"When you get those rare moments of clarity, those flashes when the universe makes sense, you try desperately to hold on to them. They are the life boats for the darker times, when the vastness of it all, the incomprehensible nature of life is completely illusive. So the question becomes, or should have been all a long... What would you do if you knew you only had one day, or one week, or one month to live. What life boat would you grab on to? What secret would you tell? What band would you see? What person would you declare your love to? What wish would you fulfill? What exotic locale would you fly to for coffee? What book would you write?"


Saturday, December 31, 2011

Resolutions from 2011

Hey all! So, if any of you pay attention to whatever I write for new years resolutions, you should know that I annually dissect my past resolutions and make new ones, yes? Well, this year I have been astronomically busy (literally, like every second) up until the new year. I have also taken it upon myself to travel this new year holiday and am in Michigan (still am!) and therefore was travelling on lots of airplanes on the day I would normally have done this post. But alas, here it is, last years resolutions! Next post will feature next year's (2012!). Be excited. The Italicized paragraphs will be the actual made resolution, and the real writing is me talking....now. Got it? Okay.




1) I want to learn. I feel like such a dumbass either when I'm talking to smart people or when I'm trying to do something by myself (usually something simple) and I realize that I am not capable of living on this earth and cannot do anything. And that seriously bothers me! I want to know, I want to be able to talk about the Health Care Reform. See, I don't even know if that should be capitalized or not! I only JUST learned LAST YEAR that you put TWO spaces after every period when writing a paper. WTF? Anyway, its not just politics. I know nothing about religion. I want to know, though. But every time I try and read bible stories or pay attention in church, I get extremely lost and give up and start thinking about fun colors and songs in my head. Yesterday when I was babysitting, I was cleaning up their house toys and found this book that was "Bible stories: For Children" and I was like, oh, this is totally what I need. So in the middle of my child-watching duties, I was all like, hold up- I have to read this book and catch up. It had all the stories. But unfortunately, kids are crazy and get into everything and I could not keep reading, nor could I realistically steal it and take it home for later reading. So, politics, religion...Shakespeare, literature, famous people...famous bands, famous movies....Stuff that people know. And thats just what people talk about. The other day I had to google whether or not I could use olive oil to make eggs because I couldn't find cooking spray. I also had to google how to use a real tea kettle and not a water boiler. Do not laugh. I am ashamed. Really. So it's stuff like that. Stupid stuff. Sometimes people ask me to do stuff, and I'm like....seriously? You're gonna have to show me how to do that.So how do I accomplish this resolution? Well...I don't know. I plan to like....read the paper more. I guess. Because that has worldly important things in it, right? I'm already reading a lot of books...even though they are all nursing. So...I guess reading the paper is all I've got right now. And paying attention to smart people when they talk.

WOW. Long enough resolution paragraph?? Geesh. New Resolution: Make next years shorter!
But anyway, I did do well in this one, sort of. After I made this resolution, I did religiously read the paper (New York Times), almost every day, and I loved it. It really made me feel up to date on everything going on in the world,what people were talking about, etc. But at the time I was still in school, and nursing school...well you know, kicks your ass. So I to stop reading it everyday because it was seriously cutting into my study time. I instead switched to a book called "Smarter by Sunday", written by NYT writers, that you're supposed to read a chapter every weekend, and each weekend they teach you about something new in the world....music, politics, history, etc. This was an awesome book, but even that was cutting into my study time and I had to stop. Alas,  since then I have not picked up the book and have not bought the NYT, and this saddens me greatly.

Having moved into my own apartment, I no longer receive the daily local paper ( I actually DID read that daily over the summer). At work, each morning when I leave, I see all 6 of the local and national papers lined up and I glance at the headlines, saddenly (word?). I desperately want to read them all and know whats going on....but lately I've been doing nothing but work, breathe, eat, sleep, drink (water!), and...well, facebook. And postsecret on heavy occasion as well. :-) But you get the point. I've been busy.

However, I have been getting smarter nonetheless. Being on my own now has taught me so much. I am learning more and more about the world and how things work, just from day to day living. My nursing knowledge is increasing rapidly, as every patient teaches me something new. So, once the holiday season is over and things calm down again and I return to my home, I do plan to try and get back into the paper-reading thing, as I do miss it. Plus, I need coupons..... :-)

2) This is sort of a spin off of number one. I need to pay attention to people when they talk. I have ADHD (self-diagnosed) and when someone is talking and talking and talking, especially about a topic that I have no interest in, my ears literally shut off. Its like a defense mechanism gone haywire. It is really bad, because while the person is talking about something they deem really important, I am thinking about oompa loompas and prairie dogs and green things and how i should eat more vegetables and fruits and less carbs but then what kind of carbs? Why are carbs that bad, actually? Shit, do i have to babysit tomorrow? Crap. I totally forgot. what time was that? I should get a calendar. and stick to it. And -
"Julie? What do you think?"and I'm all like FUDGESTICKS I HAVENT BEEN PAYING ATTENTION EVEN THOUGH I TRIED REALLY HARD." I guess when the topic doesnt interest me or doesnt make sense, I just stop listening. Solution? Listen to every single word and process what is happening. Get some ADHD medication. Either of those two would work out great.


I have been doing a LOT better with the listening to people when they talk part. Being an actual RN now, It is my JOBBBBB to really listen to my patients. Everything they tell you is a vital, vital clue to their condition. Not only that but patients need to be heard. I've had patients literally tell me, "You know, I feel so much better talking to you. I feel like you are REALLY listening and not just nodding and smiling."  So, that makes me feel good. Since I have been improving that skill at work, it has also naturally transferred to my social life as well. I no longer drone out things that don't interest me from friends. Instead, I listen to everything they say because in reality, everyone is in your life to teach you something. So even if the topic is about Mango-fruit-rabbit ears or something off the top of my head like that, I try to listen because you never know, I could really need to know how to use a mango-fruit-rabbit ear one day.

As for the ADHD, not much improvement on this forefront. I don't like to resort to drugs, I don't. I'm pretty sure I've had the real ADHD since I was 6 years old, and I've survived, so why start now with the heavy drugs? As much as I know I need them...But I have tried Omega-3 gummies, which I guess are known to help improve concentration and focus in children with ADHD. I can't say for sure if they are actually doing anything, or if its just psychological, but I like to pretend that it helps.

The ADHD is tolerable when its just me,doing my thing, chillin mcgillin. Who cares if it takes me 43 hours to clean my room because I can't focus on one task at a time? Its my time and if I want to take 43 hours to organize a closet, then by golly I will. The problem however, is at work, and when I'm with my friends/dates. At work, nursing is NORMALLY hectic for any new starting nurse. But for an ADHD brain, my brain is presented with 14 tasks that need your attention and you have to prioritize quickly. You have to complete all these tasks quickly or delegate them to someone else. This can be hard when naturally, your brain has trouble finishing one task before starting another. So, Its definitely something I have to work on.



3) So, I just had a depressing moment. I just voted on a poll on facebook that was all, 'do you think 2011 will be awesome??" and my immediate reaction was YES! but then, my overthinking, over analyzing self was like....well...actually, no. 2011 is the scary year. Hopefully, an amazing year, if it all works out nicely....but, nonetheless, a year about uncertainty, and graduating, and getting a JOB, and getting through the first couple months of that job...and liking it.....Scary :-\
So I guess I just really need to have more confidence in myself. Just....go with the flow. Fate/Destiny has a plan. It will all be OK in the end...I just have to be the best that I can be...take care of myself, and have days to de-stress. It will all be OK. I hope by this time in 2012, I can look back on 2011 and say "awww, what the heck was I so worried for? 2011 was fantastic!!" My 20's are supposed to be the best years of my life. I hope nursing doesn't prevent that...:( *stress*

Okay. So. Where do I even begin on this one? You might want to get-the-popcorn-out on this one if you know what I'm saying. My brain has a lot of mixed feelings. First things first, 2011 was...............................VERY INTERESTING, to say the least. A lot of people I've talked to have  told me how much 2011 sucked for them. I....don't think it sucked, necessarily. It was a hard year, there is NO denying that. It was a sad, sad year, no denying that. But, It was also a very good year, in so many ways. Lets discuss the major points of this year, shall we? Hang in there with me, It will help me sort my own thoughts out.

  • I graduated college! This is big time coolbean worthiness because there were SO many times I made a back up plan on what to do with my life because I was so certain I would fail out of the program. But, somehow, I made it through. I graduated college after 5 years of school, with a Bachelors of Science in Nursing. Woot!
  • I also graduated a member of Sigma Theta Tau International, the nursing honor society. I also graduated with a special award for excellence in community health nursing, and a scholarship! All awesome accomplishments.
  • I went to EUROPE! This was obviously something I've wanted to do since I was five years old, but never actually thought it was...possible. I came up with the idea in fall 2010 and didn't want to let go of it. And so I did it. Obviously, this was an extreme highlight of 2011.
  • When I got back from Europe, I found out my maternal grandmother had passed away while I was overseas. This came as more of a shock than anything and I didn't even know how to begin...mourning away while I was overseas. This came as more of a shock than anything and I didn't even know how to begin...mourning. I was at an extreme...just, shock. And it took me a long time to come to terms with what happened and how I should react to it. This was obviously a low-light (opposite of high light?) of 2011. I miss her.
  • Being that my grandmother passed away, this in turn created the opportunity for the entire maternal side of the family (we're a big group), to meet for her memorial service. Despite the dire unusual circumstance for gathering, I still consider this a huge highlight. It finally got 99% of our family together at once. We laughed together, we shared her memories, we hugged, we cried, we caught up...it was amazing.
  • After my I got home from that reunion trip, I soon found out that one of my best friends at work was diagnosed with stage IV cancer....and all of us knew she wasn't going to make it. I lost her in the summer. That was really hard, being that It was so quick from diagnosis to death. She was always smiling when I saw her and she was my first friend at work. She meant a lot to me and it was a lot to lose her. It was a lot of all of us.
  • In July sometime, I got the unique opportunity to practically do the whole disney world experience for nearly just $300! Sounds like a lot of $ if you haven't been to disney, but if you have, you know that this is an AWESOME total for flying, lodging, eating, park ticketing, etc. One of my great friends from high school is an official employee of disney and was able to let me and my other great friend from high school into the parks for free! You can't beat that. It was awesome, and I got to spend time with two friends I haven't been able to spend much time with in the past couple years.
  • Soon after, I passed my NCLEX! This was......the ultimate high, as I literally really didn't think I would, especially on the first try. This was a huge highlight. This, ultimately opened up the rest of my nursing career.
  • Soon after THAT, I was officially hired as an RN! I started in September, and obviously it has been a rollercoaster road ever since. This is huge for me as well because I was so scared for this stage in my life to happen. I didn't have any confidence in myself that I would ever be able to do it. I couldn't picture myself actually doing WELL in the field, in addition to not-killing patients. Yay! I am doing well! Huge highlight....so far.
  • Soon after, in October, I moved out on my own with a roommate from college! This is AWESOME in so many aspects, and a huge highlight of my life. A huge step in the right direction for the rest of my life of inde-freaking-pendance! Yeah!
  • After that, in November, I was officially elected to be a part of the nursing honor society convention. I got to go with my professor from school and do really important cool nursing things. Pretty awesome.
  • In general, 2011 has been a remarkable interesting year for love. In this time span of one year, I have lost great love and gained great love. Thats all I'll say about THAT. :0)

So, yeah, 2011 had some pretty interesting points. Unforgettable year, that is for sure. It has taught me so much about life, about grieving, about celebration, about friendship, about love, about independence, about working, about nursing.....

I will never forget this year. But, I am also so, so, so ready for 2012. 2012 just "sounds" like a good year. What can I expect to happen in 2012? Not sure yet...A lot of 2012 will be about saving up money for bigger and better things. It will be about furthering my independence, furthering my nursing career, taking my GREs, looking into schools, etc. And maybe travel? Who knows? Very exciting. Also, end of the world? perhaps? Probably not? So, yeah. Cool stuff.

Okay I hope you're done with your popcorn now, because I am done. I think. For now. You can highly expect I will be adding to this blog in time as I'm sure There are points of 2011 I forgot to mention. But I got the big ones.

With so much love, and thank you so much for reading this year,


~A Writer in a Nurse's Body

Tuesday, December 27, 2011

Bluebird

How the hell, does a broken heart get back together when it's torn apart? And teach itself to start beating again?

-Christina Perri



I'm so tired of these dreams.

.

Monday, December 26, 2011

A Christmas Nurse

Hey all! I've had lots of blog post ideas flying through my head lately but literally, absolutely not a single second to post.

Life has been....interesting? Confusing? Good? Different?

I think the "holiday season" is like that for everyone, and for a lot of people, the holiday season is different for everyone each year.

This year I've been feeling a little anti- Christmas-y and I'm not even sure why exactly. I just keep feeling that time is flying so fast, and why let myself get attached to the christmas season when it's over so fast? I think it has to do with the "I'm 23 phase and life is really starting to fly", which is, sad, because I know that feeling will only get worse with time... I also think I'm going through a phase where I'm trying to commit to things that will last...I get Christmas gets the short end of that stick this year? Next year will be different, I know it will.

Also, this Christmas was entirely different from the rest because it was my first Christmas on the job...being night shift, I worked Christmas eve into Christmas. I wasn't sure what to expect, but i sure learned a lot.

Nursing is a whole other ball game on the holidays. Like a complete idiot, I was assuming that our Christmas eve would be pleasant on the floor, as not many people like to be patients on the holidays, and not many doctors like to be doctors on the holidays.

So yes, we did have a low census. I had three patients, one admission. But the type of patients was different, in a big way.

Over the holidays, I find there are two types of main patients. At least two types I've encountered thus far.

Type one: being that no one likes to be a patient on Christmas when they should be home with their family, and no doctor wants to be rounding in the hospital when they could be home with their family, doctors I've found usually try and make an effort to discharge as many patients as they can, even if it's christmas eve, 4 pm. (my section discharged four on christmas eve!)

So, that being, the patients that re left, are the ones of high acuity status and cannot be sent home because they are just that sick. We, as nurses, don't treat these patients any different or fear their acuity status, because on a "normal" day we're used to having those patients in addition to five more.

Type two patient:

This Is where I learned the saddest lesson of all in nursing. Well, maybe not the saddest, but pretty high up there. Turns out, it's pretty common for stressed out caregivers of intense family members to "drop off" their family members in the ER a day or two before christmas, and say "they have been acting funny." This, in a way, forces the ER doctor to admit an elderly patient who has "been acting funny", to run some tests. When most of the time, the family member really just wanted a "break" for Christmas and enjoyed some alone time without being a caregiver, and there's nothing wrong with this patient.

Now we have a confused elderly lady with severe Alzheimer's, she's out of her usual habitat, and we're forced to run her through expensive tests and bolus her with IV fluids.

Now this all would be fun except this patient needs constant reorientation. She wants to pull her IV out ( that I successfully put in! YAY!!), and she is looking for her baby and thinks her mon and dad are upstairs looking for her. Awesome. Let me tell you now that when reading the ER admission assessment, it read, "family member reports patient was throwing remotes at people." Also, awesome.

The first night i had her, she was reorient-able, but she forgot everything we said within five minutes. By the time I came in for christmas eve, she was an official 1:1 visual observation, and she was not reorientable.

My shift starts at 7pm and by 9pm she was (literally) pushing my nurse aide doing the 1:1. She wanted to put the eggs from the store into the fridge. She wanted check on Jimmy. She wanted to go lock the front door, she wanted to go run to work and finish up.

I feel sorry for her, really, I do. But seriously? I tried reorienting her, i did that's what we're supposed to do. But by hour 5 of repeating myself and her behavior worsening, I tried a new rote of playing along. Yes, I locked the door. Well take care of the eggs in the morning. I checked on jimmy, he is all right. Your parents are okay, they said its time to go to bed. I did the dishes already. Work can wait til tomorrow. Is that so wrong to leave them under their illusion?


So I can't really say I blame her for wanting a break over christmas. She's a lot to take care of. But that's not the way to handle it. She needs to be in an Alzheimer's unit or nursing home, or have a 24/7 aide hired. Not an expensive hospital stay for no reason.

So, overall it was a fun night. Definitely not an "easy" night as I was so foolishly expecting. But, that's part of nursing.

So, lesson learned: never anticipate an easy night in nursing. Everrrrrr.



This next week I'll be quiet- I work three nights then flying out of town and won't have much blogging time. But I hope to post for new years. :-)


Goodnight all! ~ WNB




.

Wednesday, December 21, 2011

The Magical Bookstore

I found magic!

For those of you that have seen "A midnight in Paris" movie, remember how Owen Wilson's character felt when he found the secret society? How magical it felt?

Well, I found that. In my town. My new town...(I recently moved).

My new city now is known every where to the nation to be "The Christmas City", if that gives you any clue. The city alone is very, very, very magical, culturally fun, and very artistic. I have been astronomically impressed every time I venture outside my bubble here, and new (and old!) friends have been so kind as to not only show me these new magical experiences, but to experience them for the first time themselves as well. It's been kinda pretty awesome.

Anyway, tonight's adventure was out to dinner, but this was no ordinary restaurant! First of all, it was called "the bookstore". Now, any of you that know me personally know that I was already in love with any restaurant called "the bookstore" without having stepped foot in it.

We had trouble finding it at first. The location our gps brought us to...well, it didn't exist. The magic of this place I guess is that it wants you to discover it on your own. Without technology. To open your eyes.

It was finally found in a little alcove in the city- a tiny black door labeled "the bookstore". We hesitantly went for it and walked in anyway. And it was amazing.


The restaurant was truly...just, out of this world. It looked like a 1920s bookstore. Piano, with 1920s music (of course), a bar with 1920s drinks...and the tables were set up so you could actually have a conversation.

They gave you a rule book, with some cute rules, and some serious, some funny, including how to actually pretend you're in the 1920s with them.

We ordered drinks from the era, and ordered off a menu that was literally taped inside an existing book. Adorable.

The atmosphere was just, jolly. It was happy. It's what I've needed.

A previous restaurant near and deaf to my heart will always have that first place, the "favorite memorable restaurant"category, but I can no longer go there. But it will always own a chip in my heart and memory. But this restaurant, this is a pretty wicked, and different- replacement. I can't wait to go again. Magical.


Some pictures to enjoy....(it was pretty dark so I only have a couple) :-)

Sunday, December 18, 2011

Every Day

The human race amazes me. Every day. In a good way......usually.


We're all just trying to make it day to day.

Saturday, December 17, 2011

And I Like Pina Coladas...

...and getting caught in the rain.





What I need is someone thats going to be there for me no matter what when I'm 85, old and wrinkly with a bajillion health issues, and still holding my hand.


Thats what I need.

Tuesday, December 13, 2011

Unexpecting the Expected

So I just found out tonight that the patient from This Post from the other day has died.

:-(


Like I said in my prior blog about her case, I kind of had a bad feeling that she just wasn't going to make it......but to accept it as reality? Thats a whole other ball game.


Its this incredibley eerie feeling that literally on Saturday I was taking care of her and by monday she had passed. It happened so fast. On Friday it started with a worrisome wheeze. By Saturday she couldn't breathe. By Sunday she was back in the ICU. And now what bothers me the most is that her husband is alone.

The story that I've heard from other employees is that she wanted to pass. She was mad at her family for even putting her on a breathing machine. She didn't want to die like that, and neither would I. I don't blame her.

It just kills me that such a nice soul, a nice person, had to die in pain. At least she wasn't alone. She had such a wonderful caring husband, by her side for every minute.

It just......feels funny. You know? Although I've had many many many patients that have died in my care before, as an aide, even some where I was the first one to find them passed, some took their last breath in front of me....but this is only my second as an RN. And they were very similar cases. Not similar medically, but similar in the way they both touched my heart. They both taught me something extraordinary. I will never forget.

The weirdest and hardest part is that they weren't even under my direct care upon their passing. I couldn't even hold their hand. And when I did have them under my care, I had no idea that the very hand I was holding would be gone in two days. In fact with both cases, I didn't even find out about the death until a couple of days after. Here I am thinking how they are probably doing much better by now, and then I hear that she passed. Sigh.  She was supposed to get better. She kept telling me how she couldn't wait to just recover from this surgery and get back to normal. Back to normal...

I hope she died in peace with everything. I hope her husband isn't alone.


I know as an RN or any health care personnel, we aren't supposed to get attached...but I can't explain it. Its just a weird feeling. Like nothing me or any of the other nurses did, helped. It was all for nothing because now she's gone. Its a hard gulp to accept, but I will accept it in time. Its part of nursing, all part of the emotional toll.

Like I said, what matters to me most is that I hope her husband is OK. :(


Thanks for reading, with love- ~WNB



.

A Crystalized Morning

I remembered two more advantages/disadvantages of working night shift......



Advantage:






Ice crystals in the morning! When I leave at 730 am, the air is so still as everyone is waking up. The sky is silent. And everything is covered in frost, frost that crystalizes and covers cars in beautiful flaky fashions. So as I was sitting inside my car waiting for it to defrost, I took the above pictures. :)



Disadvantage:

Defrosting your car at 730 am after working 12 hours and you just want to sleep.




~WNB :)


.

Sunday, December 11, 2011

In Sickness and in Health

This has been probably the weekend with the most lessons learned in one spree of shifts since working as an RN. My first shift started with a set of all new patients, as I hadn't been there in a couple days. The words "You have a brand new ICU transfer" are never exceedingly happy words to a new graduates ears. And this case was exceedingly unique.

This lady had been in the hospital for weeks before her ICU trip and before she was my patient. Just two days before receiving her as my own, she had a major abdominal surgery, taking out 20 pounds of subcutaneous fat that was touching her knees and therefore creating a pressure ulcer, on her abdomen. Yikes.

So, this lady is still, even minus the 20 pounds, a good 400 pounds. She is 71 years old.  She has four drains coming out of her abdomen that are draining the fluid from the surgery site. Meanwhile, guess how many I'd worked with before these four? You guessed it, none. As an aide I had come from a Medical oriented floor rather than surgical. Anyway, her incision site was 1.5 feet (yes, feet) across her abdomen, and it was leaking. A lot. Can I add here that I have minimal experience in uncovering, cleaning, and redressing surgery sites?

I guess there's nothing like throwing you into the worst of the worst and learning that way. After working with her all weekend, I have a lot better of a handle on surgery drains, and surgery incision care. I even felt that I had a really good way of doing it that was actually working for her, being that they were leaking so much.  Its a hard internal battle with yourself as a new graduate, because you want to desperately trust your instincts on how to do something. You really do think you know what to do. But then theres that part of you that says, questionquestionquestion!!! So you begin to doubt yourself. You lose all faith that you're even doing a remotely good job, because you're so new. How can we even tell the difference? We think we're doing a good job and then it all comes crashing down on us.

So, having this patient before me, (in addition to another ICU transfer, a chemotherapy patient, and another hard case, also in addition to 2 PICC lines, and 1 Port-a-cath), i knew it was not going to be an easy weekend.

Trips to the commode were an extreme hardship with this woman, who was beginning to really have respiratory distress, let alone her size. She needed a special commode, special chair, etc.  Her dressings needed to be changed 2-3 times a shift, which took no less than 30 minutes each time. Her drains needed to be emptied 4-5 times a shift. Basically, my care during my shift was centered primarily around her as I was in there the most, and attending to my other three when ever they needed me.

But theres nothing like that daunting feeling that you really don't think this patient is going to pull through, in the long run, and you just pray they can just survive the night. With her worsening respiratory status, I got a couple of her doctors on the phone, who all advised getting the ICU on board. So In comes the ICU resident, who orders a stronger source of oxygen, (she was already on 5L) and some breathing treatments to help ease her breathing and her wheezing. Her oxygen levels were dropping down into the mid-80s, which is, really not good, particularly with someone with no existing respiratory disease.

Needless to say, this morning, she eventually got sent to the ICU and I can only pray for her from here on out.

What was most unique and heartfelt about her case, besides the fact that she was a very nice and enjoyable lady to talk to and work with, was her husband. Her husband, also in his 70s and very thin,  was by her side every minute. Being that I work nightshift, I can tell you that he slept over both nights on this little tiny recliner, and got up to every unique sound she made or mention of his name. He got her everything she needed. He gave her a massage when she sat on the commode. He didn't just hold her hand, he grasped it. She grasped it back. His eyes, they were so beyond exhausted but also so madly deeply in love. You could just tell she was his everything. Which is, beyond amazing. I'm not implying that all guys leave a relationship when the woman gains excess weight, but most guys don't stick around. But he not only stuck around, he was her caregiver, her nurse, her husband, her best friend. They played around with cute little inside sayings and banter. They had their own way of saying I love you, without even saying it. There were times that she would wake up in the middle of the night and just say her husbands name, making sure he was still there. And even with him being a little hard of hearing, he jumped up and held her hand whenever she did call out.

It got to the point however, that I extended whatever care I could come up with to her husband, because I was seriously concerned over his well being. Not only emotionally but physically. I hadn't been sure of his sleep cycle during the day, but on my shift he was there every minute and only took intermittent naps. He was literally exhausted. I got him all set up on a comfortable recliner and highly encouraged that he needed to get some rest and to eat some food, water, etc.






Thanks for reading everyone. Round three tonight.... more blogs on the way this week. Love you all,


~WNB


.

Friday, December 9, 2011

Never Let Go

Free spirits are exceedingly hard to get ahold of, and we are hard to match with other souls.


But when we do latch on to another soul, we never let go.

Free spirits are heartbreakers and are eternally heartbroken.





.

Thursday, December 8, 2011

The Worst of Them All

Sometimes, I think having hypochondria is worse than having the disease. Because with hypochondria, your mind literally creates symptoms to fit alllllll the diseases and on a daily basis you think you're dying from something different. And your mind literally thinks its real. Very real. No wonder I hate doctors and they hate me. I'm beginning to really see it now, I guess. But theres nothing I can do about it. Its an anxiety disorder.

At this current moment, I think I may have:
- pneumonia
- ovarian cancer
- acute renal failure
- diverticulitis
- MS
- fibromyalgia/ CFS
- a brain tumor
- Gastric ulcer ( I wonder WHY)
-Arthritis/ some major joint pain disorder


So am I psychotic enough? yeah. Its a problem.
I can only imagine how I'm going to be when I'm pregnant, and when I have kids. They are going to cough and I'm going to freak out. Ohhhhh this is not good.

Meanwhile, I went to my nurse practitioner yesterday, and literally got a clean bill of health. The problem is that my mind is so twisted that I can't believe her. But I have to.

At this point, to battle the hypochondria, I just have to accept it. I have to say, "For now, I have a clean bill of health as said by the NP/MD, even though I repeatedly told her my symptoms. If, in the future, there arises a major problem that is officially diagnosed, then I can deal with it then." The end.

But it really makes it tricky for hypochondriacs to decide when to go to te doctor. We have spent our lives being laughed at and shunned by the MD community because we come in with the strangest, most odd and specific  descriptions of our symptoms, that they just brush us off as hypochondriacs and prescribe us some tylenol or something. So most of us hate doctors by now because of this. So our anxiety gets worse because we "hide" our "problems" and choose to deal with it ourselves, without the MD. We turn to the internet, to textbooks, to other nurses(in my case), etc. We buy our own medications. We battle it ourselves. But in the back of my mind, I think, "Its probably nothing, as usual, but what if this really is cancer? What if this really IS a brain tumor, and I let it go this long and by the time I eventually show it to the doctor and they diagnose it, he's going to say "If only we had caught this sooner".  And then you start really debating because, even though you really hate doctors, you feel like its necessary to get one on board so at least someone is aware of your potential brain tumor. Sigh.




And that my friend is the twisted anxious mind of a true hypochondriac. I'd give anything to get rid of it.


~WNB

This pretty much sums it all up:



.

Tuesday, December 6, 2011

YAY!

OK, Nightshift has mannyyyyyyyyyyyyyyyyyyyyy drawbacks. Excessive, even.

But, its really starting to illuminate its many advantages. Lets discuss.


Drawbacks:
  • You're tired, all-the-time. Even on your days off. Just, all the time.
  • You never know what day it is, ever.
  • You never know when to eat and its confusing.
  • Its lonely and there is no one to talk to, (people sleep when you re available to talk to, and you're asleep when they are available).
  • Its really hard to go to doctor appointments, luncheons, or really do anything midday. Thats like asking you to go to a doctor appointment at 2 am and then go back to sleep for a couple hours and then be at work by 7 am. Do THAT.
  •  Hospital Pharmacy isn't open at night. This. Sucks. (well, my hospital at least. I'm sure i'm in the minority here).
  • You have to wake doctors up and get yelled at when all your patient needs is tylenol.
  • You have to ethically debate first, if your problem is worth calling a doctor for/waking him up, and then debate if its doctor worthy or resident worthy.
  • On nightshift, you are the nurse, the secretary, sometimes the aide, transport,  maintenance, IT dept, and anything else you could possibly think of. Especially in a smaller hospital like mine that doesn't staff completely at night, we do a lot. And make shit up when we don't know how to fix the heating.
  • You miss prime-time tv. :(
  • You get woken up by mailmen and maintenance workers (i live in an apartment) in the middle of the day and other random people.
  • when a doctor orders some random test STAT in the middle of the night, guess who gets to wake your patient up, get them in a wheelchair, bring them down to the test, stay with them, and bring them back up. Thats right, you.
  • You have no idea who the big-time doctors are because you only talk to residents, PAs and interns (most of the time).  (This is also an advantage though...)
  • You actually get tired of writing narratives that say, "pt is sleeping. No signs of distress noted at this time. Pt appears comfortable. Respirations regular." and you actually kind of want something interesting to happen so you can write a narrative about it. I've actually written a narrative that my patient went to the bathroom. No joke. That was the highlight of my night.
  • You have to wake your patients up for the randomest stuff and get punched, kicked, yelled at, etc. Its awesome.



ADVANTAGES:
  • You get to drink wine for breakfast and its kind-of OK! Yay!
  • You lose weight (sometimes. If you do it right.)
  • You get out of doing random stuff because you have a good excuse: Sleep.
  • You get to really know the nurses you work with at night. Because at 2 am when all else is quiet, what else to do but have serious conversations about the most random things?
  • you get to be a LOT more autonomous and independent as a nurse. Some room to breathe, but yet resources are still there if you need them.
  • You actually have *time* to research your patients history, their unique diagnosis, print out education packets for them and go over them, (learn about their condition more yourself), and overall, just spend more time with your patients.  Normally on day shift my morning assessment could only take 10 minutes because I was under serious time constraints. But now I let my initial assessments take up to 30 minutes sometimes because when I go in the room, I literally pull a chair up to their bed and sit and talk with them for a bit before I just jump in and listen to them with a stethoscope. The other day I sat with someone for an hour talking in the middle of the night because I could. It was awesome.
  • It is so much less crowded and a lot more quiet. There is not a million doctors stealing all your computer space. There is no physical therapy, no food services, no transport whizzing by asking for charts, no residents, no case managers....its just....quiet. So quiet that I know if my patients up to something mischievous just by listening carefully from down the hall.
  • I can literally take over an entire computer workspace (up front! at the nurses station). Normally I had to go find one in some dark dusty corner on day shift because everyone else and their mother had the nurses station computers. Now, I literally set up my binder, and steal the entire area and no one even cares because there is actually room to spare! Its awesoommeee.
  • You can actually have legit- intelligent conversations with the residents about what is going on with your patients. Because what else do they have to do at 230 am? Besides sleep? :)
  • Your shift FLIES BY. Day shift used to take FOREVER. Once you get the busy part of your shift over, (up until midnight), you do paperwork til 2,3ish, then break for your meal, then its 330 and you just chill til 5 and then from 5-7 it gets really busy again. Flies-by. Awesome.
  • When your patients are all tucked in and happy and no one needs anything and you finished all your meds and paper work, researching, computer work, your fellow nurses don't need anything, (usually 2-4 am), the time is yours. To prevent yourself from falling asleep, its okay to keep yourself occupied in my opinion, providing that you listen very carefully for anything your patients are up to. So this is my newfound time to WRITE!!!!

WOOOOO! After all, thats half of what this is blog is about! Writing!!
I have been writing down little ideas for this novel for 4 years now. I planned a lot of it in high school but haven't really touched it since, besides the occasional idea. I have constantly had it on my mind and always think, "I really just have to get started, sit down and write it." But never could seem to. But now, that I (usually) have that 1-2 hour time window in the middle of the night now, I can writeeeeeeeeeeeeee. 

sooooooooooooooooooo happy to finally have an outline in. I'm about 1/4 of the book through. Yes!


Anyway, thats it. If you are blessed enough (lol) to work night shift as well, feel free to comment with some additional benefits/disadvantages of your own!



~WNB 



.

Sunday, December 4, 2011

No, I wouldn't Want to do that...

So! Life has been really good lately. I am happy. :-) Yay!



Work has been good so far, no catastrophes (yet) and my patients seem to like me. There have been many (WTF!!!!!) moments and many moments where I know I am in the right profession. And then, there are moments that are really, really funny. Like these:


#1- Patient is mid-age. Female. I am giving her night time medications. I notice a cheerio stuck on her gown at the top, under her chin.
Me: Oh, Looks like you have a cheerio stuck here, let me get that for--
Patient: NO!! I am SAVING THAT! They didn't feed me enough breakfast so I saved a couple for the rest of the day.



I legit cannot make these things up, guys.


#2 Same patient as above actually. She was the last stop on my med pass, and it was about 1030 at night. She had a sleeping pill ordered and she had told me earlier that she was going to want it. Well, she called the call bell just as I was about to go in anyway with her meds.
Me: Hello, I'm here with your medication before bed.
Patient: Do you have my sleeping pill?
Me: Yep.
Patient: Oh, good. I was worried I was going to fall asleep before you gave it to me.



No, we wouldn't want you to get any restful sleep before the sleeping pill. That would be silly.


#3- Patient is a new admission. It is 5-friggen-AM.
Me: Do you have any allergies?
Patient: Nope.

Loooong pause.

Patient: Rabbits!!!!
Me: Excuse me?
Patient: I'm allergic to rabbits.
Me: Okay.


At five AM, just the thought of writing "Rabbits" on an official medication drug allergy sheet, almost sent me into an inappropriate fit of extreme giggles. But I refrained. So I could keep my job.



Oh, good times, folks, good times.



~WNB


.

Friday, December 2, 2011

Its inevitable

I let you slowly creep into my thoughts during the day and then BAM, you invade my dreams by night. It's not fair and I'm tired.

Saturday, November 26, 2011

Is it Possible?

How is it possible to want something so bad and yet I find I'm constantly pushing any possibility of having it away? I can have it all and yet I'm blatantly pushing it all away. There must be something wrong with me.




But I do want it. I think. I just don't make any sense. I've literally spent some long moments off in space just trying to figure myself out. Like, having conversations with my alter ego's in my head, going back and forth trying to figure out why the heck I am so ridiculous all the time and I literally can't come up with anything. Nothing. So I just leave it at the fact that I'm just weird complicated and want what I can't have and don't want what I can? Eeeeeeebiejeebies.


There are so many times where if I described myself in one sentence, right now, I don't like what I hear. Sometimes I think I'm becoming I used to look down upon. I'm a good person in a lot of ways, also, I know that. Who knows. I try to be a good person.


I just don't even know what I want right now.


Sorry for the sad, vague, depressing, intuitive(?) post.....i'll be back to happy outgoing self soon. Ish. :-)


~WNB



.

Thursday, November 24, 2011

Well, I do all the other holidays...

So I might as well write about this one! First of all, thanksgiving has always been my favorite holiday. For me it's always been a holiday spent with family from afar, and obviously lots of good food. The family I'm with every year from childhood is everything I could ask for. From just a child I've transformed in this big family from sitting at the kids table with them to progressing to the adult table.

Now as an equal, or at least seen as more of an equal adult nowadays, I've learned a lot about what true family Is, what it means, and how thankful we are for family.

For me, thanksgiving is about family.

This year in particular, however, I am thankful for:

- first and foremost, being 99% healthier than I ever have been.
- having a full time job that pays decent in the degree I went to college for
- having a wonderful, generous, understanding family that always supports me
- my brand new car (it's kind of amazing)
- my new found time to write, and draw (my sanity)
- my best friend (s)
- this blog (what would I ever do without it??)

So I hope you all can think of at least a handful of things you are thankful for this season, no matter how bad you think things are. Things could always be worse! Just don't tempt the fates ;)

With love,

~WNB

Wednesday, November 23, 2011

Drowning Alive

So these past couple nights I had a pretty interesting round of patients. My one though, was probably my first patient who scared me. She has chronic COPD and emphysema. Now, we learned about these two evils in class...In clinincals and as an RN I've had patients with "a history" of COPD/EMP and occaisonally they ask for an inhaler...And I guess in my mind thats all I thought it was. I guess I knew it got worse but so far I had never encountered it. Until last night.

She was extremely nice. Elderly woman. But the simple act of going to the commode which was right next to the bedside, was the equivalent of you or me running two miles with no break. Audible wheezing, gasping for air. On top of all this, she was admitted with extreme back pain and was going for surgery the next day, which was giving her extreme anxiety on top of it all.

So, luckily she slept through the night for me. I checked on her every hour (theres that hourly rounding for ya) and was thankful to see her breathing normally with no problems and she didnt appear to be in any pain.

But then comes time to wake up. First what happened was she needed to take her pills, but I had to have her sit up so she wouldn't choke. So she leaned forward in the bed, and she's now the color purple, and shaking violently. However she manages to get down the pills and falls back into bed but she's in excrutiating pain. Now, ( in comparision to the twenty something I had the shift prior who was making up reasons why she needed Dilaudid), this lady was truly in 10/10 pain. This was the first time I was actually watching the clock waiting to see when the next time I could give her Dilaudid. She even told me she hates painkillers, but the pain is so severe that she needed to take them. I believed every word.

So after I got her less purple and breathing a little better (just from the simple act of leaning forward in bed), she got a breathing treatment. After that, she wanted to seize the golden window to get on the commode. Nursing is the art of timing everything just so, so that maybe, if you're lucky, you can avoid emergencies and your patient ending up blue on the floor. So me and her timed it right so that she would get up to use the commode right after her breathing treatments and I would time it so that she would get her pain medicine about 30 minutes before we made the move.


Even so, its always an epic adventure/risk but a needed one. I always try and time it so that I can spend *at least* 30-45 minutes with her on one of these trips to the bathroom (oh the beauty of having time on nightshift!). She told me, "you know you have a loss of dignity when you can't even have a normal trip to the bathroom and peeing all over the floor." It broke my heart, to feel for what it must be like in her shoes. For those of you that don't have asthma, COPD, or emphysema, imagine when you've had a bad cold in your life, that tight feeling you get in your chest that you just aren't breathing right.  You just can't seem to take a full breath. You get short of breath faster. The simple act of brushing your teeth makes you exhausted and gasping for air. Now imagine that feeling being 10X worse. Now imagine suffering through this for 20 years, until your death. You are on your death bed, gasping for air, feeling like you are slowly drowning alive. In her case, add on 10/10 excrutiating nerve back pain and you've got yourself hell.


After I got her back into bed and *somewhat* comfortable, I had some time to really sit with her and talk to her. I knew she was having extreme anxiety about the surgery and that certainly wasn't helping her breathing. So I stayed with her for an hour, sitting at her bedside, even holding her hand. I let her talk and talk because thats what she truly needed. I listened. She needed someone to listen. We all do.


As my first week flying solo (meaning I have left the comfort of having a preceptor to guide my decisions), I feel extremely unconfident. As I teach my COPDer breathing exercises to calm her down, am I even doing any good? Should I be doing more? When she says, "I can't breathe", do I freak out? If it were any patient, she'd be a CAT call or possibily even a code. But this is her baseline. So I have to think around the problem. The best we can do is breathing treatments, repositioning, inhalers and breathing exercises. But with me being so new and her being so sick, I was so nervous I wasn't doing enough. I prayed that she'd just make it through my shift, just keep breathing, please.

However I am beginning to really see whats important and whats not in nursing. I'm slowly beginning to see the bigger picture. Even though she is admitted for back pain, has baseline horrible COPD, a big big problem was beggining to be her bowels. On my second shift, she hadn't gone in over 6 days. I offered her prune juice and her prescribed laxatives but she kept refusing. Eventually I got it out of her that she is afraid to take any laxatives because she's afraid of having to rush to the bathroom and not being able to breathe. So I'm beginning to recognize that as almost an equally significant problem as both of her admitting diagnoses.

Apparently I did a good enough job, because when I got her settled in the morning, I gave report to the day nurse and we both went in to meet her. After that I finished some charting, and by 8am I walked by one more time and stopped by to say goodbye. She confided in me and told me she was really going to miss having me as her nurse. She then began to beat around the bush and was indirectly trying to ask about the day shift nurse. Eventually I had to ask, "What is your question?"  to see what she actually wanted to know, because I didn't want to give the wrong answer. She then said, "is the day nurse going to be as good as you? Is she going to.....you know, know how to take me to the bathroom like you have been?"

I was........astounded. She felt that comfortable with me? Me? A three day old solo nurse? (of course she didnt know that, but still). After I got over the initial shock, I reassured her that her day nurse was one of our best and is the nurse that even trained me. That helped her anxiety some. But I was truly astounded. After three nights of literally just *praying* she would make it.



I keep waiting for the day I can complete a 12 hour shift and feel like I *truly* did a great job. I knew how to do everything, I made all the right decisions.....but will that ever even come? probably not. At least not for a long time....



Well, goodbye for now folks, thanks for reading through!



~A Writer in a Nurses Body

Sunday, November 20, 2011

Call Me if You Need Me

Hey Everyone! Its been a pretty insane week, I just pulled through 3 twelve hour's, one night off (last night) and have three more to go starting tonight. Yay! And I just started the inevitable daunting night shift this week, as well... So, I'm tired. But anyway, my hospital is starting a new approach to patient satisfaction, hourly rounding and reducing number of call bells. As many nurses do and all nurses should be doing anyway, hourly rounding is supposedly the key to making patients and nurses happy. As nurses, we naturally are in the room almost hourly anyway, but our new approach is to make it obvious with our wording, and say "Hi, I am doing my hourly rounding, Can I get you anything? I have some time." I think this is great. It does make the patients happier and they don't feel like they are bothering you if they do ask for something, especially with the "I have some time" thrown in there at the end.

At the end of our interaction at hourly rounding, we are supposed to say, "I will be back in a couple of hours to round on you again." We are not supposed to say "Call me if you need me", even if we tack it on to the above said phrase. Supposedly if we say this, it invites patients to call if they need something in the middle of the rounding cycle, and therefore there are more callbells to be answered. Whereas if we don't say it, Patients are more likely to group all their requests together and wait until we come back for rounding to have all their requests completed and questions answered. This is supposed to give nurses more time for attending to more complicated patients, emergencies, charting, etc.

Now, I have been trying really really hard to adapt to these phrases our hospital wants us to use. I try to work them into my interactions with patients without sounding like an automated nurse robot. However, I cannot seem to not say "Call me if you need me." I try, i do try to not say it, but somehow to me It just feels so wrong. Although yes I see the benefits for the nurse, I feel like my patient would feel like they cannot call me, and they must wait for hourly rounds to get something from me. I want patients to feel comfortable and call me if they need anything at all. I think hourly rounding is highly beneficial as well, and I don't want to ONLY say "call me if you need me" because then that dips the patient on the other side of the spectrum and they feel like they are alone and will never see you if they don't call for something. Then they call for every tiny request because they are subconsciously checking to make sure you are even still on the floor with them, especially overnight when not as many people are walking through the halls continuously. No one wants to feel alone while in the hospital.

So basically, I am happy saying to patients, "I will be checking in with you hourly throughout my shift but feel free to call me if you need anything in the meantime". It may not be fitting with my hospital policy, but it is fitting to my personal morals. I feel like the above said phrase lets patients know that I will be checking in hourly, and that they are not alone, but also gives them comfort that I am only a call button away.

There is a high possibility that I am wrong about this. I am a brand new nurse and still have a LOT to learn, not just skill but in communication. Maybe in even just five years I will look back on this post and think, hourly rounding is better without throwing in the "call if you need me part". Maybe I will see the true time saving benefits of doing so. Who knows. Fellow nurses out there, what are your hospital policies for rounding or key phrases? Do you agree or disagree with not saying "Call if you need me?". I just can't seem to not say it!  :-\



Sincerely, a Writer in a Nurses Body


.

Sunday, November 13, 2011

A Worthwhile Trip!

I have been meaning to go to This Bookstore since I first saw a brochure for it last June, I just haven't been able to make the day trip out anytime since. (I know, sad.) But I finally saw an advertistment for a book festival they were having and I knew it, I had to finally go. No matter what. So I did.

It.was.heavenly.

Despite the two hour trip, it was so worth it. The city of Harrisburg was nice (sketchy in areas, but nice overall) and the bookstore was definitely something to write home about. You could just tell, the minute you walk in their doors, that every soul in there loves bookstores just as much as you. Its a passion, in fact. All the people in the world that go to bookstores to de-stress and just be in a happy, comfort-zone place, they are there. They are just like you...in that aspect.

There are millions of books. It reminds me a lot of The Strand Bookstore in New York City, where there are millions of books in very tight spaces. You can't come in the store necessarily looking for a particular book. As much as I loveeee Barnes & Noble, that kind of task is for a store such as that. You have to come into this store with an open mind. You're looking for a book but not sure what kind of book, what you feel like reading, maybe not even what genre. There are four levels to browse and this is the only type of store where you can let yourself just be free, and wander. Wander until your heart desires to stop, and turn to your side and pick a random book off the shelf. The books are in all forms, from used books in the 1800s to modern day releases. They are not in any order, nor are they even stacked neatly, but isn't that what makes it enjoyable? It makes it random, as if when you stumble upon a random book you want, you can consider it fate, or a "good find". PLus, the books in general are a lot less expensive than normal, being that a lot of them are used.

Also, they have an extensive and diverse collection of topics and genres to browse in, enough to keep you busy for at *least* two hours. It took us two hours just to walk up and down every aisle! Of course, that entailed continuously stopping to check out a new book you find, read a couple pages, etc. But still.

Andddd, they have TEA. But not just tea, but like 5,000 different types of tea! It was overwhelmingly glorious and tasted way too yummy to have been made on this planet.

Being that its become to be a pretty well known bookstore, they have famous authors come in and speak/read. They have a specific section for readings and poetry readings. Even a little stage, mics, lights, etc.

Throughout the upper level that overlooks the rest of Harrisburg, there are couches that they encourage you to stay awhile in and enjoy your book. Couches! And they have board games scattered about (scrabble, chess, checkers, monopoly, etc) that you can just start playing with at your pleasure.

It just felt heavenly, unrealistic. Like I was wandering around aimlessly in my created heaven, just happy. No problems in the world, they left when I opened the door. It was definitely a very cool, worthwhile trip. If you live within the 2-3hour radius of Harrisburg, PA, I highly encourage you to make the day trip if you like bookstores, this one is worth it!

Here are some magical pictures:

This legit cannot describe me any more perfectly, that is a fact.

also pretty true. Lovely quote

View of the whole store from the top level :)


They had LADDERS. Books to the CEILING! Like...BELLE!



With love, (so much love),



~ A Writer in a Nurses Body

Saturday, November 12, 2011

Transformation

Its all worth it. Believe it or not....


I just did three twelve hour shifts, and they each ended in their own way.
The first, I felt overwhelmed. The first out of three is always a bit overwhelming because chances are you don't know any of your patients, because if you do 3 in a row, chances are you've had off for a couple days. So the first day is spent getting to know your patients, getting a hold on things, and making plans. Although 3 shifts in a row is exhausting, I really do love the continuity of care.

I love being able to say at the end of my shift, "Sleep well tonight, see you in the morning! I'll be here when you wake up." My patients love when they know I will be back, I know them, they know me. They feel comfortable with that, with the same set of nurses taking care of them. Tonight, my third shift, I went and said my goodbyes to all my patients considering I have three days off. My one patient was sad to hear this and told me she had a question for me but couldn't remember what it was. I told her I would still be on shift for another 30 minutes if she remembered, but if not, the next nurse would be just as likely to know the answer as I would. And she said, "I know, but it's nice having you. You know when you just get comfortable with someone, and you don't want to give that up?" I said I understood and I was flattered but that the next nurse was very good and she would be in good hands. :-) So, continuity of care is excellent for the nurses and patients.

The second shift, I almost cried by the end of shift. The day started out with an admission rolling up to the floor at 6:30 am. Being so late on the night shift, the night nurse was not realistically able to do any of the admission work. So in addition to seeing my 4 other patients at the start of shift, I somehow had to work in a 30 minute long (at least) admission assessment. So, thats just a sample of how the rest of the day went. Not well. I drove home last night pretty much as a zombie, staring at the road, flat affect. I was just done. LAst night I dreamt of IVs, doctors orders, patients coding, etc. Fun.

However, my goal on each and every shift, before I leave my shift an before I come in to the next one, I make a goal. I think to myself, what went wrong today? How can I do my best to prevent that from happening again? Not everything can be prevented, but you can prepare better. What mistakes have I made today? How can I better that for the next shift? Each shift I make at least one goal to improve on for the next shift. I add something new to my "system" or pilot a new self-program until I find something that definitely works for me.

That being so, today (my third) I came in with lots of new tips for myself, to prevent reoccurences from the past two shifts that I wanted to avoid. I came in ready for the day. I knew my patients well. I could predict what could go wrong, what would go right. I improved on skills I lacked the day before. Tonight I left work, for the first time, thinking "I actually don't hate my job today. I don't dread coming back! I can do this." It was a nice feeling, for the first time.


The best feeling in the nursing world (well maybe not the best, but its pretty high up there) is seeing patients get better. For example, this one patient I had my first two shifts. On the first shift, I learned that he had a stroke a couple months ago, and has been suffering some deficits in daily living since then. I learned he runs his own business, and is normally a very independant elderly gentleman. However, when I had him, you would have never known. Suffering a severe hypoxic bout of pneumonia, he was very confused. He was a mess. He was not able to follow commands, he didn't know where he was, his speech was incoherent, he was trying to get out of bed, he was not compliant with keeping his oxygen on, and would not eat any of our food (or medication). So, he was a handful. The family kept telling me how this was so not normal for him, how normally he is so independant. I found it hard to visualize.

The second day I noticed improvements. He would have bouts of time where he would occaisonally open his eyes and respond appropriately to a question. His o2 SATS were doing better and he was a little bit more compliant.

Well, today, by golly I don't know what happened. I had to give him to another nurse in a trade off unfortunately, but was able to continually walk by his room. Being that his family members knew me well by that time, they saw me and gave me updates and I went in to say hi. I was astounded. This gentleman was up in the chair, eating breakfast, having a full conversation with me. With his eyes open. He saw me and called me sweetheart. I joked with him that he probably didn't remember me since he was confused with his eyes closed, but that I had taken care of him for the past two days. He said he did remember me because he recognized my voice. =)

I was so glad to see him get better. He is definitely not 100% yet, but now I can see part of who he was before his hospital stay. I can see the marked improvement in status over the three days. It felt so good to see.

I had another patient yesterday (the 6 am admission) who I took care of all day with a kidney stone. He was in a lot of pain all day and therefore was pretty dopey on pain medication all day. His family commented that he never gets drunk, and this was how they imagined him to act if he ever did get drunk. But it was better that than in pain. He told me he was a lawyer and that this was his first hospital stay. Today, I had to give him up too in the trade off, but I went in to say hi before he was ready to go home, and he and his wife told me that they were astounded with the care they had received during their hospital stay. What really mattered was that the family had a lot of experience with hospitals with other older family members, and they had therefore been in and spent time in a lot of other surrounding community hospitals. And they thought ours was by far the best yet, in terms of the nursing staff and general care they received. I was astounded. Our hospital? This one? Our little NFP hospital? Really? It was really nice to hear. Thats why we do what we do. To make that difference right there.


Well, I have wedding photography to edit, yay! (my second life...)


Sorry its been long periods in between updates. I like to wait until I have interesting updates rather than "today was a bad day. blahhh". unless you want to hear that. in which case I would make posts that say that, if you want. Up to you.


With love,

~ A Writer in a Nurse's Body



.

Friday, November 4, 2011

I'm Sorry Sir, Repeat That Please?

I'd like to start off this post with mentioning that my day started out today, before report, with:

"You're going to have an ICU transfer as a patient today. Patient is not here yet. You can practice accepting an ICU transfer. Also, a patient that will probably be a CAT call (rapid response team)."

my response: "Wait...those are two separate patients?"


I was frightened.


However, despite the day that you can only imagine that might have entailed, one funny/interesting moment did arise from it:


my patient (the ICU transfer, actually) was originally sent down to the ICU due to extreme lethargy and not being arousable. However, his status improved greatly and was able to be sent back up to us a couple days later. Meanwhile, the ICU nurse told me he didn't get much sleep last night (big surprise for the ICU) and that he would probably be tired. So I had to play the fine line game of: Do I let my patient sleep today, or do I continuously awaken him to see if he's lethargic? And if he IS lethargic, is it because he's just really, really tired, or is it because something is wrong?

It turned out that he had so much going on with his medical care today (IVs, lots of meds, assessments, etc. in addition to normal stuff -mealtimes, bathroom times, etc.-) that I ended up waking him up every hour practically anyway.


Well, waking him up for dinner was after a period where he was able to have slept the longest for me (about 90 minutes). So this is what went down:

Me: Mr. Patient? Mr. Patient?

pt: *wakes up*

Me: HI mr. Patient. Sorry to have woken you. Your dinner is here for you.

Pt: Oh okay. Good. * pt sits up in bed to get ready to eat tray*

*I start getting tray prepared and he starts mumbling nonsensical words strung together. I am instantly concerned.

Me: Mr.Patient? Can you repeat that? I can't hear you.

Pt: *pt continues to mumble*

* I am legit concerned now and instantly start going through a very simple mental assessment*....

Me: Mr. Patient- Can you tell me your name?

Pt: yes. Its Ima Patient

Me: Okay, good. Can you tell me where you are?

Pt: In Suchagood Hospital

Me: Okay good. Can you tell me what day it is?

Pt: Friday.

Me: How about the month?

Pt: November.

Me: Good.  (However, I'm still not convinced, because he just *looks* confused)

Me: Mr. Patient, can you tell me who the president is?

*patient nods*: Yes. Oswald.

Me: Excuse me?

Pt: Oswald.

Me: Mr. Patient, can you tell me what year it is?

Pt: 2011.

Me: Okay good. And who is the president right now, in 2011?

Pt: Oswald.

Me: Not quite....Can you describe him for me?

Pt: Um...He's african american...young fellow.


(at this point I at least knew we were on the same page. Sort of. So I quit.)

Eventually, after being awake for 5+ minutes, he started to go back to normal and was able to recall being confused but didnt know why. But, all turned out well. And Oswald is not the president.

For those of you that don't watch Nick Jr. while you babysit, let me demonstrate the first thing that shows up if you type in Oswald to Google images:



Its a blue octopus.


Need I say more?



~ WNB :)


.

Thursday, November 3, 2011

Changing the Future

Holy Crap!

First of all, for an idea of what I will be talking about, Read This Post to catch up on things. If you recall in June 2011, I was uber excited for being picked to go to this Nursing Honor Society Convention, in October. It felt so far away then, being June. But now its here- And I am here! In Texas. And OH MY God! What an amazing, and most of all-strange- experience it has been thus far.

I have met really important people and have had some great networking contacts. My ex-professor, and my travel partner on the trip and reason for being here in the first place, is somehow friends with every important person in this entire organization. I have lost count on how many CEO's, Deans of (good) schools, and Presidents I have met because of her. Not only met but they actually gave me business cards and if I apply to their school and email the deans directly, I will get in for my MSN or DNP or PhD.. Oh my god! This is absolutely insane. Absolutely. Goes to show how important it is to be overly polite, kind, interesting and interested....and how far it can get you. And to have a really strong hand shake, and to say the right things....yadayada.

But so far the conference has been listen to important people speak during the day and write down notes, learn really important stuff, and then by night- regroup and "drink socially and eloquently" with the people you listened to all day. So being that my professor is in the circle of important people, by night I have somehow found myself drinking wine (way too much wine-this is troublesome) with some very important people.  Crazy!!

Also, I have met other nurse bloggers! Which is so cool. Apparantly nurse blogging is really picking up popularity among nurses in general but is also catching the attention of this organization. So I made extra sure to be wary of what they were saying on the nurse blogging frontier, to make sure I wasn't stepping in any muddy ground by having a blog about nursing. It seems to be the ongoing current question right now- is nurse blogging taboo, or is it the future? Should our workplaces know about our blogs, or is it OK to keep them private? Is it OK to tell them? What about our schools we graduated from? Can we openly talk about our schools of nursing? Where do you draw the line?

It was brought up in one of the workshops I attended that some schools of nursing (more advanced in the technology game) require their students to create a blog to document their journey through education, and nursing. How cool is that! I guess that's part of what my blog has been about the whole time anyway, but its cool that those students actually get to do it as an assignment...

But I think most important thing so far I'm taking away from this conference is...the rest of my future. If I tell my professor I'm interested in one particular thing, she says "Oh! I know the exact person you need to talk to!" However, as many of you know, I'm interested in a lot of things. I can see myself doing a lot of different career paths in nursing. So, I've met a career link in each one of the divisions I can envision myself in. So now I reallly have to choose soon, because I have so many opportunities. Opportunities are great, but how do I narrow down what I can see myself doing?? The problem is they are all so unique career lines that really don't intersect. My professor suggested I have a couple career paths and do something different after every couple years...but I think I want my career to make a direct line, one line. Start at the beinning somewhere, and move to the top. Learn about the entire career, the ins and outs and then by the time I'm at the top, I know what I'm talking about.  But we'll see. On the plane ride home, I actually made a diagram to sort it all out- Because I am a visual learner. I need to see things mapped out. After I made this- my professor was able to help me draw lines on what nursing paths can definitely intersect and totally relate to each other. Hence, this lovely diagram of my entire future:




Crazy, right?

What we narrowed it all down to was that "Nursing Informatics" was the core of all things nursing for me. Informatics can leave me openings not only for a long education, but to possibly delve into NASA, the Air Force, Politics, Humanitarian efforts, Emergency medicine, Epidemiology and Disaster relief. What it all comes down to, is that technology fits everywhere. Can I say it enough times that technology is the future? Of everything?

"Nursing Informatics" and its a rapidly growing field. Its all about revolutionizing nursing through enhancing technology. And, I come from a family of technology and I consider myself to be pretty competent with technology, and I have a lot of strong ideas for technology and nursing in the future.

At the beginning of the conference, I didn't know what nursing informatics was. But I had(have) at least three solid nursing inventions.
By day 2, I discover this new field. It intrigued me, but it was so foreign and new to me that I really had to think it over and learn more about it before I went crazy over it.
By 5, after listening to multiple "technology in nursing" seminars, I was crazy about it. I kept itching in my seat- I wanna learn! I want to do this! I can do this! I want to get in this field now- this is where we're all going! Not just nursing, but the entire planet! This is the answer. I wanted it. I do want it.

Also, with one of the particular schools that want me, I can skip right over the MSN and go right for my PhD, which is, insane. I'm 23. Am I really ready to think about PhD? Granted, I signed my soul to a 2 year contract with my hospital now, so I can't officially start my PhD until I'm 25.....Ah. Could I actually be Dr. Somebody by the time I'm 30? Could I?

There's the age battle, right there. I can get my doctorate by 30. Why not? It'd be hard as hell, but I could eventually do it....but in addition to just the schoolwork, you are judged going in so early. You have the older doctorate students that look down on you because

1) you are so young
2) you dont have nearly as much "clinical expertise" and lifelong practice as they do
3) they fear you, for being so young and ambitious
4) you're just really, really young.

There were people I met at the conference that were in their 50s-60s that were still doctoral students, or even just thinking of getting their doctorate soon. And here I want it by 30? You can see where some discrepancies and arguments might arise...


Looking back to the diagram above, there are two strong sides of who I am. Its like two hemispheres of me. There is nursing me, who wants to (literally) change the world. But I only ever went into nursing because I didn't have the courage to be who I really wanted to be, an artist...The real me. But I like nursing. Its worthwhile, a lifetime career, and its productive. I can help other human beings. Thats why I stayed, and why I will always be in nursing. However, the second hemisphere of my brain is the artist, the drawer, the painter, the photographer, the writer, the mom-wannabe, the wife wannabe, the daughter/sister/friend.....How can I be everything? Is it so sad that I so badly desire to be immortal and live forever and take a normal lifetime span to try everything? I set my goals too high. I want to learn every language. I want to read every book. I want to travel to every country. I want to write at least eight novels. Like, strong, hardcore novels. But those novels have nothing to do with nursing. Can I really be a stand alone writer and a Nurse, too? Why not, I guess, right? We shall see...


There was something really intriguing, however, that I noticed at this convention that has to do with the question: Who do I be, mom/wife, or powerful nurse? Well, at this convention I came across multiple women in very-high up positions. Granted, 95% of the organization has got to be women. Most of the government is made of women. And some of the men in the audience? They were there for the sole purpose of supporting their wives. They came to this conference of nursing to congratulate their wives who are probably making way more than them and just got an award for saving a bajillion people in Africa, or something. But seriously how sweet is that? How awesome is that? How new millenium is that? Awesome!


This organization seems to be the one door to open that will open a thousand more doors, If I play my cards right. And by golly, I'm about to start learning how to play some cards! This organization not only can help me travel for fun and business, but for humanitarian/volunteer efforts. Like, safe children in Africa sorts of trips.


Summary of the entire blog post:
I really doubt my life will ever have a dull, boring moment. If it does get boring, time to start the next big thing I want to do!




Also, I am absolutely crazy.


~ A Writer in a Crazy Nurse's Body




.

Wednesday, October 26, 2011

Internal Breakdown

Breakdown. Thats different from Burnout.

Breakdown.

All the experienced nurses look at you, waiting for it because they know its going to come. They know every nurse goes through it. They have to go through it. No one makes it through the first two months without a good, solid breakdown.

The most important factor about you, though, is how you pick yourself back up after you fall down.


Today was probably my first "breakdown" (internal). There was  a moment where I literally had at least six *critical* priority tasks to accomplish. What do you even do first? They are all top priority, so what takes even more top priority?? Sometimes its a fine line of ethical debate.

During that one moment where I had many important (and unimportant) things to do and I was rapidly running out of time, I was about to lose it. I literally had to stop everything, take a deep breath, and then get back to it. I didn't have time to lose it.

In my experience, I've seen new nurses really breakdown. I've seen them cry on the floor, cry in breakrooms, cry with their preceptors, quit the job, snap at coworkers, etc.

But I literally don't have time to do that. I don't have time to cry. Yes I feel overwhelmed and like I'm drowning. But If I seriously took the time to go into a corner and give up and cry, what the heck would happen to my patients? Other nurses don't have time to cover for you. There is no time to lose it. Instead, there is time to tell yourself that this will pass, and to just keep moving as fast as you can with being safe, keep re-prioritizing, delegate as many things as you can, and keep it together.

Its hard when it all comes down to acting. When you have a thousand tasks on your mind, and you are literally walking 25mph in the hallway, and then you have to slow everything down when you're with your patient, even though your brain is trying to move a thousand miles a minute to get things done. You can't zip around the room like a maniac. You can't talk fast with patients. You can't act like your in a rush. You have to make it seem like you have all the time in the world to sit and be with them and answer all their questions. You can't ruin it all by leaving in a rush after you just poked them, gave them new meds, hung a random bag on their IV, etc. They need explanations. Slow explanations. Its easy to forget that patients have no idea what you're talking about half the time. GO slow.


It's hard when you're keeping up with all the chaos, you feel like you're drowning but at the same time you can see the light of the top of the water at the same time. You have 8,000 really important, hard, tasks to do at that moment but somehow, you're holding it all in and you're ok, but then, the copier breaks- and for some ungodly known reason the universe does not want you to scan this stupiddddd piece of paper down to pharmacy that you really need pharmacy to get and you cant give up because its kind of crucial and WHY IS THE COPIER NOT WORKING when you need it to the most???

That, my friends, was the moment I nearly had my (external) temper tantrum breakdown.

I nearly almost even stomped my foot and whined and literally wanted to scream that despite making it through most of the wicked storm, I couldn't make this stupid copier scan a paper to pharmacy. That, is frustrating.

Its kind of like grief. When  a spouse loses their spouse, they somehow make it through. No dramatic breakdown. But then the dishwasher breaks 5 days later, and they find themselves sobbing and sobbing for 3 days straight over the dishwasher. But is it really over the dishwasher? No. Was my near external breakdown over the copier? No.


I have a great team of support system nurses. They are all my friends, being that ive been an aide on the floor for so long. They all came up to me in my time of need and asked if they could help. But I couldn't even tell them what to do because I couldnt even keep track of it all myself. I was so busy that I couldnt even take a minute to figure out what they could help me with. I was having a hard enough time keeping up with keeping everyone safe by myself, and for some reason the thought of proper delegating just seemed like it wasn't worth the hassle. Its hard to delegate to another nurse. Lets say you just really need your insulin coverage given, but you're tied up somewhere else. If another nurse does it, they know nothing about your patient. They don't know your patients quirks, where they like their insulin, where they got it last, etc. The patient doesn't know that nurse. So in their mind, here is some random new person in scrubs coming at me with a needle. They don't know anything more than that. But when they see me, they know and trust me and understand what I'm doing because I've been doing it with them all day.



Somehow, I made it through. I know I am becoming a much better nurse, day by day. I am catching myself before I make mistakes, I am asking all the right questions, I am communicating very well with doctors, I am getting to be great at working with IVs, and I have gotten a multitude of very pleasant compliments to my face and to others about my work. I know I am still a baby nurse but I know once I get a true hold on things, I will be really great. I feel destined to be really great. Its a toss up because I want to be great enough to change the world of nursing. But in order to do that, you generally leave the bedside. You go into political nursing. Or supervisory nursing, maybe. As much as I love to entertain the thought of being that important one day, I can't bear the thought just yet of not being that nurse at the bedside with you making all the difference to you at that moment in need. So we shall see. Even 100 years doesn't NEARLY seem like enough time to do all the things I want to do, in my career and life in general. And I don't even have 100 years. I have like 80. If I'm blessed.

If I had the offer to live immortally and never grow past 35, I'd take it. To stay between my age now and 35 forever and age really, really slowly, that'd be grand. Theres so much I feel like I need to do in this specific age time span. My career, my masters degree, husband, (well, boyfriend needed first), kids.....there isn't enough time for all of it!  I wish I could make these years really last. Im turning 24 In June which is almost 25 and then how the heck am I 5 years away from 30!?


Ah!


My second wish would be to never need sleep, ever.

but thats another story.



Well, I worked late until 9:30 pm. Got home at 10. Ate dinner. Wrote this blog. Going to bed now. Doing it all again tomorrow. Yay.


With so much love,


WNB



.

Saturday, October 22, 2011

Walking Away

It takes a lot to push my buttons.


OK thats a lie. I get annoyed easily. Really easily.


However, It takes a lot to notice I'm annoyed, because I'm pretty good at not letting it show. Nurses need that skill. So if it does show that i'm annoyed, then you really pissed me off.

For example, this patient hit just the right button.....


Scene Set up:

I am helping out on the floor. I have no patients of my own, because i am working an odd-hour shift, so I am floating around the floor helping out everyone and answering call bells. So I answer this particular one...

Patient: Hello.
Me: Hi. How can I help you?
Patient: I don't know.
Me: Did you ring your call bell?
P: Oh Yeah. I want water.
Me: OK, no problem. I'll go get you some.

I pick up water pitcher, realize its been recently filled, with ice water.

Me: Actually, you have some. Its right here. Let me pour you a cup.
P: Then whats this in this cup over here?
Me: Well, it says "Pink Lemonade" on the top, so I guess its Pink Lemonade. Would you like some?
P: No. I want water. I hate pink lemonade.
Me: OK, let me pour you a glass. Pours glass. Here you go.
P:Thank you. Whats in that cup over there?
Me: More pink lemonade.
P: Oh, can I have some?
Me: Um. Sure.  I hand it over, she drinks.
P: This is gross. What is this? I want water. Get me water.
Me: you have water.
P: Where?
Me: Right here, in front of you. Remember?
P: Oh yeah, OK. Thank you. Dump the rest of that pink lemonade out I dont want it.
Me: OK. Can I get you anything else before I go?
P: Nope.

I leave room. 30 seconds later, her bell goes off again. I go back in.

Me: Hello again. Did you need something?
P: I think I have to use the bedpan. I'm so sorry, I'm taking all your time, you were just in here.
Me: It's not a problem at all, thats what we're here for. I'll be glad to help you.

I pull covers down so she can roll over and use bedpan.

Me: Um, It actually looks like you already went in the bed.....do you still have to go some more?
P: Yes.
Me: OK..Well lets roll over and you can finish in the bedpan. Lets turn on that side over there.
P: I can't turn by myself. It hurts me too much.
Me: Okay, no problem. I will help you roll.
P: Okay. Pt starts to roll, I help, but she's not budging.
P: Don't push me. I can do it by myself.
Still not moving.
Me: Mrs. Soandso, I am going to have to help you turn if we are going to get this bedpan under you.
P: Okay. Just don't listen to me if I say it hurts.
Me: Um, Okay....

 I get it under, after finally getting her to roll.

Me: Okay, you can go in the bedpan now.
P: I don't have to go anymore. Can you take it out?
Me: Stares at her. Just try and go for a couple minutes, just in case.
P: Okay.
Me: Okay. I will give you some privacy and come back and check on you.
P: Okay. Before you go, can you fix your hair?
Me: Stares at her, again.
P: Your hair is so pretty but you have that one flyaway strand and its really making me angry. Come here and I will fix it.
Me: Um, no thank you, I will fix it.
P: Then why haven't you already?
Me: I am very busy. I just haven't had time today to readjust my ponytail.
P: Thats why I'll help you.
Me: Thats Okay. I'll go fix it.

Walks away.


>

Seriously though, wtf?! The water/pink lemonade episode is comical, thats like talking to Dori. The bedpan issue is annoying but it happens sometmes, its part of the job. But after I went through everything, including your poop, to help you, and then you throw an insult at me? Thats pushing my button. And I will walk away.


Seriously, some people. *Sigh*




~WNB


.