Turning into a real complainer

I'm ready to quit. Not sure why I havent yet. Working nights is insane. It's not natural. Plus I still feel like a total fucking idiot and shitty nurse. I'm slow, I'm bumbling, I don't know where to find the right answers to my questions. My IV skills seem to be getting worse. I had a good catch the other night: An older patient in for a sorethroat and fever (like 103) was going to get discharged. I go to get him ready and he's pretty darn sweaty. I let the doc know, he's all "no biggie". I go back, guys like even more sweaty, I ask the doc to come look at him at least before he goes. Guy stands up and has some stridor, and is like dripping sweat. Docs decide to do a CT before he goes- low and behold he winds up having epiglottitis! One way ticket to the ICU. But so far that feels like just about the only thing I can be proud of. Every other moment I feel stupid and substandard and stressed and like I want to just go home and cry. So...yay! Off to another shift.

OMG another first, they just keep coming

As I type this it is 3am. I have been up since 610am. I am preparing for my first ever night shift, tomorrow night, later today? I'm not even sure anymore. I'm so disoriented. Not sure how I will function tomorrow (today). In an effort to stay up here is some stuff that happened last Friday:

Had a patient with a C7 fracture, dementia, but a+ox3 more or less. He was uncomfortable but doing okay with his head somewhat propped up on a few sheets. When the doctor came in and ordered the pt to lie completely flat, this completely sent my patient over the edge. I asked if he would be okay with the couple of sheets since being totally flat was extending his head (in cspine collar) and causing his pain to rise significantly. I may not be a doctor, but it seems to me if putting someone in a certain position causes them to be increasingly agitated/in pain, its probably not a good position for them, even if it goes against cspine precautions. Especially since this caused him to try and sit up, turn, get out of bed. Couldn't convince the doctor of that tho, but eventually me and the nurse I was working with decided that a few sheets to keep him in better alignment was the best move and we did so, patient was much better after that. 

Same day, we had a medical alert patient come in, 30 year old on a ventilator, satting 50s-60s in ambulance. My job should have been to chart, but I immediately got flustered and did nothing! Its definitely not a good sign, I've been there long enough now to do SOMETHING, I would hope. Oh well.

Fack

It's crazy to say that I'm nearing the end of my ER orientation. After this week I have 20 more shifts left (I'm pretty sure) before I'll be on my own. Fucking terrifying. I think we've only had 15 or so shifts so far, but it still feels like it's been a while and like I haven't learned enough and not doing as good as I should be, especially in relation to my peers.

This week was pretty good, I got to hang with Nurse R on Monday, I've spent the most time with her and feel comfortable working with her, we have a good thing going and I feel like I can ask her all my dumb questions. I knew I wouldn't be with her Tuesday or Wednesday because it was her weekend, so I was nervous about who I would be precepting with. Both nurses were great, totally supportive. Tuesdays nurse let me go a little more on my own which was great. Wednesdays nurse let me go on my own by the end of the shift, but the beginning she was doing lots for me. Todays nurse, who did tell me multiple times about how tired she was, never let me stray too far on my own. I appreciate that, but also I have a tendency to rely too much on my preceptors, and I'm trying to push myself to be more independent. We definitely weren't communicating as easily as I had with the other nurses I have worked with. On top having a rough day with IV's, and doing a bunch of things for the first time and needing lots of guidance, or lack of communication was really draining. Today was the first day I've had where I left feeling actually shitty. I always feel like I don't belong, like I'm faking, and everyones going to figure out that I'm an idiot and kick me out of the ED sooner or later, but thats always a kind of benign feeling that I can ignore and brush off. Todays feeling was just of being totally stupid. 

Patient wise we had an interesting one, an actual cardiac case, wound up getting diagnosed as NSTEMI. We get lots of chest pain work ups that usually don't amount to anything. Or troponins that come back positive because of kidney issues. So this lady hadn't been complaining of chest pain for most of the shift, then she starts to. I get the doc, who orders nitro. I check her BP, its good, give a nitro SL. Her chest pains not budging, so I try to track down the doc to get her an order for morphine as well (she's also got bad abd pain that is bothering her more than the chest pain). I'm trying to talk to my preceptor but shes being a bit unavailable. Everything turned out fine but I guess I could have kept giving her nitro until her pain got better. I dunno, I'm too tired to right things out well, or even remember how things really went. All I know is that I'm finally back in bed, my happy place. 

Week 2

Second week on the floor was just as crazy as the first, and I felt possibly even more inept!

Highlights:

1. Psychotic gal who super glued her eye lids open, guess how crazy she looked after we pumped her full o haldol and benadryl...

2. Preceptor: Have you ever seen V-tach in real life?

Me: Nope!

Preceptor: Points to cardiac monitor- run and go look at the patient!

So I did, another one of the Newbies was in there with a gaggle of people. A respiratory distress had an episode of v tach after he got intubated, wasn't doing great, wife and son were in the next room crying. I felt like an asshole standing there and watching...

AAaaaaaahhhh!!!

Today was my second day on the floor. We had one day last week of shadowing, and today we were supposed to take a patient.

I didn't sleep at all last night. I tried so hard to zen out, took some kava, benadryl, deep breathing, and my favorite tv shows, didn't help! I was so nervous going in to work today. But then I met my preceptor and she was so incredibly nice, most of my nerves went away. I still felt like a fucking useless idiot most of the day, but that was all on me, not on her.

We had a major GI bleed patient, another guy tachy into the 130s, another patient having an anaphylactic reaction, all at the same time. I still cannot figure out how she got everything done, she smiled the whole time, never seemed flustered. I was so impressed. I can't imagine that being me. But over all it was a good, long, day. Three more days this week and then the weekend, I already can't wait!

Another first day

Had my first day of big ol hospital orientation yesterday, and it was alright!

Met some of the other nurses that will be going to the ED with me.

One is a new grad but with 13 years experience as an EMT (fuuuuck thats hard to go up against), another has been on med surg at the same hospital for 6 months (jealous of that inpatient prioritization!) and the other gal has been outpatient for the same medical group, she seems super confident though!

Gonna have to start faking it till I'm making it...

An old blog post and a new opportunity

I'm about 3 weeks shy of finishing my third semester of nursing schoo.l Its been a real fuckin rollercoaster. Half the time I dont even think I want to be a nurse anymore, at least not one in the hospital. Med surg nurses work fucking hard, for little thanks, and they (in my experience) have not been the happiest, friendliest lot.

I've been looking back over my blog the past few days and found this pleasant draft of a post above. Ironically I just was offered and accepted a position in a Critical Care Program for the ER at a big ol Level 1 Trauma Center. I was really hoping I wouldn't get the job (I'm an asshole)! I still have major reservations about working in a hospital. Especially one I will have to commute 45-1.5 hrs to and from, depending on traffic. I know that this is an insane opportunity that anyone would be crazy to turn down, but the thought of commuting, and working nights, and having zero idea what I'm doing, and feeling constantly stressed, and terrified, and more stress, and more scared, and having four patients at once, and did I mention I'm going to be stressed? for at least a year, probably closer to two, frankly sounds horrible. Especially when compared to the cushy job I'm working now. M-F 930-6, no holidays off, no weekends, walk to work, eat lunch on the beach, spend time with my family and friends, still don't really no what I'm doing but... there's plenty of other rn's and mds around to ask questions to, usually. The only downside is I spend all day sitting on my butt. Doing lots of stuff I did as a medical assistant.

I do want that critical care experience, but at what cost? My mental health? Le sigh... I feel like I must be the only new grad who has this problem! I know most people would kill to be in my shoes and I'm being an ungrateful twat, my gut is just turning thinking of having so much responsibility.

Off to drink heavily....<3 p="">

Jobby job jobs

So I've been a nurse for a little bit now! It's fucking nuts! Been trying to get here for so long.

I worked for 5 months in an allergy department with some awesome people but not learning a whole ton or feeling like I'm really using my nursing skills.

Then about a month ago I got an offer to work at a clinic in town that is very progressive (liberal) and it's a federally qualified health center. There's some great people but most of my time is spent on the phone. A lot of the things I do are stuff I was doing as an MA, but there's also plenty of telephone triage, and getting to give people advice! It's still totally strange to me to be able to give advice. I work my dream schedule, 930-6 and have weekends and holidays off.

Just when I've started to get in the swing of things, and think I want to stick to clinic nursing, I wind up with a fair amount of hospital interviews.

This past weekend I interviewed at a level 2 trauma center for both ER and ICU (didn't get the job), and then interviewed for surgical icu and trauma icu at a level 1 trauma hospital on Monday. I have another interview for the level 1 trauma center ER where I did my preceptorship.

It's raining interviews! I don't really expect much to come from them, not getting my hopes up at least.

But what if I did get an offer? I have no idea what I want to do. I love my schedule and not having to commute to work, or being stressed really, but I can see myself getting bored quickly! I definitely wouldn't be bored on the ER or icu, but would the mental and physical exhaustion that comes from working nights and commuting an hour each direction and having no idea what I'm doing be worth it for the experience?

Lord, if you know, please tell me!