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.

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.

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.

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.

Working hard

Well,it's looking like summer time out there. My husband and I have been able to go walking everyday I have not been working. It's a great stress reliever. I have also been going to the gym but not as often as I should. The stress has been pretty high at work. I think most of it I put on myself. The floor I am working on has no nursing assistants. The patients have multisystem problems and a lot or renal failure so they are not able to do much for themselves. I spend a lot of my day cleaning, repositioning,feeding, and serving patients and their families on top of my regular nursing duties. Granted, I only have 3 patients but it can be really draining. The hospital is having a mock JACHO survey this week so the charge nurses were all stressed out. It was a long week. Plus, I have been trying to get some overtime and there still is none to be had.
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.

Still Raining

Wow, it's still raining here in Napa. Everyone says,"It's never like this!" I have heard that almost everywhere we go. In Providence, in Oklahoma, in Florida, in Phoenix...makes me wonder if this wonderful weather is following me and pushing me forward to the perfect place. I thought I had found it here in Napa. Last year when I was here it was almost paradise, aside from the one patient I had to care for that was so difficult rain has to stop sometime doesn't it?
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.

Gray days

Will the rain ever stop in Napa? Just when you think it won't, you get a beautiful sunny day with blue skies...yeah and I'm stuck at work for 12 hours. Figures, huh? Does that happen to you too or is it just me?
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?

Where do I go from here?

Hi all! Sorry it's been awhile since my last post. I have had a nice visit from my husband. He came to Napa for 3 days and didn't want to leave. Isn't that sweet? We've been together for about 12 years and this is the first time we have spent any time apart. It has been difficult. Absence does make the heart grow fonder.

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)

Crab Feed

Well, I'm glad that's over. As all my despite friends say,I'm back from the dark side. Well,sort of, I worked my last night shift Friday night and had to work day shift on Sunday. So Saturday was really weird, almost like not a day off at all. The shift thing just has to do with your body's clock I guess. You are either a day person or a night person and the first time you work the wrong shift, your body will tell you. Some people get nauseous, some people get crabby,me, I just sleep all the time when I work nights. So, hopefully I'm done. If my boss asked me again to do it for a short period of time I would probably agree, because I see my role here as helping out the unit. Plus no matter what the night shift says they are not as busy as the dayshift, most nights.
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!

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

Roommates

Hi all! The weather sure has cleared this week...sunny and 60-70 degrees. The view just isn't the same without the green leaves or the grapes on the vines. That hasn't stopped me from visiting my favorite winery, V.Sattui. You can only get the wine at the winery but it's worth the trip! It's located just north of here in St. Helena. A nice drive up route 29.
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.

I'm back! I've been in Napa for a week now with a terrible internet connection. I have my laptop with me and was using my Cingular wireless card....Supposedly wireless anywhere....anywhere but where I am I guess. The cable guy showed up today so I am on cable internet...what a relief! It worked very well, I used my wireless card to get to comcast online and never had to pick up the phone! Now what to do with this card?
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!

Holidaze

What a holiday season. My husband's father took a turn for the worse and went home on hospice a week before Christmas. My husband had to go, .they have had differences but my huband went anyway. His Dad said something about Christmas when my husband got there but he thought nothing of it. Not knowing or realizing the power of the mind. His Dad hung on till Christmas day, the last 24 hours were agonizing I'm sure, everyone sitting around counting his breaths because he had lost consciousness. I can't imagine. This was my husband's first encounter with death. I can't imagine how awful it was for him because I have only seen it from a nurse's view. As a nurse,I hope for a peaceful ending, the quicker the better. Especially if the patient is unconscious,the family are the ones suffering. I was asleep in my bed when my father passed away 20 years ago from lung cancer. Is it fate that my husband had to deal with cancer in hus father as I did? Is it fate that we both had a parent die on Christmas? I was on my first travel assignment in Denver and worked on Christmas Day when I got the phone call that my Mother had passed. It's ironic. Most of my family are here in Oklahoma for the holidays, except for my husband. It should be a joyous time. I truly believe everything happens for a reason, you may not know the reason right away, but it will become clear in the days to come. Sorry if this post bummed any of you out...that was not my intention. Just to give some incite into the life of a nurse. I worked 8 hours today and am going back for 12 hours tomorrow...God willing. Remember, first do no harm.

Returning to Napa

Hi Everyone, Happy holidays! It's cold here in Oklahoma, they lied to me. My sisters said the weather was nice only a week or two of cold . It seems like its been cold for a month and it has snowed! Plus it's going to be snowing again this week. What did I get myself into? Just kidding. I wouldn't trade this time with my family for the world.I even got a new great nephew out of the deal. Great nephew...makes me sound really old doesn't it? My only defense is that I am the youngest of 6.

As my heading says, I am headed back to Napa in January. I'll be staying with another traveler friend of mine and her husband and their 3 dogs. It should be a blast! I haven't had a pet in 5 years because it's just easier to travel without one. My husband will be staying in chilly Oklahoma to run our store. It's called the Estate Sale Store and we are in Moore Oklahoma. We sell new and used furniture and household goods. Like the name says anything you might find at an estate sale. It's doing ok but nursing pay out here is nothing compared to California. We had discussed it when we decided to open the store and said we'd do whatever it takes. I think I'm getting the better end of the deal...all I have to do is work. He has to go to the estate sales and auctions and run the store and pay the bills and take care of himself in cold windy Oklahoma. It will be an adjustment. I'll keep you all updated. I leave January 9th.
Hope everyone has a great holiday season. Stay warm!!!!

SNOW

Well, who would have thought I'd have seen snow twice already this year. Last year...not at all. My husband and I went to Colorado to the Army vs. Air Force football game early last month and it snowed...it was beautiful but unexpected. Then yesterday here in Oklahoma it has snowed ...unbelievable. It's a far cry from the perfect weather of California.
I did an orientation in the ambulatory surgery area of the little hospital (Moore Medical Center) where I am working prn. It was nice...they don't have a full surgery case load yet so it's pretty quiet. It's bascially pre-op out patient stuff. They come in the day of surgery or the day before and get their blood drawn (by the nurse) and fill out the questionaire then radiology comes over and does their chest x-ray and respiratory therapy comes and does their ekg. Then, if it's the day of surgery, we start their IV and have them sign their consent forms and wait. This hospital currently is discharging their surgery patients from the recovery room, most other hospitals send them back over to Ambulatory surgery until they are ready to go home. It was nice so I think I may pick up a few days there as well.
I will be taking an assignment back in Napa, just 8 weeks to start. With the store my huband and I opened he will have to stay behind in Oklahoma and run the store. I decided on only 8 weeks to see how we do apart from each other. We have been together everyday for the last 5 years since I started traveling...so it will be a transition.
Happy holidays,happy blogging...Remember first do no harm.

Branching out

Hello again, sorry it's been so long. I've been really busy. The agency nursing thing is going pretty well. There is a state run mental health facility that has been requiring some help. I took CAPE training. (Creating a positive environment) It was 2 days and only slightly helpful. One thing they taught was the CAPE hold...I thought I might not want to work there after learning that. It is a way to hold onto the client without them hurting themselves or you and it's supposed to help them to gain control of themselves. I haven't seen it in practice and after talking to the nurses that work at the facility they haven't used it much either. I was really glad to hear that. The clients are an interesting mix and the staff has been helpful. Just goes to show you can teach an old dog new tricks...I am still working at a hospital as well...it's brand new as of August this year. The ratio is 4 to 1 and they are only using nursing students as nurse aides and using them very minimally. I haven't worked there much yet but I'll keep you all posted. Happy blogging...and remember first do no harm.

Moving on

Well, I sure do miss those staffing ratios in California, not to mention all my friends at Queen of the Valley. I highly recommend it if you get the chance to travel there and I hope to be back there soon. Oklahoma is a different story. It's not bad, there aren't many travel positions to be found and the money isn't so great but, it's not too surprising. We didn't come here for the travel opportunity. We came here to try to be entrepreneurs. My husband and I are opening a resale shop next Friday (that's why I haven't been blogging) in Moore Oklahoma. We are hoping (of course) that it does really well and that I can stop nursing. It's a great profession and has served me well and I hope to do some strike nursing (sorry all you union nurses) soon. I'm just tired...15 years is long enough to be taking care of others...now it's me time...I hope.
The staffing here isn't too bad. The most I have had is 6:1 on a rehab unit. Mostly it's 4 or 5 to one on tele and med-surg. Very little use of LPN's or CLPN's in the hospitals. One hospital is trying all RN and no aides their ratio is 4:1...we'll see how that works. Shift times are different, they start at 6:30 or 6:45 instead of 7...and believe me that half hour or fifteen minutes means a lot at 5 am! Most of the rest of the stuff is the same. One little hospital I have been working at still counts narcotics at the end of the shift...can you believe it? No Sur-med or Pyxis....the agony. If you've never had to do a narcotic count at the end of your shift...you haven't lived...lol.
I have been working with a local staffing agency. I get on average $30/hr. they do offer benefits (at a minimal price) and PTO, so pretty good for an agency but they are short on the day shifts so I have picked up a PRN position at a little hospital in the same city where we will be opening our store. That should be enough to keep our dream alive...until I don't have to work at all!!!!
Well, I'll try to keep you informed...remember first do no harm and happy blogging!!!

The Search goes on

We had a few days and took the drive to the coast to Muir Woods. The redwoods we saw were incredible pictures just don't do it justice. I hear the redwoods along the coast up to Oregon are even more incredible, unfortunately we will not be making that trip this time. I have just 12 days left here in California. I have spoke to several different agencies and will probably go that route this time. The flexibility is there so I can basically work when and where I want. Plus the travel agencies haven't gotten back to me with any travel assignments in the area that I want to be in. So, keep that in mind when they tell you "you can go anywhere"..yeah, almost.
Work is going well, I'm ready to go to a new facility though. We had student nurses this week. I love students, maybe because the nurses were so mean to me when I was a student. I remember them talking about hating to have students and how much of a burden we were. I remember them not giving me any information about the patients at all. I remember how scary it was to go into that first patients room. It would have been so nice to have a nurse include me in the patients care. I try to be helpful and teach a little bit. I didn't find the instructor to be too nice or helpful but sometimes that happens.
The weather here is getting foggier in the morning and cooler in the evening so I'm ready to find a new climate. There is some talk of a party before I leave, but most of the time everyone is too busy with their own lives. We'll see.

Got grapes?

Wow, what a grape, I mean great time of year to be here in Napa. You can finally see the grapes hanging on the vines. We got this upclose picture in nearby Yountville. The grape harvesting has started by some of the vineyards. Just incredible.

Work is ok. We have a bunch of new grads in training and a couple that just got off of orientation. They also hired a new group of travelers so there is an abundance of new faces around. I am awaiting my exit. The search for a new assignment doesn't look too promising. As you can assume not many nurses want to go to Oklahoma which would make the job market great you would think... but since not many nurses want to go there the number of travel companies that have assignments there are few. And some of the ones I have called have not gotten back with me. Very frustrating. As of tomorrow I have 30 days left here in Napa. Would you be scared? Not knowing where you will live or work 30 days from now? Think about that....not too much though, cuz now I'm even scaring myself!! Just kidding. I'm fine, I'm used to it. I have faith that everything will work out just the way it's supposed to. More pictures to follow as we will be touring the redwoods soon. Take care and remember first do no harm.

Going back to work

Back to work
So even when it's back to work, it's still better here than back home. Sorry guys, I love being from Cleveland, not living there. Napa is beautiful, the hot air balloons in the sky every morning, sunshine all day, nice cool evenings. I'm even learning to like the morning fog, the longer it stays the cooler the day will be. One of my traveler friends has moved on. She started with me in May and her last week was last week. I totally missed her all week because my sister was here and I only worked my 3 days. It's a bummer, she was really fun. Whenever one of us was having a hard day we would help each other or just be there to listen. Lucky for me she only moved to San Francisco so I can see her again before I leave CA. It's an unusual feeling for me because I am usually the one leaving. Hopefully the rest of my assignment will go smoothly without my friend to commisurate with. It's only 2 short months now,I'm sure it will fly by. I still have a couple of places I'd like to visit and then there's the whole finding a new assignment thing. That usually consumes the whole last month of an assignment. Which is great, because by the end of an assignment I'm usually counting my days. If it's a good assignment I'm counting the days the last month, if it's a bad assignment I'm counting from the first week. So, I'm lucky, it's been a good assignment so far. But, I am looking forward to spending some time with my family. We are headed to Oklahoma next, most of the tornados should be gone by then. Along with the unbearable heat, I hope. We'll see how different nursing is in the plains states and how I will survive without staffing ratios. I must say, it's the best thing about nursing in California, hopefully the governor realizes it.
posted by TravelingNurse @ 11:05 AM

3 Comments:

At 8:24 AM, Third Degree Nurse said…
Love the balloon! Kind of close to those power lines, though.And although I wouldn't want to live in Cleveland either (I used to live in Akron, which was close enough),I've thought about doing an internship at the Cleveland Clinic. Ever worked there?

At 11:43 AM, TravelingNurse said…
The balloon picture was taken as this balloon was landing. I have not worked at the Cleveland Clinic just at Hillcrest Hospital which is part of the Cleveland Clinic foundation. I enjoyed working at Hillcrest. I have worked at University Hospital of Cleveland and found it to be very interesting. Lots of things you won't see anywhere else.The apartment we get from the travel company usually is a one bedroom. We have often asked for a two bedroom and generally have to pay something minimal if anything for the extra room. When we went to Phoenix we got a 2 bedroom so family and friends could visit and we actually had some company. It was so nice.