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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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