I’ve been at my new job for about a year now and I’ve been an RN for almost 2 years. (I know. I can’t believe it either. Seems like last week I started “Not Nurse Ratched” as a prenursing student.) I keep thinking “by now I should feel super confident about everything I do.” I thought it at 6 months and a year as well, and now I’m starting to think that in this career I may never feel comfortable and expert, as I did as an editor. I was able to be an expert in that field, but in this one there will always be unknowns and new things. Perhaps it’s the nursing condition and I need to settle in to it, much like that point in some shifts where you realize and accept that you are NOT going to get “caught up” and are able to relax into the chaos.
Anyway, I’ve gotten a lot done in my fledgling career; I’ve guest-lectured twice on dysrhythmias to BSN students, I’m a board member of our local state ANA chapter, and I was invited by AJN to edit a new technology column and become a manuscript reviewer (yes to both, obviously). So when am I going to get that “I have arrived” feeling as a nurse? I am certified in ACLS and PALS, I’m taking TNCC next week, I keep really up to date with current research, I poke my nose into cases I haven’t seen before at work so I have more exposure to new things, and it still seems like it’ll never be enough. UNTIL. I remember what I felt like when I very first started and then I feel like I’ve learned a mountain’s worth (I vividly remember my first day in clinical when I was stymied by getting a nursing home resident from wheelchair to toilet, and that wasn’t all that long ago).
Things just may never settle down, and come to think of it that’s one reason I chose to change careers. I was TOO settled in my previous one. I was bored. I knew pretty much all I could learn and was at the top of my career ladder with nowhere to go. I may feel a lot of emotions about being a nurse, but boredom is not among them. Settled, schmettled. In other words, I’m thinking the answer to my question is no, they don’t, and that this is a good thing.
I understand why physicians find these conversations difficult, why it’s preferable to focus on the good we can possibly accomplish rather than the likely futility of the struggle.
But there’s another story to be told in these cases, and it’s usually the nurse who’s the observer of that narrative: the suffering caused by these well-intentioned treatments. Chemo was risky for this patient because of his age and medical history, and the damage done was unbelievably bad.
I’ve found it: the Holy Grail! I’ll share right away. Here it is: Bookmarklets for your iPad.
It’s the Holy Grail because I have LONG lamented the inability to publish links to Facebook from my iPhone or iPad and have them show up as links and not status updates or some other form of gibberish. This method makes links just like from a desktop computer.
Peds is my weakness. (One of them. That and anything to do with eyes. For different reasons.) Deep down I’m still a cardiac nurse, for grownups, and I don’t have children of my own. Frankly, until I went to nursing school and was forced to interact with them, kids freaked me out a little because I wasn’t used to them and couldn’t successfully communicate with them (I’d be immediately foiled by the first “no!” from a 2-year-old). I like them a lot now. They’re interesting creatures, and I’ve gotten a thousand times better at successfully assessing and treating them. But sometimes you need a little voodoo. I learned some that I feel I should pass along.
It happens often that kids appear in the ER because they’re really dehydrated, for whatever reason. They’re not that big, so they dry out fast. They’re also not stupid and have figured out that drinking stuff makes them vomit, and they’re not having any of it. No one wants to put an IV in a kid, so we try to give them oral medicine and then get them to drink, which is usually frustrating for everyone. But I learned the best cocktail EVER for tempting a kid to attempt oral intake. Here’s the recipe.
- Half of a double-header popsicle, rinsed and upended in a cup: microwave for 15 seconds. Rinsing is important to avoid freezer burn taste. Kids are very discerning about their popsicles.
- Use the stick to break up the rest of the popsicle.
- Add a splash of apple juice.
- Mix. If medicines are still needed, take a medication cup to put a smaller amount of this magical concoction in to mix it with.
- Tell the child you have a magic drink. Use the spoon like a magic wand, complete with “ta-da!”
- Then say, “I bet you can’t drink it, though.”
The child will seize the cup to prove you wrong. The spoon-wave may be what makes it work. Maybe it’s the splash of apple juice. I’m not sure. But you can’t deviate from the routine at all.