10 week old baby fetus; a poor mother that's miscarried a life that is so perfectly human already. Each limb is delicately shaped, gently suspended in his sac. my heart hurts for this family, my mind marvels there is no skin difference in utero; I never would have guessed they were African American. My soul says a prayer for this tiny being. my fellow nurse says, "to think we all started this small" Que será, será
a homeless man with pancreatic cancer. his vital signs are dwindling, his body is emaciated, yet he seems like he has so much life within. from the ED to the ICU, and in my heart I know it won't be long before I'll read about him in the paper. Que será, será
It's out of my hands, and it always has been. I have no ultimate control over life and death. I can give compassion and learn medicine, applying it to the best of my ability, but ultimately, I have no control. Whatever will be, will be.
Que será, será will be my next tattoo, because as much as I love this job as an ED nurse, sometimes it really hurts to have no control over human suffering.
And then we have a patient come in with anxiety, and suddenly she's coding. We do what we know we're supposed to do, and cath lab comes and whisks her away, only to come back to let us know she had a 'widowmaker' MI, the worst one, but she was already being extubated up in CICU. Que será, será
Wednesday, December 4, 2013
Friday, August 2, 2013
In the Company of Stars...
Another restless night/Whispers too faint to hear/A pull, something just beyond the edge of my senses/Making me feel a little lost/Nothing is wrong/Everything is okay/Still I search within/and without/Solace in loneliness/Underneath the blanket of stars/Andromeda...and Vega...sing to me/Tell me somehow/What am I supposed to know?/Where am I supposed to go??
Trying to get control/I clean, and I scold, and I try to keep a toddler and a young lab/Keep my hubby happy/Try to live in the moment/Choose happiness/It works most of the time/Yet others I feel too far out/My mind is somewhere else/I'm happy but my heart is heavy/I don't want to be perfect, couldn't care less/I want peace within/I want to be at peace with myself...
Trying to get control/I clean, and I scold, and I try to keep a toddler and a young lab/Keep my hubby happy/Try to live in the moment/Choose happiness/It works most of the time/Yet others I feel too far out/My mind is somewhere else/I'm happy but my heart is heavy/I don't want to be perfect, couldn't care less/I want peace within/I want to be at peace with myself...
Sunday, June 30, 2013
Getting in my own way...
"Never let yourself get in your own way"
Wait...what does that even mean? *Sigh* Quick tongue, quick temper, quickly in trouble. If I can just figure out when to bite my tongue and let things go and when I need to speak up and hold my ground I feel I'll be a lot better off. So many personalities, opinions, patients, situations in the ER. To explain a little further, we had a registration gal tell us they wanted to bring a patient back, skipping four patients that had been waiting longer, because "this patient never comes in". Uhh, that's technically discriminating, and we can't do that. Another registration gal makes a little mistake and brings back a patient who hasn't been waiting as long as someone else. Not really the end of the world, but I know these patients are watching who is going back first, and keeping mental tabs on who has been waiting longest. I got to hear all about it last week when a patient flipped his lid that I saw someone else before him (he was brought back out of order, and I tend to look at the situation first, then the triage time, so yeah, he came back first, but the other patient was waiting longer). But the second gal wants to make a big deal about this, in front of everyone, and it's awkward, and I'm wishing I had just not said anything to feed into this dispute. I have six patients to take care of, and I really don't want to piss off the charge nurse.
Wait...what does that even mean? *Sigh* Quick tongue, quick temper, quickly in trouble. If I can just figure out when to bite my tongue and let things go and when I need to speak up and hold my ground I feel I'll be a lot better off. So many personalities, opinions, patients, situations in the ER. To explain a little further, we had a registration gal tell us they wanted to bring a patient back, skipping four patients that had been waiting longer, because "this patient never comes in". Uhh, that's technically discriminating, and we can't do that. Another registration gal makes a little mistake and brings back a patient who hasn't been waiting as long as someone else. Not really the end of the world, but I know these patients are watching who is going back first, and keeping mental tabs on who has been waiting longest. I got to hear all about it last week when a patient flipped his lid that I saw someone else before him (he was brought back out of order, and I tend to look at the situation first, then the triage time, so yeah, he came back first, but the other patient was waiting longer). But the second gal wants to make a big deal about this, in front of everyone, and it's awkward, and I'm wishing I had just not said anything to feed into this dispute. I have six patients to take care of, and I really don't want to piss off the charge nurse.
Sunday, June 9, 2013
Demons & Denial
Whiskey eyes/It's not him looking down at me/He's mad, and a small bolt of fear hits my heart/I don't know this man/There's no reasoning with him/He's mad, and I don't know what to say, or do/I keep quiet, refusing to argue with him/Crashing and anger/This isn't real...
He's gone and back again/This time he's hellbent/Threats and anger seeping out of every pore/I'm still half asleep/What is going on???/There's a gun now/And I'm calling 911/This isn't my life/His whiskey eyes are angrier, filled with fire and hate/I don't know what exactly he's capable of/But I don't want to find out...
There's so many cop cars parked in front/This isn't my life/That isn't my husband/I'm so upset; so angry/This is my home/My peace and serenity/I second guess every decision I've ever made/Do I stay or do I go???/My little guy is wide eyed, looking around/Trying to figure out what is going on/Why are Grandma & Grandpa here so late?
Somehow, someway, everything turns out okay/No felonies, no harm/My heart is broken/My mind is reeling/I'm so upset/do I stay or do I go???/I look down at my little guy, sleeping in my arms/I made a promise once/He deserves the life I never had/So I reach out to his dad/He's beside himself/Hating himself and blaming himself/He knows now he can't drink/He knows now how close he came to losing everything/Somehow we'll try again and try to make it work/For him...
He's gone and back again/This time he's hellbent/Threats and anger seeping out of every pore/I'm still half asleep/What is going on???/There's a gun now/And I'm calling 911/This isn't my life/His whiskey eyes are angrier, filled with fire and hate/I don't know what exactly he's capable of/But I don't want to find out...
There's so many cop cars parked in front/This isn't my life/That isn't my husband/I'm so upset; so angry/This is my home/My peace and serenity/I second guess every decision I've ever made/Do I stay or do I go???/My little guy is wide eyed, looking around/Trying to figure out what is going on/Why are Grandma & Grandpa here so late?
Somehow, someway, everything turns out okay/No felonies, no harm/My heart is broken/My mind is reeling/I'm so upset/do I stay or do I go???/I look down at my little guy, sleeping in my arms/I made a promise once/He deserves the life I never had/So I reach out to his dad/He's beside himself/Hating himself and blaming himself/He knows now he can't drink/He knows now how close he came to losing everything/Somehow we'll try again and try to make it work/For him...
Saturday, June 1, 2013
Inadvertent Skirmishes
Time: 9 days ago
Setting: All by myself, no second nurse, no ER Tech, no breaks. My bladder is about to explode, my stomach has stopped rumbling a long time ago. The ER is getting pounded with ambulances, every room is full with ten people in the waiting room. The queue keeps getting longer. I'm helping out as much as I can, taking people back to fast tract to "get them going" until a bed opens up front. Never mind the acuity, never mind the lack of monitors. Never mind there are six of them and one of me. There's a gentleman who will need moderate sedation to pop a dislocated ankle back into place. Labs & IV started, x-rays done, pain meds given. No problemo. The usual drug seeking behaviors, lots of time-consuming IV abx. My charting gets more and more behind. The ER medical director asks me if I'll stay late; kind of a moot question since I'm already late getting off. No problem, I agree to stay until the 4's are gone. The last one finally leaves, at around 145 AM, and I look at my mountain of charts that still need to be documented. Wait, my NP provider says. There's a "soft 3" in the waiting room, we should see him too. She says something about IV fluids, and I know I've hit my limit. I set the clipboard down with a little more force than necessary, and tell her I'm already behind...I'm due back tomorrow, on a shift I've picked up on top of my regular schedule, my little guy will be getting up in 5 hours, regardless of how much sleep I've gotten, and I am done. I just don't have it in me. The ER Gods smile down on me as I learn that the S3 has eloped, or has left before being seen due to the wait times.
Time: 8 days ago
I'm back for the shift I've picked up, and I'm getting pummeled again. I have a sepsis work-up, two infants (one 12 days old) that need IV hydration, and an admit. At least Siv is my ER Tech; he's good and a hard worker. I'm so grateful to have someone to help out a little. I talk to the NP about my outburst later on that shift, and apologize. She says she understands, and I tell her I'll work harder on controlling my emotions. I didn't realize I upset her so much, but I feel better after talking to her. 0100 rolls around, and my crazy string of shifts comes to an end. I walk out, looking forward to six glorious days off.
Time: Yesterday
I email my manager to relay my concerns about the acuity and being so understaffed. She apologizes, states she didn't realize the ER Techs were being pulled from me to do random things up front. She's hired another nurse to start the beginning of July. And by the way, what was up with me throwing a chart last week? I'm shell shocked. What? I didn't throw a chart. I had no idea Deb was so upset about this. Why would she go to Kendra? She never said anything about this when I talked to her. I apologize to my supervisor, try to explain what happened, but I get the sinking feeling it isn't doing any good.
Time: Today
My first day working with Deb. I am still a little upset and hurt, but I've decided to suck it up and just be professional. Subconsciously I think I'm deliberately being extra cheerful because I don't want her to think I have a bad attitude. The shift goes well, and we're on the last patient of the day. Slammed her hand in a car door...looks pretty painful. No obvious fracture on the x-ray, so Deb gives us an order to ACE wrap and her discharge papers. I go in to let her go, and place the ACE wrap on her hand. I'm wrapping it a lot more loosely than I normally would; she's cringing and appears to be in pain. She looks up at me and says, "I think I'm going to pass out". Her skin is super pale, especially against the contrast of her raven black hair. I tell her to put her head between her knees, ask the ER Tech to get her a cold washcloth, and check her vitals. Her blood pressure is 80 something over 37. Shit. That's not good. I'm asking her questions, and taking her blood pressure again. I try to find Deb, but she's gone. I have a sinking feeling in my stomach...technically the provider isn't supposed to leave until the patient is gone. I ask the charge nurse, Mike, if he's seen Deb. He says she's done for the night. I explain to him what's going on, and he comes back with me. I check a blood sugar, another blood pressure reading, and so on. Mike talks to the ER medical director about bringing her up front. Crap. This is Deb's boss. I can't help thinking, I really hope Deb doesn't think I'm just trying to get her in trouble. The patient feels better and is insisting on going home. As I finish up my charting, say my good-byes and walk out the ambulance bay doors, my stomach is churning and Nate's saying is running through my head...ducks and kangaroos and orangutans with healthy doses of rhyming profanities to go with each.
Setting: All by myself, no second nurse, no ER Tech, no breaks. My bladder is about to explode, my stomach has stopped rumbling a long time ago. The ER is getting pounded with ambulances, every room is full with ten people in the waiting room. The queue keeps getting longer. I'm helping out as much as I can, taking people back to fast tract to "get them going" until a bed opens up front. Never mind the acuity, never mind the lack of monitors. Never mind there are six of them and one of me. There's a gentleman who will need moderate sedation to pop a dislocated ankle back into place. Labs & IV started, x-rays done, pain meds given. No problemo. The usual drug seeking behaviors, lots of time-consuming IV abx. My charting gets more and more behind. The ER medical director asks me if I'll stay late; kind of a moot question since I'm already late getting off. No problem, I agree to stay until the 4's are gone. The last one finally leaves, at around 145 AM, and I look at my mountain of charts that still need to be documented. Wait, my NP provider says. There's a "soft 3" in the waiting room, we should see him too. She says something about IV fluids, and I know I've hit my limit. I set the clipboard down with a little more force than necessary, and tell her I'm already behind...I'm due back tomorrow, on a shift I've picked up on top of my regular schedule, my little guy will be getting up in 5 hours, regardless of how much sleep I've gotten, and I am done. I just don't have it in me. The ER Gods smile down on me as I learn that the S3 has eloped, or has left before being seen due to the wait times.
Time: 8 days ago
I'm back for the shift I've picked up, and I'm getting pummeled again. I have a sepsis work-up, two infants (one 12 days old) that need IV hydration, and an admit. At least Siv is my ER Tech; he's good and a hard worker. I'm so grateful to have someone to help out a little. I talk to the NP about my outburst later on that shift, and apologize. She says she understands, and I tell her I'll work harder on controlling my emotions. I didn't realize I upset her so much, but I feel better after talking to her. 0100 rolls around, and my crazy string of shifts comes to an end. I walk out, looking forward to six glorious days off.
Time: Yesterday
I email my manager to relay my concerns about the acuity and being so understaffed. She apologizes, states she didn't realize the ER Techs were being pulled from me to do random things up front. She's hired another nurse to start the beginning of July. And by the way, what was up with me throwing a chart last week? I'm shell shocked. What? I didn't throw a chart. I had no idea Deb was so upset about this. Why would she go to Kendra? She never said anything about this when I talked to her. I apologize to my supervisor, try to explain what happened, but I get the sinking feeling it isn't doing any good.
Time: Today
My first day working with Deb. I am still a little upset and hurt, but I've decided to suck it up and just be professional. Subconsciously I think I'm deliberately being extra cheerful because I don't want her to think I have a bad attitude. The shift goes well, and we're on the last patient of the day. Slammed her hand in a car door...looks pretty painful. No obvious fracture on the x-ray, so Deb gives us an order to ACE wrap and her discharge papers. I go in to let her go, and place the ACE wrap on her hand. I'm wrapping it a lot more loosely than I normally would; she's cringing and appears to be in pain. She looks up at me and says, "I think I'm going to pass out". Her skin is super pale, especially against the contrast of her raven black hair. I tell her to put her head between her knees, ask the ER Tech to get her a cold washcloth, and check her vitals. Her blood pressure is 80 something over 37. Shit. That's not good. I'm asking her questions, and taking her blood pressure again. I try to find Deb, but she's gone. I have a sinking feeling in my stomach...technically the provider isn't supposed to leave until the patient is gone. I ask the charge nurse, Mike, if he's seen Deb. He says she's done for the night. I explain to him what's going on, and he comes back with me. I check a blood sugar, another blood pressure reading, and so on. Mike talks to the ER medical director about bringing her up front. Crap. This is Deb's boss. I can't help thinking, I really hope Deb doesn't think I'm just trying to get her in trouble. The patient feels better and is insisting on going home. As I finish up my charting, say my good-byes and walk out the ambulance bay doors, my stomach is churning and Nate's saying is running through my head...ducks and kangaroos and orangutans with healthy doses of rhyming profanities to go with each.
Thursday, May 30, 2013
I'll never make it out....alive
Twisted dark thoughts Fighting to remain in control Feeling of overwhelmingness An overwhelmingness that has no rhyme or reason I'm not sure what I'm doing here But I'm swimming against the tide The water gets darker Not unlike my thoughts My dreams continue to haunt me Each night gets darker than the one before And I fight to sleep for a moment Undisturbed, at peace. Fighting for a deep breath but there's something inside Taking up space and so I gulp on these bits of air Trying to get enough To calm this panic The tide is rising and I'm fighting as hard as I can But how long can I go before it's too much?
What is wrong with me? Why do I think this way...First world problems I have nothing to be upset about. I have nothing to feel this way about.
What is wrong with me? Why do I think this way...First world problems I have nothing to be upset about. I have nothing to feel this way about.
Monday, May 20, 2013
Thousand Yard Stare
Slipping out the door after my fourth 13+ hour shift, without a real break in between, scarfing down a piece of pizza here, my Starbucks caramel machiatto and Rockstar, a few walnuts and candies there. So ready for some time off, to rejuvenate and recuperate after this particularly stressful stretch. The patients are a blur, the rooms they occupied a revolving door. At one point I stand in one spot and survey the emergency room, and I notice after a particular rush of patients has ebbed away, almost everyone has that thousand yard stare; going through the motions; their personalities, energy, and sometimes compassion sucked dry by the demands of doctors, patients, coworkers, themselves, their hidden worries about their families at home. The call lights continue, the orders keep coming, and the waiting room queue only gets longer. The panicky feeling rises higher and higher, the feeling that I'm losing control, that I'm getting further and further behind. I haven't peed since this morning, but there are so many things that need to be done, he needs pain medications, this person needs labs drawn, the 1 year old baby is crying in room 1, and my provider wants to know what the status is on the patient in the other room, and family members are asking for water, and it continues, as one minute clicks into the next, and I just do my best to keep up with the chaos. I try to be in the moment, this patient has been waiting an hour and a half to be seen; my mind flashes to the time I had to wait that long to be seen, the anxiety and frustration, the impatience. What are they doing in there? Why is it taking them so long to come see me? I look them in the eye, introduce myself, and thank them for their patience. They are my focus now, and I sit and listen, and try to my best to make them feel better. It's rewarding, so rewarding and so utterly draining. Lying here in bed, wondering what time my 2 year old will wake up in the morning, and wondering if I'll have the energy to focus on him, to give him the attention he demands and deserves.
Yet on my days off, I can't help but wonder what's going on at the hospital, what I'm missing out on...
Yet on my days off, I can't help but wonder what's going on at the hospital, what I'm missing out on...
Sunday, May 12, 2013
The Hardest Part
The family. We were a strange little band of characters trudging through life sharing diseases and toothpaste, coveting one another's desserts, hiding shampoo, borrowing money, locking each other out of our rooms, inflicting pain and kissing to heal it in the same instant, loving, laughing, defending, and trying to figure out the common thread that bound us all together. ~Erma Bombeck
“Parents can only give good advice or put them on the right paths, but the final forming of a person's character lies in their own hands.” ~Anne Frank
I knew couples who’d been married almost forever – forty, fifty, sixty years.
Seventy-two, in one case. They’d be tending each other’s illnesses, filling
in each other’s faulty memories, dealing with the money troubles or the
daughter’s suicide, or the grandson’s drug addiction. And I was beginning
to suspect that it made no difference whether they’d married the right person.
Finally, you’re just with who you’re with. You’ve signed on with her, put in a half
century with her, grown to know her as well as you know yourself or even better,
and she’s become the right person. Or the only person, might be more to the point.
I wish someone had told me that earlier. I’d have hung on then; I swear I would.”
Anne Tyler, "A Patchwork Planet"
"A successful marriage requires falling in love many times, always
with the same person."
Mignon McLaughlin
I'm not advocating for loveless marriages. But it's also the case that marriage
doesn't make us happy every day. No marriage does, but your marriage serves
as so much more than just a vehicle for immediate individual adult needs. It makes
one world for your child, and children will tell you that means everything to them.
Elizabeth Marquardt, Between Two Worlds
A baby is God's opinion that the world should go on.
Carl Sandburg
Making the decision to have a child - it's momentous. It is to decide forever to have your heart go walking outside your body.
Elizabeth Stone
“Parents can only give good advice or put them on the right paths, but the final forming of a person's character lies in their own hands.” ~Anne Frank
I knew couples who’d been married almost forever – forty, fifty, sixty years.
Seventy-two, in one case. They’d be tending each other’s illnesses, filling
in each other’s faulty memories, dealing with the money troubles or the
daughter’s suicide, or the grandson’s drug addiction. And I was beginning
to suspect that it made no difference whether they’d married the right person.
Finally, you’re just with who you’re with. You’ve signed on with her, put in a half
century with her, grown to know her as well as you know yourself or even better,
and she’s become the right person. Or the only person, might be more to the point.
I wish someone had told me that earlier. I’d have hung on then; I swear I would.”
Anne Tyler, "A Patchwork Planet"
"A successful marriage requires falling in love many times, always
with the same person."
Mignon McLaughlin
I'm not advocating for loveless marriages. But it's also the case that marriage
doesn't make us happy every day. No marriage does, but your marriage serves
as so much more than just a vehicle for immediate individual adult needs. It makes
one world for your child, and children will tell you that means everything to them.
Elizabeth Marquardt, Between Two Worlds
A baby is God's opinion that the world should go on.
Carl Sandburg
Making the decision to have a child - it's momentous. It is to decide forever to have your heart go walking outside your body.
Elizabeth Stone
They're the ones dying...
Recording a trauma...motorcycle accident, no helmet. His injuries severe, prognosis bleak. Recording blood transfusions, medications, injuries. Hardware sticking out of his arm from previous surgeries, swollen left eye, the doctors looking at him, shaking their heads. Just another patient.
Until I hear he is related to so-and-so, and with a sinking heart I hear he's related to people I know, and my dad even knows him, and so on, and he's not another patient; he raised so and so, and these broken arms cradled her, and those eyes looked down on her as he gave her away, and suddenly it's so much harder to leave him behind as I walk out the ambulance doors. He stays with me, days later, as I watch her Facebook updates, and my heart is heavy with sorrow and prayers.
I don't want to know relationships. I don't like knowing the details of who they know. Montana is way too small. It's so much easier when there is no relationships, when they are an unknown person.
My heart aches, and my prayers go out to him. God knows what is best for him; the x-rays stick with me. If he makes it, he has a hard, long road ahead of him. Part of me wants him to go in peace, but then I think of her, and God, what would I do if that was my dad? I would want him to fight with everything he has, because I can't picture life without him.
I hate that life is so fragile. I hate that it changes in a split second. I hate that we can't control it.
Until I hear he is related to so-and-so, and with a sinking heart I hear he's related to people I know, and my dad even knows him, and so on, and he's not another patient; he raised so and so, and these broken arms cradled her, and those eyes looked down on her as he gave her away, and suddenly it's so much harder to leave him behind as I walk out the ambulance doors. He stays with me, days later, as I watch her Facebook updates, and my heart is heavy with sorrow and prayers.
I don't want to know relationships. I don't like knowing the details of who they know. Montana is way too small. It's so much easier when there is no relationships, when they are an unknown person.
My heart aches, and my prayers go out to him. God knows what is best for him; the x-rays stick with me. If he makes it, he has a hard, long road ahead of him. Part of me wants him to go in peace, but then I think of her, and God, what would I do if that was my dad? I would want him to fight with everything he has, because I can't picture life without him.
I hate that life is so fragile. I hate that it changes in a split second. I hate that we can't control it.
Saturday, April 27, 2013
Highs and Lows
It's the highs and the lows and the joys and the pains and they call the damn thing...
not the rodeo; but trauma. I think I'm becoming a trauma junkie. Dead one night in the Minor Care, so I went up to watch/try to help with a patient who came in unresponsive. The medics brought him in on dopamine and yet his BP was still only 50/30. When the seasoned RT comes in after pulling the results from an ABG, shaking his head, I had a feeling this might be interesting. "Goddamned pH is 6.5...I can't believe it. Not compatible with life..." The MD didn't think he'd make it out of the room alive, and the other nurses are putting on defib pads, preparing for the worst. Several hours later he's still holding on, but now intubated, a Foley put in, IVs started, several amps of bicarb and other meds given, an NG put in, etc and escorted up to the ICU nurses to let them take over his vigil. Three days later, and he's still in ICU, but being weaned off the vent. I don't enjoy seeing people that ill, but when they do get that way, I love the process and the way people come together to put them back on track and return them to their lives.
The next day I'm slammed in Minor Care, and I feel myself getting more apathetic with each low-income person who comes in, appearing in distress and telling me the only thing that will help them is a shot of morphine, of Dilaudid. They're allergic to Toradol, to Tylenol, to Motrin. They are unemployed, on disability for one thing or the other, and they don't care they're siphoning my tax dollars for a temporary high. One lady stubbed her toe (not even her big toe...) three nights earlier, and the only thing she felt would help was some Percocet. The provider, under the ever increasing DEA surveillance, firmly tells her she won't get anything more than ibuprofen or Tylenol. I don't want to be a jaded, judgmental nurse. I need to figure out a way to look past their situations/habits and see them as people. But only to a point...we can only do so much to try to help them get pointed in the right direction; the rest is up to them.
not the rodeo; but trauma. I think I'm becoming a trauma junkie. Dead one night in the Minor Care, so I went up to watch/try to help with a patient who came in unresponsive. The medics brought him in on dopamine and yet his BP was still only 50/30. When the seasoned RT comes in after pulling the results from an ABG, shaking his head, I had a feeling this might be interesting. "Goddamned pH is 6.5...I can't believe it. Not compatible with life..." The MD didn't think he'd make it out of the room alive, and the other nurses are putting on defib pads, preparing for the worst. Several hours later he's still holding on, but now intubated, a Foley put in, IVs started, several amps of bicarb and other meds given, an NG put in, etc and escorted up to the ICU nurses to let them take over his vigil. Three days later, and he's still in ICU, but being weaned off the vent. I don't enjoy seeing people that ill, but when they do get that way, I love the process and the way people come together to put them back on track and return them to their lives.
The next day I'm slammed in Minor Care, and I feel myself getting more apathetic with each low-income person who comes in, appearing in distress and telling me the only thing that will help them is a shot of morphine, of Dilaudid. They're allergic to Toradol, to Tylenol, to Motrin. They are unemployed, on disability for one thing or the other, and they don't care they're siphoning my tax dollars for a temporary high. One lady stubbed her toe (not even her big toe...) three nights earlier, and the only thing she felt would help was some Percocet. The provider, under the ever increasing DEA surveillance, firmly tells her she won't get anything more than ibuprofen or Tylenol. I don't want to be a jaded, judgmental nurse. I need to figure out a way to look past their situations/habits and see them as people. But only to a point...we can only do so much to try to help them get pointed in the right direction; the rest is up to them.
On the other side...
I don't know if I should have been more intuitive, but Dillon didn't eat anything today. He's 2. Sometimes he just doesn't eat. He was acting like his normal self, getting into everything. He felt a little warm this morning, so I took his temp: 99.1. Hardly anything to get excited about. He's passing gas, and it smells as awful as the dog's, if not worse. Maybe he just ate something and it's messing with his system. I take him to TCU with me, so I can help out with Marci's MDSs while she's swamped and so I can earn a little extra cash. He's cuddly, but he hasn't taken a nap.
Nate comes to get him and they go home. I carry on with my MDSs, and then I get a frantic phone call from Nate telling me he's taking Dillon in. I think he's overreacting; it's just a little throwing up. I don't want to be one of those parents that take their kid in for every little thing...He was fine just a few hours ago; unless he had some fall or some other injury, he doesn't need to go to the ER! I clock out, and meet them in the waiting room at the ER. Dillon is lethargic, and his eyes are glazed over. Maybe Nate knows what he's doing after all. So he's a little tachy, and Deb wants to give him IV fluids. Wait a minute; how did he get so bad so fast?...a small tremor of fear goes through me, and I know it's for the best, but how really, how did he get so dehydrated so fast? Teresa pops the IV in, and with each drop of saline he becomes more animated, more like his usual outgoing into everything self Dillon.
It's hard being on that side of the emergency room. I forget too easily the fear, the anxiety, everything that goes with having a sick loved one waiting to be taken care of. But my co-workers are amazing, and if I can have half as much knowledge and finesse as Teresa someday, I'll be satisfied. Dillon tells her, "Good job buddy" as we leave.
I kissed Nate good-night tonight, and thanked him for being such a good father. He has some good instincts, and maybe I should listen instead of automatically thinking he's wrong...
Nate comes to get him and they go home. I carry on with my MDSs, and then I get a frantic phone call from Nate telling me he's taking Dillon in. I think he's overreacting; it's just a little throwing up. I don't want to be one of those parents that take their kid in for every little thing...He was fine just a few hours ago; unless he had some fall or some other injury, he doesn't need to go to the ER! I clock out, and meet them in the waiting room at the ER. Dillon is lethargic, and his eyes are glazed over. Maybe Nate knows what he's doing after all. So he's a little tachy, and Deb wants to give him IV fluids. Wait a minute; how did he get so bad so fast?...a small tremor of fear goes through me, and I know it's for the best, but how really, how did he get so dehydrated so fast? Teresa pops the IV in, and with each drop of saline he becomes more animated, more like his usual outgoing into everything self Dillon.
It's hard being on that side of the emergency room. I forget too easily the fear, the anxiety, everything that goes with having a sick loved one waiting to be taken care of. But my co-workers are amazing, and if I can have half as much knowledge and finesse as Teresa someday, I'll be satisfied. Dillon tells her, "Good job buddy" as we leave.
I kissed Nate good-night tonight, and thanked him for being such a good father. He has some good instincts, and maybe I should listen instead of automatically thinking he's wrong...
Wednesday, April 3, 2013
Pushing Propofol
"Patient is waking up, give her some succinocholine and some Diprivan!" The moment where the patient is intubated and starting to pull at lines, what do you do? There isn't a doc in the room so what do you do now?
Maybe I need to get in touch with my ER training person.
Friday, March 29, 2013
Remember
I remember Delores, and Chris, and why it didn't work out. I remember the max setting for a pediatric IV infusion is 100 cc/hour. I remember until I don't sleep, and it's 4 in the morning, and I'm sitting in the living room, in the dark, about to have a cup of coffee, and there's a tear threatening to leak. I'm slightly hungover from my Presidente Margarita and glass of wine last night, and I'm dreading today and tomorrow. It's only appropriate her funeral would be Easter weekend. Easter was always her holiday. The spread of food laid out in her garage, the games of Poker that would follow. I'm not sure why I thought that would ever end. I want to know what will happen to her house. Just another house in Shelby that will become a symbol of "remember when" like Grandma Norma's and our old house on 10th Ave. Will our poker games be the same? I don't know how they can be. Will Grandma be okay? I'm so afraid of her losing her will, and giving up. I'm not sure I can stand losing her. Delores is the herald sign; we're not all going to be around forever...things don't stay the same. The petty squabbling and minor grievances aren't worth it. Delores was the first one to forgive, the first one there when someone needed help. Holiday get togethers just won't be the same without her. I'm going to miss her smile. Good-bye Delores...thank you for being such a wonderful woman.
“I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”
― Maya Angelou
Saturday, March 2, 2013
Lessons Learned Vicariously
I've learned so ridiculously much since I've started in the ER. Lessons learned vicariously through the poor patients who are enduring them first hand. Some are their own faults, others is just bad luck, karma, whatever.
Most mind blowing moment this week? Getting ready to start an IV on a grandpa type patient and having him roll up his sleeve and point to his right AC and tell me, "I used this one to shoot up Friday...seems like a good one". Yes, he was talking about meth. I would walk past this man in Walmart 50 times and never suspect he was shooting up meth.
Most disgusting moment this week...tonight. Had a man on oxygen via nasal cannula try to smoke a doobie and ended up lighting his nose, upper lip, and beard on fire. Nothing like soaking eschar and slough (black and yellow dead skin) with saline and then trying to scrape it off with a toothbrush and Q-tips. At least the poor man didn't complain. Just said he'd never smoke again. At least not with oxygen on. Good thing. Lucky he's still with us.
I will never approach a wild animal. Rabies prophylaxis is not fun. Say you get bit on the hand. You get to have this thick immunoglobulin injected just beneath your skin all around the bite site, then the rest injected into a muscle. Then you get the actual vaccine injected into your arm. And THEN you get to come back every few days for more shots. Just stay away from the damn animals. Don't break up the cat fights. Leave the feral animal in heat alone. Ugh.
I'm loving this job as an ER nurse. It makes me feel like I'm doing something, actually making a difference instead of plucking away at a computer, filling in assessments for Uncle Sam to know how much Medicare $$ to throw our way and watching my nursing education slowly slip away from me until I don't even know how to start an IV anymore.
Montana is such a small state. Having patients, then finding out they are so and so's boss, and my heart aches because their prognosis isn't all that great, and just saying a prayer that everything turns out okay.
I see patients come in, Dillon's age, with things that could so easily happen to Dillon. Standing up in a grocery cart and falling to the floor, fracturing his skull. Getting into some medicine/chemical/Pine-sol. It makes me a little more careful when it comes to some things...
I can't believe how big a difference it makes when I'm happy in my job. I come home, and I'm happy. I spend time with Nate and Dillon, and I'm happy. I look forward to going to work. It's insanely busy at times, and overwhelming, and stressful, but in the midst of chaos, I know I wouldn't trade it for anything in the world.
Most mind blowing moment this week? Getting ready to start an IV on a grandpa type patient and having him roll up his sleeve and point to his right AC and tell me, "I used this one to shoot up Friday...seems like a good one". Yes, he was talking about meth. I would walk past this man in Walmart 50 times and never suspect he was shooting up meth.
Most disgusting moment this week...tonight. Had a man on oxygen via nasal cannula try to smoke a doobie and ended up lighting his nose, upper lip, and beard on fire. Nothing like soaking eschar and slough (black and yellow dead skin) with saline and then trying to scrape it off with a toothbrush and Q-tips. At least the poor man didn't complain. Just said he'd never smoke again. At least not with oxygen on. Good thing. Lucky he's still with us.
I will never approach a wild animal. Rabies prophylaxis is not fun. Say you get bit on the hand. You get to have this thick immunoglobulin injected just beneath your skin all around the bite site, then the rest injected into a muscle. Then you get the actual vaccine injected into your arm. And THEN you get to come back every few days for more shots. Just stay away from the damn animals. Don't break up the cat fights. Leave the feral animal in heat alone. Ugh.
I'm loving this job as an ER nurse. It makes me feel like I'm doing something, actually making a difference instead of plucking away at a computer, filling in assessments for Uncle Sam to know how much Medicare $$ to throw our way and watching my nursing education slowly slip away from me until I don't even know how to start an IV anymore.
Montana is such a small state. Having patients, then finding out they are so and so's boss, and my heart aches because their prognosis isn't all that great, and just saying a prayer that everything turns out okay.
I see patients come in, Dillon's age, with things that could so easily happen to Dillon. Standing up in a grocery cart and falling to the floor, fracturing his skull. Getting into some medicine/chemical/Pine-sol. It makes me a little more careful when it comes to some things...
I can't believe how big a difference it makes when I'm happy in my job. I come home, and I'm happy. I spend time with Nate and Dillon, and I'm happy. I look forward to going to work. It's insanely busy at times, and overwhelming, and stressful, but in the midst of chaos, I know I wouldn't trade it for anything in the world.
Saturday, January 26, 2013
Irony
I'm sitting here with a glass of wine after trying to calm my thoughts enough to fall asleep. Eventually I realized there was too much on my mind and gave up...so I'm typing out my thoughts as they tumble out. Another 12 hour shift in the ER. I love it as much as I did last week, if not more. It's challenging, and I'm learning something new every day. I am a "newbie". I may have been a nurse longer than some of the other nurses, but this is different world. I feel silly asking some of my questions, but I'd rather appear silly than be the one to make a fatal mistake. I've never hung IV fluids without a pump. What do you mean I can just let it hang and it'll infuse? I don't have to worry about the air? I don't say these out loud, but the other nurses understand where I'm coming from and are quick to answer my unspoken questions.
I like helping people, and making them feel better. I like watching the kids bounce down the hall, headed towards the Exit, feeling better now with whatever we did for them. My biggest fear is that I will become one of those jaded ER nurses that doesn't care...just going through the motions.
It seemed like there was a lot of tragedy in the ER today; people falling, coming in unresponsive, crying family members spilling into the halls, consoling each other. It's morbid, but each time I can't help but wonder, when is it my turn? Why haven't I lost anyone close to me? The only experience I really have with death of a loved one is my cat, when I was seven. Losing a parent, a spouse, or God forbid, a child...I can't really imagine. So I just make a mental note to myself to not take those simple moments for granted. Crochet in the backyard. Football games on Sundays. Poker games on holidays. You really never know when tragedy is around the corner.
I had a patient who came in, drunk and in pain. He tried marijuana, and alcohol, and finally four ibuprofen but that darned pain from his recent SDH and back injury just wasn't going away. He had just been discharged from us a few days ago, to the homeless shelter. He admitted he was an alcoholic, and his sadness saddened me. I never felt judgmental; I just wished that he would realize he does have the power to make better choices for himself, to get some help for the drinking, and that he does have the power to turn his life around. He was weighing on my mind so heavily tonight, and I realize that I'm sitting here drinking wine, thinking about this guy with an alcohol problem, and it's ironic.
Ten year class reunion is coming up. I dreamed about it last night. Kinda like going through graduation again, only not knowing hardly anyone. At the party afterwards, and there's gigantic pie slices that are too big to eat and huge machines falling from the sky, squashing people who don't watch out. I made it one of my New Year's resolutions to go, and as apprehensive as I am, I guess I'll go. I hate feeling like I never really fit in, but if Nate is willing to go with me, why not. The whole thing just makes me feel old.
I am proud of where I'm at with my life. I'm married to a good guy, who takes care of my son and loves me. I have a job that I'm excited to go to in the morning. I think I'm doing okay.
I like helping people, and making them feel better. I like watching the kids bounce down the hall, headed towards the Exit, feeling better now with whatever we did for them. My biggest fear is that I will become one of those jaded ER nurses that doesn't care...just going through the motions.
It seemed like there was a lot of tragedy in the ER today; people falling, coming in unresponsive, crying family members spilling into the halls, consoling each other. It's morbid, but each time I can't help but wonder, when is it my turn? Why haven't I lost anyone close to me? The only experience I really have with death of a loved one is my cat, when I was seven. Losing a parent, a spouse, or God forbid, a child...I can't really imagine. So I just make a mental note to myself to not take those simple moments for granted. Crochet in the backyard. Football games on Sundays. Poker games on holidays. You really never know when tragedy is around the corner.
I had a patient who came in, drunk and in pain. He tried marijuana, and alcohol, and finally four ibuprofen but that darned pain from his recent SDH and back injury just wasn't going away. He had just been discharged from us a few days ago, to the homeless shelter. He admitted he was an alcoholic, and his sadness saddened me. I never felt judgmental; I just wished that he would realize he does have the power to make better choices for himself, to get some help for the drinking, and that he does have the power to turn his life around. He was weighing on my mind so heavily tonight, and I realize that I'm sitting here drinking wine, thinking about this guy with an alcohol problem, and it's ironic.
Ten year class reunion is coming up. I dreamed about it last night. Kinda like going through graduation again, only not knowing hardly anyone. At the party afterwards, and there's gigantic pie slices that are too big to eat and huge machines falling from the sky, squashing people who don't watch out. I made it one of my New Year's resolutions to go, and as apprehensive as I am, I guess I'll go. I hate feeling like I never really fit in, but if Nate is willing to go with me, why not. The whole thing just makes me feel old.
I am proud of where I'm at with my life. I'm married to a good guy, who takes care of my son and loves me. I have a job that I'm excited to go to in the morning. I think I'm doing okay.
Sunday, January 20, 2013
Changes
I did some research online, found a great website, and in my excitement shared it with his daycare. Now I see why that wasn't such a bright idea; I think I frustrated her. I received an email back that they were giving us 2 weeks' notice. Completely blindsided me; per the contract I had to sign with them there was a whole process before getting to this point, but maybe this is for the best. Maybe Dillon needs a smaller setting, with more supervision. Nate describes the daycare as "chaos" and sometimes I wonder if the kids are being watched as closely as they should be. Nate and I toured a different daycare a few weeks ago, so maybe we should have seen this coming. Either way, it's no one's fault and everybody's fault. It is what it is, and all those trite sayings.
I'm surprised at how much this upsets me. I tossed and turned last night, after watching the first half of Breakfast at Tiffany's, trying to think about other things besides that email that created such a mixed bag of emotions for me: relief that there was finally a decision made; sorrow because I appreciated them and Dillon really seemed to like Bear, fear that I'm doing something wrong with Dillon as a parent, and not knowing what the future holds for his daycare while Nate and I work, and hope because maybe this is a sign that we really don't need to be paying for full time daycare when we only need 6-8 hours a week. There's really nothing I can do but say a prayer to God to show us the way and then to let it go.
Getting ready for PALS tomorrow. I'm afraid I'll fail and they'll wonder if they made the right choice, hiring me for the ER. I've been studying ECGs (pretty much teaching myself each one) and reading the PALS book cover to cover. Of which I still have 100+ pages left to go...I'll do my best and go from there.
Friday, January 11, 2013
The Hardest Part
The family. We were a strange little band of characters trudging through life sharing diseases and toothpaste, coveting one another's desserts, hiding shampoo, borrowing money, locking each other out of our rooms, inflicting pain and kissing to heal it in the same instant, loving, laughing, defending, and trying to figure out the common thread that bound us all together. ~Erma Bombeck
“Parents can only give good advice or put them on the right paths, but the final forming of a person's character lies in their own hands.” ~Anne Frank
I knew couples who’d been married almost forever – forty, fifty, sixty years.
Seventy-two, in one case. They’d be tending each other’s illnesses, filling
in each other’s faulty memories, dealing with the money troubles or the
daughter’s suicide, or the grandson’s drug addiction. And I was beginning
to suspect that it made no difference whether they’d married the right person.
Finally, you’re just with who you’re with. You’ve signed on with her, put in a half
century with her, grown to know her as well as you know yourself or even better,
and she’s become the right person. Or the only person, might be more to the point.
I wish someone had told me that earlier. I’d have hung on then; I swear I would.”
Anne Tyler, "A Patchwork Planet"
"A successful marriage requires falling in love many times, always
with the same person."
Mignon McLaughlin
I'm not advocating for loveless marriages. But it's also the case that marriage
doesn't make us happy every day. No marriage does, but your marriage serves
as so much more than just a vehicle for immediate individual adult needs. It makes
one world for your child, and children will tell you that means everything to them.
Elizabeth Marquardt, Between Two Worlds
A baby is God's opinion that the world should go on.
Carl Sandburg
Making the decision to have a child - it's momentous. It is to decide forever to have your heart go walking outside your body.
Elizabeth Stone
“Parents can only give good advice or put them on the right paths, but the final forming of a person's character lies in their own hands.” ~Anne Frank
I knew couples who’d been married almost forever – forty, fifty, sixty years.
Seventy-two, in one case. They’d be tending each other’s illnesses, filling
in each other’s faulty memories, dealing with the money troubles or the
daughter’s suicide, or the grandson’s drug addiction. And I was beginning
to suspect that it made no difference whether they’d married the right person.
Finally, you’re just with who you’re with. You’ve signed on with her, put in a half
century with her, grown to know her as well as you know yourself or even better,
and she’s become the right person. Or the only person, might be more to the point.
I wish someone had told me that earlier. I’d have hung on then; I swear I would.”
Anne Tyler, "A Patchwork Planet"
"A successful marriage requires falling in love many times, always
with the same person."
Mignon McLaughlin
I'm not advocating for loveless marriages. But it's also the case that marriage
doesn't make us happy every day. No marriage does, but your marriage serves
as so much more than just a vehicle for immediate individual adult needs. It makes
one world for your child, and children will tell you that means everything to them.
Elizabeth Marquardt, Between Two Worlds
A baby is God's opinion that the world should go on.
Carl Sandburg
Making the decision to have a child - it's momentous. It is to decide forever to have your heart go walking outside your body.
Elizabeth Stone
Long time gone...
It's been so long since I've posted. I don't even really journal any more since I've been with Nate like I used to when I had so much time alone. There's a liberation in knowing this blog is private, and I don't have to worry about what people might think. I'm itching to write, to let go of some of these pent up emotions that have been lurking inside for so long. I feel a little lost...but I also feel like I'm being called to look deeper into my spiritual side.
So much has changed. Bought a house, a dog, adopted two cats, started working in a sub-acute rehab as an MDS nurse, worked there for a year and a half, and one night I'm sitting at work, it's late and Sue is still there in the office with me, but I feel compelled to put in an application for the ER and for L&D. I sincerely doubted anything would happen with it since I've applied in the past, and I'm not even ACLS certified, but I did it and sent if off to HR.
The next day I have a missed call from HR. Of course my voicemail isn't working but I call HR back and they want an interview for the ER position. I'm ecstatic and in disbelief. I go to work and dread telling Marci and Gaye. I tell Marci first, and she looks at me and doesn't say much. I wait a few days and then sit down and tell Gaye. She tells me exactly what she thinks, one of the things I love most about her. "We finally got everything the way you wanted it and now you're leaving." I tell her how much I appreciate her and everything she's done for me and Dillon, and that it has nothing to do with her. I'm just not cut out to be a desk nurse, wearing out the seat of my scrubs. She looks at me and then says, "I understand completely" and then tells me she knows I'll get the position.
I'm in the interview, and they ask me questions, then ask how I deal with difficult doctors. I tell them about Dr. Grams, everything I've learned by working with her and basically sometimes I just have to have a thick skin and realize their temperament doesn't necessarily have anything to do with me.
I get the position, starting in Minor care (soft 3's, 4's, and 5's) and hopefully will be able to advance into the ER once I'm ready (which won't be for a while!). I started last Tuesday. Twelve hour shifts passed by quickly, and the more I work and study the more I realize how much I have to learn. I start two IVs effortlessly my second day, and then miss one on a 30-something dialysis patient in the main ER (floating with my preceptor to help them out while we were slow) and miss an AC lab draw. I watch the lab tech do it so effortlessly (pretty much made it look like he was sliding the needle into butter and got flash immediately). I follow him out of the room and tell him he just put me to shame (with a smile) and beg him to teach me his secrets. He smiles back and gives me some pointers.
My preceptor is young but amazing to work with and smart. She doesn't talk a whole lot about herself, but is fun to be around. After our final shift last night we walk out and she asks me what she could do more, what would help, etc. I told her I feel like she could yell more. She laughs and I like her that much more because she gets my sense of humor.
The nurse practitioners change and it's challenging to get their quirks down. They're both down to earth and willing to teach and I like that I can approach them without getting yelled at instantly.
The patients come in, the revolving door of the ER. Flu season is upon us, and we see a lot of pediatric patients. We have a little boy with a raging ear infection who seems to be older than his age (5 going on 25) and tells me he gets his flu shot every year. I give him ear drops and cotton balls and he looks at me and tells me, "You're a good nurse". This makes my week and I know that I'm where I'm supposed to be.
I float over to the ER with Chris for a bit and while I love the chaos and they're so incredibly busy and short and I'll be honest and admit I was overwhelmed, but not in a bad way. We help triage a pt brought in by ambulance who slipped and fell on the ice, now with a fractured ankle. I learn to always put on gloves when removing pants as she was incontinent. Gross...
We get drug seekers but no one really rude yet. Our providers really don't give out narcs for anything...just recommend Motrin and Tylenol. One 20-something fractured his clavicle in a snowboarding accident and he actually got a script for Lortab, but that was pretty much it.
I'm trying to get the charting system down, and getting there slowly. I realize I'll have to do things differently then my preceptor, and start using a blank piece of printer paper folded in fourths. Whenever I do anything, I put the time, room number, and pt initials, along with whatever I need to chart. Put in an order for x-ray, I write it down; give a med, I write it down. Then I highlight it when I chart it.
I've given so many IM Toradol and Phenergan shots. Still trying to figure out the dorsogluteal vs. ventrogluteal thing.
I experienced my first patient(s) that had media involved with their situations. They were fine, but reading the news on my iPhone local news app makes me realize sometimes the news blows things out of proportion.
I have a patient who is in a Fed Ex truck accident and treat him. Then I see his truck on my husband's Facebook. Friend of a friend. Only in Montana.
I go to sleep and I dream of work. I feel a little guilty, missing time with Nate and Dillon. As Nate puts it, we're passing each other in the sheets. I come home at 1am, he's up and gone by 6am. Dillon is talking more and more, and the animals continue to drive me up the wall. The dog is so hyper and stubborn (whose idea was it to get a lab puppy, seriously?).
Taking it one day at a time, looking forward to learning and growing. Trying to ignore the doubt that springs up in the back of my mind at times. The what ifs and fear of making a mistake and being a failure; of not being able to "cut it". One thing at a time.
So much has changed. Bought a house, a dog, adopted two cats, started working in a sub-acute rehab as an MDS nurse, worked there for a year and a half, and one night I'm sitting at work, it's late and Sue is still there in the office with me, but I feel compelled to put in an application for the ER and for L&D. I sincerely doubted anything would happen with it since I've applied in the past, and I'm not even ACLS certified, but I did it and sent if off to HR.
The next day I have a missed call from HR. Of course my voicemail isn't working but I call HR back and they want an interview for the ER position. I'm ecstatic and in disbelief. I go to work and dread telling Marci and Gaye. I tell Marci first, and she looks at me and doesn't say much. I wait a few days and then sit down and tell Gaye. She tells me exactly what she thinks, one of the things I love most about her. "We finally got everything the way you wanted it and now you're leaving." I tell her how much I appreciate her and everything she's done for me and Dillon, and that it has nothing to do with her. I'm just not cut out to be a desk nurse, wearing out the seat of my scrubs. She looks at me and then says, "I understand completely" and then tells me she knows I'll get the position.
I'm in the interview, and they ask me questions, then ask how I deal with difficult doctors. I tell them about Dr. Grams, everything I've learned by working with her and basically sometimes I just have to have a thick skin and realize their temperament doesn't necessarily have anything to do with me.
I get the position, starting in Minor care (soft 3's, 4's, and 5's) and hopefully will be able to advance into the ER once I'm ready (which won't be for a while!). I started last Tuesday. Twelve hour shifts passed by quickly, and the more I work and study the more I realize how much I have to learn. I start two IVs effortlessly my second day, and then miss one on a 30-something dialysis patient in the main ER (floating with my preceptor to help them out while we were slow) and miss an AC lab draw. I watch the lab tech do it so effortlessly (pretty much made it look like he was sliding the needle into butter and got flash immediately). I follow him out of the room and tell him he just put me to shame (with a smile) and beg him to teach me his secrets. He smiles back and gives me some pointers.
My preceptor is young but amazing to work with and smart. She doesn't talk a whole lot about herself, but is fun to be around. After our final shift last night we walk out and she asks me what she could do more, what would help, etc. I told her I feel like she could yell more. She laughs and I like her that much more because she gets my sense of humor.
The nurse practitioners change and it's challenging to get their quirks down. They're both down to earth and willing to teach and I like that I can approach them without getting yelled at instantly.
The patients come in, the revolving door of the ER. Flu season is upon us, and we see a lot of pediatric patients. We have a little boy with a raging ear infection who seems to be older than his age (5 going on 25) and tells me he gets his flu shot every year. I give him ear drops and cotton balls and he looks at me and tells me, "You're a good nurse". This makes my week and I know that I'm where I'm supposed to be.
I float over to the ER with Chris for a bit and while I love the chaos and they're so incredibly busy and short and I'll be honest and admit I was overwhelmed, but not in a bad way. We help triage a pt brought in by ambulance who slipped and fell on the ice, now with a fractured ankle. I learn to always put on gloves when removing pants as she was incontinent. Gross...
We get drug seekers but no one really rude yet. Our providers really don't give out narcs for anything...just recommend Motrin and Tylenol. One 20-something fractured his clavicle in a snowboarding accident and he actually got a script for Lortab, but that was pretty much it.
I'm trying to get the charting system down, and getting there slowly. I realize I'll have to do things differently then my preceptor, and start using a blank piece of printer paper folded in fourths. Whenever I do anything, I put the time, room number, and pt initials, along with whatever I need to chart. Put in an order for x-ray, I write it down; give a med, I write it down. Then I highlight it when I chart it.
I've given so many IM Toradol and Phenergan shots. Still trying to figure out the dorsogluteal vs. ventrogluteal thing.
I experienced my first patient(s) that had media involved with their situations. They were fine, but reading the news on my iPhone local news app makes me realize sometimes the news blows things out of proportion.
I have a patient who is in a Fed Ex truck accident and treat him. Then I see his truck on my husband's Facebook. Friend of a friend. Only in Montana.
I go to sleep and I dream of work. I feel a little guilty, missing time with Nate and Dillon. As Nate puts it, we're passing each other in the sheets. I come home at 1am, he's up and gone by 6am. Dillon is talking more and more, and the animals continue to drive me up the wall. The dog is so hyper and stubborn (whose idea was it to get a lab puppy, seriously?).
Taking it one day at a time, looking forward to learning and growing. Trying to ignore the doubt that springs up in the back of my mind at times. The what ifs and fear of making a mistake and being a failure; of not being able to "cut it". One thing at a time.
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