"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, November 12, 2011
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.
~ A Writer in a Nurse's Body