The frustration with University of Facebook

I’ve seen it. You’ve seen it.

The posts FULL of misinformation about COVID: who is most affected, how it’s spread, magical yet TOTALLY UNSUBSTANTIATED treatments, it’s enough to make a nurse want to flip a table!

I let go of Facebook years ago because of the stuff I would see on my time line. People seem to think that if someone says that someone major said it, it must be true! They offer no evidence, no background information, no research data, just whatever they think is true. And goodness, do NOT try to provide evidenced based information about why what they said isn’t true, then you’re a “sheep” or you’re gullible.

Think about that: you’re gullible for looking up evidence, but they aren’t gullible for placing their faith in a Facebook post.

That’s where we are now, folks.

To all my nurses and other medical professionals, if your education is falling on deaf ears, let it go. You have done what you can do. Don’t waste your time arguing with people on so I media about how unsafe their posts are. It’s not worth it. Your sanity, however, is very worth it. Continue to be safe for yourself and continue to institute measures to keep your family safe. That’s your priority.

Have any of you seen something online that made you want to scream?

Exhausted

Does anyone come home exhausted from work? Not just physically exhausted but emotionally exhausted.

It feels like I pulled a 24 hour shift when I get home. I’m so tired, all I want to do is retreat from the world and sleep. Between the constant news about COVID 19, people refusing to wear masks, new outbreaks in states, more unarmed black people being murdered by cops, “Karen’s” throwing fits and calling the cops for nothing, children being caught in the crossfire of shootings, it’s all too much for me.

It feels like I’m overwhelmed all the time. I feel weighed down a lot.

So I decided to turn off the news, stay off social media, talk to my therapist, watch my nerd shows, and play my switch.

I am doing the things that help me relax and release the stress. I have a habit of carrying way too much weight on my shoulders. If I don’t let go, I just end up exhausted to the core.

How are you feeling? How do you release the stress?

It’s hit home

I have been following COVID-19 since December when I first heard about it, and it was still being called the “Wuhan Flu”. Reading what the CDC is saying, reading WHO recommendations, reading articles about it, and so on.

But it was over there and I am over here. I kept up with the information but it remained at a distance to me. I was curious as we nurses are, but I wasn’t yet concerned. It hadn’t hit home.

And then that started to change. First Washington state. Curiousity turned to slight concern because now it’s on home soil… but still it was over there on the west coast and I am over here safely on the east coast. Then it hit California. Now I’m following it far more closely because it’s spreading. However, somehow in my mind I was still safe. That’s when I started hearing about cases in Florida. Okay, now it’s over here but it’s states away.

I’m still safe.

And then it hit Washington DC.

It hit home.

It was only a 2 hour drive away. That’s when I began closely following everything. I’m watching the news, I’m reading all the WHO and CDC updates. I’m trying to learn all I can. It hadn’t yet hit my city though and there was still that little idea that I was somehow still safe.

That idea dissolved when I heard about the case in one of the hospitals in my area. More cases followed. Now my hospital is dealing with cases and it’s a nightmare. We are now rationing masks. We have to be mindful of how many antimicrobial wipes we use because there is a limit on how many containers of wipes we can get a day. The department I am in cares for inpatients and outpatients so our risk of exposure is high. The ER is at the front line. God bless those providers. Visitation has been suspended. People are being screened before walking into the hospital now. I’m no longer concerned, I’m officially rattled to my core. It feels like things are spiraling out of control and as a nurse that’s a big no-no! States are having to go into quarantine. We haven’t hit that yet but I don’t think it’s far away. It feels unreal, like a movie almost. People are panic buying everything. I can’t find a roll of toilet paper anywhere. I had to go to two stores to find garlic…GARLIC! Who panic buys garlic?

The panic and fear is real.

It’s serious and we need to make sure we are taking it seriously. My colleagues and I have been making sure to teach patients proper hand washing techniques. We are all trying to send each other health care memes to keep our spirits up.

It’s not been great for my anxiety.

I can only hope and pray that we start to get things back under control. I hope humanity can band together and get through this as one. I hope we see that the differences between us are nothing in the grand scheme of things. I hope we as a people come out of this better than we were before.

Addiction

Addiction is rough. I witness it with patients everyday.

I encountered a patient with necrosis in the arm and it’s not a small area of necrosis, it’s pretty much the whole forearm.

They still shoot up in that arm.

The addiction is so strong that they are willing to literally risk life and limb for a high.

It’s sad and disturbing.

It makes you realize just how strong addiction is. We in the medical field often blame the patient:

“Why won’t they quit?”

“They obviously don’t care!”

“They should know better!”

“They did this to themselves.”

I’ll admit, I’ve thought that about patients. I’ve been judgmental even when it’s my job not to be. I’ve generalized and stereotyped people.

I am calling myself out for it.

It’s not my place to judge, it’s my job to treat.

It’s not my job to wonder why a person is suffering from addiction, and they are suffering.

It’s not my job to scold and belittle a patient for being addicted.

It is my job to provide the best care I can. It is my job to connect them with substance abuse counseling if they want it. It is my job to provide as much education as possible. It is my job to be their nurse. I’ve got to remember that.

Alpha-gal syndrome

I learn about new disorders all the time here in MRI. Normally I’ve at least heard the name of the disease or disorder before, or I know a teeny bit about it.

I have never heard of alpha-gal. At least, I’ve never heard the name.

Turns out, I have heard of the disorder before. I had a patient once tell me he was allergic to pork because of a tick bite.

Alpha-gal is a “sugar molecule found in most mammals (except in people, apes, and monkeys)” (CDC.gov, 2019). Turns out there is a tick (lone star tick) that can transmit the molecule in blood from the animal to humans. We humans don’t normally make the molecule but apparently we can make an immune response to it. If we develop an allergy then we can no longer eat meat from cow, pork, rabbit, deer, lamb, essentially the animals work hooves! The odd thing about it, and what makes it kind of hard to diagnose, is the fact that the reaction tends to take place 3-6 hours after the ingestion of meat. It’s hard for a lot of people to make the association between meat and their allergic reactions.

I found a good podcast about the disorder. Lots of information about how it works and the ongoing research around it.

One of the things I realized while looking further into the disease is how important it is to ask your patient about allergies. Alpha-gal is uncommon, however, patients with it can’t have certain medications. Heparin is typically derived from pork. Some insulin is derived from pigs and cows as well. There are quite a few medications that have porcine or bovine derivatives. A nurse would have to make sure to take this into account for their patient with this particular allergy.

Then again, when is the nurse not taking safety into account, right?

Guilt

I’m on school break and restart October 1st.

I didn’t have to take a break because of life events or anything like that. I am on term break until classes restart. I finished my 4 classes for the first term and had 5 weeks left until next term starts. If I had finished my last class a little earlier I would have had 6 weeks left which would have been enough time to add in another class. Since there, technically wasn’t enough time left, my advisor told me to take a break until the next term starts.

OK, cool, I earned a break…

Yet I feel guilty… Anxious. I feel like I should be doing something school related right now. I feel like I should be logging in to see if I can get the requirements for the next class. Not doing something school related makes me feel guilty.

I shouldn’t feel like this. I know that. However, I’ve been a full-time nurse and full-time student for so long that I don’t know what to do with free time. I’ve been playing Final Fantasy, enjoying friends, I even picked back up on learning how to knit. Yet I still feel this anxiety about school. My mind keeps telling me I am wasting my time and should be doing something, anything related to school… EVEN THOUGH THERE IS NOTHING I CAN ACTUALLY DO!

I hate that I have used school and work to occupy my time for so long that I feel guilt about free time. That’s not fair to me… And now you see why I’m in therapy…

Team

You need a team.

If you’re a nurse, you need a good team. There is no way to survive on any unit without team work.

When you interview for a position, ask about the team work. How well do the nurses work together? How is bullying handled?

You’ll want to know these things. A unit that isn’t a team is a unit headed to hell in a hand basket. It can’t function effectively. Trust me, I’ve worked on units where it was every nurse for themselves. It was horrible. There were nurses that wouldn’t help with the new admission. It took an act of congress to get someone to help clean up a patient. Gossip spread like wild fire. Nurses ate their young for fun. It was two years of nursing that I never want to experience again. From that point on I decided I would not waste time on units like that.

That’s why finding about the team mentality is so important. You want to work somewhere with nurses that work together. You want to work in an environment that is not toxic. Regardless of how the shift is going, you want to know your coworkers have your back.

Nursing isn’t a solo job. We aren’t super heroes that can handle everything on our own. We have to depend on each other to get through the day. When the shift is nuts, you want someone you can vent to. When you aren’t able to save the patient, you want someone that understands the pain. You’ll want someone you can ask questions to that won’t make you feel like you’re stupid. You’ll want a team.

Do yourself a favor, find a good place to work.

No days off

Have you ever encountered this particular situation,

Them: “Hey, when are you off again?

You: “Well I am off tomorrow but I…”

Them: “Oh good because I need you to…”

Or my other personal favorite,

Them:How are you doing?”

You: “Whew, I am worn out! It’s been a long week!”

Them: “How are you always tired, you only work three days a week!!!” 

Seriously? SERIOUSLY?!?!?!?!

Let’s start with the fact that nurses work with people every day we are at work. PEOPLE. Like, human beings… HAVE YOU SEEN OUR SPECIES??? We deal with emotional outbursts, insults, violence, unrealistic expectations, death, etc. ON A DAILY BASIS! It’s not just 3 days, or 4 days, or 5 days, or whatever schedule that we work. It’s the emotional baggage we deal with on days off. It’s wondering if you could have saved that patient if you had done one thing differently. It’s trying to figure out why this one nurse hates you. It’s sitting at home thinking about the child abuse victim that you know will be given back to their parents. It’s thinking about the insults the doctor hurled at you because you weren’t moving fast enough. It’s class assignments due at midnight. It’s the kids having soccer, baseball, and basketball practice the couple of days you have off. It’s 3 weeks of laundry that still needs to be done. It’s a house that desperately needs cleaning because you haven’t had time. It’s never having an inkling of downtime.

It’s constantly feeling like you are walking on a razor-thin edge between success and insanity.

It’s stressful.

The last thing we need is to be made to feel guilty because we are too tired to hang out or because we don’t have time to be someone’s personal errand-runner.

Your days off belong to you. Every single one of them. You deserve to power down. You deserve to do NOTHING if that is what you want to do. You aren’t being “lazy”. You are trying to maintain your sanity. You are not wrong for turning down a night out on the town. You are not wrong for telling someone “no” when they start to come up with your schedule for your day(s) off for you. You are not wrong for shutting out the world temporarily if you need to. You take care of so many people, you deserve to take care of yourself. Nurse yourself back to health. Take your days off and do whatever the hell you want with them.

A nurse that doesn’t take care of themselves can’t effectively take care of others.

 

 

Pacemakers?

My hospital is one of the few in our area that will perform an MRI on patients with pacemakers.

It makes me nervous.

I KNOW it’s supposed to be considered “safe” now. The newer pacers and defibrillators are being made to be compatible with MRI scanners.

It still makes me nervous.

I just don’t feel I should be throwing a person, with a magnet sensitive device, into a giant magnet. I feel like it’s a risk everytime I do it. Is an MRI of the wrist really necessary on this 79 year old man with a pacemaker/defibrillator combo? Like, is this life or death? Are you going to do surgery?

No?

Then why are we taking this risk?

I just don’t like it.

Do any of your facilities perform MRI’s on patients with pacemakers or defibrillators?

July…

It’s July. For some of you that’s no big deal. However, if you work in a teaching hospital July means something deeper… Darker…

The “brand new” residents begin their rotations…

Chaos ensues.

If you have had the pleasure of avoiding the July rush, you’re lucky. For the rest of us, there’s a sense of impending doom.

So many orders. Most make no sense.

-pediatric doses ordered for adults.

-level one head CT for “AMS” on your 98 year old patient with known dementia.

-12.5 mcg of fentanyl q3hrs for your chronic pain patient.

-one unit of blood for an hgb of 5.

-MRI of the ankle to look for osteomyolitis of the toe.

Many, many more orders from an alternate reality…

In this moment, it is your time to shine! You are the only barrier between your patient and a doctor that is still getting their bearings. You’re going to have to speak up, a lot. You’re going to have to advocate. You may even have to knock a new doc off their self-appointed pedestal (when they tell you you’re “just a nurse” please refrain from punching them in the throat).

You can do this. Take a deep breath and remember: you’ve made it through many July’s and you’ll make it through many more…