Nursing Myself

It is, in my opinion, much easier to be someone else's nurse than to be my own.  This past week has been potentially one of the most stressful ever, making my "welcome home" week seem more like it should be a "why did I decide to do this again?" week.  I've dealt with taking care of Dad and also with changing my residency status.  I've dealt with messes and have cleaned some up.  However, last night I began making messes too.

Someone, somewhere tried to poison me.  I seriously thought I'd end up in the ER, as I was purging fluids in almost every possible way -- crying, sweating, puking, and you can only imagine the rest.  It's really hard to take care of yourself through that.  My thoughts were "How far do I have to crawl to get my cell phone?" and "I could drive myself to the ER, right? Ok, maybe not." and "Damn, the bathroom floor feels soooo good.  This should totally be a therapeutic option for my patients!"  After much reflection, I've come to the conclusion that I'm not ever allowing all of my people to leave town at once again.  You all are jerks for leaving me here by myself!  :-<

just kidding....kinda   

The Problem With Being a Nurse

In the past few months, I have been extremely blessed, beyond normal measure.  I was offered a new position in a rockin' hospital close to home, making more money in a community with a lesser average cost of living set before me.  I have received authorization to test for my critical care certification at a time when I actually have time to study.  There will be no gap in important things, like insurance coverage or paychecks.  The timing of events really has been perfect, for all intents and purposes.  

Unfortunately, life isn't always as it ought to be.  Circumstances can't remain perfect all the time, and I find myself needing to cling to God more through these "calms before the storms."  The problem with being a nurse is the inability to shut it off.  What happens when someone in the family is ill?  Everyone calls the nurse (or doctor) in the family to help sort through the medical jargon.   She then picks herself up and overextends her limits trying to fix the problem.  Perhaps trying to do it all herself because honestly, who could do a better job anyway?  

This is the predicament plaguing my future.  How do I take care of myself, love my career, and still have enough "caring" left to spare at the end of my day, when I'm needed by people such as my father who may no longer be able to care for himself?  How should I handle my feelings of anger, disappointment, disdain, and frustration for being placed in the position of responsibility?  I don't want to pick up the pieces to anyone's broken life.  I do it for people I don't even know every day and for a paycheck.  How do I protect myself from feelings of guilt and inadequacy?   How do I protect myself from burn-out? 

Even though things are rough right now, I am very hopeful a way exists for me to find balance and peace in my life.  At least he's pleasantly confused at this point.  Perhaps he'll be my muse for good blog stories.  Everything happens for a reason.  Isn't that what they say?  

I wish you 2 would share

Last night was a lot of fun.  No, I didn't get to sit around and play games at work, and no, I didn't even get a "lunch" break.  I was running my tail off from the time I walked in until the time I walked out.  It was fun because I felt completely in control and confident that I was making good decisions.  Finally, a sign of growth!  Haha!  Just kidding...kinda.

Anyway, one patient was rolled to me from the OR at shift change and started displaying signs of septic shock throughout the night.  Systolic blood pressures in the 80s are not good.  It was exciting to be able to give her family answers and to teach them about what was going on in her body.  It was also fun to see how the medications we used and the fluid boluses really helped her.  It's neat to see how the body can correct itself given the right help.  Furthermore, it is neat to have a patient who is so closely monitored.  I had an arterial line to closely monitor blood pressures, a CVP line to measure venous pressures on the right side of the heart, she was on a ventilator, and she was not on sedatives so she could still answer my questions.  And she was sweet, which makes everything go much more smoothly.

My other lady came in with a hypertensive crisis that lead to a hemorrhagic stroke.  She had been doing fine, but I noticed what I thought could be a neuro change, so I rushed her down to CT only to find out the problems she had probably weren't neuro related.  So I spent the night trying to get her pressure out of the 200s and down to a normal level.  It didn't happen, but I tried my best.  If only she could give some of her pressure to my lady who barely had any, we'd be all set.  Oh well, can't always get what we want, can we?

Public Apology

So my previous post landed me in the principal's office, for good reason.  Apparently, it is unprofessional to blog about co-workers, and honestly, I have to agree with the logic behind that statement.  It is unprofessional.  That's why I have a personal blog with no names, just stories.  I am very sorry the blog was left on the computer screen at shift change, and I am very sorry the person's feelings were hurt.   Honestly, I am. 

However, I do believe all things happen for a reason.  I would not have reported the incidents that happened to my manager had I not been yelled at by this person.  Rather, a rational, calm, cool-headed conversation might have been had, and no one would have been publicly embarrassed.  What also might have happened though, is the person would continue to believe it is ok to intervene without doctors' orders.  What might have happened is someone could have been seriously affected in the future by this incident not being reported today.  

Regardless, I will totally feel like a tattle-tale for at least......well, all of today.  It's a good thing I might sleep through most of it.  

Cramping My Style

I learned today that one of my biggest pet peeves as a nurse is following behind someone who puts my patients at risk simply by being a moron. Don't make up your own orders. Don't try to play the doctor--that's not your job. Don't try to teach me anatomy when you don't know it yourself. And don't teach me about diabetes when you don't know what a hemoglobin A1C reflects. I don't care if you have diabetes. You obviously have no idea what you're talking about.

No, it's not ok for you to hard-stop a nitro drip and then bolus/run maintenance fluids on my renal patient the day she just had dialysis. She has CHF. Wouldn't you first assume first that the purpose of that dialysis was to pull fluids off??? And then, wouldn't you think "Self, perhaps I should SLOW this drip down rather than shut it off???" Her BP will just rebound--and it did. And can't you please show me when you called the doc for her chest pain? Don't you realize she had a heart attack this morning and perhaps the doc would like to know if it's getting worse? Oh and can you show me the orders for the morphine you gave her since she has no PRN orders? Why didn't you do an EKG? And where is the doctor's note? AAARRRGGHHHH!!!!

Likewise, it is not cool if you can't tell your right from your left if it means that you're going to turn my other patient on his right side when he has a butt wound there. Turn him LEFT for crying out loud!!! And please, learn to do ostomy care correctly so I don't find poop on his skin when I enter the room.

Don't be that person I have to call when your shift is over. Don't put me in the position of thinking I should report you to my manager. Don't be that person who breaks down the team, who is unteachable, and who does nothing but demand the respect you do not deserve from your coworkers. It just pisses off people like me,those trying to save lives here.

Achy Breaky Heart

Unfortunately, the world doesn't pause for shift change.  Today my patient, who had been doing great all night, started complaining of chest pain at 725 AM.  Ugh!

"Can I get a stat EKG, please?  Oh, and page her doc!"  

After bumping up her Nitro drip, giving her some nitro sprays sublingually, and getting orders for morphine, we finally got her pain under control.  Luckily for her, she was already pre-scheduled for a cardiac catheterization and had already had her premeds.  The timing for her almost-tragedy could have happened at no more opportune time than when interventions were immediately available.   She did infarct, but at least it wasn't at midnight when circumstances weren't so favorable.  

Feet

I haven't blogged in about a month for a few reasons. First, I have been incredibly busy, and sitting down to write just seems too daunting. Second, I haven't had any really good stories to share. Lastly, I have been studying for CCRN, looking for a job, and getting set to move all at the same time as working some CRAZY overtime. Consequently, today's story will likewise be short.

Tonight I'm caring for the sweetest man you'll ever meet in your life. He's has been plagued by a host of medical complications stemming from a AAA repair gone bad, including bilateral above the knee amputations. Besides being cut nearly in half, he also is plagued with a family idiot. Someone brought him in a snuggly fleece blanket with the best of intentions. The only problem is the blanket is covered in hundreds of pink, blue, and green FOOTPRINTS. Doah!