Saturday, October 17, 2015

Catching Up

It's been a while since I've blogged here - obviously. School, work, family, and daily life has eaten up every spare minute I've had this year. Such is life, right?
I have my last class, my capstone project class, remaining until I get my degree in December. The kids are excited, more excited than I thought they were going to be. They even know the last day of class, December 5th. I didn't realize how much harder this past year was on them. I thought I was doing an okay job of trying to balance everything, but I guess they thought otherwise. The kids are relieved that this holiday season I will be free to do the things we normally do. I can't blame them. When a semester ended, I usually picked up as many shifts at work as I could. Sometimes I would work 5-6 days in an 8 day stretch. When classes began, I would be home, but not really 'there' because of the schoolwork. No wonder they're excited.

If all goes well, I'll have a 4.0 in every class I took this past year. I'm happy about that because I thought it would give me an edge when applying to graduate schools. My plan was to take a semester off, take the GREs, and apply to grad school. I think this past year has altered my plans because of the toll it took on my family. I don't want to put them through this chaos another 3 years. I'm going to have to think of another plan.

Monday, April 20, 2015

Untrusting New Grad

I had a shift the other day in my old, crazy hospital based ER. They are not short many day shift nurses anymore; however, they have filled those positions with non ER nurses and several new grads. I was a floating and helping out when the charge asked if I could help one of the new grads prepare an intubated patient for transport to the ICU. I walk into the room and she is absolutely freaking out. She immediately asks me what the amount of the medication she has on the pump.
I asked her before looking at the pump, "Did you use the library on the pump?"
"Umm, my preceptor did it." She's being trained by the charge nurse who also has a full load of her own patients.
I look over at the pump and told her, "No, she didn't use the library."
"Yes, she did."
"No, she didn't." I was taking my critical care booklet out of my pocket when she turned and left the room to get the charge nurse.
I turned to the tech, "Where did she go?" The tech shrugged.
I walked out of the room to see that she was standing next to the charge who was on the phone dealing with another problem.
"Would you come back in here? I'm trying to help you. How much does the patient weigh?"
She ran back inside the room and told me.
While looking up the medication, I asked her if she gave report. She did, but she said she didn't know the answers to many of the questions the ICU nurse asked in report.
I told her how many mg/kg/min the medication was running. She then ran outside of the room again and stood next to the charge nurse to ask her if that was right. By that time, respiratory showed up to transport the patient. Normally, the nurse should have packaged up the patient by that point so the RT doesn't have to wait long for transport. She was nowhere near ready. I got the patient ready for her. She came back into the room and I asked her what the hell was she doing. She said she wanted to check with the charge nurse about the medication.
The new grad had a bottle of extra medication with her. She asked what she should do with it. I told her she could send it with the patient and document that it was sent with the patient to ICU. I guess she didn't like that answer because she ran out of the room to the charge nurse who was busy with a patient. At that point I felt like slapping her. The RT rolled his eyes and sighed loudly. I told him that I would transport the patient to ICU because at this point, the patient would be here forever.
She ran back into the room and looked completely frustrated. I understand how she could feel that way, but hell, she had people helping her and she didn't trust any of them.
I told her to calm down and I'd transport the patient which she said she would do without my help.

What a cluster. I think new grads can start in the ER, but they really need a strong preceptor program and a dedicated teacher. These kids are going to make some major mistakes and hurt someone.
They already have had one of the new grads leave because he said he wasn't cut out for the ER due to its incredible stress and pace.
I wonder if this nurse will do the same.

Wednesday, March 18, 2015

When the Poop Literally Hits the Fan....

Hospitals have protocols for what they will and not to do in the ER. One of my ERs will not perform manual disimpaction in the ER. Rather the hospital wants the patient to be temporarily placed on the observation floor for that procedure. For whatever reason, that is their decision.

In the past, we had a few doctors who actually traveled from out of state to pick up shifts in our ER. I thought that was strange, but the financial incentive must have been great for these doctors to fly into our area each week to work. This one doctor was a real gem. He liked to get into your personal space in order to make you uncomfortable, told off colored jokes, and basically was an asshole - Dr. A-hole. He did not like any of the policies in my hospital, so when I had a chronic constipated patient turn up in my room, I knew it was going to be an interesting day.

He said he was going to fix this patient's problem. I reminded him of the hospital's policy and he scoffed and said it was a fu&%ing stupid policy. Maybe so, but what can I do about it? Next he told me to go in there and disimpact the patient. For some reason, the hospital felt strongly about this procedure and nurses are not allowed to perform it and especially not in the ER. He was livid. He marched into the patient's room, told the patient that he better relax because he was going to, "Dig the shit right out of him." What the hell?!! He proceeded to do just that. The patient started screaming in pain as this doctor entered him.  Dr. A-hole began talking about how stupid it was to not do this in the ER and began flinging feces into the garbage can. As he did that, fecal matter flew around the whole room - on the walls, the floor, the cabinets. Perhaps this is why the hospital didn't want it done down here? Ya think?

"You're not much of a basketball player, are you?" I said this deadpan.

I was trying to break the tension. With that, his face turned red and he flung more across the floor violently, not even trying to hit the garbage. I left the room, afraid he was going to start throwing it on me and went to find my charge nurse for back up.
Needless to say, this particular doctor did not last very long at my hospital - not for the poop party, but for his general attitude and treatment of others. The patient turned out to be okay, the room had to be closed for a few hours for a terminal clean after his 'monkey at the zoo' fecal flinging fiasco , and the whole ER smelled like crap for the rest of the day - literally.

Monday, January 5, 2015

My Holiday: Leave Mommy Alone, I have to Study.

The holidays were rough this year. Mostly due to time - there was not enough of it for me, it seems. I started my journey to obtain my BSN in a year. Since I already have a degree, I mainly have to take nursing courses except for 2 classes. In order to follow my year plan, I had to figure out how to take a 3 credit computer class in the least amount of time.. somehow. I found a 15 day "mini-mester" course at a local community college. I have never taken one of these courses, so I expected the course load to be heavy, but much could you fit into 2 weeks? Well, I discovered - all of it.
In those 2 weeks, they managed to map out reading the whole text, a quiz on every chapter with 3 exams and one comprehensive final, 10 discussion posts, and 10 labs in various computer programs and online research. Unfortunately, I had scheduled some shifts to work during this time which added the stress of doing double on the days I had off. Most days I had around 10-14 hours of schoolwork.
This was a big mistake on my part because it was during the weeks of Christmas & New Years. I have no real background in computers - I was sitting at my computer trying to learn how to write html code in notepad because I had to design a simple website and thought, "What the f#@* was I thinking by taking this class?!!".

I had to pass on a lot of our Christmas traditions this year. I didn't have time to send out cards (except one to my former patient that lived when I was in EMS - see previous year's post), I couldn't have my Christmas cookie bake day that my kids look forward to, I didn't have time to take them to see the light display at a local park. I did manage to triple up on one day (it nearly killed me) in order to have Christmas Eve with no school work so I could make 2 batches of cookies with the kids. They were very understanding and still enjoyed it.

My daughter asked me if I plan on taking a class like this again. She said it was too crazy because I would go into my office around 9am and ask them not to disturb me. I would pop out for breaks and ultimately be done well after they went to bed. Laundry was piling up, housework was non existent although everyone helped as much as they could. I'm glad it's over, but I feel like I missed the holiday experience this past year.

I'm still catching up with doing things around the house and my other obligations that were ignored. I've got 2 weeks before my next class starts and 3 weeks until my second one begins. This is going to be a rough year.