"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?"


Showing posts with label Intravenous lines. Show all posts
Showing posts with label Intravenous lines. Show all posts

Friday, January 13, 2012

Anxiety.

HI! Wow. Okay. So, I know I can't give this disclaimer every friggen time I post, but again, I am so sorry for not updating more often lately. Life has been.....really strange lately? My "me" time has been severely compromised. Its January 13th and I feel like I'm still waiting for the holidays to just simmer down. Is it terribly wrong that I am longing for a day, just one day, to just have to lie in bed and watch tv, read, draw, and eat all day? Not see anyone, not run any errands, not work, not solve any problems......?  And yet I can't ask for that. That, for me, is not healthy, and I've come to realize that. If I let myself do that, I don't come out of it. Once in bed doing nothing for the day, I never want to stop. Suddenly the simplest errand to run becomes a giant, monumental task that I come up with multiple reasons why I shouldn't do it. I make up lots and lots of reasons why I should stay in bed therefore and only get out to eat, sometimes.

So I have to have balance. And that is hard to find, especially on night shift. Because on top of it all, on a work day, on a off-day, on a normal day, on a not normal day, I'm tired. I'm tired when I slept all day to recover from the previous night shift. I'm constantly yawning. So I want to crawl into bed. The bed, all the sudden, becomes the number one priority and I just can't wait to crawl back in, day after day, always looking for the next opportunity that I can sleep and I'm allowed to sleep.

So, I have to figure something out, I guess. Each day, I try to accomplish a mission on my neverending to-do list. Something I've been procrastinating, putting off. Something I've been afraid to do or finish. Each one of these tasks that I accomplish, life gets a little better and I can sleep better, knowing that at least I accomplished something small that day. Anything.


I know that this lifestyle is worth it. That I'll get through it. That despite the above depressing three paragraphs, that I am in here and I am going to be OK. It's winter. I'm on night shift. I see the sun 5% of the time it is out. I am practically a vampire. I like to follow the delusion that I am reacting normally, and I'll be fine. I definitely don't plan to be on night shift for long. 

I know its worth it because I help people at work. I know I do. Its the hardest job I have ever done thus far, and who knows, maybe the hardest division of nursing. Floor nursing.


I am getting better every day. Every shift. I learn something new every day at work. I am slowly developing a bag of skills and tricks to use to make me a better nurse in the future. Other nurses have told me they forget that I'm new, and forget that they need to help me at times, because they think I'm good. And that is good, I guess, but it makes it hard. I like figuring things out, I like solving problems for patients. I like making ethical decisions. I can't wait to be a seasoned experienced nurse so that I can do all those things, except better. I try and solve problems now, and I do, but in 10, 20 years....I can exponentially solve those problems even better. I can't wait to have those extraordinary skills. That "nursing instinct". To know what is wrong with my patient without even them running a test. I want that.


I'm doing fabulously better with communication with doctors. Extraordinary. I never thought I'd say this, but the problem went from being 95% of a problem to nearly 5%. I learned pretty quickly that, 1) Doctors signed on to be called at the randomest of times when they took an oath be a doctor, that 2) if they don't want to be called, they'd have hospitalist/residents cover for them, and 3) in the heat of the moment, you don't have time to be nervous to call the doctor, you just have to call and 4) it is your JOB to at least call the doctor and make them aware.

So thats not a problem for me anymore.

What is my current problem? The simple, mundane task of starting an IV. I am not getting them. The one thing I thought I'd be good at, the one thing I thought I'd enjoy doing....I'm just not getting it. I'm not getting the best veins to go for in the first place. I see everyone as a "hard stick" unless they have bulging veins I could put a 18 G in. Its my number one thing I'm afraid of. I know this fear will go away by practicing. But practicing sucks for your victims. I hate hurting people. I hate having to stick people just so I can get practice, and then not getting the stick and having to send better nurses in.  But, I'm still only 3 months old. I'll get it. In time. Just have to....keep practicing.


Other than that, I just have to learn new things yet. I have to just wait for new experiences.

I'm still afraid to have my first Code, or even first CAT/ RRT call. I'm trying to avoid my first Code BY calling the CAT/RRT before the Code. I try to do my best by remembering everything about my patient all the time so that in the unfortunate a code or CAT/RRT call happens, I can tell the team everything they need to know....but I'm still pretty scared.

The worst part of it all is the anxiety. The insomnia. Every time i do try and sleep, my entire shift replays in my head. Did I cross my T's and dot my I's? Did I remember to waste all the drugs in the machine. Did I remember to chart about everything I did? These thoughts race through my head. My entire shift gets repeated, constantly, in my head, just waiting for a mistake for me to realize I did, so that I don't get any sleep. I hope that 1) this is normal for new nurses and 2) this will go away soon....its exhausting and definitely not contributing to restful sleep.


Well, I work tonight. Every shift I have to make myself a better nurse, somehow. I remember always having a back up plan in school, like- "If I don't pass this test, or if I fail out of the program, what am I going to major in next? What will I do?"  Well I passed school, I graduated, I got a job now. Obviously. But the confidence still isn't there. I'm still constantly conjuring up a back up plan. Is that detrimental to my career? I'm constantly thinking, "If I get sued so bad I can't practice anymore, or If I got fired, or If I got laid off, or lost my license, what would I do with my life? Would I be able to move on? To do something else? To maybe follow my real dream, art?" I think these thoughts are detrimental.



But anyway. Time to get some shut-eye before tonights shift. Sorry, depressing post. But it helped, a lot. Got a lot of my current anxious thoughts out of my head. Look forward soon to a happy post. With photography. And artwork. And a movie review! Coming up! :-)


With love,


~WNB


PS- Don't worry about me, I'll be alright. I promise :-)


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Sunday, September 25, 2011

Week Two as an RN: Getting my Legs

Would you believe I have seven blogs in draft mode that I've thought of in past week, and this is the first *spare moment* I've had to sit down and even start the first one? (This one). It's been absolutely insane!
Well, I survived week number two as an RN, and boy..........have I learned and done a lot. Tomorrow it starts all over again, three more days. This past week I've had a very interesting set of patients, as well as having practiced continuity of care. I started the week with two patients and kept one of those two for the whole three days.


I ran into a lot of problems, but was able to solve them. I'm running head first into a lot of "oh my god I can't handle this!" type moments, but the important thing is learning that they ARE going to happen everyday no matter what and no matter how experienced you are. The important thing is to take a deep breath, close your eyes, reprioritize, and get right back to it. As long as you constantly reprioritize and act with the best intentions, you can't go too wrong.


So that was my second week. I missed things, yes. Things fell through the cracks. But as the week went on I learned from those fallbacks and made sure the next day to not let it happen again. As much as I hate making mistakes, in my opinion-bring on the mistakes now while I have a preceptor (rar!) who can teach me the right way, rather than in a month when I'm on my own on nightshift. The worst thing you can do, and something I am faulty of, is trying to figure out something on your own. The hardest (and easiest, sorta) lesson to learn is knowing when to ask for help. To put aside your own pride and dignity for your patients sake and safety.


Its funny, those frazzled moments....You start off your day with everything calm. You get there, get report, organize all your papers, make to-do lists, draw up your AM meds, do assessments....and for the most part its pretty calm. But then, then the frazzle moment happens. Its been a different time of day each day so far for me. Sometimes its 10am med pass, sometimes its a random point in the day at 2pm, or sometimes its right before we leave, in the evening. The frazzle moment is when you HAD a plan, but somehow that plan was thrown out the window, and replaced with four new plans, and everyone needs you to do something. But not only do they need you to do something, but they ALL need you to do it right away. And its hard to prioritize when they all want you at the same time, and you have to figure out who to make wait and who can't wait.

But, talking with my staff development educator after one of these frazzle moments helped me learn something else: Knowing when to delegate!  I explained to her that I was having a hard time with that, because the aides on the floor are my friends, and its hard going from working with them to now telling them what to do. She noticed I was having a problem because I was trying to do everything myself for my patients. Things aides can do, and my own nurse work, and thats where everything was getting to be too much. So, have to work on that.


But, I'm really excelling in my skills. The hardest part so far has (still) been communicating with doctors, and prioritization. But, that will come. Every day I learn something new! :)


So, exciting news?? I got in my first IV!! on the FIRST TRY!! WOOT!!! It was pretty amazing, and I really had to restrain myself from literally jumping and doing a dance in front of the patient, but I refrained because I didn't want to further help clarify that it was my first time. I think she was already nervous enough as it was. But yay! But despite having done one once, I'm still nervous for # 2....Is that normal? :\


Needless to say, There has been a LOT of prayers coming from me this week. I have levels of prayer...some are just mere wishes, like, "I hope the cafeteria has chicken sandwiches today".....and some are level 1 prayers, like: "please let me have a good day today." Level 2 would be, "please let work, please let this work!"  and the ultimate......Level 3: WHen you hear the beginning sound of a code when you're on your lunch break, "For the love of GOD, PLEASE don't let that be my patient!"


Lets just say a lot of Level 3's have been entering the prayer (center? Receiving area?) from me.



But eventually they will fade. In a couple years, I won't need prayers answered, because I will know how to do things myself rather than rely on chance and fate.


Also, I got to use my "therapeutic communication" skills (or lack thereof, I really don't know). I was sitting at one of our more secluded nurses stations, by my section of patient rooms, and a woman (visitor) came outside of a room.  I looked her way, we made eye contact, I smiled, and went back to charting. But then I registered that she was crying. I looked back and asked if she was alright. She nodded, but clearly wasn't. So, even though she wasn't in my patient section, I'm not about to just continue sitting there while she cries in the hallway. So I closed my charting, walked over next to her and told her that although her loved one was not on my patient section (and therefore I couldn't answer any questions) I'd be more than willing to sit and talk with her if she wanted. She agreed, and explained to me why she was crying (it was a really sad story :( ) and so....with all this sadness..I didn't know what to say, but who does? I tried to remember all the things we learn, that silence is golden, and people like hugs....So I tried to just stand there with her and not say anything, and when it was time to say something, I just tried to say encouraging words and encouraged her to talk more. Hopefully it helped some and I wasn't an intrusion.




So, here's to a new week ahead! The most important thing is to learn from my mistakes and learn something new every day. :-) I need to invent a portable screeen of some sorts that follows me around and my tasks to do get added to it and things that ive done get added to it on a time schedule, results come up right away, orders.....and so when you do something on the to do list, you can virtually cross it right off and the computer prioritizes for you whats next. We could all be super-nurses! Until the machine breaks....lol.




With much love, WNB.



PS- I have like eight more posts to write, so keep an eye out for them coming up soon!



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Wednesday, September 14, 2011

Day 2 as an RN: Overcoming Fears

AH!

So.....day 2. I survived. I'm still sort of gathering my thoughts....


I got my own patient! But he was not complicated at all, and all I got to do with him was some education, an initial assessment, lots (and lots) ((and LOTS)) of meds, IV meds, piggys, primarys, subqs, and other fun stuff like that. Felt *just* like I was back in clinical. Which is OK.....because at least I don't have my intimidating teacher looking to fail me anymore. Now I have a preceptor trying to teach me and make me a good nurse, and she trusts me (probably a little too much) to do a lot on my own. So, thats good.


The biggest hurdle I have yet to cross is getting over whatever I fear I have of doctors. Okay, It's not that I'm afraid of doctors. It's just in my personality code that I:

1) hate to bother people
2) hate to talk on the phone
3) have trouble understanding diction...especially heavier accents =\

So,  ^^ all that is pretty much all doctorness. I don't mind at all talking to doctors in person. I am a very personable person and I understand nonverbal communication so much better than over the phone. I don't care if you are furious with me, I'd still rather talk to you in person than on the phone. I hate the phone. Hopefully that will change. That has to change. Nurses are on the phone just as much as they aren't.

Today I was only working with one doctor since I only had one patient. Luckily I got to see him on the floor so I took advantage and snuck in there and got to introduce myself while asking him to change a patient order (that sounds so awesome and nursy official but it really wasnt lol). And so then a couple hours later I had to call him again and get an order verified to continue it. Well, I did not want to call him. But my preceptor felt it was time I get over it and get on the phone and start calling the doctors. She reminded me that if I don't call, then I'm not looking out for my patient.

Luckily during our quick 40 second phone conversation, I didn't say anything too entirely stupid, I understood him (most of the time) and I got what I needed.... But it was still not preferable.

I guess at this point its just a matter of learning what each doctor is like, their personality, when you can call them, when you can't, what you can call them for, or should you call their intern? Funny thing is night shift won't be so bad because unless your patient is dying, chances are the residents will take care of what ever you need. And the residents/interns are usually closer to my age, just as clueless as me, and in the same boat (ok different boat, but similar), and we work together. Together is key. If were both equally as clueless, lets work together with our different knowledge bases and solve this together!


Anyway, my other hurdle is putting in an IV. Tomorrow is day 3 and its about time I at least attempt my first....so, I'll update on that tomorrow. =\

It's funny how in nursing school my biggest fear was anything to do with the IV system. Piggy's, primarys, tubing, or whatever. My teacher always made it seem to frightening. But now I love working with them. It all makes perfect sense now and I don't understand why I ever thought it was scary. So, thats good! I knew I would get my technical skills down fast, its just a matter of learning reasoning behind actions, remembering everything, doctors, knowing what to do in emerging situations, etc....it will all come with time, I hope! It's only day 2 and I think I'm expecting my personal performance to be at day 124,111,293. I'm a perfectionist I guess and I can't sleep at night if I know I did something wrong with, on or too my patient. So I also have to learn that mistakes do happen and thats how we learn and become great nurses. And, no one is perfect on day 2. Right?


So, tomorrow, pretty much just a repeat of today except hopefully can do better, be more on top of things, and hopefully get my first IV stick.



Thanks for reading! To my non-nursing affiliated readers, I am sorry! I hopefully will come out with a non-nursy post soon, this weekend perhaps. What would you like to hear about? A funny story? Some photography? Writing? Just an update on my life? :-)



~ WNB < 3

Friday, September 9, 2011

IVing it up

Hi!


So, the much anticipated IV certification class was today! I still have not been on the floor during orientation because my state takes *forever* to get our license numbers, and the hospital needed to be SURE that I passed NCLEX. But, they finally got it today and I will be starting on the floor monday!! Ah!!! Look for a scaredy cat post Sunday night? Probably.

Anyway, today was the IV class, which I was actually really excited about. I've spent the last five years holding arms down for nurses and being literally right there watching them do every move. I've been taught by experienced nurses how to pick the best veins, how to get the good sticks, and I've watched the procedure done a couple hundred times, but never have legally been able to do it! Until now!

So of course the class was mostly lecture (a whole ninety-eight minutes!!!) and the whole time I was wiggling around in my seat because I just wanted to DO IT. Of course, the 5 hour energy I took before the class probably didn't help that ( I literally almost ran into the building because I was so excited).

Because I couldnt wait to actually do it, I actually volunteered to go first and that is very rare. I am never the first volunteer. I'm usually hiding in back until I watch everyone else do it and mess up first and then I'll try. But I felt I had a pretty good handle on it and I wanted to dive right in.

For the most part, I got everything right! It's really just a matter of getting all the steps down and engraining them into your brain so that the order comes naturally. Its hard to remember all the little steps sometimes. And the hardest part sometimes is finding the right vein.


All that aside, I have the feeling that I will be one of those nurses that is really good at IVs and gets called by other floors to come do theirs. With a lot of experience that is. I probably just jinxed it by saying that, but I really do think/hope I'll be good at it. I've always had a "feeling" for those types of things, I'm good at sort of just....knowing...which vein to go after and I am pretty good at feeling others pain. 


So, yay! Despite watching for five years and sucessfully sticking a plastic arm, I'm still undoubtedly going to be very nervous for my first human! I think its going to be more of a matter that the person will be able to tell its my first time, because I will have the natually tendency to be constantly looking to my preceptor for reassurance and thats kind of a dead giveaway. If I could practice on someone that doesn't mind that fact or is kind of unconcsious, then yay! (lol I'm such an awful person, i know).


So....monday it all begins. Get ready for some interesting posts!


~WNB