It Takes a Little Time

So don't worry, I am still here. I have so much to write about that I don't know where to begin. First and foremost, I am still enjoying my job as an RN. Does it suck sometimes? Yes! Am I exhausted when I get home? Yes! Do I want to cry from time to time? Yes! Would I change a single thing? Hell no!

I am beginning to think that the first year as an RN in a hospital is a lot like military boot camp. I have never been to boot camp, but as emotions go I can only imagine that this can compare. I swear that I am being beat down emotionally so I can become numb later. The patients that I have had the privilege to take care of have taken an emotional toll on me. I have seen people bleed, die, bleed then die and I have seen those people try and be saved. I have been with families as their loved one has been diagnosed with cancer, I have visited with patients that are going through their second or third round of cancer. I have told a patient to just let go, I have told a dying man that sometimes it is best to just go home. I have also laughed with them, talked sports with them, and one time even gave relationship advice to one! I am always perky with a smile on my face. Why be glum? These people that I take care of are dealing with pain, fear, and disease and the last thing they need to see is a bitchy nurse walk in the room. We as nurses are the caregivers, the ears, the advocate and so much more. Am I the best? Far from it! I never pretend to know everything and I am more that willing to admit to my faults. I don't mind being humbled and I always apologize when I am wrong. It is the best I can do. So what will the rest of my first year bring me? I have no clue but I can't imagine it can be any more emotional than my first six months has been.

Back at Last

Hey people! I know it has been quite some time since you have heard from me. I gave birth to my second son Miles Robert Jesse on August 7th, so needless to say I have been off work since then and just returned last week. I must say, it was great being off for ten weeks but it is nice to finally be around adults!

I am currently still on orientation because my son was born a little early. I have three weeks left of orientation before I am out on my own. I lucked out while I was on maternity leave because I bid on an 11a - 11p shift and got it! (Seniority helps!) So that means that I have never had to work a night shift as a new nurse (I am sorry all of you other new nurses out there...I really am not trying to brag). That is pretty much unheard of these days. All nurses for the most part have to put their time in on the night shift and get enough seniority to move to days. Where I work it doesn't seem to take long if you are in the Float Pool.

My first day back was a bit hairy. Of course they stuck me in the ICU! Nothin' like coming back from almost three months off and starting right back with THE sickest patients in the hospital! But all in all I did OK. I made a few stupid mistakes (like back flushing blood into the bag of normal saline that I hung it with) but nothing that put my patients in danger. Right now I am working in the ER for this week and next. I like it a lot better than I did before. It must be because I can move again and I don't have that huge baby belly in my way. I don't really have anything interesting to report to you right now so I really just wanted to let you know I am back! Please keep following my blog...I promise I will have more stories for you soon!

A Loss

I haven't been a nurse for very long. I will come into contact with so many people I won't remember most of them.

Today I learned that one of my patients passed away. She was 42. It saddens me a great deal this time because I was able to take care of her for a few weeks while in the ICU so I got to know her and her family fairly well. She came in with abdominal pain and unexplained weight loss. She was diagnosed with pancreatic cancer last week and given 3 - 12 months to live. She died yesterday.

I am grateful that I got to know her. She was a feisty, spoiled, and demanding woman. But for some reason it never bothered me. I guess because I thought of myself lying in that bed not knowing what was going to happen to me and realized that I knew nothing of what she was going through. I didn't care how she acted because she was fighting her own demons and fears I couldn't possibly understand her battle.

She came down to see me in the ER last Tuesday while she was in the hospital. She was out and about and wanted to come say "hi". Her friend wheeled her down to see me. She looked awful. She probably weighed all of 85 pounds. But it made me feel good that she thought of me the way she did. I am glad I was her nurse and was able to care for her. And I know I gave her the best possible care I could have.

They say that there will always be a few people in your nursing career that will touch you in some way and that you will always remember the first one that dies. I believe them. I will always think of her. If I met her outside of the hospital in some other capacity, we probably would have never been friends, but she touched me in a way that I can't explain. I knew when I went into this profession that it wouldn't be easy. And its not. But I love it anyway. I will always remember her.

Time Will Tell

Unfortunately for me, my ICU experience was cut by one day because my unborn son decided he wanted to try to come early. Luckily for him they stopped the contractions but I am supposed to take it easy until Monday. Tuesday is when I start my ER training. I am sure I will have LOTS to blog about when that starts!

For the past three weeks I have been in Surgical Intensive Care (SICU) training. I must say, it is very different than Medical/Neuro ICU (MICU). The first thing I noticed is that everything goes much smoother down there. Surgeons are just a different breed of doctors. Most of the time they don't have to deal with multi-system problems because their patients have been operated on, which means one thing not a million. I was able to see a few open heart surgery patients come out of surgery (at our hospital, open heart patients come right to SICU after OR, they do not go to the Recovery Room). As a float nurse, I will never take care of an open heart patient but I was able to see how incredibly COMPLICATED it is! Holy Shit! The open heart patients come out with tubes that go everywhere and are hooked up to machines I have never seen before. It's very intimidating.

I was nervous about SICU. The nurses there have very strong personalities and surgeons don't have the best bedside manner either. But all in all I liked my experience. I think the nurses accepted me just fine and I did my best (which is all I can do.) It will be different when I am on my own, but I am not afraid to ask for help which is the most important thing in an ICU. Never assume you know everything or those nurses will eat you alive! There is a small window between life and death and you always need to remember that.

That is all I have for now. I will catch up with you next week hopefully. Have a nice weekend!

3 Days, 36 Hours

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

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:

1. Everyone has liquid stool and it is constantly coming out. Bed sheets need to be changed A LOT
2. You want your patients sedated, and if they aren't sedated enough, give them a bolus of Diprovan
3. There is never just one problem you are dealing with. These patients are having MULTI system issues, and it seems to go on forever
4. 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.

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.