Tuesday, December 2, 2008

The Honeymoon is Over

Lately I’ve been feeling down about work. Despite the fact that I’ve been working more independently, I still feel like I either work only slightly faster than a speeding slug, get caught up with other nurses’ bullshit and/or get stuck with asshole drunk patients. I also feel like I’ve hit a plateau in my learning and I’m stuck in the endless cycle of scut-work.

The other night I got a set of admission orders that included a dose of IV Cipro. I fax the orders down to the pharmacy and get a requisition ready to order it from central dispatch (drugs that are not stocked on the unit are sent to us by central dispatch during night shifts so a form has to be faxed to them – they deliver whatever is needed in 5-10 minutes). I get everything ready and start walking towards the fax machine when another nurse walks over with the bag, hangs it up and tells me that there’s a ‘secret stash’ of Cipro in the back rooms. Great. But how the hell was I supposed to know about secret stashes? I got irritated because I just wasted my time filling out the damn forms when I could have resited her IV and saving me a hell of a lot of time.

Yet another nurse that was preceptoring me has a thing against ‘fussy’ old people who ask for things when she’s busy planning her upcoming wedding. I’m mighty pissed at myself for giving into her way of working when I really should have had the balls to stand up for myself and the patient. This nurse had me convinced that since the patient was 99 years old and had a history of bone mets, she was not able to walk and she could not get hot water for tea (even though we were sitting on our asses doing nothing). She told me that if I tried to make her walk and she fell it would be my problem when our manager finds out about it. Fair enough. Except I never gave the patient a chance to explain herself and she ended up sobbing in her bed. I was aghast at myself for having made an elderly lady feel this way. I know that the ER is a busy and fast paced environment but I sure as hell would not want to be treated like a crazy piece of crap by a kid with 3 months of nursing experience when I’m elderly.

Since I can speak two other languages (besides English), some of the docs also ask me to translate for them. When this happens during a time when I’m really busy, I tell them to hold off for a little while unless it’s an emergency involving the ABCs (yes the nursing school basics), In that case, I quickly tell the patient what’s going on and when I can return. I know that I can’t be abandoning my own patients to run away and translate but that’s what we have float nurses for. When a situation like this came up, another nurse got pissed at me for taking too long translating! She told me that I should have told the doctor to hurry up with his assessment. Again in some cases that’s fair. But this was an exceptional case because the patient that I was translating for was a suicidal refugee who lost his wife and daughter in a bombing. That requires some diplomacy, tact and sensitivity – it most certainly is NOT the time to tell the doc to hurry up because I have to go triple chart on some mundane intervention. When I tried to explain this to her, she just mumbled something along the lines of ‘you weren’t hired as a translator’.

On top of this, I feel like a glorified babysitter when I have to deal with belligerent and violent drunks that constantly come in every Thursday, Friday and Saturday nights. I’m so sick of calling security to wrestle them down so I can put in yet ANOTHER line into them, hydrate them, give them a sandwich and kick them out in the morning just to have them come back the next week. During my last night shift, I was particularly infuriated with my entire patient load because you guessed it – they were all bloody drunks. I don’t feel like I’ve gone to school for 6 years just to babysit violent 300 lb men with drinking problems with ensuing incontinence and send them away with a smile and a breakfast at the end of my shift.

Not surprisingly, I feel the happiest at the end of my set of shifts because I know it’s the longest time before I have to come back into work. Likewise I feel the most depressed the night before my next set of shifts starts. The honeymoon is most definitely over. Work sucks something mighty fierce.


Deeba said...

that's a pity. I didn't know that it was so mundane interspersed with drunkeness (is that even a word?) I love you and miss you!

St. Murse said...

This might sound depressing but really it helps. Instead of thinking of all the interruptions and frustrating patients as distractions from "real nursing", reframe them as a normal part of the job. I used to get really irritated when I couldn't even get through my start of shift assessments without multiple interruptions. Then one day I just accepted that the interruptions were normal and absorbed them into my workflow. Take it from me, you'll reduce your stress level plenty and you'll get faster/better with time on the job.