20 March 2012
Random Victory
You know you are a nurse when you are thrilled to make it to pee in an 8 hour shift...Not once, but TWICE! And you actually had the time to drink enough water to produce enough urine for that second pee trip :}. #Winning.
16 March 2012
Confusion Pt. II
The up side of some confused patient is that sometimes they are pleasantly confused. Last night I had a patient who was adorable, but very confused. Let's call her Mary. Every time I walked into Mary's room she would smile and say, "Oh, hi honey". She is a petite woman and I instantly think she is cute enough and perhaps small enough to carry in my pocket. I check in on her and see how she is doing upon arriving on shift and she instantly starts telling me about her cat, baby. She thinks baby is in bed with her and she doesn't want me to squish him. She has dementia so I don't acknowledge or disagree that there is a cat in the bed; That is kind of a losing battle. After her story about how she found baby, she tells me that she doesn't want to keep me from my work. So I try to make her comfortable and turn off the lights for her to rest.
4am comes and Betty is awake crying. She is crying because she doesn't know when she is going to have her surgery on her knee. It's Friday and her surgery was this past Tuesday. I kneel down next to her and explain to her that she had surgery, it went very well and she just needs to rest so she can heal. She continues to cry and talk about all her family and that maybe they didn't know she had surgery. I let her know her family is well aware of her condition and recovery. I orient her to the time and explain that she may be forgetful due to anesthesia and pain medication. This is not a complete lie. Her confusion is the dementia, but I felt that if I told her the other mentioned reasons for not remembering her surgery, that it may calm her some. I let her know that after the surgery she was very sleepy and may not remember some things. I reassure her again and let her know her knee is doing very well and that we are there to make sure she gets better. Mary puts her hands on top of her head as she sobs and tells me how she hates her brain and hates how it doesn't work anymore. For that moment I knew she knew she was confused ... Looking into her eyes I almost lost it and had to fight my tears. I am not sure why this hit me. Maybe I understood her frustration or maybe because I had seen her so happy and content and here she was having a breakdown. There is nothing in school or this job that teaches you how to deal with these situations or know the right thing to say. I grab her hand and explain everything to her over again, let her know she is doing well and that I am there to help. The sound of her crying breaks my heart. An hour or so goes by and she gently falls back into sleep. I wonder how her family must feel to see her come and go out of confusion. I wonder if she knows who anyone is or what her perception of reality looks like. I imagine her moments of clarity and her frustration with the confusion. It's almost like ALS, or Lou Gehrig's disease... Your body fails you, but you are alert and oriented enough to realize it...And you can't do anything about it...
4am comes and Betty is awake crying. She is crying because she doesn't know when she is going to have her surgery on her knee. It's Friday and her surgery was this past Tuesday. I kneel down next to her and explain to her that she had surgery, it went very well and she just needs to rest so she can heal. She continues to cry and talk about all her family and that maybe they didn't know she had surgery. I let her know her family is well aware of her condition and recovery. I orient her to the time and explain that she may be forgetful due to anesthesia and pain medication. This is not a complete lie. Her confusion is the dementia, but I felt that if I told her the other mentioned reasons for not remembering her surgery, that it may calm her some. I let her know that after the surgery she was very sleepy and may not remember some things. I reassure her again and let her know her knee is doing very well and that we are there to make sure she gets better. Mary puts her hands on top of her head as she sobs and tells me how she hates her brain and hates how it doesn't work anymore. For that moment I knew she knew she was confused ... Looking into her eyes I almost lost it and had to fight my tears. I am not sure why this hit me. Maybe I understood her frustration or maybe because I had seen her so happy and content and here she was having a breakdown. There is nothing in school or this job that teaches you how to deal with these situations or know the right thing to say. I grab her hand and explain everything to her over again, let her know she is doing well and that I am there to help. The sound of her crying breaks my heart. An hour or so goes by and she gently falls back into sleep. I wonder how her family must feel to see her come and go out of confusion. I wonder if she knows who anyone is or what her perception of reality looks like. I imagine her moments of clarity and her frustration with the confusion. It's almost like ALS, or Lou Gehrig's disease... Your body fails you, but you are alert and oriented enough to realize it...And you can't do anything about it...
15 March 2012
Sundowner
The term "sundowning" refers to a state of confusion at the end of the day and into the night. Sundowning isn't a disease, but a symptom that often occurs in people with dementia, such as Alzheimer's disease. The cause isn't known. Once the morning comes, people who had this "sundowning" episode are more alert. They are no longer that confused patient.
I.
I saw this first hand. There is two meaningful things in this story. The meaning of how It feels to fail a patient. The meaning of how it feels to see this patient sundown at night but in morning, flip a 180 and become a different person completely.
I got report on a patient, lets call her Betty. The report I got was not the report I should have been given. According to the nurse handing the responsibility of patient care to me, the patient had some "bouts" of confusion, but was easy to redirect and orient. She was a post operative patient that needed vitals frequently, medications, IV fluids...The list could go on. I take the report and run with it. I go and see my other patients first, compared to my others, Betty seems like a low acuity and priority.
By the time I get to Betty...Betty has taken off her blankets, her gown, leaving her girls open and lying in her armpits...She has taken off her blood pressure cuff, her pulse ox sticker (That I myself, usually can not get off peoples fingers very easily)...She has removed the cotton IV sleeve and ten layers of tape to find her IV line and pull it out. I walk in and she is calmly rubbing her hands on what ever she can grasp. And I'm like okay...Dress up, vitals, new IV start. I am most excited about the last one. Something about starting an IV makes me happy. I get her dressed because I know it is the best thing to do, but quite honestly she doesn't care if she is naked and I've seen more body parts in the last ten years that it just doesn't even phase me anymore. You'd have to have an extra boob or 2 foot long dick to shock me. I get Betty comfortable then go for my IV. She doesn't budge as I stick a needle in her forearm. She just lays there. She talks about how she is in her sister's bedroom, about how the cats will not stay off her bed, and the door bell ringing that she can not answer. I start trying to orient her to where she is and letting her know there are no cats or door bells. After about 20 minutes of that I decide I am not going to win this. They teach us to always orient the patient in school, tell them truth...But after 20 good minutes I am ready to just talk about the cats so we can go on to another topic. So we do. We talk about cats and how they are all over the hospital room looking for food and beds. Whatever. No harm done. The night goes on. Betty constantly pulls on her Foley (catheter that drains her bladder), her blankets, her attends and pulls on the sleeve I used to cover her IV. Under that sleeve is my hell of a tape job to keep her IV in place, that sucker was going to stay in... and did. She would moan and ask to use the bedpan frequently. It was like a crying baby you could not calm, she would just moan and fuss and pull on things. We'd put her on the bed pan, she would pee maybe 50ml. It was like really? Okay well Betty do you feel better? She would tell me yes and then continue fussing with everything she could get her hands on. There was no communication that you would have expected from someone in her state of mind. As the night went I felt myself getting internally frustrated with her. I controlled my tone and my actions and was never in anyway abusive. I just had had it with her. And I felt like I was neglecting my four other patients. Which madw me feel bad also. I tried to get through the night, try to reassure her, constantly put her back together and at 5 am she finally falls asleep. We tip toe past her room careful not to wake her up. I carry around the feelings with me feeling badly for myself. Why did I get so irritated. The patient didn't know any better. I kept reminding myself "this is someones grandma" and if any nurse was shitty with my grandma, I'd have their ass. It's not like a harmed her, I just was flooded with aggravation and then self defeat making myself believe that maybe I was not a good nurse.
Betty woke up at 6 or so. She stated she needed to have a bowel movement and asked if we could help her to the bedside commode. When the nursing assistant came and got me, I was like really? Ya I guess we can try I thought, but I am only trying because she is 50lbs so I know if she falls or gets unsteady I can hold her. Would you believe this patient got up to the side of the bed and on to the toilet without problem? Her vocabulary was clear and appropriate. She told us she would call when she was done. I didn't trust this at first because she had been on a bed alarm all night for being impulsive and trying to escape her bed. The nursing assistant assured me she had come around and was alert and oriented; I waited by the door since it's my license on the line for little grandma Betty. Turns out Betty was as alert and oriented as you and I are. She called. She cleaned herself up. We got her back to bed. Then I talked to her for about 10 minutes about her surgery, her doctor, her breakfast menu... She was clear as day. She was not confused at all. It was like talking to a completely different person. I was so blown away, I didn't know what to think... Or what to say...
This sundowning is someones way of punking me? It's like God gave these patients two different personalities... Then bam when the sun comes out- The patient's state of mind is back to normal. I couldn't look at Betty without thinking WTF? Betty are you in tight with Ashton...Am I being punked?
II.
Part two of another confused patient I recently had. Was a man. Let's call him Dick. Dick had been nonverbal for his stay at the hospital. He would rather sit in his dirty sheets and not eat than move or talk to anyone. Dick has dementia. None of these descriptions fit when I first started to walk in and talk to Dick. He answered my questions and was appropriate. I don't bug him and try to move him in bed although he looks all lopsided and wrinkled up in sheets. I heard he is a fighter. I offer to help him move in bed, he says no. I hang my IV and go see my other 3 patients. When I get back to check on Dick, he smells like shit. Fuck. Okay guy it's you and me and we are going to get you changed. I try to roll him and gain his cooperation...He fights. We just turned into WWF hospital style #winning. I finally get him over on one side so I can start to clean his sheets and get him off his attends (diaper)... I start to clean his hairy asshole with washcloths, of course Dick has a hairy ass and of course he ate glue because this shit is sticky-er than I have ever seen in my 10 years of patient care. There is not a lot of shit, but what is there is sticky icky icky! I've seen asses and shit but not like this. To make matters worse his pubic hair in front was so long the shit flowed back into his ass so there was all this matted hair with shit stuck in it. Ugh. I don't call for help. I just decided I am going to go for it. I let him know what I am about to do. I start whipping like a mad women. Then he thinks its appropriate to tell me "Stop fucking with my asshole" over and over again. At this point I am like really? Could you shut up and I'll clean you hairy asshole! All I needed was staff to come in and be like... "Um, JJ, what are you doing in here?" ... So I can reply, "Oh nothing I am just living the damn dream in here, care to join?"...Ugh. I quit. I'm sweating my balls off trying to get this guy clean and my back is hurting. I get most of the hairy shit and honestly I left some there, done fighting. I slapped on a new attends, covered him in sheets and went on about my way... Ya right, an hour later the same patient, Dick, tries to pull out his IV. He manages to get all the tape off and gets the lines from his IV fluid unattached. This sneaky little unhook makes two things happen. From the first line, coming from a large bag of normal saline, lots of normal saline ran freely into his bed, soaking his sheets, Yes- love when there is wet sheets. The second line from is vein has blood flowing out onto his shirt. Even better .Now it looks like I murdered him, shot dead in the middle of the gut. Fuck. Okay. I save the IV (get kinda excited about that) then tape the fucking shit out it. That IV is going to last another 30 years. I then wrap a sleeve around it. That is a fight. He keeps asking me "What are you doing?" I reply, "fixing your arm Dick!" Then time to change this mans shirt. I almost went EMT mode on him was gonna cut it off with trauma sheers....but I got Dick to participate enough to lift his head and put his arms up so I could slide the shirt off. Don't worry about the bed, I laid down towels where I could under him and that would be the end of that battle. I got him into a hospital gown wrapped him in warm blankets and said goodnight while turning off all the lights. Go mimis Dick!
It's internally frustrating fighting with adults, specially confused ones. You have to be sneaky, creative and quick! I feel like calling my boss in the middle of the night to let her know the deal for me to stay on her Med/Surg floor for a year is off! But I don't. I give report to the next nurse and tell her "God bless you my child"... I leave the floor and feel like shit. I get so frustrated with these confused patients. And that is just real. I have the ability to control my reactions and words...I don't cause any harm to these patients when I am boiling inside... But I still feel bad after wards, more for myself, because I feel like I shouldn't feel like that...
I.
I saw this first hand. There is two meaningful things in this story. The meaning of how It feels to fail a patient. The meaning of how it feels to see this patient sundown at night but in morning, flip a 180 and become a different person completely.
I got report on a patient, lets call her Betty. The report I got was not the report I should have been given. According to the nurse handing the responsibility of patient care to me, the patient had some "bouts" of confusion, but was easy to redirect and orient. She was a post operative patient that needed vitals frequently, medications, IV fluids...The list could go on. I take the report and run with it. I go and see my other patients first, compared to my others, Betty seems like a low acuity and priority.
By the time I get to Betty...Betty has taken off her blankets, her gown, leaving her girls open and lying in her armpits...She has taken off her blood pressure cuff, her pulse ox sticker (That I myself, usually can not get off peoples fingers very easily)...She has removed the cotton IV sleeve and ten layers of tape to find her IV line and pull it out. I walk in and she is calmly rubbing her hands on what ever she can grasp. And I'm like okay...Dress up, vitals, new IV start. I am most excited about the last one. Something about starting an IV makes me happy. I get her dressed because I know it is the best thing to do, but quite honestly she doesn't care if she is naked and I've seen more body parts in the last ten years that it just doesn't even phase me anymore. You'd have to have an extra boob or 2 foot long dick to shock me. I get Betty comfortable then go for my IV. She doesn't budge as I stick a needle in her forearm. She just lays there. She talks about how she is in her sister's bedroom, about how the cats will not stay off her bed, and the door bell ringing that she can not answer. I start trying to orient her to where she is and letting her know there are no cats or door bells. After about 20 minutes of that I decide I am not going to win this. They teach us to always orient the patient in school, tell them truth...But after 20 good minutes I am ready to just talk about the cats so we can go on to another topic. So we do. We talk about cats and how they are all over the hospital room looking for food and beds. Whatever. No harm done. The night goes on. Betty constantly pulls on her Foley (catheter that drains her bladder), her blankets, her attends and pulls on the sleeve I used to cover her IV. Under that sleeve is my hell of a tape job to keep her IV in place, that sucker was going to stay in... and did. She would moan and ask to use the bedpan frequently. It was like a crying baby you could not calm, she would just moan and fuss and pull on things. We'd put her on the bed pan, she would pee maybe 50ml. It was like really? Okay well Betty do you feel better? She would tell me yes and then continue fussing with everything she could get her hands on. There was no communication that you would have expected from someone in her state of mind. As the night went I felt myself getting internally frustrated with her. I controlled my tone and my actions and was never in anyway abusive. I just had had it with her. And I felt like I was neglecting my four other patients. Which madw me feel bad also. I tried to get through the night, try to reassure her, constantly put her back together and at 5 am she finally falls asleep. We tip toe past her room careful not to wake her up. I carry around the feelings with me feeling badly for myself. Why did I get so irritated. The patient didn't know any better. I kept reminding myself "this is someones grandma" and if any nurse was shitty with my grandma, I'd have their ass. It's not like a harmed her, I just was flooded with aggravation and then self defeat making myself believe that maybe I was not a good nurse.
Betty woke up at 6 or so. She stated she needed to have a bowel movement and asked if we could help her to the bedside commode. When the nursing assistant came and got me, I was like really? Ya I guess we can try I thought, but I am only trying because she is 50lbs so I know if she falls or gets unsteady I can hold her. Would you believe this patient got up to the side of the bed and on to the toilet without problem? Her vocabulary was clear and appropriate. She told us she would call when she was done. I didn't trust this at first because she had been on a bed alarm all night for being impulsive and trying to escape her bed. The nursing assistant assured me she had come around and was alert and oriented; I waited by the door since it's my license on the line for little grandma Betty. Turns out Betty was as alert and oriented as you and I are. She called. She cleaned herself up. We got her back to bed. Then I talked to her for about 10 minutes about her surgery, her doctor, her breakfast menu... She was clear as day. She was not confused at all. It was like talking to a completely different person. I was so blown away, I didn't know what to think... Or what to say...
This sundowning is someones way of punking me? It's like God gave these patients two different personalities... Then bam when the sun comes out- The patient's state of mind is back to normal. I couldn't look at Betty without thinking WTF? Betty are you in tight with Ashton...Am I being punked?
II.
Part two of another confused patient I recently had. Was a man. Let's call him Dick. Dick had been nonverbal for his stay at the hospital. He would rather sit in his dirty sheets and not eat than move or talk to anyone. Dick has dementia. None of these descriptions fit when I first started to walk in and talk to Dick. He answered my questions and was appropriate. I don't bug him and try to move him in bed although he looks all lopsided and wrinkled up in sheets. I heard he is a fighter. I offer to help him move in bed, he says no. I hang my IV and go see my other 3 patients. When I get back to check on Dick, he smells like shit. Fuck. Okay guy it's you and me and we are going to get you changed. I try to roll him and gain his cooperation...He fights. We just turned into WWF hospital style #winning. I finally get him over on one side so I can start to clean his sheets and get him off his attends (diaper)... I start to clean his hairy asshole with washcloths, of course Dick has a hairy ass and of course he ate glue because this shit is sticky-er than I have ever seen in my 10 years of patient care. There is not a lot of shit, but what is there is sticky icky icky! I've seen asses and shit but not like this. To make matters worse his pubic hair in front was so long the shit flowed back into his ass so there was all this matted hair with shit stuck in it. Ugh. I don't call for help. I just decided I am going to go for it. I let him know what I am about to do. I start whipping like a mad women. Then he thinks its appropriate to tell me "Stop fucking with my asshole" over and over again. At this point I am like really? Could you shut up and I'll clean you hairy asshole! All I needed was staff to come in and be like... "Um, JJ, what are you doing in here?" ... So I can reply, "Oh nothing I am just living the damn dream in here, care to join?"...Ugh. I quit. I'm sweating my balls off trying to get this guy clean and my back is hurting. I get most of the hairy shit and honestly I left some there, done fighting. I slapped on a new attends, covered him in sheets and went on about my way... Ya right, an hour later the same patient, Dick, tries to pull out his IV. He manages to get all the tape off and gets the lines from his IV fluid unattached. This sneaky little unhook makes two things happen. From the first line, coming from a large bag of normal saline, lots of normal saline ran freely into his bed, soaking his sheets, Yes- love when there is wet sheets. The second line from is vein has blood flowing out onto his shirt. Even better .Now it looks like I murdered him, shot dead in the middle of the gut. Fuck. Okay. I save the IV (get kinda excited about that) then tape the fucking shit out it. That IV is going to last another 30 years. I then wrap a sleeve around it. That is a fight. He keeps asking me "What are you doing?" I reply, "fixing your arm Dick!" Then time to change this mans shirt. I almost went EMT mode on him was gonna cut it off with trauma sheers....but I got Dick to participate enough to lift his head and put his arms up so I could slide the shirt off. Don't worry about the bed, I laid down towels where I could under him and that would be the end of that battle. I got him into a hospital gown wrapped him in warm blankets and said goodnight while turning off all the lights. Go mimis Dick!
It's internally frustrating fighting with adults, specially confused ones. You have to be sneaky, creative and quick! I feel like calling my boss in the middle of the night to let her know the deal for me to stay on her Med/Surg floor for a year is off! But I don't. I give report to the next nurse and tell her "God bless you my child"... I leave the floor and feel like shit. I get so frustrated with these confused patients. And that is just real. I have the ability to control my reactions and words...I don't cause any harm to these patients when I am boiling inside... But I still feel bad after wards, more for myself, because I feel like I shouldn't feel like that...
03 March 2012
Night Owl
Night shift. It is for the birds. It sucks. I am thankful to be on the same floor as a nurse as I worked on as a tech... I love the actual job itself, I love my bosses, I love the staff I work with... The nurses I worked with as a tech and work with now as a nurse, were some of the most supportive people and my biggest fans while I was in nursing school.
With that said, it doesn't make up for the shift. It's rough. It is basically 11pm to 7am. Granted it is a $4 raise a night and on the weekends a $6.75 raise... To me the money is not worth it. I did get offered a evening shift spot, which is the shift I started on... I am very thankful for this, it will be nice to go back to those hours. Evening shift hours are not too early and not too late. I can sleep in, go the the gym and then go to work...AND then be home at an acceptable hour.
Nights is hard for many reasons. You try to sleep during the day while everyone is awake. I get more missed calls/ texts during the day because I am sleeping, I get woken up by people mowing their lawns, I get woken up by the sunshine and the increased warmth of the day...
The next thing that is rough is when I have a night off...I get off at 7am on my night off, workout, then end up sleeping all day and all night just to catch up. Technically the first night off I have of my weekend I get is consumed with catching up on sleep. The days I try to do something on my first night off...ends up a mess. I probably don't sleep until 2pm then wake up around 6pm or so to get ready. My eyes are red and look like they are about to pop out of my head, I get grumpy and short tempered and by the end of my outing all I want to do is eat and go back to bed...Just like a damn kid. It's hard.
The next thing that is even worse is waking patients up at 11pm to do an assessment/ take vitals/ check on their well being. I very frequently get pretty shitty responses from patients like they are expecting to be treated like they are the damn Hilton. No you can not hang a no disturb sign on your door and come out whenever you feel like for that damn continental breakfast. This is a hospital. It is my job to check on you.
The patients that kill me are the ones that had an "elective" surgery. This means they chose to come in and get a knee replacement...or whatever...and still get pissed off when you wake them up to check on them. I'm just like the next person, I hate to be woken up, but if it was a nurse coming to give me pain medication and check on my well being... I just might be a little more nice. Nope, people are rude. One of the last nights I worked a grumpy middle aged lady asked me, "are you going to be doing these tests all night?" I let her know I would check on her, you know to make sure she was still breathing, but that after my assessment I would let her rest.
I frequently get annoyed and short with these "rude" types of patients...I do my thing and bounce asap. If they are nice I usually stick around to go out of my way for them...I know that probably isn't right, but it's the truth. Why would I want to stick around if you are obnoxious. I don't. I do my thing and jet. Lately I decided I need to not take this type of grumpy patient to heart. It's not me, it's the patient and it's the time of night. Later I thought to myself when that lady asked if I would be in all night...I should have said "Yep, every hour on the hour"...Bitch. Lol okay, maybe not the bitch part, but the rest of the statement, yes.
I love the other types of people that offer to turn on the light, ask me how my night is going and tell me, "I understand you are just doing your job". Evening shift will work out way better for me. I not only get to be around while people are awake, but I get to actually spend more time with the patients. I've learned I actually do enjoy the human interaction and I especially thrive off patient teaching and dressing changes. If the patient is agreeable and well mannered I really enjoy spending the time in the room as a nurse and doing my job. Imagine that.
With that said, it doesn't make up for the shift. It's rough. It is basically 11pm to 7am. Granted it is a $4 raise a night and on the weekends a $6.75 raise... To me the money is not worth it. I did get offered a evening shift spot, which is the shift I started on... I am very thankful for this, it will be nice to go back to those hours. Evening shift hours are not too early and not too late. I can sleep in, go the the gym and then go to work...AND then be home at an acceptable hour.
Nights is hard for many reasons. You try to sleep during the day while everyone is awake. I get more missed calls/ texts during the day because I am sleeping, I get woken up by people mowing their lawns, I get woken up by the sunshine and the increased warmth of the day...
The next thing that is rough is when I have a night off...I get off at 7am on my night off, workout, then end up sleeping all day and all night just to catch up. Technically the first night off I have of my weekend I get is consumed with catching up on sleep. The days I try to do something on my first night off...ends up a mess. I probably don't sleep until 2pm then wake up around 6pm or so to get ready. My eyes are red and look like they are about to pop out of my head, I get grumpy and short tempered and by the end of my outing all I want to do is eat and go back to bed...Just like a damn kid. It's hard.
The next thing that is even worse is waking patients up at 11pm to do an assessment/ take vitals/ check on their well being. I very frequently get pretty shitty responses from patients like they are expecting to be treated like they are the damn Hilton. No you can not hang a no disturb sign on your door and come out whenever you feel like for that damn continental breakfast. This is a hospital. It is my job to check on you.
The patients that kill me are the ones that had an "elective" surgery. This means they chose to come in and get a knee replacement...or whatever...and still get pissed off when you wake them up to check on them. I'm just like the next person, I hate to be woken up, but if it was a nurse coming to give me pain medication and check on my well being... I just might be a little more nice. Nope, people are rude. One of the last nights I worked a grumpy middle aged lady asked me, "are you going to be doing these tests all night?" I let her know I would check on her, you know to make sure she was still breathing, but that after my assessment I would let her rest.
I frequently get annoyed and short with these "rude" types of patients...I do my thing and bounce asap. If they are nice I usually stick around to go out of my way for them...I know that probably isn't right, but it's the truth. Why would I want to stick around if you are obnoxious. I don't. I do my thing and jet. Lately I decided I need to not take this type of grumpy patient to heart. It's not me, it's the patient and it's the time of night. Later I thought to myself when that lady asked if I would be in all night...I should have said "Yep, every hour on the hour"...Bitch. Lol okay, maybe not the bitch part, but the rest of the statement, yes.
I love the other types of people that offer to turn on the light, ask me how my night is going and tell me, "I understand you are just doing your job". Evening shift will work out way better for me. I not only get to be around while people are awake, but I get to actually spend more time with the patients. I've learned I actually do enjoy the human interaction and I especially thrive off patient teaching and dressing changes. If the patient is agreeable and well mannered I really enjoy spending the time in the room as a nurse and doing my job. Imagine that.
Not Just A Nurse...
Nursing care comes in many forms. Sometimes it is the ability to make someone feel physically comfortable by various means. Other times it is the ability to improve the body's ability to achieve or maintain health. But often it is an uncanny yet well honed knack to see beyond the obvious and address, in some way, the deeper needs of the human soul.
~Donna Wilk Cardillo, A Daybook for Beginning Nurses
This quote reminds me of the many roles I've thought I've taken on as a nurse. We are/I am not only a RN... But sometimes I feel like the minute I step into the room I start to fulfill the following roles:
Nurse
Doctor ( I answer the questions you didn't ask/ or your doctor never addressed)
Medical dictionary ( I am expected to know the answer to any health question you have)
Teacher ( I teach you how to take care of yourself and how to prevent coming back here)
Crystal ball ( You expect me to know your outcome, though I am usually only 50-75% sure)
Media technician ( You expect me to fix your TV and mechanical bed)
Mom ( I have to remind you to eat vegetables and drink water)
Dietitian ( Because you don't take care of your diabetes)
Therapist ( I sometimes feel like you talk too much about your personal life and I'm to answer)
Baby sitter ( You let your kids aimlessly roam the hospital)
Marriage counselor ( You announce to me you are no longer intimate with you wife?)
Mediator ( Nothing like a patient and the spouse together in the same room- not getting along)
Referee
Chaplin ( I pray with you when you ask me to)
Security ( My license is on the line if you get hurt on my watch)
Physical therapist
Slave ( You take advantage of me at times and ask me to do things you are very capable of doing)
Belongings keeper ( If you lose something you request I find it or else it's my fault it's lost)
Punching bag ( You treat me badly sometimes...I think because you are scared or in pain or perhaps just an asshole)
Discharge planner ( I assist in coordinating your life at home after your hospital visit)
Friend...
I'm sure the list could go on.
I think the biggest shock is when these roles hit you and you weren't prepared for them, especially since you didn't learn this during school... They don't warn you about all of these roles. You step into them and are expected to know the role and all of the answers. You fly by the seat of your pants. I know now that I can do all of these roles because even though I may not have all of the answers, I know now where to find them...
~Donna Wilk Cardillo, A Daybook for Beginning Nurses
This quote reminds me of the many roles I've thought I've taken on as a nurse. We are/I am not only a RN... But sometimes I feel like the minute I step into the room I start to fulfill the following roles:
Nurse
Doctor ( I answer the questions you didn't ask/ or your doctor never addressed)
Medical dictionary ( I am expected to know the answer to any health question you have)
Teacher ( I teach you how to take care of yourself and how to prevent coming back here)
Crystal ball ( You expect me to know your outcome, though I am usually only 50-75% sure)
Media technician ( You expect me to fix your TV and mechanical bed)
Mom ( I have to remind you to eat vegetables and drink water)
Dietitian ( Because you don't take care of your diabetes)
Therapist ( I sometimes feel like you talk too much about your personal life and I'm to answer)
Baby sitter ( You let your kids aimlessly roam the hospital)
Marriage counselor ( You announce to me you are no longer intimate with you wife?)
Mediator ( Nothing like a patient and the spouse together in the same room- not getting along)
Referee
Chaplin ( I pray with you when you ask me to)
Security ( My license is on the line if you get hurt on my watch)
Physical therapist
Slave ( You take advantage of me at times and ask me to do things you are very capable of doing)
Belongings keeper ( If you lose something you request I find it or else it's my fault it's lost)
Punching bag ( You treat me badly sometimes...I think because you are scared or in pain or perhaps just an asshole)
Discharge planner ( I assist in coordinating your life at home after your hospital visit)
Friend...
I'm sure the list could go on.
I think the biggest shock is when these roles hit you and you weren't prepared for them, especially since you didn't learn this during school... They don't warn you about all of these roles. You step into them and are expected to know the role and all of the answers. You fly by the seat of your pants. I know now that I can do all of these roles because even though I may not have all of the answers, I know now where to find them...
02 March 2012
Scary Monster
Yep- It's a code name for a nurse. A big scary, mean looking, mean acting nurse... Who will make you think her shit doesn't stink, but your shit does and she can smell that shit from a mile away, she'll let you know of this. Big scary monster is big into unions, she speaks up about everything regardless of the topic and regardless if she is right and she is overly opinionated. She has to be heard and seen always... Oh boy is she seen. Her pannus (stomach fat) is so big I am not sure when the last time she saw her juice box, but that is a whole other story! How dare you get me off track and on such an inappropriate track! Hahaha... Not really.
The truth is her attitude is about as nice as her hair, skin, and clothes...It's just all one big ball of OMG! I use to feel bed for her, until the time I became a nurse and had to give end of shift report to her. Wow, I thought my night had gone fine. I sit down, convinced myself "I got this" in a "white girl gangsta kinda way" (Yes I do this) I hardly had a sentence out of my mouth when she growls back...."What did you do that for? Why did you do this? Why didn't you do this? Didn't they teach you to do things this way? Did you call the Dr.? Did you tell this to the patient? Did you try to SAVE THE WHOLE FREAKING WORLD IN 8 FUCKING HOURS?
Nope. In fact scary monster... I started my shift cleaning up left over shit from the shift before me... Calming my patients down, settling them in, did my head to toe assessment I am required to do/ (that I do thoroughly), took vitals, assess labs, looked at doctors orders, assisted the CNA (peeps have to eat and poo!!) ...Of course there are many other nursing tasks that consume my eight hours. I had to give medication/ pain medication mostly, monitor people as they take these new pain medications, make sure my charting was up to date and speed and entered correctly in case someone should take me to court. Then after my patients were all comfortable and settled... You, scary monster, came to my desk to get report and have the audacity to ask me what I did and what I didn't do. Well luckily for my upbringing, I have the balls to tell you I didn't even have a chance to piss and are you f'ing kidding me right now!?!?!... But everything is done for you to start your day-And you're welcome bitch.... At least I think we are ready to give report until her questions begin....Making me feel like an inch tall. Then after my slaughter she laughs and tells me about her over the top wine consumption with her husband after he got off from his job at the local convenient store. Winner she has got there. Ugh I swear she hates her hair (she does, it is long and ratty, but she won't go see my hair stylist, I tried), she hates her job, her life, I'm sure she'd swat at a beautiful butterfly if it flew gracefully on by her. Or maybe I was the butterfly...but I am squished. Not winning.
I took this whole baby mama drama into my boss's office... Come to find out my boss has the same views as me about such scary monster...Which made me feel like I just scored the game winning touch down. I knew better, I knew it was not me, I was never brought up or conditioned to be the person she was making me try to feel like... And at the end of the day I won knowing it's her not me, everyone else views her that way and she is one of those people who will be miserable about everything. So I'll collect my butterfly wings...And move on <3
I don't know how much of this venting actually portrays this nurse. The moral of the story is she forgot what it feel like to be new, maybe to be young, ambitious, to want to do a good job....But missed somewhere along the way that you get along further in life with honey... If anything was missed during my shift, all she had to do is let me know in a not such a "make me feel like I am an inch tall way" instead she could have treated me as a new / eager to learn RN and just explained it to me. OR do like I do... Let the shift before me (who didn't get to a task) know that I will take care of it when I can. Nursing is a 24 hour job. Seriously. I am not supper-women, no matter how much I try and hustle, it doesn't work... But bitch I am gangsta and she should watch out in the parking lot. Hahahahaha.
The truth is her attitude is about as nice as her hair, skin, and clothes...It's just all one big ball of OMG! I use to feel bed for her, until the time I became a nurse and had to give end of shift report to her. Wow, I thought my night had gone fine. I sit down, convinced myself "I got this" in a "white girl gangsta kinda way" (Yes I do this) I hardly had a sentence out of my mouth when she growls back...."What did you do that for? Why did you do this? Why didn't you do this? Didn't they teach you to do things this way? Did you call the Dr.? Did you tell this to the patient? Did you try to SAVE THE WHOLE FREAKING WORLD IN 8 FUCKING HOURS?
Nope. In fact scary monster... I started my shift cleaning up left over shit from the shift before me... Calming my patients down, settling them in, did my head to toe assessment I am required to do/ (that I do thoroughly), took vitals, assess labs, looked at doctors orders, assisted the CNA (peeps have to eat and poo!!) ...Of course there are many other nursing tasks that consume my eight hours. I had to give medication/ pain medication mostly, monitor people as they take these new pain medications, make sure my charting was up to date and speed and entered correctly in case someone should take me to court. Then after my patients were all comfortable and settled... You, scary monster, came to my desk to get report and have the audacity to ask me what I did and what I didn't do. Well luckily for my upbringing, I have the balls to tell you I didn't even have a chance to piss and are you f'ing kidding me right now!?!?!... But everything is done for you to start your day-And you're welcome bitch.... At least I think we are ready to give report until her questions begin....Making me feel like an inch tall. Then after my slaughter she laughs and tells me about her over the top wine consumption with her husband after he got off from his job at the local convenient store. Winner she has got there. Ugh I swear she hates her hair (she does, it is long and ratty, but she won't go see my hair stylist, I tried), she hates her job, her life, I'm sure she'd swat at a beautiful butterfly if it flew gracefully on by her. Or maybe I was the butterfly...but I am squished. Not winning.
I took this whole baby mama drama into my boss's office... Come to find out my boss has the same views as me about such scary monster...Which made me feel like I just scored the game winning touch down. I knew better, I knew it was not me, I was never brought up or conditioned to be the person she was making me try to feel like... And at the end of the day I won knowing it's her not me, everyone else views her that way and she is one of those people who will be miserable about everything. So I'll collect my butterfly wings...And move on <3
I don't know how much of this venting actually portrays this nurse. The moral of the story is she forgot what it feel like to be new, maybe to be young, ambitious, to want to do a good job....But missed somewhere along the way that you get along further in life with honey... If anything was missed during my shift, all she had to do is let me know in a not such a "make me feel like I am an inch tall way" instead she could have treated me as a new / eager to learn RN and just explained it to me. OR do like I do... Let the shift before me (who didn't get to a task) know that I will take care of it when I can. Nursing is a 24 hour job. Seriously. I am not supper-women, no matter how much I try and hustle, it doesn't work... But bitch I am gangsta and she should watch out in the parking lot. Hahahahaha.
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