10 secrets this nurse shouldn't tell you...

1. Between 0200-0400 in the morning, all I can think about is fast food.  When I drop trash into the garbage can of my patients room and I see a McDonalds bag and the smell of stale fries wafts out, I have to hold back from checking to see if there's any left.  And I don't even like McDonalds, unless I'm super hungry that is.  I daydream about Arby's curly fries, or a Taco Bell crunch wrap supreme.  Mmmm fast food...
2. I often have to hold back my laughter while dealing with certain patients because I just can't believe the things people say sometimes.  I've found that people are very uninhibited while in the hospital.  Telling super nasty jokes, talking about their bowel habits (I pretty much walk into that one when I ask people, "Are you passing gas?"), or telling me about their hallucinations when they've had one to many Percocet.
3. You may be the coldest most unhappy patient ever.  You may act like nothing I do to help you does.  You may frustrate me to no end.  But that will only make me work harder for you.  I will see you as a mountain to climb and when I've reached the top, and I've won you over, I will walk home knowing I didn't give up on you.
4. I might sneak into your room while your sleeping and watch you breath.  It makes me feel better and if you wake up while I'm doing this and say "Yes?" I will lie and say, "Oh I was just making sure your room was warm enough."
5. Nurses must talk about our patients together.  It's how we cope.  Whether a patient is being absolutely hilarious or completely rude and belligerent, we will talk about it.  What else are we supposed to do at 3 o'clock in the morning?
6.  I suggest if you are a women, that you should let your hair grow long and gray when that time comes.  Someday when you're in the hospital your nurse will honor you for letting yourself age gracefully and she may even fix your hair up nice and pretty.
7. At first I may think it sweet that you call me "babe," but when you start requesting me as your nurse and say "If only I was twenty years younger," or "Where were you twenty years ago?' I may get creeped out.  Besides, try more like 40 years ago buddy...how old do you think I am?!
8. When you are in excruciating pain, I'm not ignoring you.  You may feel like I'm moving like a slug, but I'm not.  I'm on the phone with pharmacy telling them to put you orders in stat.  I'm fumbling with equipment trying to go as fast as I can to provide you some kind of relief.  Be patient, I'm going as fast as I possibly can.
9.  Contrary to what some sweet little old ladies think, I don't sleep while I'm at work.  I know I work the night shift, but that doesn't mean I'm in the room next to yours sleeping until you push the call light and wake me up.  I've had so many people ask if they woke me up when I come into there room or apologize for bothering me while I sleep.  Nope, can't sleep while I'm a work, just wouldn't be right.  Don't worry people, you won't wake me up.
10.  If you ever feel just like a number to your nurse (a good nurse that is), don't.  You're not a number.  I know your name.  I was there when the man you love, the father of your children, died.  I remember when they told you of the cancer growing in your stomach that couldn't be cured.  I still check up on you and your recovery even though I'm no longer your nurse.  I haven't forgotten you.  I cried for you then, and I still cry for you now in pure sadness, in joy, and elated happiness.

I Was Proud.

This was my "to-do" list the other night.  You know how I like lists.  This was all the things I needed to get done in the 0600 hour.  For some reason that morning the 6am hour was particularly busy, and I knew it would be, so I made this list, to make sure everything got done.  How organized am I?  I really just like to look at a list and see all the little boxes colored in.  Makes me feel good.

So let me decipher for those of you confused: 

*Update Medication Administration Record(MAR), a list of meds the patient took while in our care, and when they had them last, and when they can take them next.

* Discharge patient (this rarely gets done on my shift so figuring that out was fun.)

*Make sure I gave all morning meds to patient before being discharged.

*Ask doc about discharged patient PICC(peripherally inserted central catheter) and discontinue.  This is pretty much a small tube placed in the arm and threaded into the top of the heart.  It's a hardcore IV.

*Discontinue foley catheter in another patient.

*Do an exit urinalysis on said catheter patient, had I forgotten to do this "Dr. Imafreakaboutexiturinalysis" would of had my head.

*Reinfuse Orthopat machine.  AKA: give patient back their blood from special drainage device.

*AM meds to all- Make sure all my meds were given to all my patients before going home, which also completes the assessment that all my patients are still breathing and I didn't kill anyone.

So needless to say, I got my to-do list done.  When I pulled that list out of my pocket when I got home, on time I'll have you know, I swelled with pride.  So many things that were specifically timed and I got them all done, with no red-fonted late reminders.  And then I fell into bed and slept.

My First Memory

I titled this post “My First Memory” because I know I will remember this patient.  I take care of so many people it is hard to always remember every patient, but this one I’ll remember and it will go down in my memory as the first at this new job.

The last two nights I took care of a person.  This person had been in an accident that left them with major brain injury, and broken bones.  The patient’s spouse had witnessed the accident, and you could see from the look on their face when they looked into the eyes of their loved one, that moment has left a permanent scar on their heart. 

The patient had short-term memory loss and woke up night one at 3:30am asking where, what happened, and can they talk to their spouse please?  I finally got a hold of the spouse (which I felt awful for calling at that terrible time, but it was clear the patient needed so badly to hear that familiar voice).  When I put the patient on the phone with their spouse, I heard their voice crack, tears welling in their eyes, that moment of knowing it was all going to be okay just by hearing that well-known voice of a partner.

When I took them, patient and spouse, out to the car to meet up with their transportation home early in the morning the next day, my breath caught in my chest.  Their love for one another, and staying by each other’s side, in sickness and in health, was so profound.  I helped the patient into the car, touching their arm, telling them “It was a pleasure caring for you.”  I turned and hugged the spouse.  It was a special moment of knowing that a hug was needed.  The patients spouse said, “Thank you so much.  Have a great day.  Actually, have a great life.”  I said “You too.”  We knew we’d probably never see each other again, so it was fitting.

They left an imprint on my heart.  It was a much-needed feeling of making a difference.  As I drove home I almost missed my exit through my teary eyes.  And this is why I’m a nurse.

I'm trying so hard

Starting a new job is probably one of the more difficult things you'll do in life.  And most of the time, you're doing it because of a choice you made.  And we ask ourselves, why did I want to do this again?  That last job wasn't that bad.  That last town wasn't that bad.  I had a lot to be thankful for.  Why do I want to go through this anguish again?
But alas, here I am again, a new job, a new staff, new equipment, new everything.  And I'm decimated to a completely incompetent nurse(in my mind, that is).  I know you're all going to be like, be patient, give yourself a break, and I know, thank you for that, but for right now all I'm surrounded with is the struggle.
Those first few weeks or months at a new job are bad.  No matter how good you are, or quick you are with computers, it is still hard.  It will behoove you to just hang in there, keep going, but recognize how bad it really is.  Any skill I had with equipment or confidence I've built up, is all gone now.  When I scan meds to give to a patient, and the computer doesn't like it, I have to go grab someone to walk me through the right way, all in front of the patient.  This will knock any confidence into the Grand Canyon, far far away.  Your patients may say, "Oh are you new?  How long have you ben a nurse?"  I can hear the fear in their voice.  When I go to initiate a PCA pump, something I could do in my sleep, but don't, I have to grab someone because I can't figure out how to get the key in the machine.  You get the idea.  I walk into my patients room and in my best tootie fruitie voice I treat them like Queen Elizabeth, and all because I'm trying so hard.  I want them to like me.  I laugh at my co-workers jokes even when I don't get them, all because I'm trying so hard.
I'm trying so hard.  All to prove myself.  So show that I'm good at this.  To show them they can trust me.  It's exhausting and I wonder how long it will take me at this job to finally stop trying so hard and just be the normal nurse I usually am.  To just treat people how I treat all my patients, my co-workers, myself.  Just tying a knot and holding on and waiting it out.

Making the jump

So I needed to write a blogpost about this memory before it becomes too far away and I forget.
Sometimes in my previous job I would have a team of patients that varied significantly in age.  I could have a patient that is 2 days old to 98 years old(that was actually my oldest patient, and was really in quite good health, she tripped and fell when she was watering her flowers, imagine that at 98 years). When I walk into a pediatric patients room, I don my excited, enthusiastic self and talk my best baby-talk based on what age the child is.  I could walk in to my toddler patients room when I first assess them and say, "Hey Punky Brewster or Princess so-and-so, what's wrong with your tummy?  Is it mad?"  the usually respond appropriately and I can sit on their bed and have a nice, long chat about the boo-boo on their belly.
When I first walk into an adult patients room I'll usually say something like this, "Hi Mr. 'Smith.'  I'm Kelsy, I'll be your nurse today.  How are you feeling?  Any nausea?"  They will then respond appropriately and demand a pain pill now.
Well, this one night I had just spent the last hour in a pediatric patients room trying to calm him down enough from the pain he was in (you may be thinking to yourself, where are his parents?....Oh, they were sleeping, snoring actually).  I was singing songs and blowing up gloves, saying "Lightning McQueen goes Ka-chow, Ka-chow," pretty much making a complete fool of myself and saying any line from a Disney movie that I could remember.  I finally removed myself from the room and went down the hallway to check on an adult patient of mine.  I walked into Mr. "Smith's" room and said in my squeakiest high-pitched voice and said, "Hey Buzz, how's your tummy feel?"  Eh, oops.....Mr. "Smith" then looked at me and said, "My tummy in fine, but the dressing on my hip is falling off, could you take a look?"  I turned three shades of red and had to explain to him that I had three pediatric patients that night, and he was my only adult patient, hence the baby talk.  He was very understanding and actually quite sweet about it.  Nuf said.

A Year Ago Today

Do you know what today is?  A year since one of the worst days ever.  My state board exams.  The NCLEX.  National Counsel Licensure Exam.  In other words.....repulsive.  I wanted to share with you something I wrote after the day had come and gone and all my fears were relieved.  I will never have to take that test again(I smiled as I wrote that.)
__________________________________________________________
NCLEX
The day came and went.  February 5th.  I woke up early, way before I needed to be up.  Felt sick.  Drank my coffee.  Still feel sick.  Tried to choke down some toast.  Mom and Dad called to pray for me.  They love me.  Upset stomach.  I cried while they prayed.
Driving to the testing center I feel this strange sense of doom.  I've prepared all that I can, I'm relatively smart, I should be able to do this.  Yet, that one little inkling of a doubt leaves me feeling like death is only a breath away (Oh, and yes, I can be very dramatic in my brain.)
The test center staff was very kind.  They tried to alleviate fears.  I check myself in.  Fingerprinted.  Picture taken.  Signature. Then fingerprinted again.  Escorted to my desk.  Pockets checked.  Sitting there my heart is pounding around 95-100 beats per minute.  I know, I took my pulse.  I'm a nerd.  I'm taking the test.  Staying calm is much easier said than done.  I'm trying to use all the techniques I was taught, but feel they don't work with these questions.  My mind is playing games with me, saying "You are missing all of these."  I lay my head in my hands, pray to God, please let me pass, I will lose it if I don't.
Finally after two and a half hours, seventy seven questions later, the screen turns blue.  My heart stops.  It was over.  Walking out to my car, I feel as if throwing up will come at any moment.  I'm crying.  Again.  Trying to figure out who to call.  I totally failed that test.  I don't even remember what my questions were, what it asked, my brain is complete mud.
The next two days are awful.  I'm crying every fifteen minutes.  My poor parents.  I stayed at the house all weekend trying to get my mind off things.  I try to prepare myself and others for my failure, so that just in case I do fail, it won't be such a blow to the heart(and the pride).  I even have myself convinced.  My mind continues to play games with me.  There is no way I passes that test, no way.  Wait, I had to have passes, the last question I answered I know was right, that has to be good right?  I must have passed.  Oh, I just want my score.
6:00am Sunday.  I get up early.  I know my scores are posted.  My mom sneaks up the stairs to the computer to be with me.  Clicking the results button....click it....just click it.  I click it.
PASS
Four little letters that instantly heal me.  I cry, again.  Mom screams.  Dad wakes up, runs up the stairs, hugs me.  Still crying.  It's all over.  I did it.  We did it.  I couldn't have done it without my parents help.  They were so encouraging.  They are my people.  No more worries.  I'm smart.  I only had seventy seven questions.  The least you can get is seventy five.  The computer deemed me competent a nurse at that point.  That's really good.  It's really good.  So good.