Saturday, October 31, 2015

Start slow means crazy at the end

Why does it seem that when the shift starts off slow that the shit hits the fan at the end and you're stuck late on the unit completing charting.

But guess what... T-38 days til I get to start on the surgical/ortho unit!!!

I was talking to a nurse who floats to lots of different units and she said that she enjoys working there and it's MUCH better than my unit.

Can't wait to start!!!

Thursday, October 29, 2015

From neuro to surgical nurse in T - 39 days

I received my transfer letter yesterday, signed it and sent it off today. I suppose that finalized it all.

I begin orientatino on Dec. 7th and I'm absolutely excited!

I'm sure the learning curve will be quite steep, I'm sure there will be times that I will be overwhelmed. Transferring to the surgical unit will put me back to square one (almost) where, although I'll have the basics, I don't know how to handle the adverse events that occur when someone's on the unit after having had surgery. At least not firsthand. I'm sure it's quite different to experience it than to read about it in a book.

I'll be having 4 wks of orientation then reassess whether I'm ready to take on the pt load myself. I think in terms of prioritization and juggling many different balls will be easier because of my experience on the in-pt neuro/gen-med unit.

I doubt that my unit will do anything to commemorate my transfer to the new unit. It bothers me how some are given things but others are not. I suppose I shouldn't be surprised. I'm ready to leave, that's for sure.

On a side note - little tyke comes home from Pakistan in FOUR days!!!! I miss her so much. We haven't talked as much as I would have liked. My BILs & SIL came home last week so I was able to see a video and some pics of her, bringing the longing for her out to the open. On the flip side, I'm oh so excited that she was able to experience her heritage through this trip. It's important that she knows that side of her history.

Tuesday, October 27, 2015

Oh the times they are a changin

So a little back story...

Last week hubby's uncle died and under Islam laws you must bury the dead "as soon as possible" unless there are factors that will delay this (autopsy, dying overseas, etc...). Well I was supposed to work the next day (the day when they were to bury him) so I called in and told the acting charge nurse about the death. I was told that I didn't have to work the shift - so I focused on the family as I should have. Then they call me back not 2 hrs later to tell me that I have to find someone to cover my shift - giving me less than 24hrs notice to do so! I went home after a couple of hours to begin the phone calls.

I called FOURTEEN ppl - and EVERY one (except one - who said that she would trade me shifts) told me no - even though I explained WHY I needed the time off. If it hadn't been for the fact that the prayer part (sort of like the viewing in the caucasian world) of the burial started during the last part of the day shift but the burial part was during the first part of the evening shift - so in essence I needed both shifts off. So ya, I'm pretty damn pissed at the ppl on my unit.

It seems to me that the ppl I work with are becoming less helpful as the time goes on. As such, I have been applying for positions elsewhere.

So when we got back from being with family I came home to a voicemail offering me an interview for a position I hadn't even applied for at another hospital - I had applied for a different position but they were offering me an interview for a position (provided I was interested in it). I called them back and left a voicemail indicating that I was intersted. So the next day they returned said voicemail and asked if I could come for an interview on Saturday. Unfortunately, that was the day that I was to attend clinical. So alas, I had to decline the interview. They said that they would put my name in the pile for the next round of interviews and I was cool with that.

So I ended up having to work my shift afterall and when I got back from my shift I had another voicemail offering me an interview for a position I had applied for at my hospital. I called back and we set the date for this morning.

Hubby was nice enough to ensure that he called me a bunch this am to wake me up so that I could make it there on time. He told me that there was an accident on the highway and it was hugely backed up. So I made sure that I left an hour & 15 min before said interview. Even when I work and have to take local roads, it usually takes me ~45 min... so I figured I was good to go.

Ya, not so much! It took me almost an hour and a half!!!! Nearly double the amount of time that it normally takes me when I have to drive the local ways.

That meant that I was LATE for an INTERVIEW!!!!!  Holy shitballs I was so embarrassed. I apologized profusely and they were so easy going, tell me it was alright - that they were just worried.

Otherwise the interview went swimmingly, but I certainly thought that I lost my running in the race for the position because of being late.

When I got home I was talking to my BFF and as I stepped in the door she was telling me to call her when I heard one way or another about the position. My BIL was sitting in the living room overhearing my conversation and when I got off the phone with her, told me that I had a voicemail on the phone. When I played it, it was this...

"This is Alice (not her real name) in HR, we would like to offer you the position at Big Hospital on the in-pt surgical/ortho unit that you interviewed for today, if you're interested please call me back at such and such a number"

O M friggin G I got the position!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  Against many odds, they offered ME the position.  WOOOOOOO HOOOOOOOO

Of course I returned that voicemail immediately! I was told that I had to wait to hear when my manager would "release me" (as though I'm a prisoner - HA) before I could start the orientation on the surgical unit. So until then, I'm kinda in a holding pattern.  

On a separate note, but equally awesome - clinical has wrapped and I have passed - exceedingly well! My preceptor gave me VERY high praise, which I will absolutely use in the future when it comes to positive references of me and my abilities as a nurse. Now to finish up the theory portion in just as exceedingly positive (if I can). Wish me luck - I need it with this course!

Friday, October 23, 2015

Watching a grown man cry

Last week when I worked I had a pt who had a sinal aneurysm that was leaking and was so large (8.5cm) that the family was told that surgery wasn't an option - but then a new doc came onto the case and told the family that decisions would be held until a MRI was done - but wouldn't be done for 2-3 more days.

Unfortunately the pt was in incredible amounts of pain with shooting pains down & up the left leg - which no nurse was really trying to get a handle on. I took pity and ensured that it was my mission for the day to get the pain under control. Which I managed to do.

The sad part was the conversation that I had with the daughter & son-in-law... about watching the parent die a slow and REALLY painful death... about how the pain wasn't being controlled/managed, and how they just wished she would be snowed into oblivion because it was painful to watch this parent suffer.

The talking was cathartic to them but it was difficult. The daughter started crying which made me choke up a bit but when the son-in-law started crying the tears welled up and I only JUST managed to control them. I was able to get through it just barely though.

I was surprised to see the daughter yesterday when I worked. I asked about her parent and whether the MRI showed anything.... she told me that the aneurysm had grown to twice the size and was definately inoperable. My paultry words "oh, I'm so sorry to hear that" and my follow up "are the nurses at least controlling her pain properly". I was saddened to hear her respond that no they weren't and saw the tears well up again. I apologized on behalf of the nurses of my unit because I know that more could have been done for this pt. Then the palliative care doc took her to a private room to discuss what would now occur from that point on.

When she came out she gave me a brief synopsis of the conversation - that the pt would be moved to the palliative unit later in the shift. When they were transferring her there the son-in-law was there as well and he was looking sooooo sad, on the verge of tears. I went over to the pt and said my good-byes and then gave a hug to the son-in-law, who gave me a solid hug back who let a tear roll down his cheek. Then I gave a hug to the daughter, with whom I connected with,

When we parted ways she thanked me for being so caring and that she would always remember me and when she sent in her letter about the care she & her parent received, that I would be mentioned as her #1 nurse.

It was perhaps the hardest interaction I've had in a long time - seeing grown men cry is hard for me. It causes me to well up every time.

Tuesday, October 20, 2015

You did NOT just say that!

At clinical we had this woman come in with chest pain - history of CHF & MI so hooked her up to tele as soon as she came.

Now the state that I'm doing my clinical in has a narcotics database that u can use to pull up which narcotic was prescribed, how many have been prescribed, which doctor prescribed, which pharmacy was used to fill the prescription and when each prescription was filled

Well this woman had like 250 pills in the last month filled so that set off some bells

The doc comes in and asks what's going on with her - she tells him and he walks out - it's not something that's unusual or out of the blue and her tele wasn't showing anything abnormal so off he went....

Like 2 min after this woman shows up a little boy is brought in by one of his parents because he developed a rash over the trunk, neck & arm that didn't seem to get any better with benedryl. So the doc comes in asking a billion questions - trying to figure out what's going on then he goes away.

Well about a 1/2 hour goes by and this woman asks for pain meds and the doc actually treturns to tell her that he wouldn't be prescribing anything until results were returned.

Well the woman gets all peeved off cuz she expects that to be dealt with... and she essentially pouts then when the doc returns to the little boy to ask more questions she goes BALISTIC

"why is the doctor spending more time with him than me, aren't I important?!"

Oh no, you did NOT just say that!!!

I flat out said "well we're used to ppl like you" - ya not my best moment cuz it set her off more...

her: "well what do you mean by THAT"

me: "just that with chest pain we're used to but little boys having reactions we aren't"

That seemed to placate her for a moment til the doc went back to the little boy and then she was complaining about her chest and asking for pain meds - the doc came over and said that results weren't back and that she wouldn't be getting any pain meds

So she went crazy and signed AMA

Sayonara then!

When the results came back after she was already gone.... turned out she had fractured ribs - oh well, she was gone already

Monday, October 19, 2015

I always miss the good things & seatbelts save lives!

Clinical rocked, but as the title says, I missed the good stuff (mostly)

There was a pt that came in with septic shock who fell down on the floor and was there for 12+ hrs til found and was in such bad shape that the paramedics just wrapped the pt in the rug that was under the pt and transported them into the hospital...

The pt was in such bad shape that it necessitated intubation and being life flighted out

The pt was in such bad shape that while in mid-flight the pt coded!

Don't know if the pt made it or not but WOW!

Onto seatbelts saving lives (as docbastard always says on his blog)......

There were two men who got into MVAs that were thankfully wearing seatbelts - one walked away with nothing more than a forehead abrasion and the other suffered a L1 compression fracture.

One of the vehicles rolled and another ditched (literally) the vehicle - so their injuries would have been WAAAAAAY worse had they not had their seat belts on.

Sunday, October 18, 2015

Another first for me

I worked yesterday...

20 of 24 hours! A day shift, stayed an extra 4 hrs then had 4 hrs off then worked another 8 hrs over nite

SOOOOoooo I was basically awake 26hrs cuz I woke up early to have breakfast and drive to work

Needless to say, it was a busy, busy day!!!

Wraked up some good OT in the midst of it tho

Nothing interesting to report for work - clinical was interesting tho - I'll write about that next time

Friday, October 16, 2015

1/2 way done.... what's I've learned is this....

Finished 1/2 my clinical hours and have gotten through 1/2 the semester

While clinical has been a breeze and a joy, school less so!

I don't think that it's right when a teacher puts 20 (or there abouts) questions on the exam (out of 50) that are "select all" type of questions.... you're just trying to fail your students! I think it's poor form and I would think that if you're trying to weed out students who are weak, senior year isn't the appropriate time to do so! You would think if that was your goal that you would have done it last year or the year before!

Come to learn that this particular teacher is also going to be the teacher for capstone/preceptorship course. UGH!!!

See, my program puts a restriction on who is allowed to do high-acuity nursing (like ER or ICU's) for that course - so only those who are honor roll and have done well in their clinical courses.... now that sounds simple enough except when they are rallying for you to fail exams, that becomes quite the challenge!!!

So I'm really trying to swim against the current and stay afloat.... I'm just hoping I can do so without kicking my GPA too badly!

Saturday, October 10, 2015

It hurts to burp

Monday I went under the knife again - this time to have ear tubes put in.

Last year the quack immunologist thought it was important to have a head CT done to see whether I had any anatomical abnormalities to account for my ear & sinus infections.

I already knew about the one thing that it turned up - that I have a narrowing in my eustacian tube on the left - which would account for why I have an increased number of ear infections in that ear.

So when I saw the new ENT she thought that it was a good idea to try a new med that I shoot up my nose. Unfortunately the med was super expensive (not covered by my insurance) and it wasn't guaranteed to work.

So we waited to see what would happen with my hearing...

Well it didn't improve and the hearing tests showed that my eardrum wasn't working particularly well because I had an accumulation of something behind it - but it didn't look like fluid but she had no idea what else it could be.

So we made the decision to put in ear tubes again - but longer lasting ones this time. Because clearly I've had ear issues most of my life.

When I came out of the anesthetic (general) holy moly was I in pain - particularly the Rt ear that I thought had an infection in it. Well it turns out that my eustacian tube isn't working very well on that side either. When she came and saw me after I was in recovery she explained that the pain was from the release of pressure. She said I didn't have an infection though - so I guess that's a plus.

But holy does it hurt to burp or hiccup! I've also found that when I'm awake for a while it sort of accumulates throoughout the day and I eventually have to have a nap in order to essentially reset things. Bummers about this is that I'm supposed to be able to hang out with hubby while everyone is gone but I'm lucky if I can stay awake for very long. At least I can say he's being patient and understanding. That's a bonus! Now if only I could get him to clean!

Friday, October 9, 2015

Cleaning while in nursing school

My house looks something like this this week...

Now my house isn't toys, cuz little tyke is still in Pakistan (it would look like this if she were here tho!) but the mess and clutter evident in this photo is evident in my place - on the table, on the counter, along the edges of the room, on the side table, etc...

This week is insanely busy - it's like my prof enjoys piling on work during certain weeks. This means cleaning and tidying goes onto the back burner.

Next week I head out to do clinical then upon my return I'm working - so after all that, this is what my future holds....

Unless I can convince the hubby to undertake some of this... but as those who have husbands know, they just don't clean the same as us!

Saturday, October 3, 2015

Question for surgeons

So this is twice now that I've been taking care of pt's awaiting surgery

Both were "on call" to get said surgery

BOTH got pushed to another day (one actually got pushed back two days)

One has a nasty hip (femur head) fracture and the other had a previous G-tube insertion go wrong and they created a nicked bowel and a fistula + abcess.

The fracture was identified two days post admission and then this pt waited another day after that..

So I would think that these would be urgent enough to actually ensure that they're done on the days that they're supposed to.

Additionally, said surgeon (for the most recent one) left before 2130hrs - which makes me wonder why they couldn't have done the surgery they said that they were going to do!

Also - if the surgeon is too tired (as I'm sure that some would indicate as a reason that the surgeon stopped) - at least have the decency to call my unit and tell me this because you ordered fluids that would be appropriate for a diabetic pt who is NPO for said surgery so now I am going to have to deal with on-call to get a hold of an order to have this changed.... because you couldn't just call me and tell me that you pushed your patient to another day!

Lastly - said pt is in major pain - especially when moved (such as when their incontinence brief needs to be changed) - and I'm sure that when you put the pt out for the surgery you will put in a foley catheter - so why didn't you just order it when you did the orders so that at least I don't have to manipulate this pt more than absolutely necessary.

I put myself in these pt's positions - I hate to see them hurting and wish that others thought about these things as well!