my unit was over staffed today. so, instead of being a nurse, i got to be the secretary. it's a nice change. although, i must admit, sometimes i think being a secretary is harder. i answer phones, help doctors find orders, answer phones, fax orders, answer phones, deal with patient family members, answer phones, validate parking... the tasks are endless. and all of them seem to happen at the same time. i'm constantly being interrupted.
the most exciting part of my day today was when a nurse asked me in a hurried and frantic voice to call a show of force. it's similar to a code, in that it's announced hospital wide on the intercom. but instead of having a crashing, near-death or dead patient, it's called on a patient who is violent or crazy.
the patient on my unit was in the bathroom, yelling profanities, and refusing assistance back to bed when he was unstable on his feet. he threatened to throw a pot of urine at our charge nurse! but thankfully, within a minute or so, we had dozens of people surrounding our patient, peacefully, but intimidating-ly, "forcing" him back to bed.
nursing is kind of comical sometimes. what other profession do you have to worry about getting doused with urine?
Tuesday, February 1, 2011
Tuesday, January 25, 2011
hissy fit
i am 30 years old. but i threw a 13 year old hissy fit yesterday at work. i think it was justified. don't all 13 year old girls?
in all honesty though, it was a legitimate complaint. the charge nurse of the day was a man; he very infrequently does charge. in my opinion, he's a lousy nurse, let alone a charge nurse. and because i believe a charge nurse flavors the day with his/her unique charm, attentiveness, and help, i anticipated that yesterday might be a little chaotic or less than smooth.
sure enough, at 11:30, after a leisurely morning with relatively simple patients, the charge came to me to give me an unscheduled admission. without asking how my day has been going (which is his job) or if my patient load could be burdened by an additional patient, he gave me the patient's name and a brief synopsis of her needs. she was coming from the OR and would need chemotherapy. i begrudgingly took the admit after first asking if he had asked any other nurses on the unit if they could easily take an admit. his response was, "no, you're the first." to which i responded, "why did you choose me?"
now, know that i rarely talk back to people in positions of power. i respect my elders and most of our charge nurses. but for some reason, i was feeling obstinate. his response irritated me even more; my blood pressure rose to dangerous levels. "i think you're the only nurse qualified to give chemotherapy," was his reply. i work on an oncology unit. did he seriously think i was the only chemo certified nurse. as a charge nurse, his job is to know every one's competencies and skills. turns out, more than 4 other nurses were qualified to give chemo. i pointed out the fact and snottily asked if he had taken that into consideration; he said no.
so, by now, i was making him uncomfortable. i was questioning his skill and his role as charge nurse. i wasn't refusing to take the admission. in fact, i admittedly acknowledged that i was NOT having a busy day and that i COULD tolerate a third patient, i always can. but that wasn't my point. my point was, i ALWAYS get asked to take admissions. i often have three patients. as a capable and rather relaxed nurse, i get my job done in a timely fashion and appear calm more often that not. but it's annoying and i would argue, unfair, to give the good nurse the hard patients, the admits, and difficult families - simply because they CAN do the job and do it well. how are the other nurses - the nurses who cannot handle three patients, or the nurses who have no time management skills - ever going to learn when i pick up their slack.
fifteen minutes later (the admission hadn't arrived to the unit yet), the charge nurse called me. he said, "good news. you don't have to take the admit. another nurse is discharging her patient and will be down to just one patient." great. no admit for me. but what almost irritated me more was, if indeed he had been a good charge nurse, he would have been attuned to the patients on the floor and known from the very beginning that a discharge was taking place and that a nurse, other than myself, would have been able to take an admission.
the funny part of the day... three more patients were admitted yesterday. all of them were unplanned. i could have taken any one of them. my afternoon was slow. but, because i had stuck up for myself, or maybe because i scared him, the charge nurse didn't ask me. everyone else got admits and i enjoyed a relaxed afternoon!
in all honesty though, it was a legitimate complaint. the charge nurse of the day was a man; he very infrequently does charge. in my opinion, he's a lousy nurse, let alone a charge nurse. and because i believe a charge nurse flavors the day with his/her unique charm, attentiveness, and help, i anticipated that yesterday might be a little chaotic or less than smooth.
sure enough, at 11:30, after a leisurely morning with relatively simple patients, the charge came to me to give me an unscheduled admission. without asking how my day has been going (which is his job) or if my patient load could be burdened by an additional patient, he gave me the patient's name and a brief synopsis of her needs. she was coming from the OR and would need chemotherapy. i begrudgingly took the admit after first asking if he had asked any other nurses on the unit if they could easily take an admit. his response was, "no, you're the first." to which i responded, "why did you choose me?"
now, know that i rarely talk back to people in positions of power. i respect my elders and most of our charge nurses. but for some reason, i was feeling obstinate. his response irritated me even more; my blood pressure rose to dangerous levels. "i think you're the only nurse qualified to give chemotherapy," was his reply. i work on an oncology unit. did he seriously think i was the only chemo certified nurse. as a charge nurse, his job is to know every one's competencies and skills. turns out, more than 4 other nurses were qualified to give chemo. i pointed out the fact and snottily asked if he had taken that into consideration; he said no.
so, by now, i was making him uncomfortable. i was questioning his skill and his role as charge nurse. i wasn't refusing to take the admission. in fact, i admittedly acknowledged that i was NOT having a busy day and that i COULD tolerate a third patient, i always can. but that wasn't my point. my point was, i ALWAYS get asked to take admissions. i often have three patients. as a capable and rather relaxed nurse, i get my job done in a timely fashion and appear calm more often that not. but it's annoying and i would argue, unfair, to give the good nurse the hard patients, the admits, and difficult families - simply because they CAN do the job and do it well. how are the other nurses - the nurses who cannot handle three patients, or the nurses who have no time management skills - ever going to learn when i pick up their slack.
fifteen minutes later (the admission hadn't arrived to the unit yet), the charge nurse called me. he said, "good news. you don't have to take the admit. another nurse is discharging her patient and will be down to just one patient." great. no admit for me. but what almost irritated me more was, if indeed he had been a good charge nurse, he would have been attuned to the patients on the floor and known from the very beginning that a discharge was taking place and that a nurse, other than myself, would have been able to take an admission.
the funny part of the day... three more patients were admitted yesterday. all of them were unplanned. i could have taken any one of them. my afternoon was slow. but, because i had stuck up for myself, or maybe because i scared him, the charge nurse didn't ask me. everyone else got admits and i enjoyed a relaxed afternoon!
Thursday, January 13, 2011
the life of a heart patient
my dad is a good patient!
his cardiac ablation went well yesterday. they were able to find the pathway in his heart that has been causing his a-flutter and they cauterized several bands of heart muscle cells. ha, ha - got you, you naughty random electrical currents! burn, baby burn!
my dad is also a very brave patient...
because he is on so many heart medications to keep his blood pressure low (less stress for the heart), the nurse, whose job it is to give conscious sedation (ie. the good, sleepy meds), was limited. she could not sedate my dad because his blood pressure kept dropping to dangerous levels. so, for those who care or understand, he only got 0.5mg of versed and 25mcg of fentanyl. that's NOTHING. i give that to my oncology patients without blinking. my poor little dad (and i mean little - he only weighs 140 on a good day) was awake the entire 4 hours while they were burning his insides. he tolerated it like a champ. and according to my dad, his nurse was a superstar. she talked to my dad, trying to distract him. she patted his head. and when his back ached from hours of stillness on a gurney, she rubbed his back. she even apologized, to my dad and to us, for keeping my dad so wake. she was just doing her job - keeping my dad safe! i appreciate nurses - especially cynthia in the cath lab!
so. my dad was discharged this morning. he's to take it easy now for several days. and to continue limiting his salt intake, monitoring his fluid status, and checking his vital signs. my dad teases that life is no fun anymore. he can't drink. he can't smoke. and now he can't even eat food with salt.
but a non-alcoholic, smoke, and salt free life is better than no life at all!
his cardiac ablation went well yesterday. they were able to find the pathway in his heart that has been causing his a-flutter and they cauterized several bands of heart muscle cells. ha, ha - got you, you naughty random electrical currents! burn, baby burn!
my dad is also a very brave patient...
because he is on so many heart medications to keep his blood pressure low (less stress for the heart), the nurse, whose job it is to give conscious sedation (ie. the good, sleepy meds), was limited. she could not sedate my dad because his blood pressure kept dropping to dangerous levels. so, for those who care or understand, he only got 0.5mg of versed and 25mcg of fentanyl. that's NOTHING. i give that to my oncology patients without blinking. my poor little dad (and i mean little - he only weighs 140 on a good day) was awake the entire 4 hours while they were burning his insides. he tolerated it like a champ. and according to my dad, his nurse was a superstar. she talked to my dad, trying to distract him. she patted his head. and when his back ached from hours of stillness on a gurney, she rubbed his back. she even apologized, to my dad and to us, for keeping my dad so wake. she was just doing her job - keeping my dad safe! i appreciate nurses - especially cynthia in the cath lab!
so. my dad was discharged this morning. he's to take it easy now for several days. and to continue limiting his salt intake, monitoring his fluid status, and checking his vital signs. my dad teases that life is no fun anymore. he can't drink. he can't smoke. and now he can't even eat food with salt.
but a non-alcoholic, smoke, and salt free life is better than no life at all!
Wednesday, January 12, 2011
ablation
the family waiting room in the cath lab sucks!
i'm a family member today, not a nurse. and i'm waiting on pins and needles.
my dad is getting an ablation to correct his irregular heart rhythms. we (my dad, mom, sister, and i) have been at the hospital since 6:30 this morning (that was 6 hours ago). and my dad is still in the cath lab getting a tune-up. my boyfriend describes the procedure like this - "they're burning and electrocuting your dad." all they're forgetting in the barbaric procedure are the leeches!
we've had one update from a nurse who was poorly informed about my dad's case (not reassuring), but apparently, my dad is talking to the nurse about switzerland as they map out the naughty electrical currents on his heart muscle. how strange, huh? my dad is awake while they have cameras and tools up a vein in his groin.
anyway, there are three children in the waiting room - 2 six year olds and 1 eight year old. their mom is having the same procedure as my dad - only she's probably in her thirties. it's strange what people have to endure. while sitting here with this family, we've learned that the two six year olds are actually triplets. they were born at 27 weeks and the oldest of the three passed away. the eight year old told his dad not to talk about his mom's health; it scares him. and now they're mom's sick! hasn't this family been through enough?!?
i'm not sure what i am rambling about. all i know is, hospitals are full of sad stories. everyones lives are full of struggles. and hopefully everyones lives are sprinkled with triumphs. i sure hope this waiting room is full of triumphant stories. the three little kiddos and their dad deserve a success story - they deserve a healthy mommy. and of course, we're rooting for my dad! my mom deserves a new and improved husband (with an obedient heart) and my sister and i deserve our ornery dad back...
i'm a family member today, not a nurse. and i'm waiting on pins and needles.
my dad is getting an ablation to correct his irregular heart rhythms. we (my dad, mom, sister, and i) have been at the hospital since 6:30 this morning (that was 6 hours ago). and my dad is still in the cath lab getting a tune-up. my boyfriend describes the procedure like this - "they're burning and electrocuting your dad." all they're forgetting in the barbaric procedure are the leeches!
we've had one update from a nurse who was poorly informed about my dad's case (not reassuring), but apparently, my dad is talking to the nurse about switzerland as they map out the naughty electrical currents on his heart muscle. how strange, huh? my dad is awake while they have cameras and tools up a vein in his groin.
anyway, there are three children in the waiting room - 2 six year olds and 1 eight year old. their mom is having the same procedure as my dad - only she's probably in her thirties. it's strange what people have to endure. while sitting here with this family, we've learned that the two six year olds are actually triplets. they were born at 27 weeks and the oldest of the three passed away. the eight year old told his dad not to talk about his mom's health; it scares him. and now they're mom's sick! hasn't this family been through enough?!?
i'm not sure what i am rambling about. all i know is, hospitals are full of sad stories. everyones lives are full of struggles. and hopefully everyones lives are sprinkled with triumphs. i sure hope this waiting room is full of triumphant stories. the three little kiddos and their dad deserve a success story - they deserve a healthy mommy. and of course, we're rooting for my dad! my mom deserves a new and improved husband (with an obedient heart) and my sister and i deserve our ornery dad back...
Thursday, January 6, 2011
it's been one year...
since i started this blog. and so far, i've enjoyed writing here. my attitude towards nursing, my particular unit, and the specialty of oncology has dramatically improved. and overall, i think i'm in a better place than 365 days ago.
i don't think i can credit the blog with this shift. it helps that my outside-of-work-life has been good. i've traveled to indonesia to "study" yoga. i trained to climb mount rainier (and although i did not summit, i did some amazing hikes and proved to myself how strong i am). i trekked in the nepali himalayas and climbed to 16,400 feet. and i met a very kind man who treats me with respect and kindness. i'd say i couldn't be much luckier.
this blog has served as an outlet for me. i like to write. there is something very cathartic about it. hammering out some words and feelings on a keyboard during or after a 12.5 hours shift helps me to let go of some of the overwhelming thoughts, worries, and emotions that nursing creates in me.
here's to another year full of nursing stories - funny, sad, and even strange ones!
i don't think i can credit the blog with this shift. it helps that my outside-of-work-life has been good. i've traveled to indonesia to "study" yoga. i trained to climb mount rainier (and although i did not summit, i did some amazing hikes and proved to myself how strong i am). i trekked in the nepali himalayas and climbed to 16,400 feet. and i met a very kind man who treats me with respect and kindness. i'd say i couldn't be much luckier.
this blog has served as an outlet for me. i like to write. there is something very cathartic about it. hammering out some words and feelings on a keyboard during or after a 12.5 hours shift helps me to let go of some of the overwhelming thoughts, worries, and emotions that nursing creates in me.
here's to another year full of nursing stories - funny, sad, and even strange ones!
Saturday, December 25, 2010
scrooge vs. elf
the christmas scrooge in me woke up this morning and said,
"bah humbug..."
it's currently 5:38 PM on christmas day. i've been awake for 12 hours, almost 11 hours of which have been spent at work. sometimes being a nurse is not so fun. it means holidays spent in the hospital taking care of sick patients. it also means missing out on family traditions, the exchange of gifts, and the afternoon lull/nap once the festivities are over.
the little santa elf in me is singing a little jig of
"ho, ho, ho and a merry, merry, merry christmas..."
working on christmas can also be fun - depends on your attitude. it can mean spending time with friends/colleagues, potlucks, and christmas cookies galore. it means brightening sick people's holiday with loving care and christmas cheer. the time and half is a nice addition to my paycheck (i must admit). oh, and having my mom and auntie joanie deliver personalized starbucks drinks to the entire unit this afternoon is an extra special perk of working on the holiday - caffeine makes everything better! my patients and their families show extra appreciation too; i even got a treat of almond roca from one patient spouse to thank me for my presence.
i just feel merry because i am healthy and happy, my family is home, ready and waiting to greet me. it's the people that make christmas special - whether i am at home or at work. merry christmas to all!
"bah humbug..."
it's currently 5:38 PM on christmas day. i've been awake for 12 hours, almost 11 hours of which have been spent at work. sometimes being a nurse is not so fun. it means holidays spent in the hospital taking care of sick patients. it also means missing out on family traditions, the exchange of gifts, and the afternoon lull/nap once the festivities are over.
the little santa elf in me is singing a little jig of
"ho, ho, ho and a merry, merry, merry christmas..."
working on christmas can also be fun - depends on your attitude. it can mean spending time with friends/colleagues, potlucks, and christmas cookies galore. it means brightening sick people's holiday with loving care and christmas cheer. the time and half is a nice addition to my paycheck (i must admit). oh, and having my mom and auntie joanie deliver personalized starbucks drinks to the entire unit this afternoon is an extra special perk of working on the holiday - caffeine makes everything better! my patients and their families show extra appreciation too; i even got a treat of almond roca from one patient spouse to thank me for my presence.
i just feel merry because i am healthy and happy, my family is home, ready and waiting to greet me. it's the people that make christmas special - whether i am at home or at work. merry christmas to all!
Friday, December 24, 2010
"my" favorite patient
in my last post, i mentioned one of "my" very favorite patients - my dad. like i said, he's not really a patient of mine. i mean, i do boss him around. i tell him when and how to take his meds. i lecture him on his diet and salt intake. but thankfully, he's not really a patient of mine. his doctor is a brilliant cardiologist we met almost 12 years ago when my dad's heart started to fail him. and his nurse is named kelly; she puts up with my dad and his harem of women who worry about him (meaning me, my mom, and my sister).
anyway...
december 23rd started just like any other day on my unit. i was assigned three patients; the day would be busy. but my dad had a doctor's appointment at 11:00 and i was determined to attend. so, i begged a friend of mine to watch my patients while i escaped from the unit. and boy am i glad i did.
turns out, my dad's heart was acting up! more so than usual. instead of beating regularly, it was beating irregularly - in a rhythm called atrial flutter. the heart is supposed to act like a well oiled machine; it has a certain way of behaving that is the most efficient and the most effective. and let's just say, atrial flutter is neither. when kelly heard the irregularity, she immediately called for confirmation. within minutes, we had an EKG to verify the rhythm and both my dad's cardiologist and electrophysiologist convened to determine a plan of action. my dad would soon be admitted. he needed a trans-esophageal echocardiogram and a cardioversion. translation - they needed to put a tube down my dad's esophagus to look through the back side of the heart for blood clots. if indeed, there were no clots (potentially formed by the lazy and quivering atria), then they could use paddles (ie. a defibrillator) to shock his heart back into normal rhythm.
ugh. sometimes being a nurse is irritating. i know too much. i knew to worry. i know that shocking someone can be potentially dangerous. it certainly sounds terrifying. and it's much scarrier when it's someone you know and love - when it's your dad.
by 12:15, i ran back up to my unit and quit. not forever. just for the day. and instead of being a nurse to my three patients, i became a nurse to my dad! once again, not really. other nurses took care of him. but i waited all day with him in the hospital. i called the troops (my mom and sister). and when needed, i explained and re-explained the procedure to any and all worriers.
thankfully, my patient behaved. and so did his heart. there were no blood clots. and the electric shock converted my dad's heart rate from his naughty rhythm to the proper one.
but i think i prefer being a nurse to strangers.
anyway...
december 23rd started just like any other day on my unit. i was assigned three patients; the day would be busy. but my dad had a doctor's appointment at 11:00 and i was determined to attend. so, i begged a friend of mine to watch my patients while i escaped from the unit. and boy am i glad i did.
turns out, my dad's heart was acting up! more so than usual. instead of beating regularly, it was beating irregularly - in a rhythm called atrial flutter. the heart is supposed to act like a well oiled machine; it has a certain way of behaving that is the most efficient and the most effective. and let's just say, atrial flutter is neither. when kelly heard the irregularity, she immediately called for confirmation. within minutes, we had an EKG to verify the rhythm and both my dad's cardiologist and electrophysiologist convened to determine a plan of action. my dad would soon be admitted. he needed a trans-esophageal echocardiogram and a cardioversion. translation - they needed to put a tube down my dad's esophagus to look through the back side of the heart for blood clots. if indeed, there were no clots (potentially formed by the lazy and quivering atria), then they could use paddles (ie. a defibrillator) to shock his heart back into normal rhythm.
ugh. sometimes being a nurse is irritating. i know too much. i knew to worry. i know that shocking someone can be potentially dangerous. it certainly sounds terrifying. and it's much scarrier when it's someone you know and love - when it's your dad.
by 12:15, i ran back up to my unit and quit. not forever. just for the day. and instead of being a nurse to my three patients, i became a nurse to my dad! once again, not really. other nurses took care of him. but i waited all day with him in the hospital. i called the troops (my mom and sister). and when needed, i explained and re-explained the procedure to any and all worriers.
thankfully, my patient behaved. and so did his heart. there were no blood clots. and the electric shock converted my dad's heart rate from his naughty rhythm to the proper one.
but i think i prefer being a nurse to strangers.
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