Saying No

I told my boss this morning the reasons why I don’t like going to the other unit that they have been floating me to often.    She took notes while I said things like “not nice” and “there is a weird vibe” and “I feel there are landmines waiting to blow up in my face” and “they hate their manager” and “they treat me like I am incompetent”.  Not sure she knew what to do with my it has been a long night fighting fevers and I am tired,  statement that I was sorry I couldn’t more be more technically technical about why I didn’t like it.

Good way to impress your boss, say things like technically technical.

They wanted me to go last night.  At midnight.  Leave my patients, go over to the unit and get all new patients.  I said no, unless they would give me callback pay.   They didn’t send me.

I don’t say no often… I go to meetings, I get up early to take computer classes.  I am the only nurse on nights who hasn’t flat out refused to float to the unit.  I am on committees and a super user.  My boss loves me because as a rule night nurses don’t do things.  They are much less likely to get involved than day shift… we tend to come to work, do our job and go home.  So for me to agree to do it all makes them happy, and makes me feel less bad about saying no.

in a completely random not even connected sort of way, I am having a good morning.  One of the local rehabs brought breakfast in for the nurses, as a recommend us to your patients thing, and they served bacon.  REAL BACON.  My hospital doesn’t do real bacon, it does turkey bacon.  Same with sausage.  So, the real bacon was yummy.  And now I am sitting on my couch eating a Hersey's chocolate bar with almonds.  Healthy breakfast, that.

Bacon and Chocolate.  2 basic food groups.

nite.

For A Moment…

(I am late again with You Capture but it was vital to my sanity that I get my suitcase out of the middle of my living room last night as opposed to play with my pictures… so here we go)

For a moment, the sun reflect perfectly across the reflecting pool at the Nelson Atkins Museum… 

As the building itself, for that moment, also reflected….

For a moment, as I stared at this fence, I could pretend I was back in one my favorite places, the country-side of Ireland …

(and seriously? for a moment a wondered how hard it would be to buy a house with a stone fence.  I do so love them…) 

For a moment… my instructor was there, and then not.  Can you see him?  We are practicing light painting… it has something to do with a  black card and leaving your shutter open for a very long time… I did not quite get the concept, but it looked pretty cool. (if, you know, the person holding the camera did it right, which none of us did…)

For a moment… I could play with my camera, dream about the lens I am going to buy (as soon as I decide which one I want) with the money from the extra shift I worked (crazy corrie working 5 shifts in 6 days…), and forget about all the stresses floating around my brain and the decisions I am scared to make.  It was a good moment…

Grading Myself

In the grand scheme of things, I am a good nurse. 

I know this as surely as I know that the sun is shining and my balcony door is open.  I know this as much as I know that cardizem will lower heart rates but to watch the blood pressure… as surely as I know that I don't want to be the nurse giving ambien to anyone over 65 for the first time… as much as I know that regardless of what their oxygen saturation is putting a patient on oxygen will instantly make them feel better because it is something medical being done…

I had the same patients for 3 nights in a row.  I laughed with them, took them on walks in the hallway.  Called 2 doctors on 2 patients all 3 nights… blood sugar high. hemoglobin low.

Had a dude with a splenic infarct… think a heart attack in the spleen.  It is interesting having to worry about strokes and heart attacks and blood clots all at once… the doctor was convinced he was going to throw a clot from the dead spleen, we just didn't know where that clot would land.

I got floated on my last night.  Night 4, all of my patients were still here and they floated me to my least favorite place.  I think the time has come for me to stop being so nice and agreeing to do things I don’t want to do.  I need to talk to my boss about it…

I filled out the skills checklist for a couple of the traveling companies I am looking into working with, and then yesterday ended up talking to one of them… she said I didn’t do very good.  What?  Apparently I scored myself a 2.6/4.  She said you can usually tell the good nurses because they are honest… it is the people with a perfect 4 she worries about.  I think I took the test as a brutal self assessment of my skills, and now I need to take it again as  a selling myself to potential employers test.  I am a tad worried about the other skills list I filled out, though… haven’t talked to that recruiter yet.

I am a good nurse.  I know this as surely as I know that sometimes you don’t need haldol to calm down the slightly confused/agitated post stroke with expressive aphasia(aka can’t make sense with his words…), you just need to sit with him and hold his hand while he falls asleep.

As much as I know that sometimes a short walk in the hallway can make a patient totally depressed about his health smile again… look, I am getting better!

As truly as I know that sometimes (not always) giving 5 blood pressure medications at once is a stupid idea, as surely as i know that very few doctors care about anything not directly related to imminent death in the middle of the night, as much as I know that as a nurse it is my job to occasionally call doctors about things not related to imminent death because my number 1 job is to be an advocate for my patient.

I still fail fairly often at IVs.  I still ask questions. and more questions.  I still occasionally let my bags of Amiodarone run out, and avoid going into a patient’s room cause they give me the creeps. 

But still, I am a  good nurse.  I just don’t know how you put a grade on that…