Bad night, bad shift

 
Ugh I hate being the small fish in the big pond.  Yes I know as a nurse you have to start at the bottom and crawl your way back up the ladder.  Oh what fun.  So this fill in shift shit sucks.  I work days, then nights, then mid shift…grrr….then i am on one rotation then another.  I might work  2 weekends in a row then off one.  Then the crazy work a day off a day work 2 days off a day.  By the time I get my chores done and all my errand run I feel like I got no day off.
Worse is the difference in the two rotations.  One has all the help and works great at helping each other out.  The other is short and has a couple of lazy people who won’t get off their ass to help no one.  Even to the point of us helping them to catch up when they’re behind.  Well not a problem, but instead of sitting on your ass while I am doing your job to help you could you please help me when my patients need something ?  That’s only courtesy.
Worse thing was the day on the lazy short shift we had 5 critical patients come in.  Who got one? Me the new grad, the one that still figuring out what we do first.  I had new meds, new drips I didn’t know how to do.  Couldn’t find anyone that could help.  Got fussed on by the doctor because I wasn’t doing it in her order even though I was told by another nurse what I was suppose to do first.  Then didn’t deliver meds fast enough.  I don’t give a ferret’s anus what that Dr.. wanted but I wasn’t about to hang Cardizem without some instruction.  I love the lazy one that was overwhelm too that said I am too busy I have my own critical patients. Thanks…  I was so terrified to give that digoxin since the BP was  88/60.  I sure as hell couldn’t talk to the doctor, not that i didn’t try. She could give a rats ass if I was a new grad.  This is why when your technically on orientation one should not be left alone with no help or ask questions to.  Its not the staffs fault its the one that schedules it.

New Grad news

Work has been aggravating and educational.  I was doing so well sticking people (IV’s) and the last 3 days I suck…just could not get a line in anyone.  I would try twice and have to get someone else to get the stupid IV in..grr.  I felt pretty stupid and bad for having to bother someone else to do my job.  So I mentioned that to one of my coworkers.  I don’t know if I just messing up the technique or just getting bum veins.  So the next thing I know every time someone needed to be stuck I got volunteered.  Which was great because then I was doing better.  YEA!  Next cool thing I got out of work late.  Why is that great?  I got to do my first NG tube.  For those not familiar with what that is its a tube that goes down your nose.  I did great.  The nurse that was training me on it said I did a fantastic job.  I was so proud of myself.  I love my job everyone really likes helping out the new grads.  Unlike some places where they eat the young for dinner.  I really got lucky.. 

Shot of Reality: Drugs, Dogs and Docs

I just love it when your a new nurse and a doctor gets to fuss at you cause you can’t do stuff fast enough.  Some of the nurses I work with baby the doctors by putting in their orders and setting up their sterile field.  That’s great if your fast at your job and have all the time in the world. I got fussed at by doctor cause I didn’t get blood fast enough from a pt.  She already came in with a line.  I was trying to get her nitro in her because she was having major chest pains.  I tried to stick her twice and I don’t stick more than twice.  I couldn’t get someone to help me stick her at that moment, so I worked on her meds and some other items. I can’t help it that I couldn’t get a line in her.  Plus saying well just try to stick a line in her.   Hello what the hell does” I have stuck her twice” don’t you understand? Duh
Hot dag! Finally a doctor stood up to a drug user.  The doctor ordered a dose of Toradol, not a narcotic for those nonmed people.  The patient threw a fit and said I can’t take that it gives me a headache all I can take is dilaudid (narcotic).  So I told the doctor.  Instead of getting her toradol she ended up with a 800mg Motrin…you should have seen her face it was priceless.  Then she started saying that the doctor never looked at her leg and her back hurt and she felt like she was going to throw up.  She said the doctor was a quack and she wanted another one.  So I told the doctor and she went in and said what is wrong with her leg.  And she points to this knot in her leg and a big purple and yellow and green bruise.  You never looked at my leg and I am in so much pain.  Ma’am your records show you were here 3 days ago for you leg.  That is an old bruise and you can plainly see that by the color that it is. Well your a quack she told the doctor.  The doc just told her that they will no longer be treating her long term pain problem.  That she must go see her general practitioner.  Well the doctor left and I was discharging her and she said she wanted to see some other dr.  So since I didn’t know what to do I talked to another nurse.  She told me to tell her she would have to check in again and there was a good chance she would end up with the same dr.  She told me she refuse to leave…I had to get security to escort her out…sheesh
Next I had a inmate that was being treated for a dog bite…apparently he wouldn’t listen to the guard was sprayed with pepper spray still wouldn’t stop and they had to sick the dog on him…what is with people…
One of the first things you learn as a nurse is never assume your patients know what they are doing or understand instructions.  Like make sure you tell a patient to take the pills by mouth or by ass…depending on what it is.  What I didn’t know was I had to tell them how to put on a hospital gown.  Ask the patient to slip into a gown.  I come in and she is fully clothed with the gown over the clothes…umm duh.

duh huh

After a long shift in the ER all I wanted to do was go home.  Of course this was the time that the sky decided to unzip and let the torrential down pour to start.  I was standing there hoping that it would slow down just a tad.  Another employee was outside waiting out the rain to get to her car.  She said “ I can’t wait forever I have an hour drive home guess I’ll have to run for it.  Then at that moment the lights went out leaving us in pitch black and the sound of tons of rain beating down on the overhang.  Freaking great now I can’t even see my car to know which way to run.  I wasn’t sure if I was parked on the right or left.  I did know that I wasn’t able to find a parking spot close and had to park in the back lot.  Well I was like her I got to get home I have an early shift in the am and I worked a late one this evening.  So we decided to made a run for it…while running I must have hit every puddle.  My nursing shoes were soaked and squishy.  I was darting hoping to miss the hidden deep puddles.  No luck.  I had to stop and try to make out my car in the pitch black night.  Finally spotting mine the furthest away i made a bee line to it.   By the time I got to my car I wouldn’t need to take a shower because there wasn’t a dry stitch of clothing on me. I looked like a drowned rat.  I was trying to get my cell phone out to assess the damage.  It was wet of course but still working.  My glasses were fogged up and wet.  I didn’t have a single napkin in the car.  I headed home and the ground was so heavy with rain that the road had about 4 or more inches of rain on it.  My car belts squeaked as they got wet.  So no glasses, wet to the bone, flooding on the road I had to drive 5 miles and hour.  This of course pissed of the driver behind me.  Which decided to ride my ass so close I couldn’t see his headlights anymore.  I really wanted to slam my breaks on.  I hate jerks like that.  So  I decided to swing by Mcdee and get me a late supper and sweet tea and hope the rain would let up. By the time I got through the long drive through line the rain had died down. 
The fries were nice and hot and I expected my tea to be cold.  Nope it was hot and gross..which then proceeded me to choke on my so called “ ice” tea.  Since you have no control of choking I spewed tea all over my steering wheel all over my arms and my already drenched uniform.  I couldn’t stop coughing.  Here I am driving down the interstate trying not to wreck.  Hmm sorry officer I didn’t mean to wreck but McDee tea was choking me and it caused me to wreck.  Hmm I can see the lawsuit case already…so if your drinking your “ice” tea and it has a warning “ice” tea might be warm and not cold be careful may cause choking.  Then I won my case…lol

how not to kill yourself/ your not dying

 

1. Do not eat an entire pill container in front of your wife. She will call 911 and you will be in the ER.
2. Do not call your wife on the cell from exit 66 and say you are going to kill yourself.  The police will pick you up and take you to the ER.
3. Do not pretend to have a heart attack to avoid getting caught by your wife while you are with your girlfriend. You will be in the ER and will be diagnosed with Anxiety related to stupidity
4. Do not slice up and down your arm for the hell of it because it relieves the pain. 
5. Taking and overdose of some over the counter drugs doesn’t do much but upset your stomach.
6. Clutching the wrong side of your chest and saying your having a heart attack.
7. Diagnosing yourself and trying to tell the nurse well I know its my kidneys cause they hurt.  I drank a whole gallon of cranberry juice.  When all the pain is directly at your stomach.
8. If there is no broken skin you most likely don’t have a splinter in your ass.
9. Coming into the ER because your dying and have never been in this kind of pain all you really need is an enema and a really big fart.
10. Ambulance rides don’t necessarily mean your dying.  They are required to take you if you call.  Regardless if its for nausea and vomiting or a true emergency.  So do us a favor and save a life…don’t call the EMS unless its a true emergency.  Don’t fill our ER with your trivial runny noses and bull shit thanks.

Shot of Reality: Drug, hugs and rugs

 

Legal drug users,
Learning how to legally get drugs really irks me.  I now see why ER nurses get burnt out fast.  I know that they want to keep the masses happy and their return scores high, but if a someone comes in monthly, weekly or heck daily, doctors its time to cut them off.  It’s amazing just how many people come in for pain.  My  back hurts, my teeth  hurt, my ass hurts.  Demerol, dilaud, and other legal drugs given.  So instead of hooking these people up with drugs I think it’s time for other pain management.  Another thing that irks me is that my tax money pays for all this. $400 a pop for their drug habit?  WTH? What’s even harder is that there are true people in pain that can’t get the help that is needed because nurses assume that they are seekers when they are not. So nurses are rude and sometimes cruel.  I was laughed at because I went to a doctor to tell the that a patient was in pain.  Oh that just so and so she comes in often.  She seemed to be truly in pain.  Was she a good actor or truly a patient? So I really try my hardest not to judge…but when we can look back at your history of visits just a click away it really makes it hard not to be…
Really trying not to judge or get burnt out this early in the game

Accident prone one,
Ah my oldest one that is cursed to be accident prone.  How can you trip over your own feet and make your big toe purple?  I truly worry about your ability to walk…
nursing my child back to health again

Brown dog,
You are not a cat! Please refrain from coughing and gagging in the middle of the night.  Better yet please don’t leave me slimy piles of puke on my rug in the morning either.
Cleaning puke is not my forte

Little Black Horny Dog,
I know you are in heat and yes I really need to get you fixed.  Stop trying to hump all the dogs in the house.  All this has led to is getting peed on by boxer dog and big black dog.  Did you not learn from the 2 baths in 2 days? And brown dog snapping at you and missing and hitting little white dog.  Which now has a nice scratch on nose.  Also little white dog continues to snap at you as you try to walk and mount her…hello she says I am a girl you dumb ass.
Nurse that needs to fix that

What were you thinking?

Sometimes people drive me insane.  What the hell are people thinking when they walk out the door.  hmmm what is the dumbest thing I can possible wear out in public?  I use to work for a big retail chain and you would see some of the weirdest people and their outfits.  I know you have seen them….the pj wearers.  Is society getting soo lazy that we are now going to shop in our pj’s ? Even coming in as a family in pj’s.  Then you have the 400lb plus people (no offence to large people since I am no skinny mini) but please stop trying to wear your daughters clothes.  You do not look good in  your boyfriend thinks I’m sexy shirts So working in the ER is another place to wear your pj’s but this girl that came in had her bed room slippers the pink fluffy ones.  Then to match she had on her pinky fluffy ratty bath robe on….good grief.  But besides clothes there’s the awful smell of B.o.  Had a patient state he got dizzy and almost fell in the shower this morning.  So he came here to have things check out.  Thing was he had matted hair that matted all the way down to his long Santa's beard.  The smell was so bad that when he left you could still smell him in the room.  So what did he bathe in a pig pen?  sheesh…

Blech

Okay so I have spent the last few days of work in orientation listening to speakers all day long.  I so want to get back to the ER.  I would rather be busting my butt than listening to this drivel.  Unfortunately the last time I worked in the ER a coworker decided to share the fun of her crud.  So doped up on antibiotics, musinex, Zyrtec and at night large doses of Night Quil.  What fun right?  I was hoping to get over this before work tomorrow but it doesn’t look promising.  So I am lounging on the couch watching movies and doing laundry.  Trying to reserve all my energy for work tomorrow.  While playing on my blog I notice that my moon crazy warning is telling me that its 90 % a full moon.  Which means the weekend I work i will be up to my eyes in weirdos in the ER…so hope to have some interesting tales then.  Off to watch Percy and by the way stay away from the movie Bitten its the worse vampire movie ever made..sheesh.

When life backs you against a wall

So I finally finished nursing school and have a great job that I love and life is great.  But as soon as life becomes easy or comfortable you get slammed up against a wall.
My dad is a very intelligent man and has been my go to guy when I need advice on life.  We never really saw eye to eye when I was a teenager cause back then I knew everything.  Now that I am older and realize that my dad wasn’t so crazy and actually knew a thing or two life throws a curve ball.  First this economy sucks and my dad lost his computer programmer job.  The company said they could hire 2 new grads for the price of him.  They would be more experienced in the new technology and be cheaper to have.  Problem is alot of the newbies don’t want to really work.  My dad always came into work early and left late and work on salary.  It took my dad 8 months of searching for a job to finally get one.  He was never picky applying for every job including Wal-Mart.  Where is he working?  A gas station in his local town.  What pisses me off is that has to make him feel degraded to have all that education but is now a gas station attendant.  Also having your neighbors ask you why are you working here daily probably doesn’t help.  No one will hire him because he is over qualified.  What the hell? over qualified? I would think getting a guy for half price would be like a great deal?

Next we thought my dad had a stroke with having right sided weakness.  He did some therapy and everything was working out.  Till he had a relapse and really lost alot of mobility.  His cognitive function has decreased also.  My father never said “I don’t know,” till now.  My brother said he stopped at a blinking red light waiting for it to change.  Alot of weird things that wouldn’t add up. He didn’t want to go to a doctor. He said he didn’t want to be poked and prodded.  I tried to respect his wishes. I live so many states away i was getting all this second hand from my mom and my brother. I kept telling myself it can’t be that bad.  I really didn’t have a clue just how bad it was till they came in for my graduation.  He wasn’t my dad.  He can’t walk up and down stairs, or keep up with anyone while walking in Wal-Mart, not to mention some of our conversations seemed like pieces of a puzzle were missing.  I finally broke down in tears begging him to please get check out.  Maybe it was another stroke or just a pinched nerve.  He could no longer ride his motorcycle, play the organ at church, drive the car, find a job, or other things he loves to do.  He was depressed…hell who wouldn’t be.  If you had everything you loved to do taken away wouldn’t you?  I finally got through to him.  “what if this was reversible and you could have a normal life?  Don’t you want to ride your bike again?  So he did his tests….and its not reversible its progressive. He has MS.  So here I am 600 hundred miles away and unable to help my family.  If I lived close I could help do the things he can’t.  Of all the people in the world why dad?  Not that I wish it on anyone but my mom could handle this better than him.  I want to go home and help. Just spend time with him before he can’t do the stuff he use to be able to.  I started a new job and can’t get up and leave right now.  Mom is devastated and my brother well lets just say he has his own issues right now.  I just want to cry.  If I could just be closer…to spend time with him before i can’t…i would go to the doctors with him.  They don’t ask the questions i would since I am a nurse.  What is the prognosis?  How long are we looking at?  Is the damage reversible?  I know my dad he would rather just live the fullest without meds and die before it gets too bad.  I want to respect his decision, but i want my dad alive too.  Is this selfish of me?  I worked in LTC and saw how the families would try to make their parents drag out their life.  Is this his depression or really a decision?  I feel like i have my hands tied.  I don’t want to lose the job i love, the money I need to sustain my family but I don’t want to lose my dad either…life can be soo unfair!

Learning

 
The last few days that I have worked I have learn alot of new things.  How to discharge patients by myself, how to admit and transfer patients and having 3 rooms by myself.  Even though I have 3 rooms myself my head nurse bales me out when I get behind.  Which seems to be alot sometimes because I keep getting new things I have never done.  Everyone seems happy to teach me anything I ask questions about.  Any where from how to to a nitro drip, a heparin drip, or simple things like where the heck do i chart this.?  I know it in  time I will get use to everything.  The nurses even giggle and tease me cause I still have the out of school positive attitude about the frequent flyers or TROLL. I learned  TROLL means To Return Often Loves Lortabs (painkiller). I even transfer a patient to CCU all by myself. I learned just how grouchy some people are…sheesh. One thing I really didn’t want to learn was life can be taken from you in a flash.  This was the first day I seen a Baby less than 3 months old die.  A code blue was called and nurses from all units were trying their hardest to get this baby to breath again.  I know I should have stayed for a learning reasons. I just like it was wrong to be in there.  I felt like I was more in the way.  I knew they would be asking me to help get items or to do something.  I knew I would have to tell them I don't know.  I am just in training.  So I decided to back off and  let the experience ones do all the work.  While they were working hard with the baby It kept all the other patients labs and med orders under control.  I was shocked by the callousness of the other patients.  Some standing and gawking and others yakking on their telephones.  Not to mention the all the complaints of "what is taking so long?" "Don’t you realize I am important?"  Even though I would like to shout at them " You have been here numerous times and have yet had anything serious enough for the ER.
The code was finally over and everyone parted ways. You could see the tears in the eyes of the family, the doctors and all the nurses.  It makes me realize just how hard this job can be. The next  day when talking to the nurses I found that most kissed their loved ones, their kids, and checked on their babies 12 times that night.  This job can be heart wrenching.