When you have a combative confused patient and the attending wants to avoid all psychotropic medications

Dementia is a devastating disease.  I agree that we should avoid psychotropic drugs because sometimes they can make the confusion worse.    

However, when a patient is agitated and de-escalation is not working, and the wife is crying because this is a rough picture to watch, in addition, she got hit by her husband- and I get hit and my tech gets kicked.  Enough is enough- you are creating torture for everyone.  I do not come to work to get physically abused by a confused patient because they don’t understand that I am cleaning them up.    I literally had a battle of wits with an attending and she ended up staying in the room for a couple hours.

I have gotten hurt before by a confused restrained patient that wouldn’t let go of my arm and all I was doing was fixing a trach collar that moved to the side and he was desaturating.  He was very strong and his fingernails were never cut because he was a nursing home patient.  I ended up having three bruises on my arm.  Luckily, this was completely healable, but that’s not the point.  A more dramatic case of not controlling the situation with an aggressive patient is in my class, there is a student who works in psych ER where a patient stabbed his coworker in the eye with a pencil.  He no longer can work as a nurse.  I think we as nurses do a great job not talking about workplace violence that we experience.  I think this reason contributes to a nurse’s burnout (sounds like a great DNP project for someone).

I hope doctors read this.  When direct care provider tells you that a patient is aggressive, you have a duty to protect not only that patient but that staff that is carrying out your orders.  

This is one of those study challenges in Nursing school. Nursing is a career based off a paramilitary background that requires you to learn time management. Learning to manage your time well while going through Nursing school by being on a schedule will help you better organize all parts of your life which also includes how you study.

Study in smaller chucks such as every 30-50 minutes with a 10 minute break allows your brain time to absorb the information and enhances your recall as well for short term memory. It’s called linkage learning. Every time you learn new material, break it up into smaller parts. Cover section by section with small breaks in between and not forgetting to review the previous sections you just covered before going onto the next. I guarantee you put this study method into effect and your test performance as well as grades will go up.

Cramming in the last 30 minutes before the test will not get you very far in Nursing school like it did in traditional college classes. Always think the long term outcomes of your career as a Nurse. You are a health advocate, educator, and doing a job that often has people’s lives are hanging on the line. One of my best clinical instructors taught me recently “To be a good nurse is to know your skills. To know your skills is to understand how and why you are performing those skills to your particular patient cases. To be knowledgable of your skills is to have complete POWER!”

Something to take into consideration before you decide to cram for your next nursing test.

Watch on

Me getting my flu shot. Mind you, I hate getting shots. And yes I have lots of piercings. But when it comes to needles. Ohgaahhh!! Caveman getting a flu shot! Department of health had to make it mandatory for all healthcare providers to get a flushot! #flushot #caveman #halloween #nurse #nursing #nursinghome #nurselife #nursinglife #gay #gaysian #asian #fml #ihateshots

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It's Official!

As of May 8th, I have officially graduated from my hospital's new graduate residency program. It was a year-long (well, more than a year long) program that involved a 3-month preceptorship, two weeks of orientation, monthly seminars, and presentations of evidence-based quality improvement projects at the end of the program.

It’s weird to think that I’m not a “new grad” anymore. And it’s a bit scary. Obviously there’s more that I’m responsible and accountable for since I’m no longer the “new kid” on the block. Roles have changed. People ask me more questions. I find myself teaching others more often. I find myself having more of a routine, but of course there are still things I struggle with.

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Be grateful for the simple things…

Even the simplest things such as your own hair is something to be grateful for. Whether your hair is curly, straight, thin, or thick, there is someone else in the world wishing they can have their hair back after chemotherapy or radiation. Or another person who gets a limp amputated & mourns the loss of being able to walk normal again or hold an object with two arms. Be grateful for your body. It is your temple in which you live. Appreciate & treat your temple with grace.