I just got done working 36 hours in three days. It seems like a lot, but that can be very typical in the health care profession. It wouldn't be so bad if I wasn't almost 8 months pregnant, but I survived!
So to sum up my experience this week, I would have to say "sad". This week brought about a lot of cancer patients. Not something I would necessarily expect in an ICU (and I don't know why) but they were there. All of the cancer patients I had contact with this week had limited time left, and they all had cancer metastasize to another area in their body. They were all smokers. I am so glad I quit! One patient had accepted his death, one patient may have but it was too hard to tell because he was on a vent, but his son had not accepted his prognosis and the other patient was aloof. We also had a code this week which is not atypical for the ICU. The patient came back, but was placed on a vent so its any one's guess as to what his outcome will be.
I go back next week for more, but this time not 2 in a row! Once I gather all of my information I will reflect on what Medical ICU has left me with. Until then...ta ta!
Katie
Friday, June 18, 2010
Saturday, June 12, 2010
A Week in ICU
Being a new grad, I have to "precept" with an experienced nurse for a few months. I will be going all over the hospital eventually, so I have to train on each floor/unit. I have just begun my three week session in Medical/Neuro ICU. I spent three days there this week.
There are a few things that I have learned about ICU right off the bat:
There are a few things that I have learned about ICU right off the bat:
- Everyone has liquid stool and it is constantly coming out. Bed sheets need to be changed A LOT
- You want your patients sedated, and if they aren't sedated enough, give them a bolus of Diprovan
- There is never just one problem you are dealing with. These patients are having MULTI system issues, and it seems to go on forever
- A patient can lay there intubated and comatose for days with little changes and few new orders written. It seems that small changed take a REALLY long time
I always said I wanted to be an ICU nurse. I still might, but so far I am not too sure. First of all its incredibly overwhelming. These are SICK people. I mean SICK. Most are in a drug induced coma because they are intubated (on a ventilator). Some are on constant dialysis. Most have at least 3 drips going at once, tons of lines, and machines beeping at you. Anything can go wrong at any time and the nurse must be prepared to know what to do. An ICU is not for the weak nurse. Most ICU nurses have very strong personalities and don't take shit from anyone, including the physicians. They are very protective of their patients. That is a good thing.
We will see what happens over the next couple weeks. I will repost and let you know how I am progressing. I am just really glad to have 3 days off to recoop.
Thursday, June 3, 2010
My Day Yesterday
I have been a nurse now for a few months. Well, since February 19th to be exact. I work in a level one trauma hospital. (For those of you who know where I work, please keep it to yourself as this blog is not meant to give away any identifiable information) Being a nurse is something I have always wanted to do even if earlier in my life I didn't know it yet. My grandma was a nurse. She passed away over 10 years ago now so she will never know that I chose the same profession as her, but I sometimes think about her and wonder if she would have been proud.
When I was going to nursing school, the instructors would often make us write little one page papers about what nursing meant to us. Of course back then I didn't really know. And maybe now I still don't, but I am learning. To me nursing involves many different things as one may guess. As a nurse I have to be an advocate, a watchful eye, a caregiver, a waitress, a verbal punching bag, a silent listener, a friend, a teacher and so many other things. I am OK with all of these things I have to be because I have accepted what nursing is. And I love every minute of it.
I am getting better at IV starts, blood draws, dressing changes and reading EKG screens. I don't always know what to do next but that is part of learning. "It will all come with time" my fellow nurses tell me. And I believe them. Some days I go along, do my assessments and chart my findings. I pass medications. I put people on bedpans or help them to the bathroom. I call the doctors to request changes in medications or suggest different interventions. These days just all clump together because it is a lot of the same thing. But yesterday was a real "Nursing" day for me.
I had a patient who was a sweet old woman. She had some heart problems and decided to forgo any interventional treatments because of her age. She made herself a DNRCC-Arrest. (for those of you not familiar, it means Do Not Resuscitate, Comfort Care - Arrest). She told the physicians that she has been very fortunate to live such a long life and if it is her time to go then that is OK with her. I took care of her for a few days. She never asked for much and when I brought her her tray or repositioned her in bed, she was always very gracious. She never complained and she barely used her call light. She was alert and oriented but just didn't want to be a bother to anyone. She got discharged yesterday and taken to the care of Hospice. It was odd saying goodbye to her. We both knew where she was going and why she was going there, but yet it wasn't sad. She had accepted her fate so I had to too. I will never forget her. She made me realize that death is a part of life and if we are fortunate enough to appreciate all of the things that we have been able to experience then why not accept death as just another chapter in a life filled with joy, happiness, laughs, family, friends and all that other stuff.
Now my other patient yesterday was a different story, but in a good way too. He had some heart trouble and was an elderly gentleman. His wife was with him almost the whole time. He was going for some tests and what not, and in the end the physicians just decided to use medication treatment instead of interventional treatment (like a heart cath, electrophysiology, etc). I took care of him for a few days as well. He made me laugh. He was a joke teller with a bit of dementia but he was always in a pleasant mood. His wife was a sweet woman who took care of him. They have been married for over 50 years. I enjoyed going into the room and being with them. I would listen to all of his stories and jokes, and his wife would tell me all about their grand kids, great grand kids and their sick daughter. And when I left yesterday at the end of my shift, his wife asked me for a hug. And of course I was more than willing to give her one. I probably wouldn't see them again, and I didn't want to (because that would mean they would be in the hospital again and that is never a good thing.) She thanked me for everything I had done and I told them how much of a pleasure it was taking care of her husband. And at that moment, I was glad I chose nursing as a profession. It is the little things like hugs that make my job enjoyable and rewarding. It made me feel good knowing that I made them happy. It may sound cliche to you people reading this but it is the truth.
So maybe these two stories is what nursing means to me. Or maybe my opinion of nursing will change over the years. I mean, hell - I have another 25+ years to go. But all in all I am happy. I am tired and worn down mentally and physically when I come home from my shifts but I am still happy. I am happy because I know that each and every day that I go to work I am there because someone needs me. And I guess in a way, I need them too.
When I was going to nursing school, the instructors would often make us write little one page papers about what nursing meant to us. Of course back then I didn't really know. And maybe now I still don't, but I am learning. To me nursing involves many different things as one may guess. As a nurse I have to be an advocate, a watchful eye, a caregiver, a waitress, a verbal punching bag, a silent listener, a friend, a teacher and so many other things. I am OK with all of these things I have to be because I have accepted what nursing is. And I love every minute of it.
I am getting better at IV starts, blood draws, dressing changes and reading EKG screens. I don't always know what to do next but that is part of learning. "It will all come with time" my fellow nurses tell me. And I believe them. Some days I go along, do my assessments and chart my findings. I pass medications. I put people on bedpans or help them to the bathroom. I call the doctors to request changes in medications or suggest different interventions. These days just all clump together because it is a lot of the same thing. But yesterday was a real "Nursing" day for me.
I had a patient who was a sweet old woman. She had some heart problems and decided to forgo any interventional treatments because of her age. She made herself a DNRCC-Arrest. (for those of you not familiar, it means Do Not Resuscitate, Comfort Care - Arrest). She told the physicians that she has been very fortunate to live such a long life and if it is her time to go then that is OK with her. I took care of her for a few days. She never asked for much and when I brought her her tray or repositioned her in bed, she was always very gracious. She never complained and she barely used her call light. She was alert and oriented but just didn't want to be a bother to anyone. She got discharged yesterday and taken to the care of Hospice. It was odd saying goodbye to her. We both knew where she was going and why she was going there, but yet it wasn't sad. She had accepted her fate so I had to too. I will never forget her. She made me realize that death is a part of life and if we are fortunate enough to appreciate all of the things that we have been able to experience then why not accept death as just another chapter in a life filled with joy, happiness, laughs, family, friends and all that other stuff.
Now my other patient yesterday was a different story, but in a good way too. He had some heart trouble and was an elderly gentleman. His wife was with him almost the whole time. He was going for some tests and what not, and in the end the physicians just decided to use medication treatment instead of interventional treatment (like a heart cath, electrophysiology, etc). I took care of him for a few days as well. He made me laugh. He was a joke teller with a bit of dementia but he was always in a pleasant mood. His wife was a sweet woman who took care of him. They have been married for over 50 years. I enjoyed going into the room and being with them. I would listen to all of his stories and jokes, and his wife would tell me all about their grand kids, great grand kids and their sick daughter. And when I left yesterday at the end of my shift, his wife asked me for a hug. And of course I was more than willing to give her one. I probably wouldn't see them again, and I didn't want to (because that would mean they would be in the hospital again and that is never a good thing.) She thanked me for everything I had done and I told them how much of a pleasure it was taking care of her husband. And at that moment, I was glad I chose nursing as a profession. It is the little things like hugs that make my job enjoyable and rewarding. It made me feel good knowing that I made them happy. It may sound cliche to you people reading this but it is the truth.
So maybe these two stories is what nursing means to me. Or maybe my opinion of nursing will change over the years. I mean, hell - I have another 25+ years to go. But all in all I am happy. I am tired and worn down mentally and physically when I come home from my shifts but I am still happy. I am happy because I know that each and every day that I go to work I am there because someone needs me. And I guess in a way, I need them too.
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