the good fit

Finally! Finally, I'm on my regular schedule and it's basically the schedule I'd hoped for. One week I work Monday and Saturday, the next I work Sunday, Tuesday and Friday, all nights of course. It goes back and forth with this schedule, through November and I'm hoping it will stay like this for several months, at least for now. I feel like this will give me the best of both worlds. One world I'm a nurse, working and gaining experience to hopefully move on to a more preferable field of nursing, eventually. The other world I'm getting to be a mom and wife. Even during the days of the nights that I work I am able to do what needs to be done and still get my sleep. I wouldn't necessarily be able to do that on day shift without some finagling, as a friend found out recently. Our kids had half days last week and she was working on one of those days. Well, her kids needed to be at the school for their sports, and they don't drive yet. Fortunately another friend was able to help out. I didn't want to have to deal with these kinds of dileemas, so I chose nights. Part-time nights are working out great for me.

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.

Ugh

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...

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 care...in 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.

thirty

Imagine working for thirty years and all you want to do once you retire is nothing. You buy yourself a La-Z-Boy recliner, a bedpan, a urinal and hire someone to clean them daily, for $30.00 a day. You pay someone $30.00 a week to buy your groceries. Literally, you want to do nothing, well except maybe watch TV.

This past week we spent time administering flu shots to some of the residents. It was a pretty arduous process; very different from when I did the mass flu shot clinic when I was in the Air Force. Then we didn't need doctor's orders, patient consent, etc. They lined up and we stuck them. Wam bam, thank you ma'am! In a long term care facility it's a bit different. You are required to have the orders, consent and hands that don't tire from all the other documentation.

As we're moving along I go into a resident's room. I didn't exit until 30 minutes later when another nurse came in and saved me. Evidently this particular resident is one of those, that when you are planning to go in you plan to tell someone to save you in about 10 minutes. He's not only lonely, but from what I hear he can also be quite...grumpy. From what I hear it borders on abusive. I wasn't abused. He told me all about how he ended up "incarcerated", his views on war, politics, religion and "the jokers" (the MDs who have cared for him since his incarceration, which is actually what he calls his life in the LTC facility).

Every time he needed them a rescue squad would come pick him up, and he'd pay them $30.00 even if they refused. He has no family. No one visits him.

His existence is a sad one. Who am I to judge, though? What will I take from my 30 minutes? A deeper appreciation for those I do have around me - that and I may have given him 30 minutes of joy he doesn't often know anymore, just by listening.

now just green behind the gills

Today I was left wondering if I'd made the right choice in becoming a nurse. Or rather, it was more like....what the hell have I gotten myself into!?!

Last week there was a certain level of comfort, just sitting at a table, watching DVD movies on topics such as infection control and dementia. This week we're branching out a bit. Today we set out with "rounds sheets", which are a checklist of things that are supposed to be done in a shift. Many items are particular to each resident (O2 tubing changed and dated, A.M. care provided, etc.) and then there are such items as making sure the med cart is locked when you walk away from it.

As I'm walking around I come across a resident who complains of dizziness. She tells me that she gets dizzy in the mornings and it usually resolves as the day goes on. I go and tell her nurse who then asks me to get orthostatic vital signs on her. I didn't even think to do that. I suck. And I'm going to take care of your grandmother or grandfather!?! I'm so worried about the stupid checklist I can't even fathom to think critically.

A career switch to graphic arts doesn't so bad right now.

seeing green

Soooo, this week has been spent in orientation. I've gone from a job where I basically had no training to one where we're being oriented to the facility and there will be tons of training. I'm loving it. The facility I'm working at - orienting at - is owned by a parent corporation and I like it. I guess you can take the girl out of the military, but there's just some military-type things you can't take out of the girl. I will have no problem working for a facility that actually has their shit together. We shall nickname it the HRC (health and rehab). Once I'm done with orientation I will be on nights, working on the rehab unit.

So far it's been a bunch of training videos. You know the ones, infection control, HIPAA, blah, blah, blah. We're also having to do computer modules for CEUs. We've helped out in the dining room for lunch. It's kind of scary to me, since I don't know the residents and their needs. I'm learning though. That's one thing I like about going through orientation is it gives wiggle room to learn the ins and outs.

I actually had to buy new scrubs for this job, after just having bought the scrubs for the PO. They're what I've been wearing temporarily, but we are required to wear hunter green or white everyday, but Fridays, at which time we're allowed to wear our choice.

In family news I ended up taking both boys in to be seen last week. LB was treated for strep throat. AW has been having trouble staying awake at school for the past couple of years and evidently high school is anymore stimulating than middle school was, or so that was the thought process. Recently, as he was sleeping downstairs on the couch, I had the occasion to hear him snore like a...beast. It occured to me that maybe it was time to see if it was more than teenageritis. We ended up doing a sleep study the night we saw his PCP. As it turns out, the kid has sleep apnea. Poor thing! Soooo, we're dealing with that. We just went yesterday (had to leave orientation early) to have his x-rays done to assess his adenoids. Hopefully we'll hear soon as to what we do next.

no more crumbs!

I interviewed last week for a position at a local long-term care and rehab facility. I found out today, that I will be working there part-time nights! Woohooo!

No more PO for me!

Buhbye!

No more hunting for the ever elusive nursing job. I am so thankful for this opportunity.

that's the way my cookie crumbled

It all started oh, about 5:30 p.m., Wednesday, August 11th. Imagine that, something happening on the 11th day of any month. It is a trend in my life. I had just gotten off work and was making my way through rush hour traffic to home. As usual I'd looked at my cell phone to check for messages before I started driving. Big B had left one, "Call me".

Ought oh.

He said he had bad news and proceeded to tell me one of his co-workers had resigned, so we wouldn't be able to go on vacation the following week. Yes, just days away from a vacation we had all looked so forward to, I was hearing it wouldn't happen. I was livid. That's putting it mildly. I am a redhead and do have the temper to fit. Most times I keep it in check, but when you mess with something or someone I care about, watch out.

I arrived home and head straight upstairs to spare my family members of my wrath. I'm embarassed to admit, I was so mad that when I slammed our bedroom door, that has an over-the-door hook on it, that usually keeps it from shutting...well, I slammed it so hard, it shut.

In the end we decided, so as not to waste any money, that the boys and I would go, sans Daddy.

Yes, I'm brave. I not only took two teenage boys on a road trip for a week, but added one of their friends to the mix. ZA had already been invited that very fateful day, and they were all so excited for their Jersey shore vacation. This is all thanks to the show, Jersey Shore. They were hellbent on having their own Jersey shore experience and who am I to not let them have it? Besides, I really needed to "get away". Taking them was the lesser of two evils, those being stay and not go on vacation that I'd been so looking forward to (read as: certain nervous breakdown would surely ensue), or take three teenage boys to the Jersey shore.

Off we went. We left VA on a rainy Sunday and arrived in a splendid locale reserved by my father-in-law. We spent a couple of days on the beach and also walked the boardwalk in Wildwood. One day we spent relaxing around camp, lazing around the pool and "enjoying" each others' company. The next day we were forced to again "enjoy" each others' company since it poured rain. all. day. long. That same day LB had developed swimmer's ear, so we also spent some time in a local urgent care facility. yay.

That evening I suffered with a migraine, but was able to sleep it away that night. Thursday we set out for Seaside Heights, which is the town where Season 1 of Jersey Shore had taken place. We all wanted to check it out and you never know when you might see a cast memeber, considering they still frequent Seaside. Wouldn't you know, we turn up onto the boardwalk and there's a big crowd of people, with some police officers patrolling the scene. It was Ronnie and Snooki! They were standing in the entryway of the Shore Store, which is the store the cast worked in during Season 1.

We walked the boardwalk and bought a bunch of t-shirts. The cast has made some taglines famous and of course the retail world has capitalized on this by way of t-shirts.



I started feeling another migraine coming on, and by this time we were all shopped out and ready to head home. We make our way back to the parking lot where we paid to park, only to notice the crowd of people starting to gather. Come to find out, we were parked right across the street from the house the cast had stayed in and are currently filming Season 3. We were right there where all the action was, well, across the street from it at least. I'm thinking a sudden burst of excitement and adrenaline curbed my headache, so I was able to stand by for a while, hoping to catch a glimpse of a cast member. Alas, after about an hour or so, the headache started coming on again and the boys had become bored with watching the commotion of MTV personnel and police officers, with no sighting of any celebrities, so we headed back to camp.

"Camp" was more than a tent. We had the privilege of staying in my father-in-law's RV, and it was a biggin'. It made for a mostly enjoyable vacation, although the boys were, at times,... too much personality... in what could be a small place.

Once again I was able to sleep off the migraine, and awakened Friday with plans to hit the beach. We also headed out to dinner that night for our seafood feast at The Lobster House in Cape May. Sadly, my migraine started in again and we made it an early night. I ended up with chills and nausea and after an hour or so trying to sleep it off unsuccessfully, had LB take me to the local ER. Last time I'd felt like that was when I had mastitis after I'd given birth to AW...14 years ago.

Nine hours and a dose of Reglan, and then a dose of Toradol later, I was discharged. As all good things must come to an end, we headed back to the RV to get packed up. After a ngihtmare of an ER visit where I got little to no sleep and LB slept none, I knew we couldn't head straight back home, so we followed my father-in-law to his house where I was able to get a nap in, and then we made our way home. All the while I felt like poo.

When Monday morning rolled around I was still feeling dreadful, so I had to call in sick. Later I received a phone call from the big boss informing me I'd been taken off, and replaced, of my part-time position, and was being put on PRN status. The person who covered for me during vacation was my replacement. Why? I have yet to get a solid reason. I can say I know it's due in part to the fact that my replacement is awesome. She's a former classmate, someone I considered a friend. I know her well enough to know she's extremely comfortable in her nurse skin, whereas I don't have the experience she does, and so I'm still getting used to mine.

That's the way my cookie crumbled. I'm torn. Part of me is relieved this happened, because I wasn't entirely comfortable working there. There are a few standards of practice I don't necessarily agree with. It was experience and a paycheck though. This has been a big blow to my confidence, even so far as to make me question my worth as a nurse.

Today I have an interview for a local health and rehabilitation center (nursing home). It's exciting and daunting all at once. I welcome the opportunity to possibly be doing more nurse-like work over what I was doing at the PO. We shall see.

milestones

Without a doubt, the next few months will be filled with incredible milestones. Both boys drove off this morning, school-bound. AW was riding shotgun while LB maneuvered their way to their freshman and senior year of high school. These times are truly bittersweet.

It's exciting to see AW start high school. I'm hopeful his HS career will be um...., less dramatic than his middle school career. He is such a great kid, but he's made some very bad decisions over the past couple of years. The middle school he went to was a miserable place to be. It seems that many of my friends, who've had sons that made it out, had similar bad experiences, but their son came around and turned out for the better. This would include my eldest son, LB. He made his own share of bad decisions, but has shoved his way through and is an awesome guy.

They both make me proud. I saw a bumper sticker recently that I loved. It said "Proud parent...period". A child doesn't have to be an honor student or a gifted athlete for his or her parents to feel pride.

AW will be 14 next month. He now towers over me and has given his brother a run for his money, concerning heighth. We always knew AW would outgrow his brother. Right now, at 3 1/2 years (to the day) apart, they're within an inch of one another.

LB is a senior now and he'll be 18 in March, and with that comes many celebrations. We also have "the lasts". Today I took the last first day of school pictures of both boys. LB will head off to college next year, and although I imagine I'll take pictures each step of the way, he won't start off a new year on the same day as his brother again.

I'll have to control myself over the next several months, so I don't lose it. I feel like I haven't had enough time with my sons. Can't we go back and do like shampoo tells us, you know, to repeat? I tried telling him that I was demoting him to kindergarten. He just laughed at me.

Many friends who've had kids go off to college recently have warned me about senioritis. As sure as there are good times, there will be some bad mixed in. They're convinced that it makes it easier to part with the senior who goes off to college, or leaves home for whatever reason.

This past week is a great example of frustration with my near-adult son. That's a whole different blog post though.

sticks and stuck up

Working at the peds office (PO) has had its ups and downs. I told a couple of my co-workers Wednesday that it was indeed my favorite day of the three I work during the week. This is simply because it's just MB and I, and no other "nurse". The term is used loosely because the other person I work in patient care with is not a nurse. In the state of VA it is not required to be licensed or certified to work in a doctor's office. She is, however, certified as a phlebotomist. All that being said, she is good at her job and great with the patients. It's the way she treats those of us she works with and how she expects to be treated that I have a problem with.

We have two computer terminals in our nurses' station. She has claimed one of them, even going so far as labeling it with her name. We have three Thermoscan Ear Thermometers and three handheld pulse/pulse oximeters. Yep, one of each are labeled as well, yet they are not her personal equipment. She's also one of those who will walk into the room and in the most snarky fashion ask why something is the way it is, or isn't.

I realize there's always going to be somebody that we prefer to not have to work with. It's quite different when that somebody is one of only about ten co-workers.

Like I said, Wednesdays are my favorite days. Well, they have been. Evidently she'll be working them after school starts the 23rd. We provider match (which means when three of us are working we each work with a specific provider) and her provider will be dropping her hours down so she (the provider) can be around for her children. So rather than working to 5 p.m. 4 days a week, NFC (not favorite co-worker) will be working five and getting off earlier. Lovely.

I have my intrapersonal battles with all of this. I like my job because, well it is work, and the schedule is great. I don't have to work nights, weekends, major holidays, and so forth. But...is this what I became a nurse to do? It'll have to do for right now, because there just isn't much out there for inexperienced nurses. I figure I'll at least stick with it for the next few months, because yes, it looks like they're keeping me around for as long as I wish to stay.

Days like yesterday leave me frustrated. It was a day spent with NFC, so it was already spent overting outright frustration. Then it happened. I attempted to do a blood draw on a patient, once in each AC and the veins rolled. I'm not extremely well-practiced at this task, so I decided to stop there and go get NFC, the trusty phlebotomist. I had trouble using the safety device on the butterfly needle and going back to the days when there was no such thing, from which I was originally trained, I just decided to discard the needle in the sharps. It bounced backward and caught my thumb. Lovely.

I will say NFC was awesome about the whole event and even talked me out of my devastation over doing something so dumb. Of course, we had to go through the formalities when something like this happens, to include her drawing my blood to send off for HIV testing. Great day...not.

There seems to be a trend when certain things happen. One week was strep week. Everyone that came in seemed to be having s/s of strep throat and were of course swabbed for the rapid strep screen. This past week was let's-stick-something-up-our-nose week. One kid had stuck part of a diaper wipe up his and another had supposedly stuck a foam circle up his. We succesfully removed the former's obstruction, but had to send the latter to ENT. They found nothing.

It's all fun and games in the PO!