upset/noise/change in routine. Although I may grumble when this happens, I will always stay to help the next shift in whatever way I can, I just wish other areas would understand how huge and unsettling shift change is for psych patients.
Thursday, December 24, 2015
Bah Humbug!
One of the things I thoroughly enjoy about working in psych is the never ending questions. We are always trying to discover the root of the problem, to understand the cause and the why to the behaviors. The dangers of being in psych is that you take this questioning and longing for answers and begin applying it to not just your patients, but to others in your life and even yourself.
For the past few years, I have started dreading the holidays. The days and month up to the holidays I enjoy - making lists for gifts, decorating the house, making meal menus. Then as the days get closer to the big day, I start becoming angry and bitter. I am(self) tasked with many things such as making the entire meal, purchasing the gifts, wrapping the gifts, pleading with family members to attend at least one mass out of the year with me, and driving my mother to and from my home. All without an offer of help from other family members. I then find myself stewing over my being deprived out of an ideal family gathering where family members share in the tasks of making meals and opening their homes to one another, and staring at just another item on my list (nurses love to make lists, even adding little check boxes to make the items official) that I cannot wait to check off and call it a day. Obviously not a festive or mentally healthy way to spend what is called the "most wonderful time of the year."
So, what do I do? I need to re-frame my thinking, much in the same way I try to teach my kids at work. Look for the trigger. Examine how it makes me feel. What is my behavior. The trigger is the holidays and my belief that there is an ideal family holiday that I am not able to enjoy, which in turn makes me angry (not sad or depressed, but very angry) which makes me irritable and honestly not really nice to my family. Here's the hard part. I need to change my thinking, and I know that I need to do this in order to stop this cycle, and it is going to take a lot of conscious effort on my part. Yes, it is the holiday and I only have my family of four, my mom and my father-in-law to celebrate with, not the Norman Rockwell painting I envision for a large gathering. Although I am tasked with the cooking and baking, realistically, I am the only one able to prepare the meal. What I need to look at is delegating tasks to others and being o.k with those tasks being done by someone else. Ironically, I am feeling better already. As cliche as it may sound, I (and I am telling myself this) need to be grateful that I have family around to celebrate with. Although it may not be the celebration I envisioned long ago, it is still a celebration and needs to be viewed as such, not an occasion to be bitter and angry.
For the past few years, I have started dreading the holidays. The days and month up to the holidays I enjoy - making lists for gifts, decorating the house, making meal menus. Then as the days get closer to the big day, I start becoming angry and bitter. I am(self) tasked with many things such as making the entire meal, purchasing the gifts, wrapping the gifts, pleading with family members to attend at least one mass out of the year with me, and driving my mother to and from my home. All without an offer of help from other family members. I then find myself stewing over my being deprived out of an ideal family gathering where family members share in the tasks of making meals and opening their homes to one another, and staring at just another item on my list (nurses love to make lists, even adding little check boxes to make the items official) that I cannot wait to check off and call it a day. Obviously not a festive or mentally healthy way to spend what is called the "most wonderful time of the year."
So, what do I do? I need to re-frame my thinking, much in the same way I try to teach my kids at work. Look for the trigger. Examine how it makes me feel. What is my behavior. The trigger is the holidays and my belief that there is an ideal family holiday that I am not able to enjoy, which in turn makes me angry (not sad or depressed, but very angry) which makes me irritable and honestly not really nice to my family. Here's the hard part. I need to change my thinking, and I know that I need to do this in order to stop this cycle, and it is going to take a lot of conscious effort on my part. Yes, it is the holiday and I only have my family of four, my mom and my father-in-law to celebrate with, not the Norman Rockwell painting I envision for a large gathering. Although I am tasked with the cooking and baking, realistically, I am the only one able to prepare the meal. What I need to look at is delegating tasks to others and being o.k with those tasks being done by someone else. Ironically, I am feeling better already. As cliche as it may sound, I (and I am telling myself this) need to be grateful that I have family around to celebrate with. Although it may not be the celebration I envisioned long ago, it is still a celebration and needs to be viewed as such, not an occasion to be bitter and angry.
Thursday, September 3, 2015
Kids Say the Darnedest Things
Adolescent boys are interesting. As a parent of girls, I have no personal experience with boys other than through work. The decision was made to trial programming older kids and younger kids separately on the unit. This required switching kids between units on our floor. This also meant that some kids were not familiar with other kids once they were mixed. Our unit was all boys. The mixing involved sending a few of our boys and receiving a few girls to program for the day. I stayed on the unit with the older children and observed them interact throughout the day.
The boys were definitely "being boys" and were doing their normal acting up, disrupting group activities and being rude to the girls. Many of the boys were sent to their rooms to calm down and regroup before returning to the group activity. After this occurred a few times, my nursing sense knew what was going on, but I wanted to hear from these adolescent boys themselves.
When asked, each boy would state that they just did not like the girls in the group. After further conversation and questioning by me (and squirming by the boys), they had no idea why they were acting up. Once they calmed down, they returned to the group. Some made it through to the end, some did not. Oh the perils of being a teenager!
Our younger boys transitioned back to their "home" unit before group was over and before the girls were transitioned back to their "home" unit. One of our hyperactive younger boys interrupted group, started posturing and acting as though he was going to throw a chair, which promptly got him sent to his room. When asked why he did this, he was confidently able to state what the other boys did not. "I wanted to impress those girls."
The boys were definitely "being boys" and were doing their normal acting up, disrupting group activities and being rude to the girls. Many of the boys were sent to their rooms to calm down and regroup before returning to the group activity. After this occurred a few times, my nursing sense knew what was going on, but I wanted to hear from these adolescent boys themselves.
When asked, each boy would state that they just did not like the girls in the group. After further conversation and questioning by me (and squirming by the boys), they had no idea why they were acting up. Once they calmed down, they returned to the group. Some made it through to the end, some did not. Oh the perils of being a teenager!
Our younger boys transitioned back to their "home" unit before group was over and before the girls were transitioned back to their "home" unit. One of our hyperactive younger boys interrupted group, started posturing and acting as though he was going to throw a chair, which promptly got him sent to his room. When asked why he did this, he was confidently able to state what the other boys did not. "I wanted to impress those girls."
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