girl in greenwood

fried

2008-09-04T22:41:00.000-07:00

I woke up late today. Really late. The clock said 6:22. My carpool buddy was supposed to pick me up 2 blocks away at 6:25. I threw on my scrubs, grabbed my keys & my badge, and literally ran the whole way. We made it to work on time.

Where I had 5 patients in the course of my shift, one of whom spoke only Spanish. And was going home. And needed teaching about his new colostomy. My Spanish is really not up to the task.

Then my night-shift coworkers didn't come get report from me until 15 minutes after I was supposed to be gone.

Now I'm going to sleep the sleep of the dead. And luxuriate in my four days off.

first

2008-08-18T22:21:00.000-07:00

Today was my first day on the floor where I was actually hired to work. I had just finished 3 shifts on the unit where I was training... I had such a good experience there that I thought I would be sad to move on. But I had a surprisingly good day, and I feel surprisingly happy about being in this new place. After just one day I already have ideas about how to make things run more smoothly. And best of all, I did not feel like the "new kid". I knew 2 of the nurses on the floor with me, both of the unit secretaries, and one of the aides. And then my classmates E* and O* showed up at shift change and it was truly lovely to see them both. E* and I are sharing a locker in the staff room now, where we will keep a stash of cinnamon Altoids which my husband hates. I don't know if E*'s wife likes them or not.

I also learned today what happens when we call for a show of force from the security department: a whole lot of people RUN onto the unit and scare the crap out of whoever is causing trouble. That was awesome. (Incidentally, the trouble-causers were the friends(?) and family of the patient. The patient himself was way too out of it to be troublesome.)

At least so far, I'm feeling like my preceptorship on the trauma unit prepared me extremely well, and I am going to be just fine. That is a good feeling.

Now I am about to enjoy two days off, followed by a couple of short shifts, and then a weekend with my parents. Life is good.

replying

2008-08-16T11:29:00.000-07:00

I've been working and not blogging. But I appreciate the visits & comments from readers! So here are my replies to some of you, because I have been a terrible e-mailer lately.

UnsinkableMB -
Thanks for the thoughts on shoes, orthotics, and achey hips. I've been trying out different shoes in my closet and haven't found the perfect thing yet - but I'll keep looking. And I think I'll investigate orthotics, especially if my insurance will pay for them!

ThirdDegreeNurse - it's so nice to hear from you! I hope you're doing well in your nurse career, too. I'd love to get an update from you if you feel so inspired.

Emilie - Yes, nurses have to eat either in starving bear mode or in fluttering bird mode. One shovels without perceptible chewing or swallowing, the other zooms through the breakroom and swoops up a few bites of whatever potluck dishes are still left and repeats this move several times throughout the day.

Also thanks for the nice words about my "good" things. I am having trouble remembering the good things when I have a hard day.

Heather - Sorry for the shivers. I will keep posting my helpful tips as they occur to me, but I'll try to keep them tasteful enough for non-nurse reading. :)

Kim - Thanks for my move to the big leagues! And I love the idea that I was giving birth to a career. Hee.

Anonymous Shoreline RN program applier - You absolutely DO need to make sure that your transcript gets to the nursing department, but it doesn't have to be an official copy. Stop by the front office in the nursing building - the secretary for the nursing dept can help you make sure your paperwork is in order. And, at 115 points you should be a shoo-in to get accepted! I've heard that the required number of points is back down near 100 points now. Good luck!

Caroline - Thanks for the compliment! And hey, I know I haven't been commenting on your blog, but it sounds like you are rocking the house. Good for you!

CyNurse - Thanks! And the weight loss continues but slowly. I am down 18 pounds at this point, but I still can't fit into my favorite jeans. Not quite.

GeekRN - Hi there compadre! Nice to hear from a fellow Shoreline grad. Especially since you're still working as a nurse, which means that in several more months I will most likely still be functioning, also. :) So you're Mr. Meow Note?? When I started the program in spring 2006 the management students were passing out CDs of them to everyone. By the time I graduated, that practice had pretty much fallen out of favor. I don't think it was because of the administration, though - I think it had more to do with the fact that the curriculum has changed over time and the notes didn't match up to the lectures as well anymore.

So. I have just a few more days of orientation. And my first day on the new unit is Monday. In a cheery note, I already know that I will be giving report Monday evening to my classmate E*, who is well on the way to being my new work-spouse, after being my clinical boyfriend during last quarter. Yes, I'm being a little facetious, just to annoy my husband.

I'm surprised to find that I'm starting to feel ready to be on my own at work. I'm sure I will still need help, and that I won't be all that happy with my performance on a regular basis, but I seem to have gotten past the pants-wetting terror of my first few weeks at the hospital.

good bad weird

2008-07-22T20:15:00.000-07:00

Good things that have happened at work:

I noticed when one of my patients had early signs of bleeding internally (increased heart rate, low blood pressure...) and got my preceptor involved right away and we ended up calling a rapid response, which culminated with the attending physician coming into the room, taking one look at the patient, and saying something to the effect of "I'll see you in the operating room in 15 minutes". My preceptor congratulated me aftewards, saying I made a good catch.

I freely confess that the only reason I knew what was going on and that I needed to react quickly was because a former coworker told me about a nurse who got fired because they missed the early signs of a patient bleeding internally after surgery, and the patient died. When I heard the story, I promised myself that would not happen when I was a nurse. I had lunch with my former coworker last week and told her about my "good catch" and she was so proud of me. :)

I've been handling three patients relatively independently for a couple of weeks.

Yesterday, a patient who used to be a nurse told me that she appreciated having me as her nurse because every time I came in the room, she and her family felt calmer and more in control. That was super nice to hear, especially considering that she used to be on the other side of the bed, as it were.

I'm down 15.5 pounds since NCLEX. I credit long days of work in addition to dieting.

Bad things that have happened at work:

I've gotten to the end of my shift with little charting done and have had to stay late on more than one occasion.

I cared for a new paraplegic who was so positive and so in denial and he told me "I'm going to work hard and walk again!" and I actually started to tear up, it was so sad. Ouch.

I just worked 4 days in a row and I am tuckered out.

Weird things that have happened at work:

I took care of a person who was in the trouble with the law and was guarded by a series of police officers. One of whom tried to hit on me. That hasn't happened before.

Head-injured patient who is very confused and yells all the time saying to me "I HOPE YOU DON'T THINK I'M A F***ING PUSSY!" after asking me for pain meds. Heh. No, buddy. You've got broken bones, not a lack of courage.

So there you go. Little snapshot of what I've been doing. I'm still orienting through the 3rd week of August, then I will apparently be joining up with my future colleagues on the new unit.

weekend

2008-06-20T21:36:00.001-07:00

Since Meeegan asked - I am working tomorrow (Saturday) for 12 hours. I'm off on Sunday, though!

I forgot one thing on my list of stuff I've learned so far - working as a nurse is excellent for dieting if you can avoid the junk food in the staff lounge. I barely have time to sit and eat my lunch - and I'm not even up to a full patient load yet. Also, I'm down 10 pounds since taking the NCLEX. Just 20 more to go to get back to my pre-nursing school weight. It's like I was pregnant for two years, or something.

Tomorrow I'll be moved up to taking two patients. I handled one today pretty much independently and it went well. So I hope I don't have a meltdown with two tomorrow!

so far

2008-06-18T11:25:00.000-07:00

I've worked on the floor at BCH for 5 shifts and here are a few things I've learned so far:

1) There is a device for cleaning out gnarly wounds called a waterpick. I did not know such a thing even existed before last week.

2) Fentanyl lollipops (excuse me, transmucosal delivery systems) don't look like lollipops at all. They look like an instrument that is the perfect size to shove into a nostril, actually.

3) If you are a morbidly obese diabetic man, you may want to look into personal hygiene, before you develop an infection where the sun doesn't shine. Holy crap, I've never seen wounds like that before.

4) Apparently having a rectal tube (excuse me, fecal continence management system) installed feels like "having a Ho-Ho shoved up [your] butt". Or so my patient informed me.

5) If you inject heroin into your subclavian veins, Very Bad Things can happen. If that's not quite enough information for you, google necrotizing fasciitis. See? Very bad.

6) Working 2 12-hour shifts on consecutive days makes my hips ache by the end of the second day. But with support socks at least my feet don't hurt.

7) I really need to work on my time-management skills.

8) I probably need to make myself a more structured brain sheet/to-do list if I'm going to not forget stuff.

worker bee

2008-06-16T23:00:00.000-07:00

Hello Internet, I have not visited with you in quite a while!

My biggest news is that I started my new job as an RN at Big County Hospital (BCH from here on out). I had 5 8-hour days of classroom orientation the first week, which was shockingly exhausting. My brain felt swollen from acquiring so much information at such a rapid pace. The next week I had an all-day computer training which was excruciating - then I started out on the floor with my preceptor.

This is a little confusing to explain, but I am not training on the unit where I will eventually be working. I was pretty upset about that when I found out, but after I met my preceptor and got started, I was no longer upset. My preceptor is AWESOME. She's been a nurse for a long time, she's smart and funny and encouraging and kind - exactly the kind of nurse I aspire to be. She's been giving me both positive feedback and constructive criticism, which I really appreciate.

So working at BCH is pretty different from working at the Nonprofit Community Hospital. I have seen some shocking, shocking wounds, and I've only been at work for 4 days. Happily I turned out to be interested in gnarly wounds, and not the kind of person who passes out at the sight.

Okay. Another 12 hour shift tomorrow, so off to bed with me.

decorator slugs

2008-05-20T10:10:00.000-07:00

Look at these sea slugs from National Geographic. They're beautiful! You could use some of them as inspiration for interior decorating.

hempy*

2008-05-09T10:43:00.000-07:00

Top 50 'Sesame Street' Moments

Too much fun!

*the way I pronounced Sesame when I was 2

manipulative

2008-05-08T10:45:00.000-07:00

Ooh, interesting. One thing we talked about a lot in school is that labeling your patients as "drug-seeking" or "lazy" or what-have-you affects not only the care you provide, but the care that those around you think is appropriate to provide as well. "Manipulative" is one of those words, but I hadn't really thought about it before. Honestly, I had thought that some patients are in fact manipulative, so why not call a spade a spade?

Then I read this piece from Maria. Here's a quote:

"Consider striking the word “manipulative” from your vocabulary. Just describe what people are doing. “She says that she will kill herself if I don’t give her Vicodin” is a lot more informative than “She’s manipulative”. Furthermore, brainstorming ideas and conferring with others (including the patient) to solve this dilemma is much easier when everyone knows the specific details of the dilemma. How does one solve a problem around an adjective?"

Aha! Of course. You can't make a measureable outcome in the care plan for manipulation. :)

RN!

2008-05-01T13:49:00.001-07:00

I passed the damn test!

I did that.

2008-04-30T17:04:00.000-07:00

Took the NCLEX today. It shut off at 75 questions, which is the minimum. I think I feel okay about it. I won't know my results for a couple of days. Stay tuned!

Afterwards, I went for burgers and beers with two classmates, then we went over to classmate E*'s house and drank beer and watched a movie, until more classmates arrived and we gave up on the movie and gossiped instead. It was fun.

still here

2008-04-23T23:13:00.000-07:00

Still here. Still studying. One week to go.

I know of 5 classmates who have passed so far. There are 3 more who have taken the test but haven't gotten results yet.

I really can't think about anything else. Sorry to be boring.

Yoga Today

2008-04-14T12:19:00.000-07:00

Yoga Today

I did not even know this site existed! They post new approximately hour-long yoga videos for free. Just click on 'em and do your practice. Very cool.

wow

2008-04-09T09:48:00.000-07:00

This is a collection of science-related tattoos. Awesome!!!!

Now I'm wondering if my dad will get some phospholipids tattooed on his arm or something...

study

2008-04-01T23:05:00.000-07:00

It has begun: the studying for the NCLEX. I took inventory of myself and my study habits, and then picked up the phone and called two my favorite, most focused classmates and asked them to study with me. R* and E* are both going to be my coworkers on the same unit at Big County Hospital and we will be going through orientation together as well. We conferred on which review books we had and how we should tackle this huge body of knowledge, and yesterday we started. Today we continued with an extra bonus classmate C*. So far we've gotten through 8 chapters of the Kaplan review book and have repeatedly exclaimed "why didn't they tell us this in school??" We also learned that Maslow's hierarchy allegedly contains sex on the most basic level, right next to food, water, oxygen, and protection from extremes in temperature. This led to amusing conversation about how we've never seen any doctor's orders written for sexual interventions, and how if sex really is a basic need, as a group of stressed-out nursing students with long-suffering spouses, we may all be clinically dead.

Then since my brain wasn't quite full enough, classmate R* went home and classmates M* and D* showed up and we played RNtertainment for quite a while. There was much moaning and bitching about how the questions from the game wouldn't be on the NCLEX itself, but I wrote down 5 or 6 items to look up because I couldn't remember a single thing about them. Electromyography? Anyone? Anyone? Yeah, me neither.

And THEN, because I wasn't exhausted enough from using my brain for 8 hours, I went downstairs and worked out and then showered and cooked a healthy dinner and now I really wish someone would rub my back and hand me a chocolate chip cookie.

On that note, I spent the last 8 days watching everything I put in my face, working out more than I have in the last three months combined, logging all my food into Weight Watchers... and I got on the scale yesterday morning and there was no. change. at. all. Gahhhhhhhh. But hey, my body feels pretty good, so I guess I'll just keep at it.

test ahoy

2008-03-27T10:42:00.000-07:00

I scheduled my NCLEX-RN exam today. I will be taking it on April 30. Now I kind of feel like peeing my pants in terror... not so much because tests are scary to me, but because it means I have a hard date that I cannot procrastinate about.

ALL DONE

2008-03-23T07:51:00.000-07:00

And that is that!

I graduated on Thursday. It was the strangest feeling. Possibly because I got drunker than I have ever been in my LIFE on Wednesday with my classmates. I've been trying to make up with my liver ever since.

I have a lot of mixed feelings right now - I'm glad to be done with school and its tests, papers, and other hoops through which I had to jump... I'm both excited and terrified about starting my new job in a couple months... I'm very relieved to have some free time to myself until the job starts... I'm oddly anxious and sad about not being around my beloved classmates all the time, and am trying to feel out the right way to stay in touch with my favorite people without being annoying and clingy. The one thing that I am NOT troubled about is taking the NCLEX. I know it's a big deal, and I know I need to prepare for it, but I am completely confident that it will be fine.

one more!

2008-03-17T18:21:00.000-07:00

I'm feeling so much better today. I still have an alien mucous creature living in my nose, and I make funny sounds when I cough, but my energy level is normalizing and I don't feel like I need to sleep 80% of the time.

I had my last regular test at school today - it was surprisingly not that hard. Or maybe I studied effectively, although since all my studying was done while high on cold medicine, I'm not convinced that's the answer. The good news is that all of my classmates who were worried that they might not pass the class did really well today and are most likely going to be fine and graduate with us!

Now I'm off to go on a hot date with my husband.

mmmmmmmmmmm

2008-03-16T14:32:00.000-07:00

LUSH -- Fragrance: Silky Underwear Solid Perfume

Wow! I've been waiting for this perfume for years, ever since my first trip to a Lush store in Victoria. I adore the scent of Silky Underwear powder but I'm not much of a powder wearer... this is the perfect product for me!

Now I just need to go downtown and hit my local Lush.

six days

2008-03-14T23:34:00.000-07:00

I only have six days to go. I am much sicker than I have any right to be - coughing up gross stuff and everything. Ridiculous. I did not let that stop me from going out after clinical with my classmates tonight, though, because it was the very last day of our very last clinical!!! Thank goodness.

All that I have left for the quarter are two more exams for med-surg. They're going to be tough but I fully expect to pass them and graduate. I know several of my classmates are sweating it, though.

fault

2008-03-13T00:10:00.000-07:00

I overheard an interesting point of view tonight at clinical. A patient was admitted to the floor, apparently had been nauseated and over-sedated in the ER, came to the floor and complained of major pain, then began to projectile vomit. Lovely. The nurse was advocating strongly for the patient, saying "I need pain meds for this patient, they are hurting badly" and generally agitating to get the patient's meds ordered right away. But then behind closed doors, I heard the same nurse saying that she didn't feel any sympathy at all for the patient, because the chronic pain issues are the result of blown-out knees secondary to morbid obesity. In fact, the nurse said something along the lines of, "I feel sorry for the patients with brain tumors because they didn't do anything to bring it on, but the ones with problems from obesity I don't feel sorry for at all because they made that choice."

Wow. That's not very compassionate. And it made me wonder: Is this attitude okay? Does the patient with morbid obesity deserve less sympathy than anyone else? The nurse didn't appear to TREAT the patient any differently... but her attitude was pretty clear. And I also wondered if it's even fair - once someone gets overweight for whatever reason, it is really really hard to lose, especially if you have blown out your knees and can't exercise effectively.

What do you think?

feets

2008-03-11T14:17:00.000-07:00

World's Softest Support Socks

Beloved classmate M* gave me a tip about these new support socks she just got and says are extremely comfortable. They look excellent and aren't even spendy! Want.

hey, shut it!

2008-03-08T20:03:00.000-08:00

In Our Own Words: Anti-Complaining Campaign

I think this is a great idea. One of the reasons I'm so excited about my future job is that because it is a new unit, I will be able to have an immediate effect on the culture of the unit. The number of people from my class who will be on the unit is up to 4, with a few more still in the interview process. All of us who have been hired are non-complainy people, so I hope that we can carry that positive vibe forward!

two weeks

2008-03-06T10:57:00.001-08:00

Graduation is two weeks from today.

My last med-surg clinical is halfway over.

I think I'm finally starting to understand how to administer IV medications. Stupid IV pumps.

I've got 3 more exams and 1 more nursing process paper to write in the next two weeks.

One of my very favorite classmates got a job on the same unit as me! She may not be able to work days with me initially, but we'll be going through orientation together. That makes me really happy - she is the one person in my class who I am certain I would have been friends with even if we weren't in nursing school together.

Yesterday afternoon one of the boys in my clinical group said, "Hey guys, two weeks from now we'll be standing in [Classmate A]'s yard with beers in our hands." Unbelievable.