I'm half way done with night shift orientation-so far so good. I had my first rough night on Monday. I've had days where I just couldn't wait to get home but Monday night was something else. I wanted to tear out of that place. I wanted to scream. I wanted to cry. I wanted to call all of my best nursing friends and say, "I know it's 9 in the morning, but let's have a beer."
I picked up my team at 2300 instead of 1900 because we were going to a unit council meeting after report in the morning. I think that's where the trouble started; you just don't get in the right groove when you do that. You've missed the first assessment and you're actually coming in at a relatively busy time on the unit, especially when you have the heavier patients. I had one easy patient, she was already asleep and just needed assessments and meds and pain meds every four. I had one to come and two in isolation down the other hall. One is unresponsive and is a complete care and the other was doing well...until we found out we needed to start blood on her. So I start calling docs and putting in orders for type and crossmatch and transfuse 2 units PRBC's. They didn't type and cross until 0100 and then the blood wasn't ready til 0230, which was in the middle of my admission (with a heparin drip) for my 'to come'...about the time I was getting ready to go get the blood, something happened that caused me to have to rush down to blood bank and get the blood and rush back up and start the blood. My lunch (lunch is more scheduled on nights because of the cafeteria only being open from 0145-0345) didn't start until 0330 and then I ate as quick as I could to get back to everything. As soon as I got back, my other patient's PEG tube was clogged and we had to fix that. I got so busy and just trying to stay caught up, I forgot to draw labs on one of them and that put my even further behind. I didn't get off the unit until almost 0800. Just a lot of little things-and a few big things-that added up to make me very frustrated and very flustered.
But I went back on Wednesday night. And Thursday night. And since my preceptor was team leader she tweaked the assignment so I'd have at least one of the heavier patients I had before. I got the unresponsive one who began having blood pressure issues on Wednesday around 1500. They bolused and she was ok. Until 2100. Sigh. So all I did all night was do one bolus after another, trendelenburg and back up, BP checks every 3-5 minutes, all that fun stuff. I had the same team Thursday night and it went much more smoothly. Thank goodness.
I like 6SAC. ICU step down is great. We do have some patient's that aren't appropriate for the unit, either too medically stable or not stable enough but sometimes we can't transfer them out. Seems like people go bad on nights the most. But 6SAC is great because there aren't a lot of ego problems; nights wraps up what they can and so does days and no one is blaming anyone else for anything that wasn't done. Nights does a lot of the "housekeeping" type of stuff. Making sure that things are ready to go for days, paper work, strips are ready to be printed, people are cleaned up for the day shift since they tend to be busier. And I found out that I can apply to ICU (in a year, of course) and only do 6-10 weeks of orientation. That's all 6SAC nurses usually need. The other units have to do 6-12 months. Yikes!
Life is different on nights. I can't do the switching back and forth very well. My goal on my nights off is usually to go to bed around 0300 but this last week it's been 0600 which is kind of irritating. I sleep all day. I eat one meal while I'm at work and eat a piece of toast before. I drink a ton of water and lots of Amp and Diet Dr Pepper. But I wake up when the kids get home and see them for about an hour before work. I'm not as rushed. I have been able to go to swim lessons and play outside with them pretty much every day. The house is quiet while I do school work at midnight. I get all the laundry and dishes done while they're sleeping. I just wish Eric would put it away-it's hard to put laundry away in the dark when everyone is sleeping. haha! The worst part is feeling lonely. No one else is awake and most of my friends are day shift so I don't have anyone to call at 0200 when I feel like chatting.
School is going well. 100% in Sociology so far and a 98% in my NSG class at OU and I just have one more week of that class. Then I have a week off and start my Nursing Management course and continue on for a few more weeks of Sociology. I'll be so glad when that class is over. It's more work than my 5 credit hour nursing class, which I find to be quite ridiculous. I think I'll stick to just Nursing for a little while and fit my nutrition and English in at a later date. One year and I can have my BSN. :o)
One final thought-
Note to self: make sure my husband and family know that I am to be a DNR if I ever become unresponsive d/t brain injury. Do not, ever, trach me, PEG me, and leave me at a nursing facility. Do not stick a foley and dignicare in me; unless it's for comfort. I'm all about palliative care. Do not make me a full code if I have had a cardiac arrest that leaves me with an anoxic brain injury that leaves me unresponsive. What was the point in bringing me back the first time, let alone a second? Do not let me grow hairs on my chin-this is more of a general statement. If I am 100 years old sitting around my house, somebody better bring the tweezers over and take care of the old bearded lady. The do's: Please do help me put make up on when I'm old and have lipstick on my teeth. Send me to hospice if I'm terminally ill or unresponsive. Tell the nurses what I like to do at home. Come play music for me. Tell me stories. Bring pictures. Bring old friends to say good-bye. Say a prayer if you like. And when I die, please donate my organs. Donate my body to the med students or hang my skeleton in a class room somewhere. Let something good come from my death.
More night nurse ramblings coming soon...
Friday, April 23, 2010
Monday, April 5, 2010
A little of this, a little of that
So my life has been a crazy mess for the last week. Last Monday I worked 7a-730p, had a job interview at 2p and started classes at Ohio University and Sinclair. I found out that my Sinclair class had due dates of Friday mornings at 0800...well, I had class Tuesday and worked my 12's on Thursday and Friday which gave me one day to get a weeks worth of work done. I don't know how I did it, but I did! I'm now slowly progressing through week 2. My NSG course at OU is pretty straightforward-I'm sure Amber will be pleased to know that.
On the upside, I knew in the interview that I had the job. And it became official by Wednesday morning. :0)
So, in about a week I'll be starting my position on 6SAC (6 South Advanced Care)...on nights. Dun dun dun!! I'm nervous about getting sleep during the day but I suppose it'll all work out, it'll just take time. You can do anything for a year, right? And the extra pay will surely be nice. The plan is to work every Saturday and Sunday night and then a Wednesday or Thursday. That's even more money. Gotta get a new car!!
Mommy Update:
Austin finally came out of Terrible Two's to enter the even more Terrible Three's. He has decided that "I don't care" is his favorite phrase...after, only, "You want a piece of me, Punk?!" Which I have no clue where he got that from. He can also spell his name and he can count to 36. Do not prompt him to count higher because he will get mad and ask you the above mentioned new favorite phrase. Well, either one of them really. Funny story though: We were out to dinner with grandma and as soon as we got there, I took him to the bathroom. We were getting ready to leave and some how according to Eric's logic, it was my turn (??? can someone explain that one to me???) again. So I tried to take him. He stops in front of me, puts his hands up and says "NO! Just my Gamma take me!" Alrighty then. Gamma takes him and she comes back giggling and all I can think is OMG, what did he do now? She says that he didn't want to go potty but wanted to play in the sink so she decided to go while he washed his hands. As she turned to sit on the toilet, Austin turned and said "OH GAMMA! What a big butt you have!!" And then went back to washing his hands. So now my mother in law is known as Gamma with the big butt. Kids say the darndest things, right? (I swear, I did not prompt him to say bad things about his grandma!!)
Ryan is doing well in school. His teacher thought maybe he didn't like her because he's always so serious. She was quite worried, because she really likes him and tries to do special things for him because he is always so good and he does everything he's supposed to do. So when she has to move his boat (their warning signs, like getting your name put on the board) she has a tough time with it. And Ryan remembers everything anyone has ever said to him. He still talks about how I put him in time-out one time and he didn't even do anything. Well, at the time I didn't know that and I apologized later but I guess I need to apologize for the rest of my life. I thought he was doing so much better. Eric and I joke a lot but Ryan always has taken things so seriously. He's finally started joking back and saying stuff like, "I know you're just kidding me." It's been a lot of fun. Ryan is on Spring Break this week-I'm taking him to day care tomorrow so I can catch up on school work and then he's staying home with me all day Thursday and going to Grandma and Papa's house on Friday. He's pretty excited. He's also quite excited about becoming a soldier. It's all he talks about. He's only 6. And this soldier kick isn't going away, it's already been here for two years.
A good reminder of why I love being a nurse:
Holding my patients' hands. It's the best feeling in the world. Not just for me either, but for them. It's not for every patient; but for those who benefit from it, it makes all the difference in the world to them. A lot of times, it's the older female who needs it most. They are very scared and feel so out of control. Just sitting down and talking to them does a lot. I can't do it with every patient and I can't do it every day. But if I feel like my patient really needs it, then I deal with the consequences of trying to catch up. Charting vitals every hour is not what is best for my patient, but making sure they are safe and comforted is. How's this for the day from hell: 4 patients and three of them have MRI's that day-one at 0830 (I get report at 0730) and the other at 1000. The third has not been scheduled and I have to complete the questionnaire. Along with a patient with discharge pending physical therapy (and a few other minor details), 0800 assessments and morning meds. The phone never stopped ringing and my pending d/c patient was not very nice. But I did it. I made it through the day. And without pulling my hair out. Woot! And I still had time to stop and answer her questions and hold her hand while she cried. Man, I love this job. Or is it profession? Question of the week for NSG class last week-is nursing a profession or job? What is the distinction and why?
Well, I had planned on writing some of my paper but it's almost done anyway so I think I'll spare myself tonight and finish it up tomorrow morning. Guess I'll read my Sookie Stackhouse book instead. Finally on book 6! Gotta hurry up cause book 9 is coming out this month and book 10 will be out in May. They are easy reads and a great way to get my mind off the rest of this crazy world.
On the upside, I knew in the interview that I had the job. And it became official by Wednesday morning. :0)
So, in about a week I'll be starting my position on 6SAC (6 South Advanced Care)...on nights. Dun dun dun!! I'm nervous about getting sleep during the day but I suppose it'll all work out, it'll just take time. You can do anything for a year, right? And the extra pay will surely be nice. The plan is to work every Saturday and Sunday night and then a Wednesday or Thursday. That's even more money. Gotta get a new car!!
Mommy Update:
Austin finally came out of Terrible Two's to enter the even more Terrible Three's. He has decided that "I don't care" is his favorite phrase...after, only, "You want a piece of me, Punk?!" Which I have no clue where he got that from. He can also spell his name and he can count to 36. Do not prompt him to count higher because he will get mad and ask you the above mentioned new favorite phrase. Well, either one of them really. Funny story though: We were out to dinner with grandma and as soon as we got there, I took him to the bathroom. We were getting ready to leave and some how according to Eric's logic, it was my turn (??? can someone explain that one to me???) again. So I tried to take him. He stops in front of me, puts his hands up and says "NO! Just my Gamma take me!" Alrighty then. Gamma takes him and she comes back giggling and all I can think is OMG, what did he do now? She says that he didn't want to go potty but wanted to play in the sink so she decided to go while he washed his hands. As she turned to sit on the toilet, Austin turned and said "OH GAMMA! What a big butt you have!!" And then went back to washing his hands. So now my mother in law is known as Gamma with the big butt. Kids say the darndest things, right? (I swear, I did not prompt him to say bad things about his grandma!!)
Ryan is doing well in school. His teacher thought maybe he didn't like her because he's always so serious. She was quite worried, because she really likes him and tries to do special things for him because he is always so good and he does everything he's supposed to do. So when she has to move his boat (their warning signs, like getting your name put on the board) she has a tough time with it. And Ryan remembers everything anyone has ever said to him. He still talks about how I put him in time-out one time and he didn't even do anything. Well, at the time I didn't know that and I apologized later but I guess I need to apologize for the rest of my life. I thought he was doing so much better. Eric and I joke a lot but Ryan always has taken things so seriously. He's finally started joking back and saying stuff like, "I know you're just kidding me." It's been a lot of fun. Ryan is on Spring Break this week-I'm taking him to day care tomorrow so I can catch up on school work and then he's staying home with me all day Thursday and going to Grandma and Papa's house on Friday. He's pretty excited. He's also quite excited about becoming a soldier. It's all he talks about. He's only 6. And this soldier kick isn't going away, it's already been here for two years.
A good reminder of why I love being a nurse:
Holding my patients' hands. It's the best feeling in the world. Not just for me either, but for them. It's not for every patient; but for those who benefit from it, it makes all the difference in the world to them. A lot of times, it's the older female who needs it most. They are very scared and feel so out of control. Just sitting down and talking to them does a lot. I can't do it with every patient and I can't do it every day. But if I feel like my patient really needs it, then I deal with the consequences of trying to catch up. Charting vitals every hour is not what is best for my patient, but making sure they are safe and comforted is. How's this for the day from hell: 4 patients and three of them have MRI's that day-one at 0830 (I get report at 0730) and the other at 1000. The third has not been scheduled and I have to complete the questionnaire. Along with a patient with discharge pending physical therapy (and a few other minor details), 0800 assessments and morning meds. The phone never stopped ringing and my pending d/c patient was not very nice. But I did it. I made it through the day. And without pulling my hair out. Woot! And I still had time to stop and answer her questions and hold her hand while she cried. Man, I love this job. Or is it profession? Question of the week for NSG class last week-is nursing a profession or job? What is the distinction and why?
Well, I had planned on writing some of my paper but it's almost done anyway so I think I'll spare myself tonight and finish it up tomorrow morning. Guess I'll read my Sookie Stackhouse book instead. Finally on book 6! Gotta hurry up cause book 9 is coming out this month and book 10 will be out in May. They are easy reads and a great way to get my mind off the rest of this crazy world.
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