Friday, June 27, 2008

when the night shift snows you

We got report today, and went to check on our patients. We found Mr. N with resps of 40, heart rate 110, fever of 102.7, sats 70% on room air, A&O x 1. We came close to calling rapid response, but we got his sats up and his resps down, notified the service, and gave a tylenol suppository for the fever. Then we felt the "rice krispies" over his anterior lung fields... that was the first time I ever felt crepitus. Cool... I mean for me, not for him.

By the time we got all that worked out, we were way behind on morning meds. We asked for some help, but we still didn't get lunch until 1:30. I got to watch a driveline dressing (next time I'll do it) and dress a stage 4. So a good learning day. I got a headache at the end though.

My nursing school friend, C, started on the floor today. She was nervous, but I gave her one of my "brain" sheets for organization and told her she'd be great. It feels strange to be ahead of her.

I took my EKG test yesterday, and passed with only two points missed. I feel pretty good about EKGs now. Two of the new nurses who are orienting in my group failed. It sucks for them, but I hate to admit that I felt even more proud of myself because they didn't pass.

Wednesday I made up for my absence on Tuesday. When I got there, I saw that I was orienting with none other than the nurse educator, the one who is strict and who I've never felt liked me (or many other people). All the other nurses kept telling me "good luck" sarcastically, with doom in their voice. I was nervous as hell, but I told myself "maybe I can impress her and win her over". And I did my damndest to do just that. By the end of the day I felt like I'd been a success. She didn't criticize me and even told me 'good job' a few times. I felt like I'd passed my NCLEX... awesome!!! I think I made a good impression on my hardest sell!

Tuesday, June 24, 2008

sometimes it's all I've got

I went to my third EKG class today with the chills and a sore throat. Later on, I was warm, according to nursing friends, and I debated in my mind whether to go to the floor afterwards or not. I almost went, because I wasn't feeling SO bad. But then I thought about all of the transplant patients and surgery patients, and I ended up calling and asking if I could come in tomorrow instead, if I'm afebrile. It sucks.

This whole thing takes its toll more than people think. I've given up a lot of things, temporarily, to make my career begin successfully. I sometimes wonder if it will cost me friendships that I worked hard for in the past. I hope to get back to my usual activities later in the summer, when my NCLEX is behind me and I successfully transition off of orientation. I just have to remember that I'm fighting for this like anyone else who wants to win something. I'm putting in hours of work, determination, and dedication. But I worry that in the meantime, I'm disappointing the other people in my life.

Friday, June 20, 2008

where's my valium drip?

I survived my first three-day-in-a-row stint at work. And I had lots of fun discharging my patients yesterday. I totally remembered how to do it from my externship, and my preceptor was surprised when I took the reigns and did it without even asking her. In reality, I can feel myself sort of kicking against all the supervision. I just want to do my job, and ask questions when I need to ask questions.

I'm learning a lot about how to deal with pain, and how to get pain dealt with. It's not a joke when people are in pain, and it's important to get it taken care of immediately. I feel like I'm growing a lot more, a lot faster, during my orientation than I ever did in nursing school. This is fun!

Wednesday, June 18, 2008

my lunch smells like tube feed

I have experienced the joys of gunky empyema tubes, the smell of leaking tube feed, spilled j-tube meds, and stomach contents all over my bare hand. Oh let me count the ways I love being a nurse!

I finally got my test date- July 11th! I'm going to be the happiest NCLEX taker they've ever seen!

Thursday, June 12, 2008

they're turning me into a nurse

My days on the floor have been good, but I get impatient with having a preceptor. I especially hate having to wait for her to get meds. I only have one preceptor who won't even let me give oral meds. This is bad news for me, because the state STILL hasn't received the correction from my school and I'm still waiting for my authorization to test. I'm dying of jealousy of the other new grads who are testing next week. I want my damn license already.

I have taken a lot of classes as part of my orientation, too. Mostly med surg, but now I have started my EKG series, and there will be a big test at the end on reading strips.

I hope that I can do this job well, that I can become someone who is respected on my unit, someone who can make a difference not just with patients, but with my co-workers. I do want to be involved with the unit, I want to be a leader (eventually) and someone people think of as hard-working and contributing. I really care about our floor and our patients, and I don't think of it as 'just a job'. I feel like someone who really contributes to society. Maybe it's a puffed-up image of nurses that I have, but when people stand up and take off their hats when I enter the room and say 'I'm your nurse', I don't know... it's a good feeling.

My world has been infiltrated by chest tubes, wound drainage, monitor strips, and multiple choice questions.

Thursday, June 5, 2008

news from the front

I survived my second and third day on the floor with minimal damage to my fragile self-esteem as a new nurse. I was finally with one of my regular preceptors, a nurse about my age, and we had a couple of very laid-back days together. I took a CHF patient waiting for an LVAD work-up, a THE patient suffering from complications of her surgery, and even squeezed in a final admit with a lobectomy right before the end of the shift. I felt like I had more of a routine going on, and I'm getting a little bit more comfortable with the documentation systems and my assessments.

I heard some crazy adventitious lung sounds, and a heart murmur, and I was really proud of myself for *finally* hearing something out of the norm!

This week was my med-surg series. More lectures and demonstrations on IV therapy, drains, ostomies, chest tubes, and trachs. Friday I have an all-day class just on using our brand spankin' new online MAR.

Today I received my first 'real' paycheck. WOW! I can pay all of my bills with one paycheck!