Friday, December 22, 2006
Travel nursing basics
Sunday, December 10, 2006
Nurse Extern
Sunday, November 19, 2006
I guess we are human
Wednesday, November 15, 2006
ACLS
She went over date rape drugs and what effects the different drugs have on people. She sited a great website that gives information about drugs....www.erowid.org. It's a great thing to think about when your patients aren't responding to treatment the way they should...knowing these drugs and how they make people react can be a great tool.
She also talked about working at the poison control center...which I never thought about as a nurse but what a cool job. She had some great stories especially about Thanksgiving. I love nurse stories, so I'll share some I heard today. A lady made mashed potatoes with evaporated milk that was brown. She tried the mashed potatoes because they were white after they were whipped and she said they tasted fine. She called the poison control center to see if they thought she could serve the potatoes....of course the answer was no because evaporated milk is supposed to be white and just because she tried them and they tasted fine doesn't mean she should serve them...she was not happy, because she had to go to the store and start over with boxed mashed potatoes. Another caller said she had a fire in the oven where her Thanksgiving casseroles were, they had put the fire out with the home fire extinguisher. The casseroles were covered with foil. She wanted to know if she could serve them.....Uh...no. That fire extinguisher stuff is airborne it gets everywhere. She claimed it was probably water because she didn't see any foam...water doesn't put out grease fires in an oven so, no it wasn't water and no you can't serve the food. The sad thing is she still had the turkey, stuffing, vegetables, mashed potatoes and desserts and didn't think that was enough food. Incredible!!! So, if you are looking for some good stories, you might want to consider working at the poison control center in your town. Plus you get to help people, without worrying about hurting your back...lol. Remember first do no harm.
Monday, November 06, 2006
Just Work
I had a great idea for a blog the other day and now I can't remember what it was. I hate when that happens. Does that mean I'm getting old? I think it means I just have too much information in my brain. Too many drug names and generic names and dosages and calculations, phone numbers ,doctors names, recruiters...just overload ya know. Plus I have been working 4 and 5 twelve hour shifts a week, that will definitely overload ya. I have heard of nurse working 6 and 7 twelves a week but honestly, how long can you keep that pace up without hurting yourself or someone else?
Work has been good, lots of overtime available. I got Christmas off and Thanksgiving too...I am working New Years Eve and New Years Day...but, it's day shift so it's not so bad, and hopefully it will be slow. I feel for some of the travelers that are coming in now and the ones that came after I did, they are all working Christmas. That's one down fall of nursing, someone has to work on the holidays, all the holidays, the place doesn't close ever. It's an amazing concept really, 24 hours a day 7 days a week, 365 days a year, hospitals never close. When I was in Rhode Island the nurses all belonged to the union and they had mandatory overtime..and it was used all the time. I would hate that. I like my overtime when I want to do it.
Well , remember first do no harm.
Thursday, October 19, 2006
Learning
I also signed up to renew my ACLS and BLS. Here's my advice on that subject...get American Heart and stay with it. Don't go for the online things unless you test online and do the skills check in person. Lots of places and people will tell you that they are all created equal...which maybe true, but, you cannot argue that fact with a hospital that won't give you a job because your ACLS came from some different company. I have had travel companies refuse to submit me for a tele job because my ACLS was not American Heart. A lot of hospitals trying to get their Magnet status will only accept American Heart as well. It's just not worth the aggravation.
And, since I mentioned it, what about Magnet Status? What are your thoughts? I have worked in both, I don't see a lot of difference in the actual day to day nursing. It's a great theory and all, but I don't see it.
Lastly, I have to talk about travel and registry nursing. Not as a new grad, maybe if you are and LPN turning RN and have had a lot of experience, otherwise I wouldn't suggest traveling for 2-3 years. You really don't get into your groove until then, and you haven't experienced enough general nursing stuff. But, after that, why would you pick up and move across the country , to somewhere you have never been, on the word of a potential employer? What a gamble!!! Their job is to get you hired, and if they pay for your relocation, then you owe them a year or so of service. Why not do a travel assignment to the city you are thinking of moving to? Feel it out, maybe do one day a week of some registry to see the other hospitals, maybe they are better, before you commit. I just don't understand it. I have a few friends that have done it, moved across the country to somewhere close to family or just somewhere they had vacationed and loved. I have one friend who has done it twice, even after I encouraged her to try travel and gave her names of companies and recruiters. Both times she has regretted her move, sad really, to waste all that time and energy just to be disappointed and unhappy. So, travel is the way to go...finding the right company is a whole other day.....Thanks for listening. Remember first do no harm.
Saturday, September 30, 2006
Still getting attached
Yep that's me by a palm tree and a pond in the desert, ok it's not really in the desert, it's in Scottsdale/Phoenix area. It's a little park called Papago Park that we have visited quite often. It's a nice little oasis. This has been a long week, just really busy at work. I'm finally allowing myself a few days off to relax. I've been taking care of this patient off and on for the last month, and he finally got to go home yesterday. He was flown from a small town north of Phoenix with bilateral collapsed lungs, and has had chest tubes ever since. The diagnosis came back, and it was not a good one. Mesothelioma, that's my second patient this month with the same diagnosis, both worked construction. I lost my own father to lung cancer so it hits me pretty hard sometime to take care of these guys. So, this guy really wanted to go home as you can imagine, I mean his wife and daughter were here but he just wanted to be home. Good Sam hospital has a floor of rooms that families can rent so they can be in the building to visit the patient whenever they are needed. It's really nice for the patient and the family, especially when they live so far away. Unfortunately, the small hospital that he is going to cannot do any type of extensive surgery if it's needed or anything like that. He had to agree to be a DNR in order to go back home. Isn't that sad? I mean this guy is far from the edge he still gets up every morning and shaves and reads the paper, aside from the chest tubes to constant wall suction, he's what we refer to as a walky talky. I would go in every morning and say hello even when he wasn't my patient for the day. Yesterday we shared a tear when he told me about the conditions of his return to home. He was funny and cranky and made me smile and I think he looked forward to seeing me. It's nice to make that connection with your patients and their families. I know we are not supposed to get attached, but sometimes I can't help it. It may take a little out of me when they go but, if it makes their stay more comfortable, what's the harm? Death and terminal illnesses are not some of my favorite subjects. (Much like trachs and colostomies.) But , they have been a major part of my career. Of course, I think death is as much mental as it is physical. I had a patient quite recently that I helped take out to his car in a wheelchair, he got up into the car and petted his dog who was waiting in the car, he died the next day in his home. I guess he was ready. When you have a terminal illness, a lot of times it's a matter of being comfortable with the situation that makes it ok for you to go. I believe we have some control over it...anyway...on to better subjects.
The weather here has been warm about 100 still and, you guessed it, sunny. It should be cooling down soon...either way it's not going to be cold anytime soon. And, that makes me very happy, coming from Cleveland I have had more that enough cold to last a really,really,really long time. Well, remember first do no harm.
Sunday, September 24, 2006
Raining again?
Work is great, I really enjoy working at Good Sam. The staff that is there is very knowledgeable and helpful. I never feel alone. Plus, I am all about the overtime and there's plenty of it. I have been working 4 or 5 days a week. The pay has been great especially after not working regularly for a month. Well, as always first do no harm.
Thursday, September 14, 2006
Good Sam
The hospital is just as I remembered. Orientation was a little brutal 6:45 to 5:00 in the classroom with different people speaking and a lot of movies and overhead projector things. We got to see the facility's bomb dog...first that I have seen in my travels. In fact, I don't think they had them last time I was here. The second day was 6 hours of computer training...not too bad.
My husband got here 2 days after orientation so we were able to spend some time together before I actually had to work. I had my 2 days of orientation on the floor which were relatively easy...then they canceled me on Labor day. Boy was I mad. I had to pick up a registry day which wasn't too bad. I worked at Banner Desert in Mesa on their tele floor. It was set up oddly but I got the hang of it by the end of the day. I have been able to work the rest of my days at Good Sam. A few people have recognized me from the last time I was there and I have seen some familiar faces. It's not a bad place to work but it's really busy. It makes the days go quickly though. We usually have a 4:1 ratio with one NA for 15 patients. We normally have a transport nurse and a charge nurse for resource. The only difficult times are when you have someone to go to dialysis and the nurse has to take them or if the travel nurse is busy and you have to take them.
Most of the patients are cardiac cath or post open heart surgery so they are pretty motivated. Much unlike the patients I cared for in Salinas which were highly unmotivated. It makes the job easier if the patients want to learn and get better.
There is a large traveler population at this facility which makes you not feel alone. The staff is mostly traveler friendly and they don't go out of their way to give you the worst assignments. As with everywhere else it comes down to how you present yourself. I went through my orientation with a couple of first time travelers and they are going to have a difficult time I think. The worst thing you can do when you first start a travel assignment is talk too much about yourself, especially to the staff. It's always better to listen and not get too personal too early. We all want to fit in but do it slowly rather than quickly. Also, the staff really doesn't want to hear about how things are better at your other hospital.
Just a little advice for ya...well as always first do no harm....
Friday, August 25, 2006
The Valley of the Sun
The Banner Travel and registry has been wonderful. I went yesterday and met them. I had to do some testing and complete my paperwork. I signed my contract and even got my badge. I am so impressed with this company! They sat down and talked with me , gave me several numbers to call if I needed anything. I spoke with the housing person and with the human resources person and got signed up for my insurance as well. This is how it is supposed to work. I have never been treated so professionally by any other company I worked for. Not even the registries that I have worked for. The next closest would have to be the Cleveland office of Intelistaf. I went to their office and they really worked hard to try to find work for me. I sat down with them and they went over all the hospitals that they had contracts with, they asked which shift I would like to work and even got me in touch with their travel division.
Wednesday this week I went to the Phoenix branch of Intelistaf registry...what a different atmosphere. I didn't even get to sit down. The recruiter brought my paperwork out to a half wall by the entrance door to the office and had me sign my paperwork there. She didn't tell me which hospitals they service, didn't review their timesheets, or introduce me to the staffers (people who I will be dealing with to schedule my shifts). I was not impressed. Makes me think twice about whether I want to make them any money. Yes, I need to work, yeas I need the money but I'd like to be treated better. We'll see.
So, for now I am catching up on my blogging and email and gearing up for a long warm winter...I'll put up pics when my camera arrives.
Monday, August 21, 2006
On the road again
So, I got on a plane this evening and landed in Phoenix at 6pm. My husband will be taking his time to get out here, no 12 hour 750 mile days, unless he really misses me. The flight was pretty much uneventful until we got close to Phoenix. It's monsoon season out here I guess. The sky was almost black when I left the airport headed for my rental car. Great....I haven't driven since I was in Napa and here I am in Phoenix in monsoon season....yeah. At least I got a cute car...a Jeep Liberty...a little better than what I thought I'd end up with...I am paying for it though, this company doesn't provide a rental car...which is ok I only need it a couple of weeks til my driver gets out here.
The really great thing is that my nephew is out here. He's been here since February going to motorcycle school. It will be nice to spend some time with him. Well, I need to settle in for the night. Wish me luck with the weather. Remember First do no harm.
Saturday, August 12, 2006
Home again
Saturday, July 29, 2006
The end result
This is a view of the marine layer coming into the Salinas Valley. Just south of Gilroy CA. It was sunny with blue skies and 70 degrees in Gilroy and 66 in Salinas under a layer of gray marine layer. We had a wonderful couple of days in Reno with our traveler friends. We had a great conversation this morning before we left. It was funny, we were discussing how we had decided to becoming traveling nurses and how glad we were we had. We mostly talked about how most people work all year and get a week or maybe 2 off and they have to plan it around everyone else's vacation. We remembered those days and sighed.
I am done in Salinas this week. It has been a great time. I loved working at this hospital. The staff was great, so friendly and helpful. The physicians were caring and approachable.
This week I got to visit the ER after one of my psych patients went off. She was running down the hallway screaming and had a nursing assistant and a housekeeper against a wall. I was trying to keep her from leaving the unit and she lashed out and scratched both my hands. It took 2 security guards, 2 male ER nurses and a couple of other male staff members to take her down. I don't like psych patients on a med surg unit. The doctors and staff don't know how to handle them...I went through the PACT training and learned some of the ways to protect myself but it didn't come to mind that day. It all happens so fast, it's amazing. I ended up with just a big bruise on my hand but it's something to remember Salinas by.
As for my patient from the last blog, after I picked my jaw up off the floor and held back my laughter, I said "not with this" and pulled the straw out of his penis. At least I caught him before he had inserted it any further, it was only in about a half an inch. I had to tell his resident (new doctor) about the incident and asked if he would tell the patient not to put anything else in his penis. I'm pretty sure it was the first time he heard that. The story ends well, he was discharged 2 days later on antibiotics and voiding well.
Well, we leave Salinas in a couple of days and I still don't have a job. I have been submitted to the Cleveland Clinic but haven't had an interview yet. Keep your fingers crossed for me and I will let you know where we end up.
Remember, first do no harm.
Sunday, July 23, 2006
The Funniest Thing I Have Ever Seen
This is a picture of the beautiful Monterey Bay. It is about 30 minutes from Salinas, we go to there to the coast as much as possible. Which isn't really a whole lot when you work 4 twelve hour shifts a week. It doesn't sound like much but it doesn't leave a whole lot of time off, plus I'm tired. The work really isn't difficult here, I would stay a little longer if we didn't live in Salinas.
So, the search is really on now for my next assignment. I have spoken to about 7 different companies and am down to 2. Nursechoice has an opening in Glendale AZ which is close to my nephew and Agostini (who I am with now) has an opening in Ventura and Oxnard...they don't pay as much but the weather is better...we'll see what happens.
Now, for the heading of the blog...I have to set the stage .I was taking over a patient from an 8 hour nurse who was leaving at 3pm. His diagnosis was rule out CVA .He had been admitted 2 days earlier with confusion. The day before they had discontinued his IV, and his foley catheter.The CVA had been ruled out and his confusion had cleared, so the off going nurse said. He was still on the heart monitor, so I glanced at it while she was giving me report...his heart rate was 125. Already, I'm skeptical, we go in to assess him and his face is flushed and he is definitely not oriented to person, place and time, but he has a history of alzheimers so I wasn't too surprised. I checked his vitals and his temp is 102.3, heart rate 125 but it was sinus tach so it could have been just from his temp. His b/p was 168/94. Ok, what a great way to start the second half of my shift. Luckily the resident was still on the unit so we got some orders. I got an IV started and gave him a bolus, portable chest x-ray was done as well as blood cultures x2 and a CBC and CMP. I also did a straight cath for a UA and C&S. His heart rate continued to be 120-135 despite tylenol and a bolus of 250cc then 500cc. He had no cardiac history so, I wasn't worried about fluid overload. His urine looked pretty cloudy though. So, unfortunately when I left that night his heart rate was still elevated but he felt better and didn't look as sick. The next morning he was again my patient. He had been straight cathed a second time on the night shift because the lab had miss placed my first sample. I went to check on him after his breakfast tray was served and that's when it happened. I swear it happened, I'm not making it up. I walked into the room and he had his sheets pulled down past his waist and he's holding something. He says to me "How do I drain this?" He's holding his penis in one hand and his bendy drinking straw is coming out of his urethra like a little periscope....I almost lost it...what would you have done? I want to know...how do you handle this situation? Next blog I will tell you how I handled it...I should have taken a picture...because I know some of you don't believe me. My guess is he paid attention the day before when he got cathed twice. Reality can be so much funnier than fiction. I do love my job....remember first do no harm.
Sunday, July 16, 2006
Answers
Well it's nice to know people are reading my blog. Sometimes I think I'm just babbling to myself to get it off my chest. Thanks for reading and putting up some comments.
I do love the new nurses and nurses- to- be that read. It's so great to have a dream and have it come to be. Please, all of you new nurses and those struggling through nursing school...please continue, I don't want to work forever!!! It's not as bad as nursing school, I promise. Anyway, an I & D is an incision and drainage...see how we can make it sound not so ugly by just saying the first letters of the procedure... we do it a lot. ORIF...open reduction internal fixation. TURP transurethral resection of prostate.(Oh, just an aside the word is proSTATE not prostrate...two different animals.) LAVH laproscopic assisted vaginal hysterectomy.
The house pictured is the famed Winchester home in San Jose California. It is a lot prettier than the picture shows. See how blue and pretty the sky is way inland from the coast? So deceiving!!!!
I also appreciate the input about finding another avenue of work. I have done that, even while getting paid. I have done mental health and pre-op as well as ambuatory surgery...and it was great..I would go there anytime. At least there you have a definite time that you will go home..not like med-surg when you think you are going home and a patient needs something or your co-worker needs help or you need to finish charting. Just ask my poor husband who waits patiently(most of the time) everyday for me to come out of work. My shift ends at 7:15 and most of the time I am out by 7:30 but some days it's 7:45. Really bad days it's 8:00. Unfortunately it's not like a bank where we can close the door and no one else gets served...not for me anyway. I can't leave knowing the next nurse won't be in with pain meds for at least a half hour. Maybe that comes from living with someone with back pain all my life. That's just how I operate.It's still a great job.
The process has begun to find a new job and a new home. That's my husband's job...he's the travel coordinator. It might be San Diego, it might be Phoenix, it might be Cleveland (go tribe)...I'll let you know. Keep your fingers crossed for something in good weather for the next 3 months..that's as far ahead as I'm willing to look. Can you imagine? Kind of like nursing school...knowing you just have to make it through that next semester or quarter....
First do no harm.
Monday, June 26, 2006
Another California Summer
Yep kinda grey...that's a summer in CA. The marine layer they call it...foggy and cool in the morning and afternoon and sunny at noon and warm. It's hard to get used to especially after all the rain this spring in the Napa Valley.
Salinas is a farming town which is why it's called the salad bowl of California. They grow a lot of lettuce and artichokes and stuff here. The fields were full of people picking strawberries this past week. It doens't look like any job I would want, bent over all day. We went to Santa Cruz to the beach but it wasn't sunny, we left about 10 am and got back around 4 or 5 and they were still in the fields when we got back. But, the strawberries are good.
The hospital is supposed to be on the verge of closing because of the debt. I don't think it can because they really need the beds and the services the hospital provides to it's clientele. The clientele is mostly homeless or drug addicts. I have never seen so many MRSA infections in my life. More I & D's than I can even tell you. I & D of the neck, foot, hip, chest wall....just amazing what these people who have no home or job are doing to their bodies. Plus the stabbings and the gun shot victims. Like my own little war zone. Ya gotta love 8 week assignments though. I can do anything for 8 weeks.
Friday, June 23, 2006
Long gone
Hey there, I have had some big changes sorry it's been so long. I was very unhappy on the floor I went to at the Queen of the Valley. It is really hard to work without any support staff like nursing assistants. They are a vital part of nursing and have always been a huge part of my career. It's really hard when the staff themselves are unhappy and not helpful. I am now in Salinas California, also known as the salad bowl of California. I am working at the community hospital which is a totally different client population. It's only an 8 week assignment ,which I have not done before so we'll see how that goes. The staff is very helpful and friendly.
We are much closer to the coast so we have been to the beach several times. We saw a church group on the beach and the preacher went in the water and individuals came in to be baptized in the Monterey Bay....very interesting. If you have never been to the Pacific ocean it's very cold...about 53-58 degrees. So it's amazing that the preacher could stay half submerged for 10 minutes. We also went to Seaside California and saw Amish on the beach...I was a little confused. I thought they were stuck on the other side of the country. It just proves you never know what you'll see in California. Remember first do no harm.
Tuesday, May 02, 2006
Working hard
I spent 2 days last week looking for other work. I went to Intelistaf to get some agency work and did all their paper work which took about 4 hours. I have the possibility of working at 2 other hospitals each about 20 minutes away. I also went to an open house at St.Helena hospital which is the same distance in the opposite direction. This week I signed up at The Queen (my regular hospital) to work on Monday and the called me off so I called Intelistaf to get some extra work this week. I spoke with some one at Travis Air Force Base and I may get some shifts there. Tomorrow I get to work in Fairfield at their local hospital. It will keep me focused on my goal and hopefully keep the stress level down. Variety is what keeps me doing this job. I love patient care.
So, this week is also my birthday. I have been doing this job 15 years this year. Hard to believe. I wish someone would have given me some advice when I first started or maybe they did and I didn't listen. Everyone said to start in med surg to get my skills honed. I say work smarter, not harder. When I graduated for nursing school there was a big nursing shortage and I could have gone to any area of nursing I wanted. I probably would have gone to the ER or Maternity. In the ER it's stressful but the nurses and the rest of the staff all seem to work together. You only have to have your patients for a short period of time,rarely do they stay with you for 12 hours. Maternity is not a lot of physical work and the patient are mostly preoccupied with their children or families. I'm not saying those jobs are easier but maybe less physically or mentally stressful. I also would have worked lots of hours when I was younger so I could work less now. Live and learn. Remember to enjoy your job and your career. Do lots of different things and don't get sucked into the thinking that you have to do med-surg first. If ICU really excites you or psych or maternity go there if they will orient you. Med surg gives you multitasking and organizational skills for med surg. If that's not what you ultimately see yourself doing then pursue your passion. Time flies, before you know it you've been doing the same job for 10 years or 15 years or 20 years. Primum non nocere.
Tuesday, April 11, 2006
Still Raining
My new contract started last week and I had to float back to my old floor the first day of my contract. I laughed all day. My boss asked me last week if I had signed my new contract. Apparently the person that does the schedule went ahead and planned out the next schedule when all the travelers are gone and the numbers are not so pretty. It seems he jumped the gun and now is scrambling to try to keep the travelers that he wants. I wish he had thought of doing that when I originally asked to stay. It's ok, I'm only a little bitter, I think I made a good choice to move to another floor. The floor I am going to is a med-surg telemetry floor that specializes in dialysis patients. Their nurse-patient ratio was 3:1 with no nursing assistants. It now seems they are going to get back their nursing assistants and I'm sure their ratios will go up. The floor had mostly 8 hour shifts and the nurses were leaving in droves, 12 hours gives you such a better week. 3 days to work compared to 5. Yes 12 hours is a long day but the 5 day a week thing really can burn you out quickly.
My husband is here with me now and we have made some changes. We left the condo with my roommates and found a one bedroom which is a steal in Napa at $820/month. Sad huh? We were paying $350/month in Norman Oklahoma. The prices out here are just incredible. We did stay a few days at the condo and we stayed a few days at my friends apartment who has gone back to Florida for a month. I originally was going to stay there while she was gone until my husband came out here. That particular apartment doesn't have cable and it would be very difficult for my husband to sell on eBay without cable internet.
We spent the past weekend in Reno. There was sunshine there! It was great. Of course we didn't see much of it since we were in the casinos. It still amazes me how many people take their children to the casinos. They can't go on the casino floor and there's not a lot else for them to do. While we were there we tried a few new things. We played a few hands of Pai gow poker...not very fun...difficult to understand. We played keno as well...it's basically the lottery every 5-10 minutes. My husband and I hit side by side jackpots on slot machines. He won 375 and I won 750. That was fun...it would have been great if it had happened just before we left. The drive to Reno takes about 3 hours from Napa and the mountains are beautiful...there's still so much snow up at the summit, pretty incredible.
This week we are hoping to do a little wine tasting. Although it won't be near as fun without my sister and her husband. Maybe we can find some new places to go and find some new wine for them to try when they come back to Napa. There are so many wineries to try it's amazing how the wines can all taste different when the grapes are all from one part of the country. It is a science though, so I guess I shouldn't be too surprised. I have to encourage all of you to come to Napa or Sonoma once. It can be so beautiful...especially when the rain stops.The summers are just beautiful.
Monday, March 20, 2006
Gray days
I went "home" to Oklahoma this past week to help my husband close our store. Sad, but exciting in a way, at least now we'll be together again. We can concentrate on paying our bills and having some fun together. The business was a fantastic opportunity for us to see how we can work together. It was such an awesome learning experience, I wouldn't have given it up for anything.
He is on his way here now from Oklahoma. He says the weather there is gray and rainy, at least he will have a view here with the gray rainy weather. It's about a 3 day drive, unfortunately I have to work so I can't meet him in Vegas like I was planning. It's ok, I'll be off when he gets here.
I have just 3 more weeks on 2North. It will be strange to go to another floor but I will probably have to float from there too. I actually am going to offer to float so that the travelers that have been up there don't have to. There really is no bad place to float to in the hospital, 2North is the hardest floor and I'm used to it. The weekend at work was fairly calm. Friday we had a code. It was not my patient so I helped empty the room for the crash cart and the crowd of people then made sure the other patients were taken care of. I later found out it was a patient I had taken care of last week for 4 days before she went for heart valve replacement surgery. When I heard it was her it felt like someone had hit me in the stomach. I cried. She was a sweet lady with a lot to live for. It's something I see over and over. She was the caretaker for her husband and was neglecting her own health. By the time she came to the hospital, she was very sick. She made the brave decision to go through with the surgery despite the odds, without it she knew she would only have about 6 months. She made it through the surgery and was supposed to go home the day she died. She had gotten up that morning, had her breakfast and her meds, got cleaned up and even washed her hair. It just goes to prove that you never know. When it's your time, it's your time and no amount of live-saving measures will change that.
The week before I went on my little vacation I had a similar experience. There was a patient I had taken care of for a few days and had a day off so my assignment changed and he was no longer my patient. The heart monitor started to alarm and everyone went running to the room. He had a roommate so I grabbed a wheelchair and took him down the hall to our waiting room. Luckily the roommate was mobile enough to get in a wheelchair otherwise we would have had to find an empty room (not very common) to move his bed into. That was a hard one because the code lasted about an hour. There were several of the patients doctors in the room and his family had just left so we had to call them back. The roommate, who we subsequently moved to another room, kept asking what happened to his roommate. I was inclined to tell him about the patient not making it but then HIPPA was in the back of my head. I told him his condition was very serious. After all what would you think if the guy you were talking to this morning was dead this afternoon...wouldn't it scare you little if you were a patient. We as medical professionals see it all the time, not that we get used to it, but we know it's a fact of life. What if this guy had talked with the patient who died and they had the same thing wrong with them, wouldn't that be scary? I never did get a straight answer from anyone as to what we could tell the poor guy, luckily he wasn't my patient so I could avoid the situation. I really felt bad for the nurse. He was in there for an hour trying to help the doctors save his patient and when he was done he just had to go right back to the floor and work like nothing happened. Cops get counseling or a debriefing if they are involved in a shooting or a really bad accident, so they can talk about it ,don't they? We as nurses are just supposed to deal with it and go on. I told him to go take a break that I'd watch his patients. It seems to be the norm everywhere I've been...just deal with it and go back to work. Sad, in such a caring field, who cares about our feelings?
Friday, February 24, 2006
Where do I go from here?
As for my travel assignment, it's coming to decision time again. My original thought was to stay here for the summer as a traveler. When I arrived here my boss told me that as a traveler I could stay as long as I wanted and return as often as I wanted and he seemed really excited about that, genuinely happy that I was here and wanted to stay so long. Initially when I came to the Queen of the Valley they had a policy that you could only have 2 assignments there as a traveler, ever. Last week my boss asked me what my plan was, I began by saying I wanted to stay until the end of summer as a traveler and he cut me off right there. Apparently they have hired enough staff and will not be extending any of the travelers but I could sign on per diem. Now, if they don't have work for me 3 days a week as a traveler, just how much work am I going to get as per diem? He is also implementing changes in the nursing assistants roles and our break time. Sounds like it's time to move on, if only from that floor. The hospital has something like 40 or 50 travelers right now...getting rid of us all is going to be some feat. I understand that travelers are expensive for the hospital and I understand that we will be the first to go but I don't think it was presented thoughtfully. Cold and matter of factly, it hurt a little. Especially after me stepping up and doing whatever I was asked to do (like working night shift) and working extra shifts, the presentation could have been nicer.
So, now either I move to another floor in the hospital or I move to another hospital. My recruiter says Phoenix is paying just as well as this assignment but I dread the thought of Phoenix in the summer.
Another fun thing, the travel company I am currently working for was just bought by another company. This sort of thing happens a lot in the travel nursing world. It means signing new contracts and new insurance and hopefully more assignment choices. My recruiter will be staying on with this new company which is a plus. It's really hard to leave a recruiter you trust. So, we will see where I end up. It's hard to leave a place where I feel comfortable but I have a goal, a financial goal and a time frame in which I intend to reach it. Staying here per diem will not help me reach that goal. So, again I will step outside of my comfort zone to help me achieve it.
I had someone ask me what happens if I hate my assignment...how do you get out of it.... I have really only had 2 assignments I really hated. One was in Columbus Ohio. It was a tele floor that was nicknamed "the dump" I worked night shift, 6 patients. I constantly got to work and had at least one admission on its way up to the floor. The staff was unfriendly and not helpful. I had a patient who's chest tube came out and I couldn't leave him because I had to hold a dressing over the sight, I couldn't get anyone to answer the light. I saw 3 nursing assistants walk by the room and not one of them looked when I called out to them it was awful. I stuck that one out. I worked for RN Network at the time and they were unsympathetic to my pain. I did my 3 days a week and hated it. I clung to the assistance of the other travelers who were also having a rotten time. I left one day early...called off my last shift... and the company charged me for it. The hospital even called me to make up the shift. They said I could not work there again if I didn't make it up, I was glad to hear that.
The other assignment was in San Pablo California, it too was torture to go everyday. I was never on the same unit twice, I had to float most of the time half way through my shift. I had a nursing assistant tell me who she was going to bathe for me because "on this floor the nursing assistants don't do all your baths" . Charge nurses who did nothing but hand out admissions all day.It was really scary...I worked for World Health at the time and my recruiter (who I am still with) was very understanding and found me the Queen of the Valley position I took last summer. I didn't have to pay any penalties and it hasn't affected my ability to find another position. I guess it just depends. Some nurses just quit, end their contract and leave, others decide to see it through. Everyone has a comfort zone and if the assignment makes you feel you could lose your license if you stay then I would leave. I always consider the care I am able to give my patients as a gauge. If I can't care for all of my patients and keep them safe for my whole shift then there's a problem. I live by the creed...first do no harm. (Primum Non Nocere)
Saturday, February 04, 2006
Crab Feed
The rain seems to have stopped for the time being here in Napa. The big blue sky I remember is back, it's still a little cool but that will change as well. I went to a crab feed Saturday, kind of a funny name. Being from the Midwest I would have called it a fest..like Octoberfest, Perchfest, but here they call it a feed. The crab was from Bodega Bay, I guess it's crab season here because there is a crab feed almost every Friday and Saturday this month. It was well worth the $45 admission fee for all you can eat crab...not just the legs cuz they aren't Alaskan King Crab, their legs were pretty scrawny. The one we attended was at a High School in the Gym. We sat at long tables with plastic plates and silverware. Some of the more experienced crab feeders brought real glasses to drink their wine from. I was lucky enough to sit with Sue who brought a pound of drawn butter and little butter warmers...it's not what you know...it's who you know. Everyone brought a bottle of wine to share, most of us had to drink out of the little plastic cups that were supplied on the table. Luckily plastic doesn't spoil the taste of the wine, only the appearance. (and if you drink it quick no one will be the wiser...lol) It was a nice time with some of my friends from the Queen. We are planning a trip to Carmel next month...I promise more pictures! Take care all and remember,Primum non nocere!
Saturday, January 28, 2006
Night shift
This is the sign for my favorite winery. I didn't have the pictures downloaded to my computer when I did my last blog. It was a pretty day but there was no great angle to get the sign.
My roommate's husband came home from the hospital today. He is doing much better thank goodness. He's going to be hard to keep down which is good and bad. I think he might overextend himself. Luckily his daughter is here to keep an eye on him while his wife and I are at work.
Nights has been ok to deal with. I worked 3 12's this week and I was scheduled for tonight but they put me on call...which is rare, then at 10 they called to give me the rest of the night off. I'm still scheduled for tomorrow, which is good. I need 4 12's a week to meet my goal. Always have a goal, otherwise what are you working toward, right? The last night I worked I took care of a very nice old gentleman. I can call him old because he was over 80. He told me how nice I was and asked if I could just sit with him awhile. It was about 3am and I had just been doing my rounds checking on all my patients when he asked me. So, I pulled up a chair and held his hand while he talked for a few minutes. He was very nice and just wanted some company. It's very nice with the nurse-patient ratios here in California, I can afford to give my patient's that kind of time. Those are the times I love being a nurse, I guess they are the times that keep me going. I also had another patient that night who was a retired nurse...she also had a touch of Alzheimers. She must have asked me 10 times where I went to nursing school, not to mention the other 100 times she asked me why she was there, where she was, where her husband was...it was a long night. She had a sitter because she kept playing with her I.V. and trying to get out of bed even though we told her she couldn't because she had just had a cardiac catheterization and was flat on bedrest for 6 hours...she said she was a nurse and she knew what she was doing and she didn't need her I.V. any more or to have a sitter. It's sad really, I hope to never become that way, if I get confused I want to be pleasantly confused. The poor sitter was there for the whole 12 hours, she really earned her keep that night.
Remember the mantra...first do no harm
Tuesday, January 24, 2006
Roommates
Anyway my roommates arrived Wednesday night. 3 long days trip from PA. They took 80, which I had advised against, but they made good time. There are very few ways to get to California from Nevada one of my least favorites, and now theirs as well, is Donner Pass. Well into March you still have to put chains on the tires to drive over the pass, as they found out. It makes for a long day!
My roommates husband ended up in the Emergency Room of the Queen of the Valley here with an awful headache and nausea and vomiting. They are still trying to pin point the cause. What a way to start an assignment! She made it to orientation the first day but has had to miss the second day, the hospital of course has been wonderful and worked with her to get her working. It's so nice to work somewhere that actually cares about the staff and the travelers.
I started working my night shifts this weekend. It was a little difficult the first night, I had slept the night before and had to take a nap before work. I was sooooo tired the next morning. Last night was my second night and it was really hard. Even though I had slept yesterday, I was really tired last night. So, I'm glad I got a day off!!! Nights are much different from days, usually much slower. It's ok though. Just so you all know, patients don't sleep at night (and neither do the nurses!). They are up just as much and need just as much care. Everyone should try the different shifts before they decide which one is best for them.
Tuesday, January 17, 2006
I have been back at the Queen of the Valley hospital for a week now and after an hour it was like I was just here last week. It is a very odd feeling. Does that mean I'm home? I hope not I can't imagine trying to afford a house here. People are paying $500,000 and think they are getting a deal. If I could afford it for a year or two then sell the house for a profit it would be a good idea. One of the nurses I worked with before here is planning a move to Colorado. He sold his house here and is building a 3000 sq.ft. home in Loveland....and he has money left over.
The floor is busy as ever. They are expanding to the Pediatric unit in another week so right now we are over staffed a bit...floating doesn't bother me. I'm just glad the patient I had problems with is gone. I have had some flashbacks since I've been back...whenever I hear a ventilator alarm it sends chills up my spine. Can nurses have post-traumatic stress from taking care of a difficult patient? I think I have it. Anyway otherwise it's been great to be back...real cardiac tele patients and there was even a code on the floor the other day. I love to watch the dynamics of the floor how everyone just comes together to get something done.
It's been difficult to be here alone, without my husband, and my roommates won't be here for another 2-3 days. I have been passing the time by working and talking on the phone. I'm so glad to have the internet...what did we do before?
The flooding here in Napa is over for the time being. Although it is still raining almost everyday. I hope it stops before my friends arrive, I bragged about the beautiful weather, they might be mad...it can't be any worse than where they were....Cincinnati, yuck! Cold and grey and snowy this time of year. Besides all I have to do is take them to a few wineries and they'll forget all about the weather!
So, glad to be back, I should be able to update my blog easier and more regularly now!