Thursday, August 14, 2008

It's Over!!

A few days ago I finally finished my consolidation period. I’ve had a week to readjust to non-nursing life, which involved not waking up and sleeping and random hours of the day and constantly thinking about when I could nap next for the longest amount of time. It was especially difficult to get out of night shift schedule and fight the temptation to stay up until 0400 doing nothing and then not waking up utterly confused and disoriented at 1500-ish. Instead, I’ve been trying to get out of nursing jet lag and catching up with friends and family. I vowed to myself that I would not think too much about hospital life and nursing, but I failed. Instead, I delighted my non-nursing friends with great anecdotes like describing the appearance and odour of C. diff stool (green, mucusy and smells like rotten death) and how fast blood can ooze out of places that were previously held PICC lines. Seeing their green faces and frantic attempts to avert their gaze towards anything and anyone but myself reminded me that in the normal world, graphic descriptions of bodily fluids and odours are not tolerated well.

Even mundane chores like cleaning are reminding me of my nurse-self – so far I’ve found enough alcohol swabs to open my own store, medical tape, a few pieces of sterile gauze, endless amount of post-its with vital signs and room numbers, a few stolen pens (I’ve told my colleagues repeatedly – if you leave a pen near me, it will be mine), two 3 ml syringes, and a butterfly. I had no intention of taking these things home with me (except for maybe the pens) but since I’m too lazy to go back to my unit to return them, I’ll keep them as a souvenir of my time in consolidation.

On the other hand, it is getting much easier to indulge a few other loves of mine – namely reading magazines (give Bitch a chance) and baking. In fact, I’ve made an amazing carrot cake and banana bread so far. This leads to yet another point – ironically, I ate much healthier when I was working but now that I’m at home (and baking), I need to sample my creations (for umm… quality control purposes). My treadmill in the dungeon (the basement) will be paid a reluctant visit soon.

But while I’m glad that consolidation is over (working full time for free is not conducive to having a life that needs occasional bursts of consumerism), I’m scared of joining the ‘real’ world of nursing. For the past few months I’ve practiced under my teacher’s license which provided me with a palpable sense of security. Now that that security is gone, I’m shaking in my boots about having to be solely responsible for the consequences of my decisions. But the increased pay (from $0/hr to $more/hr) should help alleviate some of those anxieties!

Monday, August 4, 2008

The Cardiac Conduction System Explained

Why didn't our pathophysiology teacher explain it like this? It would have saved me hours of reading and note making!

Saturday, August 2, 2008

I just got this link in an email and there is no way I can't share it!

This Really Happened

On yet another night shift, I was sitting quietly in the nursing station at around 0230-ish reading a patient’s Vogue (I had permission and she was sleeping) when suddenly I hear “OH MY GOD! WHAT THE FUCK!?? WHAT THE FUCK??! GET OUT! GET THE FUCK OUT!” All of us ran to the end of the hallway where we see our previously pleasant 65 year old post MI patient in his bed. With another patient in his bed. A woman. Who was naked. It turns out that the woman was very confused (she couldn’t be oriented to her face, let alone the time) and so in her confusion, she stripped, climbed into his bed and then peed on this poor guy! If that happened to me, I think I’d probably have the same reaction. We apologized profusely to the man and tried to get the woman out of his bed. She stood up and with a misplaced sense of modesty covered her nipples but didn’t really mind that regions south of the equator were on full display. It took almost an hour for us to calm him down and we had to assure him that we would keep her bed in front of the nursing station so we would have our eye on her the entire night.

When we wheeled her bed over to the station, she asked ‘why am I here?’ to which another nurse replied, ‘because you stripped and peed on another patient’. She let out a laugh while telling us that we must be confused because she would never do something like that. There you go folks. We’ve been declared confused by a confused old lady.

Good Day, Bad Day

Sometimes I have really good days at work and sometimes I have really bad days. But sometimes, I can’t decide so I have to make a list, weigh the pros and cons and then fall asleep on a public transit vehicle on my way home. A couple of days ago, I had that kind of a day. I figured I’ll write that list down today and see what averages out for an unremarkable day.

I got to work on time to get a detailed report so I was feeling extra confident when doctors randomly decided to walk into patients’ rooms to ask questions.

A man was transferred from the ER onto our floor and was screaming lovely things towards the transport folk and nurses like, ‘fuck off you cocksuckers’, ‘I’ll fucking kill you cocksuckers with my bare hands’, ‘don’t fucking touch me’ and ‘AHHHHHHHHHHH’.

I did what could be considered the most perfect job at starting an IV.

It was on the screaming delirious patient who pulled it out 5 minutes later.

A patient’s wife gave me the most delicious almond and cashew chocolates for washing his face, changing his damp sodden sheets and putting Vaseline in his nose so his NG tube wouldn’t irritate him so much.

Another patient who was wandering and confused ate almost all of them.

The aforementioned patient’s son-in-law was devastatingly handsome.

He was happily married and had two kids. Oh and something with national nursing regulations…

We only had two new admissions.

Both of their histories were inaccurate at best because 45 minutes later, neither one of them could remember their names.

A guy at work was playing the best hip-hop and R&B songs to keep us all going.

A patient’s mother complained that we were playing too much ‘sex music’ at the nursing station. I kid you not.

I got to leave half an hour early and had enough time to pee before commuting back home,

I missed the train home because I decided to get frozen yogurt.

Surrounded by Incompetence

Lately, I’ve been noticing that there are some people who don’t do their jobs properly. By itself that statement really is not an earth shattering observation but it really irritates and scares me when NURSES don’t do their jobs properly. Several days ago, I was working (yet another) night shift when I noticed a little old lady hunched over in a commode chair beside her bed. I immediately had a funny feeling about her even though she was not my patient and went to take a look at her. She was blue. As in, ‘I can’t breathe so I’m about to give up and die’ blue. I stuck the nasal prongs on, blasted the oxygen to 100%, pressed the call button, grabbed a vital sign machine and started taking her vitals which were 36.4-117-8-67%-165/94. Not Good. She was going into respiratory arrest and she was left alone. I had another nurse come to help me out with this patient and she told me to find out who this lady’s nurse is for the night and to call the critical care team immediately for a desating possible resp arrest. I called the team first and then informed the patient’s nurse who became quite irate with me. She told me that since I’m not licensed yet, I really shouldn’t tell her how to take care of her patients. Fair enough. But this lady is BLUE! When the critical care team arrived, this nurse peaked in for a minute to tell them the woman’s age and admitting diagnosis – information that was right in front of the team leader. She then proceeded to pour out drugs and to help someone else to the bathroom leaving the critical care team alone. I could not believe that this was happening! I realize I don’t have a license but I do know the basics of prioritization – not breathing takes priority over brushing teeth before bed! In the end, this woman was transferred to the ICU for closer monitoring and she recovered.

Yet another example of incompetence in the work place happened just two nights ago. I had to leave my night shift early because I had to go to school for an early morning exam that didn’t count for any marks. That’s just another rant. When I woke up from my slightly extended nap, I gathered up the sheets to throw them back in the laundry when I saw another nurse wheeling supplies over to the unit to help out with the 5 o’clock train. I said good morning to her and she said the same to me. That’s when I looked into the room that BOTH of us were passing by and saw my new admission from the night lying on the floor in a puddle of blood and urine moaning in pain. My reaction was to drop the pile of sheets I was carrying and rush to this man’s help. This nurse’s response was to ignore it so completely that I thought I missed something. She just left on her merry way. Again, I’m not licensed, but finding an elderly man in a pool of blood is something to be concerned about. He was admitted for falls due to seizures so before I went to take my break, I told him to ring the call bell if he wanted to get out of bed so someone would be with him and he could avoid breaking his ass. Being a sweet old guy that he was, he decided to not cause us trouble for a mere bathroom trip so he didn’t use the bell and he was ambulating by himself. Of course he fell and ended up with a scalp lac nearly 5 inches in length and while waiting on the floor for help, he wet himself. I wish I could have stayed with him because he really was a sweet old guy but unfortunately, all I had time to do was to help him back to bed, apply pressure to his wound and call the ER doc for stitches. I shudder to think what would have happened if I wasn’t there to see him because the oblivious nurse probably would not have thought to call someone over for help.

So the lesson of this post: no matter what you do, do it properly. If you’re a nurse, please don’t leave your patients blue and bleeding. That’s atrocious practice and makes you look like an incompetent idiot. If you don’t know what to do, call for help! Please don’t let your ego get in the way of someone’s health.