Ramblings of Night Nurse

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...