events :: scribbles :: musings

The few of you that read this regularly (Hi!) may have noticed that updates are coming less frequently in recent weeks.

I think I’m at the stage now where I’m weaning myself off of this blog. Life has, for the most part, settled into a nice “routine” of work/school juggling, and I haven’t been very inspired to write much, here. The focus of this blog seems to have shifted gradually toward mostly nursing-related items, and there are far more eloquent blogs out there that address this niche quite well.

So, I think for now, I’ll be taking a break from this blog. Although I’ll leave it up for anyone who might be Googling nursing school and nursing experiences from a newbie.

Take care, folks. And thanks for your readership! =)

I can hardly believe I heard this with my own ears:

Patient’s son: “So, what do you girls do? Is it really like on TV?”

Me:  “How do you mean, like on TV?”

Patient’s son: “You know, relationships with the doctors, making out in the closets….”

Me: [dumbfounded. blinks eyes. grits teeth.] “TV is not real life.”

WHAT THE —-?!

For the most part, I enjoy my work as a critical care nurse. But lately I’ve had a string of days where I have been just crazy-busy and stressed out. I’d get home and think, “WHY am I killing myself, busting my behind, just to come home exhausted so I can do it all again the next day?”And then I get those days when I remember why I became a nurse.

Today was one of those days.

I left work tonight thinking, “Oh YEAH. THIS is why I do what I do.” It was kind of like a lovely glow that washed over me as I drove home.

I was incredibly busy today: hourly blood glucose checks and subsequent titrations of an insulin drip, assist with insertion of a central line at the bedside, blood cultures, fungal cultures, sputum cultures, urinalysis, urine culture and sensitivity, IV piggyback antibiotics, titrating a sedative drip, and more.

But I spent a lot of time this afternoon explaining why we were giving certain medications, what all the lines and tubings were, how to read the bedside monitors, what the family could expect in the next few days, etc. I think they were surprised at how much I actually knew and how much autonomy I’m allowed in my critical care nursing role - that I’m not just a pill-pusher who follows orders blindly. Over the day, the family shared stories about the patient, and I got to know him as more than just a name and diagnosis.

We developed a beautiful rapport, even though I was there for only twelve hours.

I got a hug from the family when I ended my shift. Along with, “Will you be back tomorrow? I like you. Everyone here has been so great, but you’re my favorite nurse.”

Knowing that my presence, my knowledge, and my actions had some sort of a positive impact during a very vulnerable and frightening time in someone’s life, that I was able to help guide someone and provide some comfort ….

It doesn’t get much better than that.

JERSEY BOYS redux - awesome.

I loved every moment of it. Loved the songs, loved the staging, loved the choreography, loved all the cast. Zachary Prince was on as “Frankie Valli” in place of Christopher Kale Jones; he did a wonderful job. His renditions of “Moody’s Mood for Love”, “Can’t Take My Eyes Off Of You”, and “Fallen Angel” were absolutely gorgeous!

At the end of the evening, the cast announced that they were collecting donations for Broadway Cares/Equity Fights AIDS (BC/EFA). As part of the fund raising, Erich Bergen (”Bob Gaudio”) would be giving backstage tours for $75 per couple. AWESOME as that was, we had to get dinner and get home - otherwise I would have jumped on that opportunity. There were some very entertaining comments made about the theater’s odd layout and design….

In other JERSEY BOYS news:

Due to a breakdown in negotiations between Broadway stagehands and theater producers, many Broadway performances have been canceled through November 25 (see here for more information about the strike). John Lloyd Young’s final performance as “Frankie Valli” in the original Broadway cast was scheduled for November 21 - the cancellation of shows means that he will not be given a proper send-off as scheduled. He stated on his blog that he’s made peace with the idea that he may have already given his final performance, but I feel sad that he won’t get a formal and proper “goodbye”.

Which is kinda weird that I feel this way, since I’ve never even been fortunate enough to have met him or even to have seen him perform live. Maybe one day….

Going to see JERSEY BOYS again, the national tour, tonight in Costa Mesa!

SO. EXCITED.

Poor Dan, bless his heart, he still puts up with my JB love. I still can’t believe he agreed to see it again - and to drive an hour away for it. I am a lucky woman.

Gah. Today was SO MUCH better than yesterday. I only had one patient all day. Even though I was open for a potential admission or transfer, I lucked out and had just the one patient. None of the crazy.

Tomorrow’s off from work - so I’ll be working on school stuff.

Friday’s an extra work shift this week - maybe I’ll get lucky again and get called off….

What a difference a week makes.

CRAZY. DAY. at work.

I had a meltdown. Got WAY behind on everything, super busy with high-maintenance and needy patients. A couple of drips, some hourly checks and tasks. Lots of samples and specimens to the lab. Fielding phone calls. Making phone calls. Trying to coordinate between healthcare disciplines. Hunting down charts, only to find that orders written two hours ago were never entered.

A dying man. Another man who wanted to die. Two very unhappy wives.

My co-workers spent the afternoon helping me out and keeping me caught up.

And I cried. For the first time in a while, I cried, just out of sheer frustration.

I have to go back and do it all again tomorrow.

(Sigh.)

It’s always fun to hear this from a patient:

• “[Last night's nurse] said the most wonderful things about you!”
• “[My doctor] spoke so highly of you just now when you left the room.”

Also this, from the doctor:

• “I’m really glad that you’re her nurse. Thank you for taking such good care of her.”

* warm fuzzies *

With all the frustrations and exhaustion that comes with my work, sometimes it’s incredibly rewarding to have that kind of affirmation in what I do.

Something random: I literally CHEERED when my patient pooped! Seriously, she had been constipated for four days (an unfortunate side effect of opioid analgesics) and had so much pain from not passing stool, that when she finally went, we both cheered. She said, “I want to get up and dance like a ballerina, I’m so happy.”

Truly.

(Shout-out to C., who I know will understand the poop-and-cheer.)

Man. The things you learn to appreciate in nursing.

Had class today from 8:00 am - 6:00 pm. An overview of the rest of the semester:

Senior project: In preparation for Summer 2008. Begin thinking about an area for change, and begin a literature review. Our final change project paper is expected to have a minimum of 35 primary sources.

Nursing Research I: Come up with a research question.  Some preliminary ideas:

1. Pain assessment in nonresponsive, intubated, and sedated critically ill patients?
2. Does placing the body in a hypothermic condition after resuscitation from cardiac arrest improve survival outcomes?
3. In cases where a patient’s prognosis is very poor, does an early family conference decrease patient’s length of time on the ventilator and increase patient/family satisfaction with care?

Assignments:

1. Annotated bibliography with 10 primary sources
2. Critique of a research article related to the research question

Management Practice Issues: Work in groups to write a business plan for a hypothetical immunization clinic.

Nursing Theory: Identify a clinical issue or problem at the graduate nursing level and apply a theoretical framework to the clinical issue.  (Whaaaa?) Six to ten page scholarly paper.

Human Diversity:  Write a paper about a cultural encounter in the clinical setting, discussing what insight you gained from the experience.

Lots of papers to write. Everything is due late November / early December. And discussion board posts along for the ride.

Sometimes I think I miss just taking exams.

On the bright side, it was kind of nice to see everyone again at school.

Just finished three 12-hr days in a row.

So. Very. Tired.

Three pacemakers (!). Three dialysis patients. One sepsis. Three transfers, two discharges, and an admission.

And candy. Lots and lots of candy. And a birthday cake (not mine).

You know what kept me going during the commutes? The JERSEY BOYS OBC album.

Going to bed now. Tomorrow’s a prep day for school this weekend.