Day By Day

 

 

I don’t know how long it takes to get over stuff like this, but each day I’m a wee bit better.  I know the upcoming holidays will bring more emotions on, which will suck, but I’ll deal with it.

I haven’t bought a thing for the holidays.  I’ll go at the end of this week.  With all the other crazy people doing last minute shopping.  Blah.   Ok, I did by myself stuff, lol.  I bought a new camera, my bedding, and some, ummm, toys.  LOL!  I need to go get the perfume I want, and some sexy pjs.  Yeah me.

Work.  I still love it.  The other night I was on my old floor, the cardiac floor and it was rough.  Besides the fact we were short an RN, leaving me with 15 patients, I followed a nurse who had NO clue what was going on with her patients.  No idea of resulted lab work, when the next lab work was due, no clue of the results of CT scans, venous dopplers, etc.  No idea of what the doctors had planned.  Nothing.  One of them she didn’t even realize was on a cordarone drip.  Uhhh hello?  Her documentation of the patients were horrible.  But I still love my job.  I can’t wait til I can go to weekend option after Christmas.  Work 24 hours, get paid for 34!  WOOT!

What else?  Not much.  I worked a bunch the last 2 weeks, and am ready for my break before Christmas.  Because of the holiday rotation and switching a shift with someone, I work Monday, Tuesday, and Wednesday than I am off until Christmas night.  SEVEN days.  WOOT!

Tomorrow I’m calling a therapy chick that is through our work (=free).  I’m just going in to talk to her, sort some feelings out and listen to her suggestions.  We’ll see if I learn anything.

My current gym membership is up in January, and then I’m switching to the bigger, nicer gym in town, where my dear friend Karen goes to.  We’ll be sexy bitches soon.  Holla!

Celexa.  I have to say it has helped.  I don’t know what kind of emotional train wreck I’d actually be in if I wasn’t on it.  Thank goodness that it is cheap!

ok, I’ve hollered (hollared?) at the boys many times to go clean their room, now I must go enforce my Mommy Powers!

 

P.S.  I don’t know what the picture has to do with day by day, but it was on google.  I ain’t hatin’!

 

Being a Nurse

So I’ve been on my own for a month now.  A few things I’ve come to realize:

1.  I love my job.

2.  Yes there is a nursing shortage.

3.  I have great organizational skills and time management skills.

4.  I need to say no.

Let me explain.

1.  I really do love my job.  Being able to teach people, talk to them, change a dressing or two, it’s great.  My paychecks are wonderful!  Better than I had planned.  I love only working 3 days a week.  I really do love it.

2.  Let’s skip this, I’ll hit this one on number 4.

3.  I’ve always been this way.  One of my first jobs was a waitress at Shari’s, which is like an IHOP.   We would have 7-12 table sections, do our own drinks, taking orders, salads, service, etc, and even bussing/cleaning our own table, and many times seating our own guests.  I was really good at it.  I’ve worked as a server and a bartender for many years and am really good at it!  As a manager, I’d be able to to the money count, inventory count, or whatever much faster than others, because I was more organized.  Now that has carried over to my Nursing job, which is really helpful when you have 15 patients.  Sigh, number 4.

4.  Most of our hospital is team nursing, meaning 1 RN, 1 LPN, and 1 PCT (CNA) take care of a group of 10 (sometimes 15) patients.  It works ok, if you have a good and helpful team, and if the other team is also helpful.  One floor does primary nursing, which during the day time they have 5 RNs and 1 LPNs (making 5 patients each) and a charge nurse, and at night it’s 4 RNs, 1 LPN, (6 patients each)and a charge.  The charge nurse opens the charts for the LPNs.  Meaning, they do the assessment and documentation for the first of the shift.  Any other thing that needs to be documented can be done by the LPN.  Of course ER and ICU are all their own entities, so I’m including those units here.

In the last month we have lost our travel nurses.  I believe there is one left on the cardiac unit.  The hospital spent so much money on them, they decided not to renew their contracts.  One bad thing about them, is that most of them live within an hour or two drive and still get paid travel nurse wages.  Well, being in a rural area, most of our nurses travel to get to work anyhow.  So many of them have signed up with travel companies, and we have lost nurses.

So one night, I was put on the primary care unit, and made charge nurse.  Ok, fine.  But due to a shortage of nurses, staffing pieced a staff together.  Which meant there were 2 LPNs, 1 experienced RN, and 2 new RNs (one of which graduated with me).  Ok, fine.  So I had to chart on 12 patients, plus deal with any other issues.  Ok, fine.  But I had to do it all by 11 P.M.  when I would be moved to the oncology floor.  Ok, fine.  I managed to chart on 11, helping a newer LPN with some skills she hadn’t done yet, calling the doctor for the new grad, among other things.  At 11, I went upstairs and received 15 new patients.  The nurse leaving had charted on 5 of them.  One room was empty, and two patients were new and needed to be admitted. That left 7 patients to see.  This is where I began to think it’s crazy.  Thankfully, another nurse (the 3pm to 11pm charge) stayed until 2 am admitting the two new patients.  I had another who was really ill, and had to have his bed changed every 30-45 minutes (not to mention he was in isolation), and be given three units of platelets and some chemo.  Thankfully I did not have any blood to give.  I ended up seeing my last patient at 6am, right before shift change.  Crazy!  I also had to draw the morning lab and get two patients ready for surgery.  Thankfully I had a good LPN and PCT, who were experienced and knew how to get a job done.

Good ol’ hindsight says I should’ve said no.  It’s my license to protect.  My job line.  My family’s income.  I am not superwoman, and I need to say no.

Oh, the week before the night above, I worked on the senior behavioral health unit.  I’ve worked there many times and a PCT, but never a RN.  The paper work is COMPLETELY different, including the three times more paper admission packet.  So two weeks out of orientation, I was sent to the pysch unit.  No problemo.  Except that I had three new admits.  UGH.  Now in this unit, there are 14 patients, 1 RN, 1 LPN, and 2 PCTs.  Great.  So the day RN stayed and did one admission, leaving me two.  I managed to get them 90% complete.  Again, thankfully my team was experieced and worked on that unit, so I didn’t have to follow up on them very much.  The day after the charge nurse/oncology floor experience, I was put back on the psych unit (no, not as a patient), again, with 3 admits.

This past week, I worked on the pysch unit (again).  Except, now they opened 4 more beds.  18 patients, TWO RNs, ONE LPN, and 2 PCTs.  IMO, still not enough staff.  These patients have schizoprenic disorders, depression, combative agression, dementia, etc, etc, etc.  So after a rough start, and somewhat quiet middle, around 4 am, the most ambulatory patient on the unit fell and broke her hip.  Of course she was my patient.  Nice.  I had to call doctors, the house supervisor, get her transferred to the med/surg floor.  What a mess.  Now, I’m not saying that wouldn’t happen with more nurses, but I do think that once again, I should have said no.  NO, NO, NO!

I’m learning, I do love it, we’ll see what the next three nights have in store for me!

 

Beans, Everywhere Beans

So for some reason, there is a two pound bag of red beans all over the boys’ room.  It is now a quarter til five pm, and they are still picking them up.  Although there has been more playing, fighting, kicking, watching tv, swording fighting, peeing, needing to ask/tell/share something with me than there has been bean picking.

Boys.

I had my yearly evaluation today.  I did get a raise (WOOT).  LOL, what’s funny was I was evaluated as an RN.  Ok, I have been out of orientation for two weeks?!?!  Oh well.

Speaking of work, last night I was floated to the geriatric psych unit.  I have worked there as a tech and as an LPN, but never as an RN.  The paper work there is completely different, especially the admits.  Of course, at shift change, I get THREE admits.  I called the house super and said that I don’t mind working there, but I don’t know the paperwork!  They said to do the best I could on the admissions.  There are many assessments (mental, cognitive) that I have not been trained fully on to determine the patients level of functioning.  Of course those pages were left blank.  It was a busy night, but a good night.  I had a wonderful RN from day shift stay over and complete ONE of the three admissions, what a  GODSEND!  And thankfully, my LPN and two techs were long term employees of that unit, and already new the patients and of course the way things work. 

And one final thought, as I leave to get ready to work day three of four (what was I thinking).  Another local hospital faces closing.  I know that that link doesn’t show it closing, but they are losing their state funding and close as of September first.  That sucks that those nurses and other staff will no longer have a job.  Also, they had an accidental death this week.  I feel bad for that nurse that made that mistake.  It’s something we all hope we never do.  Protect your liscense people!  We were taught in nursing school to check, check, and recheck!

 

Dirty Needlestick

 

This goes with my hindsight is 20/20 post.  As an afterthought, WTF did I  do?  After a long shift dealing with a clotted catheter (which ended up having 79cc’s of saline in the balloon!), nauseated clients, and endless whining, I go to my final client for the night.  A very self care type of client.  Tells you where and what to inject, what time his meds are due, and in which order they should be in.  In with a multiple of issues, but one that goes with this story, he’s a renal client, a very hard stick.  But, working on a renal/cardiac floor, I am a fairly good sticker and got two IV’s in earlier in the night and his morning lab earlier that morning.

I give his PO meds (liquids first, pills next).  He requests his heparin shot sub-q in his right arm.  No problemo.  I don my gloves, clean the arm with alcohol, pinch and inject.  When I go to flip the safety lock I drop the freaking needle.  Here is when the out of body sensation comes in.  You see yourself standing there, the needle dropping, and you think, “Hey grab it”!  But, you stand there and watch it fall . . . into your other hand.  Fuck!

A quick rub with a alcohol pad, and a good scrub at the sink, all I could do is cuss at myself under my breath.  I call the house supervisor and get a exposure pack, fill out the paperwork, have a newly arrived day shifter draw my blood.  I go to draw the two tubes of blood on the client.  Yeah, now I can’t get him.  Two sticks from me, two from my RN, two from another RN, and one final one from the day RN that got my blood.  Yeah, the client was NOT happy.

Off to the lab, I hand in my blood samples and said I needed to pee in a cup for them.  They tell me no, you need to go to business health and do it there.  Issues:  1)  I am finishing my 2nd 12 hour shift, and do not want to wait until 9 am for business health to open.  2)  Our business health is also a quick care clinic open to the public, again NOT waiting.  3)  It’s Saturday, there is NO way in hell I am going to sit in the business health office with my three kids and waiting.  Another call to the day shift supervisor (yeah, I should be in my own bed by now), and she tells them that they need to take my pee.  Fine they say.  Well, the dumb-asses didn’t know HOW to do it.  I had to tell them to take off the handles in the bathroom, color the water, fill out the paperwork, how to seal it, etc.  Dumb-asses.

But thanks to modern technology, the rapid HIV and Hepatitis tests have come back negative.  I called my husband and told him congratulations, he didn’t have to wear a condom for the rest of his life.  Lucky him.