Crunch time

It's almost time to leave the cactus behind us. 10 more days to go. I am still in the hunt for a job, but have decided to take whatever Columbus will give me and work with an agency as well. Luckily, I am working with Intelistaf, who does both. So, if no travel contracts come up I can still work. Agency or registry work is more flexible too.

It's been a rough week. Some really difficult patients, not that they were necessarily very sick but, their personalities were difficult. I really don't like being yelled at by patients or families, luckily I was able to keep my cool and defuse the situations without making them worse. Sometimes it works in my favor, sometimes nothing works.

I will miss my coworkers the most from this assignment. Some I knew from my last trip here but, a lot of new friends. There are some outstanding nurses at Good Sam, I feel lucky to have been able to work with them. I also worked with some fantastic nurses aids and secretaries. I wish I had the time and space to name them all...but I would rather just say thank you and if you ever have the opportunity to work on Tele (the first floor or the 5th floor) it's a great atmosphere. I hope to come back in the fall once the weather gets cooler. We'll see what the rest of the year brings.

My husband and I were discussing leaving Phoenix last night on our drive home. I am so lucky to have that time to relax after work. Most people have to walk to their car and fight traffic and be alert on their commute home, I get to step out the door and into the truck, relax and pet my dog on the way home. We will miss the mountains and the scenery. On our drive to work and home we pass through a small mountain, and as you crest the hill you can see all of Phoenix. It's awesome to see all the airplanes in the sky in the evening on our way home...there's usually 6 or 7 just staged across the sky waiting to land. We will also miss the weather, last week was hot in the 90's but this week has been 70 and 80 and always a big blue sky. But I'm in the job to travel...so, will keep you posted. Remember, non noc nocere.

Still waiting

Just waiting. I haven't gotten an interview yet. I have my profile in with Ohio State University hospital and Ohio Health, also with Norman Regional Hospital in Oklahoma. I am in a holding pattern, but, it's not the first time. I can always go to Columbus and work agency until I find something. It's not my first choice because I would not have the housing, but we do what we have to do when we are chasing our dreams. Who thought my dreams would take me to Columbus Ohio?
I had my orientee again this week, it was a rough day. I was back down on the surgical unit. Our thoracotomy patient who had her chest tubes pulled on Wednesday ended up getting them back in on Thursday. It was not a pretty sight. The patient has been in the hospital for almost a month. Lots of hostility and anger on the part of the husband was not making my job any easier. Then we got a transfer from the Dialysis center who was in rapid a-fib. Luckily she self converted before we had to hang the Amiodarone and start heparin. My orientee just wasn't able to keep up with the pace, the language barrier is really tough. I don't know if he is fully understanding me or the patients or the doctors.
Only 13 more days. It has been a fun ride here in Arizona, I really enjoy the hospital and my co-workers, some of them more than others. I would love to come back and work here again. The staff really tries to make you feel like part of the team, it's nice. We'll see what the future brings. Remember first do no harm.

Mistakes

Can't wait for the drive...ok, I really can, but I'm ready to go. My husband has his own personal style of driving and thinks no one else know how to drive. I find it rather annoying but, at least I don't have to drive. I am really not thrilled this time because once again we have a trailer full of stuff to travel behind us. Oh, and not to mention the lovely rise in gas prices. We figure it will cost about $500.00 just in gasoline to get from Arizona to Ohio. Sounds great, huh? Not to be out done by the fact that I don't have a job yet. Ah, the joys of traveling. The above picture was taken somewhere in California, I hate to see these especially when we are pulling a trailer.

So, I had an orientee again this past weekend. He's a nice guy, not the same guy as last time. His English is not the best, and I think I might intimidate him a little. He was looking for one of the patients Med records, I accidentally handed him a different book than the one he wanted. He administered the medication and unfortunately did not follow the 5 rights. Now, don't think that I was not doing my job. This guy is on his last week or 2 of his orientation. He has a nursing license, he has been administering medication for weeks by himself. But, he gave the wrong pills to the wrong patient, he went in the room with the medication record and claims he even looked at her name band and still gave her the wrong meds. I made sure he went right back in the room to assess the patient and take her vital signs. She was fine thank goodness. It wasn't all bad, some of the meds she got were actually right. Some were the right meds but the wrong dose. I reminded him that we are all human and not machines, we do occasionally make mistakes , we just hope no one gets harmed because of it. I had him call the doctor, but, due to his poor English I spoke with the doctor and told him what had happened. Luckily, nothing untoward happened and the patient never knew. When he went back in to administer some medications she needed and hadn't received she didn't ask why she didn't get them earlier. I would have told her they were not available earlier if she had asked. I know how it sounds, like I'm lying right? No, I am preserving the nurse patient relationship. If she had known that he had made a mistake she would not have trusted him the rest of the day. Plus he felt bad enough. I guarantee he will check every name band against every medication record from now on, probably twice. I told him that the way to stay out of trouble is to admit your mistakes, follow protocol and most of all monitor your patient for untoward reactions. It's the worse feeling in the world to know you made a mistake, I try to avoid them by following protocols and safety measures put into place. I always check my patients name bands against the medication record right there in the room. I check my meds 3 times, once when I get them together , again before I go in the room and a third time as I am opening the packages and giving them to the patient. That's why I hated giving meds at the psych hospital. They don't follow any of those rules, you can't even get most of the patients to tell you their name, plus they won't wait for you to sit there and open all the packages, so, you don't get that check. So, as I always say, first do no harm.

In search of a new home

Well, it's that time again. Looking for another assignment is exciting and frustrating as some of you may know. Especially when the company you are with doesn't go where you want to go. That's my current dilemma, Banner travel only goes to Banner facilities, which would be great if I wanted to go to Alaska, Wyoming, Colorado, or California...but this time I want to go to Ohio. I have a goal to put my husband to work and to spend some time with my brother and uncle. Also my friends and some more family are just a stones throw away in Cleveland, so we can see them too. It's lonely being out away from everyone you know but it can also be freeing. No family/friendship demands. Sounds selfish doesn't it? But, I can only live that way for a little while, then I need to reconnect with my peeps.
So, in choosing a new assignment, I have to come up with my priorities. Like this time, location is my priority, then money (it's always on the top of my list), then company benefits. The hard part is weeding out the people who cannot help you at all. It's a game. It's kind of like buying a new car and recruiters are kind of like car salesmen. I have searched hundreds of websites and sent out lots of emails, some return my calls, some don't. Like RN Network, as I have said before I was not going to use them again because they left me high and dry out here in Phoenix last time I was here. They forgot to extend my apartment lease a week until my contract was over and I had to pay out of pocket for a 3 night stay in a motel. But, I called them and a recruiter left me a voice mail about 2 days later. When I called her back, she said she was busy and could she call me back, I said sure, and am still waiting for her to call me. That tells me she is way too busy to help me. So, I talk with the ones who do call me back and tell them a little of my backround and what I am looking for. All of them want you to fill out their paperwork, whick on average takes about a half an hour. I am not spending my time on paperwork if they don't have a position where I want to go. Everyone says "We have new assignments coming in all the time, if you have your paperwork done we can submit you that much quicker." Ok, but it only takes a half an hour to fill it out, how much faster do I really need to be submitted?
I always ask about benefits, like free housing and what that includes, also if their medical benefits start day one of the contract, some start the first of the month after you have worked for them for 30 days...that's about 3 months by my count unless you start on the first of the month then it's only 2 months. That's about crazy to me. I work in health care...I know s@%t happens when you are not expecting it, I need health insurance. Some people go on their own and buy personal health insurance but I am not at that point.
Those are really my priorities, location money and benefits. Other people are hung up on travel money or bonuses, I'd rather have more per hour than a bonus that is going to be taxed away. Yeah I got a $1500 completion bonus and it was lumped in with my regular pay check so it threw me into another tax bracket and I saw about $700 of it. Why don't they just tell you it's a bonus of some kind and you'll be happy when the check is bigger instead of wondering where it all went?
So, right now I have my paperwork in with about 4 different companies, 2 have submitted me for positions in Columbus, one at OSU (go bucks!!!) and the other at Ohio Health which owns Grant, Riverside and Doctors hospitals. Hopefully I will get into OSU. Now I wait for a phone call from the nurse manager on the floor for an interview. Keep your finger crossed...remember first do no harm.

Alone again

That's my quote for the week. My goodness, between my co workers and the patients and the patients families...it was a soap opera week. Starting with a coworker who had some drama on her early (8 am) morning break with her significant other, she called us to say she was having some trouble and would be back soon. At 930 when I went to get some coffee I saw here in the managers office with the Phoenix police. Needless to say, she did not return to work and left us short. The week before I was working with another female who is pregnant and spent the whole weekend sitting in the break room and telling me what she could not do because she was sick. I know it sounds cold but, come on people...leave your problems at the door.

If you wake up and don't feel well call in sick...don't try make it...most of the time it doesn't work. Monday morning I walked into my patients room, she was on the phone, as I stood at the end of her bed she says into the phone, "Ok, I have to go, I have to unload on these people." That's a good way to start your day. She was unhappy about her entire stay and felt the need to tell me all of it before I could even introduce myself. She showed me her arm where she had had blood drawn and "someone" had taken the tape off and also removed her skin. She wanted me to call the doctor to see what I could do for it. I wanted to laugh, was she serious, call a doctor at 8 am on a Monday morning and tell him his patient has a tape burn and wants something for it. Can you imagine that conversation? I told her we usually don't apply anything to a tape burn...well, that was the wrong thing to say, she was livid that I said that to her. Then I asked her what she wanted me to put on the tape burn. I thought she was going to explode right in front of me, "You are supposed to be taking care of me. How is it that you don't know what to do? Why don't you just go call the doctor and come back when you have some answers?" So, I left the room. My poor extern was standing right by my side the whole time. I composed myself and called the doctor's PA, all I had to do was mention who I was calling about and he chuckled and asked what she wanted now. I got her neosporin and she wanted Benedryl cream so, I got her that too. I had my extern take it to her and basically take care of her for most of the day. Her heart rate dipped to 39 so I went to check on her, her husband was there as well. She was fine and proceeded to tell me about the nurse who was in that morning and gave her major attitude and how she gave it right back...then, I told her it was me. Usually I would let it go and be glad that she didn't remember our earlier encounter, but she was so blatantly mean to me I couldn't let it go. I ended up discharging her after much delay and irritation on both parts. It was a week.

I had a patient who lives 2 hours away and was brought by helicopter for a heart cath, she ended up in the ICU and then came to tele, her husband didn't visit the whole time she was there. She could press her call light but couldn't press the buttons on the bed to raise the head of the bed, ya gotta love that. It was sad, she was lonely I'm sure, but the odd thing was that she didn't want to go back to the city she lived in for her rehabilitation. I told her she would be closer to her husband but she said he wouldn't visit her anyway that he was busy. I had another patient who lived in another part of the state who's wife would call me 3 and 4 times a day. She didn't want to talk to the patient she wanted to talk to me and tell me how she couldn't come and visit and how she had bills to pay and on and on and on. These are the things that slow me down and keep me from my patients. That's why I say save the drama for your mama. I want to go to work and care for my patients and do my job. I know we need to take care of the whole person but I think they need to be an active participant in their care. A lot of people just come to the hospital and expect us to fix them without them having to do anything or change any of their ways. And when the return in a week or so with the same problem because they went home and continued to do the same things they did that got them into trouble in the first place. Just frustrating.

So, my extern is gone, he had a great time and I think he learned a lot. He won't be working in tele, it's just too busy for him. At least he got to see what it's like. Sorry for all the complaining but, I had to let it out. Remember first do no harm.