back again...

I stopped writing after spring semester, for whatever reason. Nursing Leadership and IV therapy came next, and then i was done. Much thanks to Doughboy for letting me practice IVs on him!! (especially for pretending he had Tourette's...nice). Graduating was surreal. Just because of everything that had happened in my personal life, it felt like a chapter being closed, and I was more than ready to move on. Somehow, looking back now I remember nursing school with fondness, and the only thing I would change now if I could would be to enjoy it more as I was learning. And I ran into one of my teachers yesterday, and thanked her. She taught Maternal-Child Nursing, a class that made me uncomfortable from the beginning. I've never dreaded going to class like I did that one. The idea of having children made me so uncomfortable...and then I realized it wasn't the idea of having children itself, but having children with the person I was with. So I made some changes, said my good-byes, and let him go. I hope he finds someone whom he can have an amazing relationship with, and I wish him nothing but the best. It just wasn't meant to be. So I ran into my teacher, and I thanked her as I explained to her that it was never her, or her class, that made me so disinterested. I guess I learned a lot more in nursing school than I bargained for...

So now I'm working as an LPN in a long-term care facility. At first it was the last thing I wanted to do after graduating, but with the recession, full-time jobs weren't plentiful as an LPN. And the way everything worked out...to me I knew it was where I was supposed to be for the moment.

I'm learning everyday just how much I don't know. Every time I start to think, "Hey, maybe I'm getting it..." something happens to make me realize just how much I have to learn. I've actually wanted to call my LPN instructor and ask her if I could just repeat those classes again...maybe then I'll feel like I'm more competent. But instead I ask questions. About everything. I remember Lindy, an Ortho nurse..."when in doubt, scream and shout." And I realized there are a handful of nurses I can go to who will point me in the right direction. Yes, some eat their own, but I decided to live and learn and just ignore their rudeness and try to learn from what they're nitpicking about.

I love the residents. Even when I'm in the worst mood, I could never be upset with them. They yell sometimes, spit their pills out all over me, but it's okay. And it's the crazy ones I love the most. The resident who asks me to put a blanket on her daughter, pointing at an empty chair. The resident who yells at me because now I'm her niece and I'm not dressed to take her to Mass. The resident who makes faces at me while I'm trying to chart on the computer. The resident who tells me the dirtiest jokes I've ever heard with a dead-pan expression (jokes so horrible they even gross my brothers out...). It's not about the money, because before I thought I'd be rich after I graduated. Not so much... It's not about self-gratification, because sometimes I go home and feel like I didn't do enough. It's simply about them.

I wasn't planning on blogging anymore. But lately I've had trouble leaving work at work, thinking about work while I'm trying to fall asleep, waking up, thinking about what I should do for the upcoming day. So maybe if I just write it down, I can leave it where it's supposed to be.

Today wasn't a bad day. It was just so hectic. Thank God another nurse was orienting with me, so she could focus on passing meds and I could try to keep up with everything. We suspected one resident had an URI (green, pasty/sticky phlegm coming up every 30 seconds, low-grade temp...). I called the MD yesterday, he ordered antibiotics. Trouble is, this resident refused to take anything by mouth, food, water, and especially meds. (When I speak of residents spitting their meds all over me, she comes to mind). We check her blood sugar (noting she hasn't eaten in several days) and at first it's too high for the glucometer to read. Which means it's over 600. (Normal is between 70 and 120/130). I repeat the reading, and it's 599. Yikes. Time to call her doctor. He orders blood work...so I draw the blood, send it down, and once we get it back, realize her white blood cell count is pretty high. I faxed that to the doctor, and his nurse calls back, tells us this resident just bought an all-expense paid trip to the hospital. She just came back three weeks ago, after getting pumped full of antibiotics for a suspected UTI, and looked great for a while. Hopefully she'll feel better soon...

Another resident complained of leg pain. I rub Arnica gel on her muscles with no relief. I give her her PRN Percocet, and an hour later, the CNA comes to find me, telling me the resident isn't responding. Not something you want to hear from a CNA about a resident. I go over to her, and see that her eyes are open, but her pupils aren't following anything. The expression "The lights are on, but nobody's home?" I never saw someone who fit that expression as well as she did. I check her blood sugar. Nothing unusual. I check her oxygen saturation and other vitals. Fine. The LPN who's orienting today brought her dachshund. And this lady loves dogs. So I put the dog on her lap. Slowly, she lifts her hand up and pets the dog and smiles. She's fine, but to describe it, this resident looks stoned. I left a note for the doctor, wondering if she needs something less potent. The doctor takes her off her Zyprexa instead, so we'll see how she is the next couple of days (by the way, the resident who asked me to cover her daughter with a blanket...this was her).

I didn't realize how much responsibility this job is until lately. I hate making mistakes. I catch so many little mistakes, and sometimes it's just highlighting the MAR to point out that hey, this person gets 40mg of Lasix at 8am, and 80mg at noon, so that the right blister gets pulled and used. And I make mistakes, too. I hate making mistakes, but I learn my lesson so well from them. A resident on Coumadin got orders to re-draw his PT/INR on a date. I chart it in Meditech, put it in the MAR, and forgot to order the lab to be drawn by the lab. So the PT/INR goes undrawn for over a week. But now you can bet the first thing I do is put that PT/INR lab order in. I don't want to be that nurse that insists on running to the boss and showing every little mistake so and so made. I will if there is a genuine, obvious med error. The day I found out about the PT/INR mistake? I realized the evening nurse prior to me forgot to give two different residents their pain pills. I did let my boss know, and she told me that nurse wasn't comfortable working that unit, and was actually the nurse who oriented with me today to get to know the people better. Everyone makes mistakes...including me. We're only human. It's just how we can prevent them in the future. I would love to have a stamp to use on new doctor's orders. Faxed to Rx? Check. MAR changed? Check. DC'ed blisters pulled from med cart? Check. Nurses' note in Meditech? Check. New labs entered in Meditech? Check. New labs on calendar? Check. But for now, it is what it is. Until I can convince my boss that we really do need that stamp so things don't get lost in the process.

I applied for school, to get my LPN to RN. I think I missed the deadline by a few weeks, so I don't know if I can get in. But I think now would be better for me to get my RN, before I get married again, and have kids. I actually met someone who I can't wait to have kids with. And I can't believe the difference...But everything happens for a reason, and if I get in, I'll be happy. If not, I'll continue to work, gaining my experience, and try again next year.