watch out ICU world, here I come!

So, I hatched a plan to get off of my floor at any cost, and Wednesday I interviewed in the CCMU (critical care medical unit). The sickest patients in the hospital, or for that matter, the whole region. Multi-organ failure, highest deathrate in the hospital, vents and bedside dialysis and drips to keep practically every body system functioning... you get the idea. And I have this crazy idea that the nurses there are super smart, smarter than practically anyone else in the whole hospital, and I would like to be one of them.

My interview went great and I met a few nurses on the floor who had great, sarcastic, somewhat morbid senses of humor (fabulous!) They were fascinated by the fact that I was switching from surgical to medical, and did I have any idea what I was getting myself in to? They said nothing would be more important than my critical thinking skills and getting the big picture. Gulp. On the other hand, they absolutely love their jobs and the few times someone has actually left, they usually come back. So I said, sign me up. This sounds like the adventure of a lifetime!

And then came the true test... will my manager let me go or not? I waited two days and just got the email, I start in the CCMU on April 18th! It's going to be a whole new ball of wax and I feel like I need to go back to nursing school first. Or maybe med school. They tell me it's going to change me not just as a nurse, but as a person. I guess that's true. It's not ever what I imagined I'd be doing (I grew up wanting desperately to become a midwife), but it sure sounds like one hell of a challenge, and I feel up to it! (And scared to death...)

More to come!

caffeine and xanax

This is going to be the new title for my blog. At almost two years, I guess I'm not a "brand new" nurse anymore, just a relatively new one. I started my career on this cardio-thoracic surgical unit very excited and enthusiastic about my co-workers, my profession, and what I did every day. Now- not so much. I have lost faith in my co-workers, my trust in management has been completely smashed, and I find that I do not enjoy my patients either. I feel like a pill-pusher, an ice-fetcher, and a bed-maker. I'm so grateful just to hear a "thank you" once in a while. People say "well it's your job". No, actually, ordering tuna sandwiches and making sure you have not-too-much or not-too-little ice in your cup is NOT my job! But it has become my job, and it is very disasatisfying.

Management has turned into the "mistake" police. They make it extremely hard to relax when you finally get 10 minutes of downtime. Gotta look busy ALL the time, you know! People on other shifts will write you up for every little thing. If you're sucking up to management, life is good. If not, you're on the shit list and watch out!

So I tried to make a graceful exit to L&D, was offered an interview... and guess what? They can technically hold me at this shithole job until September 2010 because our floor downsized! So the whole time the boss has been telling us that if we don't like our job, leave.... but we can't leave. We are stuck. So what does she have on her hands? A bunch of stuck employees who want get the hell out of there and don't have a voice on the floor.

BS and more BS. I could go on, but I think you get the drift.

I'm not sticking my finger in there!

I am currently enjoying a three day in a row break from work. I think it's the longest I've been off in one stretch since coming home. I love, love, love it. I have been there a lot lately, even curling up on the couch in a meditation room for a night. Then there were a few days with really horrible roads, where it took me two hours to get home.

I have had some interesting, and really sweet patients last week. Patients who hug me and tell their roommates that I'm the best nurse in the hospital. Flattery will get you everywhere with me! I heard another nurse mention that she had to digitally stimulate a colostomy q4 hours. I thought, thank god I don't have that patient, because I am just not going to stick my finger in there! Plus, he kept asking the night nurse to "finger him". And who do you think I ended up with the next morning? Same guy. And the first order of business that day was to explain to him that it was almost time for him to go home, and if he needed to stimulate his colostomy (which was 5 years old by the way, not a new thing!) he could do that himself, with a glove. Then I had to empty his colostomy bag which was full of completely formed stool, and doing it reminded me of squeezing frosting out of a tube. So gross. I hate ostomies, especially colostomies, with a passion.

fate is making all the decisions

After returning from Nepal, I found it very difficult to care for our patient population. Grown-ups who whine and complain about the amount of ice in their cups, the hardness (or softness) of the beds, the kind of foods on their plates, the medicine that's saving their lives is constipating them, the pain from surgery is too much... etc etc. I found myself wishing more and more for intubated, ventilated, sedated patients. I look at these people and think, you came to us for medical help. YOUR choice to have the procedure, to come to this facility. It's not the Hilton. We're not here to make sure you eat delicious food and sleep comfortable and undisturbed. We are going to poke you and prod you and wake you up every hour, we're going to serve mediocre food, the beds might not be top-notch in comfortability, but they do flatten in 3 seconds so we can do CPR and save your ass.

So I applied to every job I could in the hospital, and still haven't heard from anyone. No one. Nada. I guess it's not meant to be, but surely I'm not meant to play waitress for the rest of my life?

Working in the field!

I finally got to carry out one of my lifelong nursing dreams... do a service trek and serve rural communities! Of course, I did it in Nepal, where I speak the language, and so had the added experience of being a translator, which I loved. Now I'm hoping to lead a group every year to the clinic we worked at, and start to make a little progress in the area. I loved it there, the community of Sherpas was wonderful. Nursing there was more like being a doctor, though. I diagnosed and treated just using my own brain and the rest of my team. I was terrified at the thought, at first, but after a while I got kind of used to it.

We had some severe cases, like an infant suffering from hydrocephaly, looked like it was going to die soon. We had a guy with a GI obstruction, most likely, a woman who swallowed something sharp when she was drunk, and a woman coughing up blood with TB-like symptoms. But mostly we saw a lot of GERD, aches and pains, babies with diarrhea, dehydrated adults, and wounds and skin infections. The clinic could use a lot of training with the workers, more reference books and drug books, and some programs on ergonomic lifting, hygiene, and birth control.

I'm excited to really be a leader and take group after group. It's totally my niche in life!

In other work-related news, my love affair with cardio-thoracic surgical tele unit is over. I no longer click with management or my co-workers, and I'm a little bit bored with the patients, too. I think it's time to move on, and re-stimulate my brain again. I applied to the baby NICU, L&D, and visiting nurses. I haven't heard anything back, so we'll see what happens. I want more experiences so that I can be a better clinic nurse in Nepal!

reconfiguration

I nearly lost my position in the "unit reconfiguration" that is taking place. They are taking beds from our unit, the cardio-thoracic surgical stepdown, and beds from next-door neurosurgery, and creating a middle unit for otolaryngology and plastics. The positions on all floors were bid on by seniority, and by the hair of my chinny-chin-chin I managed to grab the very last day/eves spot! I would've cried. Not a single cardio-thoracic nurse volunteered to become a plastics/oto nurse. No thank YOU. This whole split cause us to lose some fantastic nurses, and was just unfair and unpopular all around. Everyone had a stomachache, for weeks.

So it is back to business on my unit of choice. I'm ecstatic even if it means being lowest in seniority. But hey- I wanted to work Christmas anyway. Triple time here I come!

patient stalkers

I took care of a very difficult patient, or should I say a patient with a very difficult family, for two 12 hour days. I bent over backwards to keep the family from going over the edge, and to keep from calling security (as the night shift had done). I went out of my way to deliver on all kinds of bizarre requests, and tiptoed around their ever-changing moods. I was exhausted by the end of those two days, but I was also tired because the family stalked me around floor, trying to convince me to join a Jewish group and go to Israel. I told them several times that I wasn't Jewish, but they didn't believe me. The stalking got out of control, to the point where if I left the conference room they would be standing outside of it, waiting for me.

I spent the next two days at work under an alias, at the opposite side and end of the hall, because they were looking for me. I think I did really good work with them, considering how hostile they were to the rest of the hospital staff, and I'm glad that they liked and trusted me. I also got much closer to the PAs on the cardiac surgery team, and one even gave me a hug at the end of the day and told me I did good work. Still, I'm more than relieved that they'll be gone the next time I go back!