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The BIG things I learned from 5 different specialties

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When I entered this profession, I never thought in a million years that I would learn so much. I thought once you learn how to “nurse,” it probably stays that way throughout your  entire career.

Boy, was I wrong.

I’ve hopscotched a bit in my career, but all of my employment positions have served a greater purpose in the grand scheme of my skill development and how I “nurse.” Ironically, how I “nurse” seems to continually change the more I do this job.

Here are some things each one of my jobs has taught me through the years:

1. Cardiac Care/Intensive Care Unit (new graduate)

  • No patient should ever die alone, even if there is no family present.
  • GI bleed + dementia = a room that resembles a maroon-colored nuclear explosion.
  • GI bleed + dementia = blood under all fingernails (I’d rather not explain).
  • GI bleed + dementia = blood INSIDE the IV pump (don’t ask).
  • There is a REASON you must lie flat for six hours post heart catheterization–don’t test those waters (FEMSTOPS are not comfortable).
  • Always, always, always have fluid hanging when removing a sheath after a heart catheterization. Just trust me.
  • If you are doing CPR correctly, ribs will crack.
  • Administering CPR becomes more difficult on a moving transport cart.

2. Orthopedic Surgical Services

  • Have a patient seated firmly and supported when removing stitches–so when they pass out they don’t drop to the floor.
  • I now know WHY joint replacements hurt–ever seen a carpenter replace a cabinet? Bones are treated like the wood.
  • I DO NOT like five day/week jobs.

3. Surgical Trauma Intensive Care

  • All bleeding eventually does stop, one way or another.
  • Be sure to ask family members if they are afraid of needles when giving their family member (the patient) a subcutaneous injection (heparin, lovenox, insulin, etc.). It’s not fun when the family member passes out and falls to the floor.
  • The rapid infuser has to be the coolest machine ever invented.
  • If a patient does not want to be restrained, they will ALWAYS find a way out.
  • The bigger they are, the harder they fall–quite literally.

4. Post-Anesthesia Care Unit

  • Always, always, always check your IV sites for patency. Never assume.
  • There’s only one type of nurse that belongs in pediatrics–one with a strong, strong heart.
  • Drugs are good.
  • Drugs are bad.
  • Crocs are not a comfortable enough shoe when standing for 8- and 12-hour shifts.

5. Critical Care (Intensive Care) Unit

  • Sometimes, the best medicine you can give your patient is silence to sleep.
  • There’s dead, then there’s dead.
  • Post-mortem care is just as important as saving a life.
  • Not all body bags are made the same.
  • The size and level of care of a hospital has no bearing on how tough your job can be.

These are my pearls of wisdom I carry with me wherever I go. It’s a cumulative process and I don’t think I’ll ever stop learning.

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One Response to The BIG things I learned from 5 different specialties

  1. therealcie LPN

    Sean, I wanted to thank you for this article. You are evidently everything a nurse should aspire to be. You are passionate about your work and always striving to learn more. You want to do right by your patient. If every nurse were like you, the medical field would benefit tremendously.
    I hate five day work weeks too. I am currently working five days a week to attempt to catch up on bills. I never quite feel renewed when I return to work. I’m going to stop doing this as soon as humanly possible and go back to a 32 hour week.
    My question may seem a bit of a letdown given all the wonderful information you’ve offered, but what I want to know is, what kind of shoes do you recommend for a long shift where you’re standing most of the time. I’ve tried several kinds of shoes and none of them quite seem to do the job. I am an older person, heavyset, and I have sciatica and foot problems. I find that at the end of a shift where I’ve done a lot of standing, either my back gets enough support but my feet hurt, or my feet feel fine but my right leg has a painful tingling numbness from the sciatica. My quest to find a shoe that addresses both continues!
    Thank you again for being a great example for all nurses, and for what you do for your patients.

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