Monday, October 25, 2010

blither blather

Ok, so maybe "hate" is a strong word. I still feel pretty much the same way, though. Let's just start by saying that I'm an honest person, almost at times too honest. If one of my fellow co-workers asks me how I'm doing, how I'm liking it so far, what am I supposed to say? I'm doing great. My med passes are getting faster and faster with each pass, and I'm feeling more and more comfy caring for the residents and using my ounce of nursing judgment that I've gained over the past month or so.

That question is easy to answer. Well, so is the "How are you liking it?" if I just answer right off the cuff and honestly. I don't like it. It's not the patients, residents, whatever... It's the disorganized, utterly frustrating chaos (I live with a fair amount of chaos on a daily basis in my family life. That's not the problem.) Basic everyday chaos isn't anything I can't handle, but the kind that leaves a unit having had 16 different unit managers in 4 years, well that's a problem. There is no rhyme or reason to how forms are kept. Need a lab form? It's on the desk in a pile somewhere. Need an incident report? Try the cabinet.

The med room could be declared a local disaster area. The treatment carts? Ugh. There is no unit secretary, person in charge of supplies, wound nurse, etc.

Our job titles: "RN Charge Nurse" or "LPN Charge Nurse" and we are in charge of everything from admission to discharge. Everything. All the everything in between has little to no efficiency in the processes.


I've even responded to an in-house posting for a Discharge Planning Assistant. (That may seem contradictory to what I just said, about nurses being in charge of discharging, but there's a lot more to it than the paperwork involved from the unit's standpoint.) I wouldn't mind staying with the facility, but this is how desperate I am to get away from the UFH (unit from hell) and for that matter, night shift isn't all that I thought it would be.

Now I'm going to go find some cheese...

Saturday, October 9, 2010

must confess

I hate my job. I'm trying my hardest to make the most of it, to make it through this adjusment period in hopes of feeling better about it overall. I started nights this past week. One thing is for sure, 8-hour nights are vastly different than 12-hour nights. First, it seems to take forever for 11 p.m. to roll around, whereas with a normal 12-hour shift 7 p.m. comes much quicker. The hours seem to roll by at a decent pace. That's a blessing.

It's more about the environment I'm working in, I think, that causes me the most frustration. This became quite apparent last night. We had a patient that had just been admitted a couple of days before. I hadn't met her yet, but was on that pod (hall/wing/whatever you want to call it) last night. Her O2 levels kept desaturating when she was on BIPAP or during her neb(ulizer) treatments. She has COPD, so when she was put on a regular mask (her NC wasn't cutting it either), she was reaching into the high 80s. All the details aside, I really liked working with the management of the problems. Most of the residents/patients I'm dealing with are sleeping through the nights so there isn't much to do for them until the few and far between times they call out or it's time to pass meds.

We also have a patient who has a history of multiple cancers, and currently has multiple abdominal fistulas. I'm talking big holes from inside out. I will admit that when I first went in to watch the LPN I've been orienting with do the dressing change I became a little queasy. Then next time it needed to be done I went right in and did it as if I'd done it a million times before. It was such an awesome feeling to help this woman as I know I provided her care with dignity. She commented on how much she appreciated my attention to detail.

I really think I'd be better off in acute the hospital, in the ER or on a med/surg unit (wow, didn't ever think I'd hear myself saying that, or read it), or maybe even an ICU. Bigger WOW. I certainly never would have pictured or fathomed that!

Tonight and tomorrow night I will orientate with a RN, a very seasoned RN and I look forward to it. I'm hoping she'll teach me some things and put some things into perspective. If after the next two nights I'm still frustrated I will continue to search for something else. As it is I'm interviewing at a local family practice Tuesday morning. It's a far cry from what I just spoke of, but it will be better than putting up with some of the craziness of LTC nights.