I had day 3 and 4 on the floor today and yesterday. I am pretty sure I love the patient population. However, my pt's today were: 1. Guillan Barre pt with a hgb of 6.5. 2. SAH with frequent neuro checks and new CT showing hydrocephalus. 3. A CHFer with increasing breathing problems and wound vac that needed attention (his femoral artery ruptured while in his first hospital!). AND 4. A vent pt that was going to be discharged today to LTC-who as soon as we saw her that was d/c'd because she was in respiratory distress.
Don't get me wrong, I love it. But holy crap. Plus, we already had an admission lined up for our discharge so my preceptor took that still since there were 2 of us (for 3 hours!!!) while I tended to the others. It gave me confidence that I could do it though. I can see where the burnout rate would be really high. But so far I think it is great. Time flies by, it seems like each time I look at the clock 2 hours has gone by.
I really miss working with people I am close with though. I am feeling a void. Although, I am enjoying my anonymous status and staying out of the drama. Who has time to be in it anyway?!?
Some fun facts:
- Per new neurology recommendations, I was pushing cooled coffee down my SAH pt's G-tube for vasospasms.
- I drew blood out of someones foot yesterday!!!
- If you get body fluids on your scrubs the hospital will send them out for you and get them washed properly.
- I ate lunch today with some MDs, RNs, CNAs, and the CEO of the hospital today and everyone was friendly with each other.
- I have already done more PICC dressing changes that I ever care to do again.
- I have been in more isolation rooms than I care to ever be in again.
- I tried logging out of my walkie-talkie yesterday.
- If you like wounds, you must come here. I had my hand in a sacral wound today and was touching touching his hip.
While I am realizing that this place is a bit more long term than I would really care to admit, a doctor described it right on today: "Our pts are the 1% of cases that you are warned about. They come into the hospital and everything that could possibly go wrong does. They are stabilized and sent here so we can clean up the mess."
I am glad to have tomorrow off. While fun and crazy, I feel like I just ran a marathon!
Tuesday, August 30, 2011
Wednesday, August 24, 2011
Cautiously Optimistic
I have been on the floor for 2 days now. I am now sick because I don't think I have been getting enough sleep. But it has been good.
Vicky-they played Santana at the 10 o'clock hour yesterday to change things up a bit.
Some floor observations:
- All of the MDs are really nice. Most of the MDs are on the staff so they are always there just like us. So it is like working with 5 Dr. Goldblatts each day. I am down with that.
- Each CNA only has 6 patients. I do the first set of vitals and all of the blood sugars. It is fabulous that they have the time to take care of pts really well. I went into one of my patients room to turn him, I was too late my CNA had turned him already each time. They buddy up so another CNA can help with turns, transfers, and baths. That is awesome. I think from my last place and I know all too well after 5.5 years, that PCAs are used and abused there. So this is refreshing and I think makes both parites happier.
- If a med is not in the omnicell (a 1960s version of the pyxis, but that is much more user friendly) I will have to go to the units in the hospital to find it. At least it will tell me which one to go to, but hey I've got time........
- I have learned more about wound care in the last week than I ever have before.
- Pts here don't find it funny when I tell them how lucky they are to have me as a RN. Maybe they already heard it the first 60 days they were hospitalized?
- Paper charting is not amazing. Neither is crossing out everything, writting error, and initial it when your dumb ass grabs the wrong chart. Plus I need to chart everything in black. What will be of all the cute pens I bought?
- 40 of the rooms have cameras in them. A monitor tech sits there and watches them and walkies, "so and so is getting out of bed" or "so and so has his vent tubing in his hand." There goes scratching myself or adjusting my boobs in sleeping/comatose pts rooms. I can only image what would be said over the walkie then.
- Suprisingly pts here are less crazy and confused than the place I came from.
- We use the same glucometers, but you HAVE to scan the bottle of strips before using them. Each time I have taken a blood sugar I have entered the room and started to the process and then have to walk across the unit to get the damn bottle.
Anyway, I am cautiously optimistic about this job. I like everyone, the pts, and the management. Of course I have felt that way before, so I am still holding my breath.
I miss all of my fabulous old hospital peeps. That is really starting to sink in.
Vicky-they played Santana at the 10 o'clock hour yesterday to change things up a bit.
Some floor observations:
- All of the MDs are really nice. Most of the MDs are on the staff so they are always there just like us. So it is like working with 5 Dr. Goldblatts each day. I am down with that.
- Each CNA only has 6 patients. I do the first set of vitals and all of the blood sugars. It is fabulous that they have the time to take care of pts really well. I went into one of my patients room to turn him, I was too late my CNA had turned him already each time. They buddy up so another CNA can help with turns, transfers, and baths. That is awesome. I think from my last place and I know all too well after 5.5 years, that PCAs are used and abused there. So this is refreshing and I think makes both parites happier.
- If a med is not in the omnicell (a 1960s version of the pyxis, but that is much more user friendly) I will have to go to the units in the hospital to find it. At least it will tell me which one to go to, but hey I've got time........
- I have learned more about wound care in the last week than I ever have before.
- Pts here don't find it funny when I tell them how lucky they are to have me as a RN. Maybe they already heard it the first 60 days they were hospitalized?
- Paper charting is not amazing. Neither is crossing out everything, writting error, and initial it when your dumb ass grabs the wrong chart. Plus I need to chart everything in black. What will be of all the cute pens I bought?
- 40 of the rooms have cameras in them. A monitor tech sits there and watches them and walkies, "so and so is getting out of bed" or "so and so has his vent tubing in his hand." There goes scratching myself or adjusting my boobs in sleeping/comatose pts rooms. I can only image what would be said over the walkie then.
- Suprisingly pts here are less crazy and confused than the place I came from.
- We use the same glucometers, but you HAVE to scan the bottle of strips before using them. Each time I have taken a blood sugar I have entered the room and started to the process and then have to walk across the unit to get the damn bottle.
Anyway, I am cautiously optimistic about this job. I like everyone, the pts, and the management. Of course I have felt that way before, so I am still holding my breath.
I miss all of my fabulous old hospital peeps. That is really starting to sink in.
Tuesday, August 16, 2011
Vertical and Horizontal Violence
Ok, I have decided that this blog will be a happy place. If not, I will start singing a certain Cee Lo Green song. That may have to be my first live performance actually because it is a great song. Anyway. Day 3 of 5:30am days have brought back that old familiar feeling of sleep deprivation that accompanied nursing school. Is everything moving slower? (30 seconds after driving through intersection) Was that light green? I hope so, I know I checked but now I don't remember what it was. Have I really been staring off into space for 15 minutes? I am sorry, what were you talking about?
Vicky: They played 'Taking Care of Business' as one of the q2 turning songs. It plays everyday at 8am. I will keep you updated on any others!
Here is my not so serious list of negatives, since I am staying positive!:
1. It is guaranteed that Taking Care of Business will now be stuck in my head each day I work from 8-10am.
2. Light blue scrubs=sweat stains and coffee stains
3. Only doctors are allowed to use the sauna and lounge with big screen tvs. No seriously.
4. 2005 called, they want their charting system back. I lived through paper charting and transition to EPIC once and I just can't wait to do it again!
5. I have yet to see even one package of crackers or peanut butter.
6. Fentanyl PCA pumps? It is not mandated that people on PCA pumps be on continuous pulse ox? Yeah, I see no problem with that.
7. No eating or drinking allowed unless you are break? But how am I going to take full advantage of FREE COFFEE then?
8. I think all HUCs are PCAs, all nursing assistants are from PT, all respiratory are ED RNs, all PT are RNs, and when I look in the mirror I do a double take thinking I am going into the OR.
Onto the good: If the doctors write an order for a lesser restraint (mitts), it is up to ME if I want to also tie your hands down. So watch it!
I had a class today on Vertical and Horizontal Violence. Why are we so mean to each other in health care? I know it happens everywhere but why so much in a profession where all we are supposed to doi is love and take care of our patients? I know I am not perfect, but I have never gone out of my way to intentionally screw someone over. My favorite point was that no one superior to you can threaten your job. I will be happy to have that in writing this time. Everything seems really relaxed (so far, day 3. We will see). No one is a strong, aggressive personality. No one outwardly says they get what they want no matter how they have to get it. Everyone is focused out patient care.
It made me think a lot about how I treat others too. It is hard as a RN to not view your duties more important than PCAs (which I HATED as a PCA), HUCs, dietary, or any non-licensed personel because I have a license on the line. But I am no better or important than anyone else. We all have a job to do and different stresses and different people on our cases to get things done. I think every workplace should have an open discussion about it. However, they have responses to these workplace incidents and I can tell you they don't work! Well, maybe in a perfect world. I know that my old hospital wasn't in a perfect world and I will put money on my new one not being perfect either.
On a happy note, my sister had a baby today!!!! She was able to push a 10 lb 2 ounce baby out! She is my hero!
Vicky: They played 'Taking Care of Business' as one of the q2 turning songs. It plays everyday at 8am. I will keep you updated on any others!
Here is my not so serious list of negatives, since I am staying positive!:
1. It is guaranteed that Taking Care of Business will now be stuck in my head each day I work from 8-10am.
2. Light blue scrubs=sweat stains and coffee stains
3. Only doctors are allowed to use the sauna and lounge with big screen tvs. No seriously.
4. 2005 called, they want their charting system back. I lived through paper charting and transition to EPIC once and I just can't wait to do it again!
5. I have yet to see even one package of crackers or peanut butter.
6. Fentanyl PCA pumps? It is not mandated that people on PCA pumps be on continuous pulse ox? Yeah, I see no problem with that.
7. No eating or drinking allowed unless you are break? But how am I going to take full advantage of FREE COFFEE then?
8. I think all HUCs are PCAs, all nursing assistants are from PT, all respiratory are ED RNs, all PT are RNs, and when I look in the mirror I do a double take thinking I am going into the OR.
Onto the good: If the doctors write an order for a lesser restraint (mitts), it is up to ME if I want to also tie your hands down. So watch it!
I had a class today on Vertical and Horizontal Violence. Why are we so mean to each other in health care? I know it happens everywhere but why so much in a profession where all we are supposed to doi is love and take care of our patients? I know I am not perfect, but I have never gone out of my way to intentionally screw someone over. My favorite point was that no one superior to you can threaten your job. I will be happy to have that in writing this time. Everything seems really relaxed (so far, day 3. We will see). No one is a strong, aggressive personality. No one outwardly says they get what they want no matter how they have to get it. Everyone is focused out patient care.
It made me think a lot about how I treat others too. It is hard as a RN to not view your duties more important than PCAs (which I HATED as a PCA), HUCs, dietary, or any non-licensed personel because I have a license on the line. But I am no better or important than anyone else. We all have a job to do and different stresses and different people on our cases to get things done. I think every workplace should have an open discussion about it. However, they have responses to these workplace incidents and I can tell you they don't work! Well, maybe in a perfect world. I know that my old hospital wasn't in a perfect world and I will put money on my new one not being perfect either.
On a happy note, my sister had a baby today!!!! She was able to push a 10 lb 2 ounce baby out! She is my hero!
Monday, August 15, 2011
5:30am comes pretty damn early in the morning!
I didn't sleep well, maybe I was nervous. Of course it didn't help that I had kitty mortal combat by my head at 2:30 am or the phone call and text message at 4am. What's up? Umm, it's 4am and I am sleeping, no correction I was sleeping. I saw a different world walking my dog at 6am. For example, young people do live in my neighborhood. I usually only see the retired folk during the day. Also, a lot of people are up at that time. What happened to 9-5, or do you all wake up that early?
My first day at the new hospital (after the HR presentation, I can no longer name the hospital! :)) brought about many questions. Such as: Are sandals business casual? Do business casual skirts have to be knee length? I decided to be formal and wear shoes. However, the thought that even though the shoes hurt a lot, they might not hurt as badly if I don't walk a lot is false. I decided to go against the knee length skirt and wear one shorter and let me tell you demonstrating proper body mechanics lifting and placing a box on the floor was interesting (and lame).
Ok, must focus on the positives. Here are the top 10:
10. The isolation gowns are disposable and made so you can just rip them off your body so you don't have to touch the outside.
9. Music plays q2 hours to remind you to turn your patients.
8. Parking to building was 10 seconds
7. All of the other full time RNs starting with me seem nice
6. Their infection control policy and diligence on preventing the spread was facinating and truly superior to other places I have been.
5. They use walkie-talkies for communication. Do you think it would get old if I ended each thing I said with "over" and responding to everything with "10-4" and threw in a "Do you copy" every once in a while?
4. I get a day with RT, wound nurse, and working in the lab and six days devoted to education and classes (one full day for EKG interpretation and medications we will administer: vasopressors, vasodialators, insulin, chemo....).
3. I now know what to tell people when they ask me what the hell is the new hospital? "It is a speciality hospital devoted to the critically, chronically ill patients. Many of whom have suffered a trauma, unexpected event during major surgery, respiratory failure, or complex wounds. Many of our pt's come from the ICUs of local hospitals because we are a more cost effective approach (medicare will pay here but not at hospitals) and more holistic." Well, at least I know what to say.
2. Lunch today: salad bar, bowl of soup, large drink, bread option, and dessert: employee cost $3. Not paying $11 for salad bar alone at old hospital: priceless.... um sort of.
1. FREE COFFEE. Not only free coffee, but your choice of regular, vanilla, or hazelnut. Well now atleast I know I won't be the scape goat at the new gig for running out of coffee on the unit!
That's it for now. I am feeling the post break up effects from Regions. So I must stay positive.
My first day at the new hospital (after the HR presentation, I can no longer name the hospital! :)) brought about many questions. Such as: Are sandals business casual? Do business casual skirts have to be knee length? I decided to be formal and wear shoes. However, the thought that even though the shoes hurt a lot, they might not hurt as badly if I don't walk a lot is false. I decided to go against the knee length skirt and wear one shorter and let me tell you demonstrating proper body mechanics lifting and placing a box on the floor was interesting (and lame).
Ok, must focus on the positives. Here are the top 10:
10. The isolation gowns are disposable and made so you can just rip them off your body so you don't have to touch the outside.
9. Music plays q2 hours to remind you to turn your patients.
8. Parking to building was 10 seconds
7. All of the other full time RNs starting with me seem nice
6. Their infection control policy and diligence on preventing the spread was facinating and truly superior to other places I have been.
5. They use walkie-talkies for communication. Do you think it would get old if I ended each thing I said with "over" and responding to everything with "10-4" and threw in a "Do you copy" every once in a while?
4. I get a day with RT, wound nurse, and working in the lab and six days devoted to education and classes (one full day for EKG interpretation and medications we will administer: vasopressors, vasodialators, insulin, chemo....).
3. I now know what to tell people when they ask me what the hell is the new hospital? "It is a speciality hospital devoted to the critically, chronically ill patients. Many of whom have suffered a trauma, unexpected event during major surgery, respiratory failure, or complex wounds. Many of our pt's come from the ICUs of local hospitals because we are a more cost effective approach (medicare will pay here but not at hospitals) and more holistic." Well, at least I know what to say.
2. Lunch today: salad bar, bowl of soup, large drink, bread option, and dessert: employee cost $3. Not paying $11 for salad bar alone at old hospital: priceless.... um sort of.
1. FREE COFFEE. Not only free coffee, but your choice of regular, vanilla, or hazelnut. Well now atleast I know I won't be the scape goat at the new gig for running out of coffee on the unit!
That's it for now. I am feeling the post break up effects from Regions. So I must stay positive.
Friday, August 12, 2011
Great BBQ tonight
Thanks to all that came out to the BBQ tonight. It was so hard to leave the old hospital and the reason was you and a few that couldn't make it. To date this was one of the harder decisions I have had to make. I racked my brain wondering if this was a spiteful or prideful decision. I wondered if I could handle the slower pace (in a way...) or if I would miss the "trauma team, emergency department" and hearing all of the stories of the going ons of St. Paul (the running masturbater-sp?). But most importantly working with some great new and old nurses who held my hand, was a shoulder to cry on, bought me lunch, or facebooked me. I hope there are some like you at the new hospital.
I am not really nervous about the new job. If anything, I am the most nervous about 5:30am wakeup calls and long days. Plus, I just want to start and be validated that I didn't totally screw myself over. I hope I can along with everyone. Most importantly I hope I enjoy going there. Over the years I have gotten quite used to going to a job that I dreaded. It was so amazing when I started on our unit and enjoyed going to work. It makes life so much easier. But the scarier thing is how much harder your life can be with work worries.
Alright, I am exhausted tonight and am full of brats, triffle, cake, chips and dip, cheesy potatoes and much more. I better make it a long run tomorrow!
~Shannon Ooohhh
I am not really nervous about the new job. If anything, I am the most nervous about 5:30am wakeup calls and long days. Plus, I just want to start and be validated that I didn't totally screw myself over. I hope I can along with everyone. Most importantly I hope I enjoy going there. Over the years I have gotten quite used to going to a job that I dreaded. It was so amazing when I started on our unit and enjoyed going to work. It makes life so much easier. But the scarier thing is how much harder your life can be with work worries.
Alright, I am exhausted tonight and am full of brats, triffle, cake, chips and dip, cheesy potatoes and much more. I better make it a long run tomorrow!
~Shannon Ooohhh
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