I had this post all planned out in my head last night. want to hear it?
Last night, I:
was not done with meds by 9 like I usually am. Or 930. or for that matter 10. I wasn't done with my chart checks by midnight, not to mention my charting. I had a bed alarm go off 3 (maybe 4?) times. A patient refuse to take her meds. I showed up with 2 patients without IVs. a guy who was laying stark naked on the bed and refused to wear any clothes. This night had the basic definition of a bad night.
But now the rest of the story.
Last night I spent 10 minutes with naked guys wife talking about the nursing homes she had visited that day, after realizing that her husband who was driving a month ago was so confused and weak she could never take care of him at home. A hard thing to realize. I also spent almost 30 minutes with the son of bed alarm lady explaining everything going on with her medically, and reinforcing what he had been told all day about why she couldn't go home alone. "she is so independant" he said. She can't tell me where she is, and she is obviously not tracking this conversation at all, I replied. I think I made headway. I moved a pt to a bed by the window so she could see the sunset. I talked on the phone to the significant other of the guy in 1*, who she had signed hte papers to make a DNR that day.
It was a good night. I love talking to pts and families. Doing basic education. That is the one thing I miss about working days.
That was going to be my post today. Until 205 this morning when I got a page that 41*s heart rate had just dropped in half, and ran into the room to find an O2 sat of 41%. I had been checking on him all night long, halfway expecting him to die, but still, not easy to find the man who the night before was talkking to me laying unresponsive and gray. My first patient died this morning. While I was on the phone once again with the significant other explaining, that no, we didn't expect him to get better two other nurses were listening for 2 minutes verifying no heart beat. Even after I got off I stiill wasn't sure she understood.
He was a DNR. A very sick man. who had been struggling to breathe, and in pain. Now he isn't. And that is good. Someday I will expound on why I am such a firm believer in DNRs and Advanced Directives. He didn't die alone, which was something I promised myself the day I saw a nurse sitting at the desk while her pt died and the family members didn't bother coming in. Unless there is just no way to avoid it, my pts won't die alone. There will be family present, and if that is not possible, I will be present. Everyone deserves to have someone with them at the end of life. It always made me feel better that my dad had made it to the hospital before Grandma Ross died. That she was with someone who could tell her how loved she was.
Okay. Just started crying for the first time all day. I expected I would start bawling when I walked in my front door, but I felt horrid so I just climbed into bed and slept for 8 hours.
Some nights, this job is harder than others. Yet sometimes I think it is the hard nights that makes it all worth while. that make me feel like the nurse I want to be.
Tuesday, June 30, 2009
Friday, June 26, 2009
The things I think about/want to tell people when I am at work.
Dear ED nurse,
Hello! this is Corrie from 4th floor. I would jsut like to say a couple of things to you. Notice I do not say these things during shift change, because I for one acknowledge that you are busy. So maybe next time you send me a pt at 715, you could show just a hint of awareness that 715 is a really bad tiime to get a pt? and that when we ask you to wait until at least 730, we are totally serious? and that calling me and getting mad that I cannot talk to you that exact minute is not going to make me any less busy and unable to talk? Oh, and for the record(and I send this out to admitting concerning direct admits too)it really wouldn't kill you to spend 60seconds finding me to tell me you dropped off the pt. or find my aid. or for that matter, tell the IA you are dropping off the orders. really, tell anyone. Just don't make me walk into a room and find the pt sitting there. it looks bad, and makes me mad enough to last all shift. Just a thought. Feel free to ignore it.
Dear People who design scrubs,
Hello. I was wondering if you are all men? Cause I have been wearing scrubs for quite some time now, and I am pretty sure a man designed them. Why, you ask? Cause most women have butts that are bigger than their waists, and buy clothes accordingly. Seriously, for me to get a scrub top that fits my chest, it is almost always too tight around my bottom, which makes it bunch up annoyingly. MAKE THE SLITS BIGGER! Seriously. I am tall, which means they shorter on me anyway. The things just don't make any logical sense. Oh, and Dickies? Yeah, I hate you. I might own 3 pairs of your pants, but I for the life of me cannot figure out the drawstring, and I always feel trapped cause I can't get it to loosen. Learn about elastic, people. Makes life easier. (in your defense, I love the flair.)
Dear God,
Hi! So I just wanted to thank you for the miracle of the fact that RaDonna and I managed through no planning to have 7 days off at the EXACT SAME TIME, and that she could find cheap tickets on a holiday weekend, and that she is coming and we are going, and I am so excited and it totally had to be a You thing so thanks. You must know how much I could use a week with my friend. Oh, and thank you also that my pt that coded twice this week already didn't code on me. It made my night so much better.
I spent almost an hour the other night sitting with an older woman while others coded her husband. She just looked at me... we have been married 64 years. He is my soul mate. I don't know how to live without him. I hate to see him suffering.
that kind of love? I don't see it all that often, but it was so real. I could feel her fighting for her husband, trying to make him fight. How do you tell a woman who doesn't know how to live without her man that maybe the best thing she could do is let him go? I didn't... just sat there, made sure she wasn't alone. That was probably the most important 45 minutes of my last 3 nights.
Someday I would like a love like that.
Hello! this is Corrie from 4th floor. I would jsut like to say a couple of things to you. Notice I do not say these things during shift change, because I for one acknowledge that you are busy. So maybe next time you send me a pt at 715, you could show just a hint of awareness that 715 is a really bad tiime to get a pt? and that when we ask you to wait until at least 730, we are totally serious? and that calling me and getting mad that I cannot talk to you that exact minute is not going to make me any less busy and unable to talk? Oh, and for the record(and I send this out to admitting concerning direct admits too)it really wouldn't kill you to spend 60seconds finding me to tell me you dropped off the pt. or find my aid. or for that matter, tell the IA you are dropping off the orders. really, tell anyone. Just don't make me walk into a room and find the pt sitting there. it looks bad, and makes me mad enough to last all shift. Just a thought. Feel free to ignore it.
Dear People who design scrubs,
Hello. I was wondering if you are all men? Cause I have been wearing scrubs for quite some time now, and I am pretty sure a man designed them. Why, you ask? Cause most women have butts that are bigger than their waists, and buy clothes accordingly. Seriously, for me to get a scrub top that fits my chest, it is almost always too tight around my bottom, which makes it bunch up annoyingly. MAKE THE SLITS BIGGER! Seriously. I am tall, which means they shorter on me anyway. The things just don't make any logical sense. Oh, and Dickies? Yeah, I hate you. I might own 3 pairs of your pants, but I for the life of me cannot figure out the drawstring, and I always feel trapped cause I can't get it to loosen. Learn about elastic, people. Makes life easier. (in your defense, I love the flair.)
Dear God,
Hi! So I just wanted to thank you for the miracle of the fact that RaDonna and I managed through no planning to have 7 days off at the EXACT SAME TIME, and that she could find cheap tickets on a holiday weekend, and that she is coming and we are going, and I am so excited and it totally had to be a You thing so thanks. You must know how much I could use a week with my friend. Oh, and thank you also that my pt that coded twice this week already didn't code on me. It made my night so much better.
I spent almost an hour the other night sitting with an older woman while others coded her husband. She just looked at me... we have been married 64 years. He is my soul mate. I don't know how to live without him. I hate to see him suffering.
that kind of love? I don't see it all that often, but it was so real. I could feel her fighting for her husband, trying to make him fight. How do you tell a woman who doesn't know how to live without her man that maybe the best thing she could do is let him go? I didn't... just sat there, made sure she wasn't alone. That was probably the most important 45 minutes of my last 3 nights.
Someday I would like a love like that.
Saturday, June 20, 2009
A week of 1sts
I am now a Registered Nurse :)
Thank you to everyone for believing in me and supporting me through this long and hard journey. It isn't cliche' when I say I couldn't have done it without my wonderful family and friends. You truly are amazing and I thank God for you all daily.
I am now settling a little better into my new role at work. It's taking some adjusting not to jump for the phone every time it rings and when the ED doc tells me to call the hospitalist, I politely remind him that I am no longer a secretary. Now I have to retrain my ears to be alert to the sounds of cardiac monitors and call bells, and when the patient in room 12 is calling "Nurse", he means me.
I don't feel stuck in the middle anymore. Going from graduate nurse to rn has made me feel much more purposeful, like I actually belong in ED instead of just looking on from the outside.
All the nurses and doctors and my bosses have been so kind to me at work. They seem almost as excited as I am with my new position. So encouraging and always looking for opportunities to teach me.
I have had many new experiences this week, some good...some bad. I had my first amputation, that was fun! Now I know you wrap the loose appendage (in this case it was a finger tip--painted nail and all!) in moistened gauze then put it on ice. Unfortunately, it didn't look like the orthopedic surgeon was going to be able to save the tip but she would still have most of her finger.
I had a gnarly old man patient that was trying to get me to come home with him and an anxious woman who yelled at me for not being able to read her mind. I am getting better at my IV starts, I can do them on feeling alone now without being able to visualize the vein at all.
There was also a little boy who got hit by a car that was brought into our ED who was in asystole and I was able to watch from a distance as my fellow nurses and the doctors tried their hardest to keep him alive. They brought him back, ct scanned him, and had him packed on a chopper in under an hour. Sadly the 8 year old boy's injuries were too extensive and he died approximately 24 hours later.
Although the outcome was a tradgedy, I was amazed to see how well the nurses and doctors worked together and knew exactly what to do. I can't wait til I am at that skill level and can help save lives.
So I am doing what I can to prepare myself. Under the advice of my daddy, I am taking a Trauma Nurse Core Course next month and tonight, I bought a book called "Emergency Nursing made Incredibly Easy". I don't see how anything in nursing can be termed easy but we will see if it can whip me into shape!
My goal is to be the best possible ED nurse I can and my dear sister Randi Jean says that's the first step in greatness, wanting it to be so and doing everything in my power to achieve it. I'll have to let God do the rest.
Thank you to everyone for believing in me and supporting me through this long and hard journey. It isn't cliche' when I say I couldn't have done it without my wonderful family and friends. You truly are amazing and I thank God for you all daily.
I am now settling a little better into my new role at work. It's taking some adjusting not to jump for the phone every time it rings and when the ED doc tells me to call the hospitalist, I politely remind him that I am no longer a secretary. Now I have to retrain my ears to be alert to the sounds of cardiac monitors and call bells, and when the patient in room 12 is calling "Nurse", he means me.
I don't feel stuck in the middle anymore. Going from graduate nurse to rn has made me feel much more purposeful, like I actually belong in ED instead of just looking on from the outside.
All the nurses and doctors and my bosses have been so kind to me at work. They seem almost as excited as I am with my new position. So encouraging and always looking for opportunities to teach me.
I have had many new experiences this week, some good...some bad. I had my first amputation, that was fun! Now I know you wrap the loose appendage (in this case it was a finger tip--painted nail and all!) in moistened gauze then put it on ice. Unfortunately, it didn't look like the orthopedic surgeon was going to be able to save the tip but she would still have most of her finger.
I had a gnarly old man patient that was trying to get me to come home with him and an anxious woman who yelled at me for not being able to read her mind. I am getting better at my IV starts, I can do them on feeling alone now without being able to visualize the vein at all.
There was also a little boy who got hit by a car that was brought into our ED who was in asystole and I was able to watch from a distance as my fellow nurses and the doctors tried their hardest to keep him alive. They brought him back, ct scanned him, and had him packed on a chopper in under an hour. Sadly the 8 year old boy's injuries were too extensive and he died approximately 24 hours later.
Although the outcome was a tradgedy, I was amazed to see how well the nurses and doctors worked together and knew exactly what to do. I can't wait til I am at that skill level and can help save lives.
So I am doing what I can to prepare myself. Under the advice of my daddy, I am taking a Trauma Nurse Core Course next month and tonight, I bought a book called "Emergency Nursing made Incredibly Easy". I don't see how anything in nursing can be termed easy but we will see if it can whip me into shape!
My goal is to be the best possible ED nurse I can and my dear sister Randi Jean says that's the first step in greatness, wanting it to be so and doing everything in my power to achieve it. I'll have to let God do the rest.
Monday, June 15, 2009
Dearest RaDonna...
My dearest RaDonna.
In a few short hours you are going to take the most horrible test of your life. (At least I hope it is, because if we ever have to take a worse one I will be very unhappy.) Anyway, it is going to be hard. Bad. You are going to leave it and be convinced you failed.
You won't.
I have so much faith in you. Faith in your ability to read the questions, narrow the answers and choose the right one. I have watched you, friend, the past years. I have talked with you about nursing things, and heard the wisdom and understanding in your voice.
I always judge the people I work with by who I would let take care of my family. I know what doctors I would choose, what nurses I would ask for. More importantly, I know who I would not let anywhere near someone I love. You, I would trust. I would trust you to take good, competent care of the people I love. Even though you are young (which can be a surprisingly big drawback for old people... get me someone with experience is something I have heard several times).
So today, NCLEX becomes the last great hurdle. When it is done, when you pass (not if, just when. cause you will. cause you are brilliant. and beautiful. not that beauty matters on test taking, but it can't hurt...), you will be a nurse. not a student nurse. or a graduate nurse. just a nurse. you will have the two vital initials behind your name to be able to walk into a room and say "Hi, I am RaDonna and I am going to be your nurse today."
And life will be wonderful.
There will be days when you want to quit. days when this job is so bad you want to go home and cry. days when you WILL go home and cry. But that is okay. Because for every one of those days there will be the days when you walk out the doors feeling like you did some good today. Like you made a difference, saved a life, or just sat and talked with a patient and made them feel better about everything going on in their life. It is the small things that count. When those days happen, you will know. Know that this job, it is great. It is hard and messy and stressful, true, but still. I wouldn't trade it for any other job.
You won't read this before the big test. That is okay, because I know you are ready to go rock the NCLEX world. You can read it later, during those horrible I think I failed why won't they just post the stupid results already hours. Just know you didn't fail, and it will soon just be a nightmare that will fade in memory.
I look forward to getting your text on Tuesday.
Corrie
In a few short hours you are going to take the most horrible test of your life. (At least I hope it is, because if we ever have to take a worse one I will be very unhappy.) Anyway, it is going to be hard. Bad. You are going to leave it and be convinced you failed.
You won't.
I have so much faith in you. Faith in your ability to read the questions, narrow the answers and choose the right one. I have watched you, friend, the past years. I have talked with you about nursing things, and heard the wisdom and understanding in your voice.
I always judge the people I work with by who I would let take care of my family. I know what doctors I would choose, what nurses I would ask for. More importantly, I know who I would not let anywhere near someone I love. You, I would trust. I would trust you to take good, competent care of the people I love. Even though you are young (which can be a surprisingly big drawback for old people... get me someone with experience is something I have heard several times).
So today, NCLEX becomes the last great hurdle. When it is done, when you pass (not if, just when. cause you will. cause you are brilliant. and beautiful. not that beauty matters on test taking, but it can't hurt...), you will be a nurse. not a student nurse. or a graduate nurse. just a nurse. you will have the two vital initials behind your name to be able to walk into a room and say "Hi, I am RaDonna and I am going to be your nurse today."
And life will be wonderful.
There will be days when you want to quit. days when this job is so bad you want to go home and cry. days when you WILL go home and cry. But that is okay. Because for every one of those days there will be the days when you walk out the doors feeling like you did some good today. Like you made a difference, saved a life, or just sat and talked with a patient and made them feel better about everything going on in their life. It is the small things that count. When those days happen, you will know. Know that this job, it is great. It is hard and messy and stressful, true, but still. I wouldn't trade it for any other job.
You won't read this before the big test. That is okay, because I know you are ready to go rock the NCLEX world. You can read it later, during those horrible I think I failed why won't they just post the stupid results already hours. Just know you didn't fail, and it will soon just be a nightmare that will fade in memory.
I look forward to getting your text on Tuesday.
Corrie
Sunday, June 14, 2009
NCLEX Blues
in exactly 12 hours, I will be 45 minutes into the dreaded NCLEX exam. I am not ready for this.
Heaven help me
Heaven help me
Sunday, June 7, 2009
my month is over.
not the literal month. The literal month just began. My month of madness, however, ended at 6 tonight. My friends graduated here the first weekend of may, parties and ceremonies all weekend long. Two days later I flew to Florida for a week. 3 days after I got home I went to a wedding 3 hours away. I took the bride and groom to the airport. I watched as my living room filled with the new roommates stuff moving in and the old roommates stuff on the way out. MASS CHAOS is what my apartment has been. I stopped trying to pick up because, quite frankly, why bother. This past week I went to the old roommate, Tiffany's, wedding. Went on Wednesday to a tiny kansas town 7 hours away. Spent all week running like a madwoman.I really don't like the part where they file your nails in pedicures...
I am tired. I am home. I really don't want to see anyone for like the next month.
My attitude has been increasingly bad. For the most part I have been able to hide it, but today it exploded. My friend Chelsie was in the car with me, and she just grabbed the ipod and put on happy music. It worked for a while, but now that I am home I am just *blah*
There comes a time when I need to not be around people. When I need to just be by myself and breathe. I haven't had time to do that in a month. Maybe this week I can. I had a grand total of 9 days off of work... three more nights to go! I am excited. On my last night my boss asked when I was going to start building the wound care box on our floor. I think she expects me to do it during work, and yet, I have barely had time to sit down the past couple of weeks. She is either going to have to pay me to do it on a day off, or accept that it might not happen anytime soon. That is my opinion, and I am sticking to it.
I was so excited to see a new RaDonna post! I haven't gotten to talk to her in forever, but I am so excited things are going well. I still hate putting in IV's. She does them all the time in the ED, I am sure, but I don't do them all that often, so I still don't feel 100% comfortable. Then the hospital changed the brand we use... so didn't help.
I so remember the feelings of the first couple of days. weeks. months. Believe it or not, it gets better.
Oh! I forgot to add that last weekend my dad and mom came up and we did the american.heart.walk. It was fun, but one more thing to add to a crazy month...
my hospital made us wear green wigs because they didn't think we got enough press coverage last year considering the fact that we are corporate sponsors. Green wigs were supposed to get attention from the press... no word yet on if it worked. I like green, so I was okay with it.
Wow. this post was random. I think I am going to go to IHOP now and get butterscotch pancakes and a splashberry.
Saturday, June 6, 2009
fake it til you make it
I have completed 4 shifts in the emergency department as a nurse so far and I feel like I have absolutely no idea what I am doing. I make the silliest mistakes like taking a blood pressure in the arm of a man whose finger was so infected and swollen that his skin split. Something is strangely a muck with my IV's--I got them all today but they just didn't seem quite right. I somehow manage to blood-let every one of patients! :)
I feel adrift in the nursing world. Being a graduate nurse is kind of crippling. I am in limbo between Registered Nurse and Secretary and I can't really find my niche. Soon though! 8 days and counting!
I did have my first "trauma" today. An 80 year old man who took a spill on his scooter going thirty miles per hour. Wouldn't have been so bad except he was on a blood thinner so it took a bit of work to get all his bumps and abrasions to quit oozing. He was so nice and sweet but his wife called me Rhianna...haven't heard that one before!
I love being a nurse though. I enjoy being the hands that bring God's healing touch. My people skills are improving so much. Dealing with all kinds of people in all different kinds of situations has a way of launching a crash course in diplomacy and patience. I have been so protected these past 3 years, deep in the nurses station only interacting with the doctors and nurses. Now I am one of them (almost) and I couldn't be happier!
My plan is to take it one day at a time. Do the best I can with each and every patient I see. And continue to fake it til I make it :)
I feel adrift in the nursing world. Being a graduate nurse is kind of crippling. I am in limbo between Registered Nurse and Secretary and I can't really find my niche. Soon though! 8 days and counting!
I did have my first "trauma" today. An 80 year old man who took a spill on his scooter going thirty miles per hour. Wouldn't have been so bad except he was on a blood thinner so it took a bit of work to get all his bumps and abrasions to quit oozing. He was so nice and sweet but his wife called me Rhianna...haven't heard that one before!
I love being a nurse though. I enjoy being the hands that bring God's healing touch. My people skills are improving so much. Dealing with all kinds of people in all different kinds of situations has a way of launching a crash course in diplomacy and patience. I have been so protected these past 3 years, deep in the nurses station only interacting with the doctors and nurses. Now I am one of them (almost) and I couldn't be happier!
My plan is to take it one day at a time. Do the best I can with each and every patient I see. And continue to fake it til I make it :)
Monday, June 1, 2009
GN day 1
I have blood on my right shoe. I survived 3 years of working in the Emergency Department as a tech and 2 years of nursing school and never once did a drop of blood ever come in contact with my scrubs. But my very first day as a Graduate Nurse and I get blood on me.
How awesome is that? :D
I had a very successful first day I think. I missed 66% of my IV starts, charted on the wrong patient only once, and got to perform CPR for the first time. My preceptor called in sick today so I was following around a different nurse than I am used to, who is great but just not what I am used to. It was good to see how other nurses assess their patients and chart and to discover what they have learned over the years and what stuck out the most to them.
I am so very tired though...I think I will write more in the next couple of days because I am just so tired.
How awesome is that? :D
I had a very successful first day I think. I missed 66% of my IV starts, charted on the wrong patient only once, and got to perform CPR for the first time. My preceptor called in sick today so I was following around a different nurse than I am used to, who is great but just not what I am used to. It was good to see how other nurses assess their patients and chart and to discover what they have learned over the years and what stuck out the most to them.
I am so very tired though...I think I will write more in the next couple of days because I am just so tired.
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