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fredericksThe dress debacle has been somewhat rectified. The bride and I spent a rather painful hour pouring through David's Bridal's bridesmaid collection and I decided upon a better-looking chocolate brown (*sigh*) long number. Still not the best choice for me (to answer the questions, NO, the first number wasn't that bad but, YES, it looked awful on me), but if pressed at least this one is something I can see myself wearing to an event in the future.
No LJ or real internet time in the last week, because my work schedule has been horrendous. I worked three days straight, had one day off (which, as my fellow nightshifters know, means exactly nothing: you sleep through the day, wake up in the middle of the night, and basically waste time until it's time to trek back in), then worked three point five days straight. The three days straight broke down to one shift on my floor, one float shift to the renal/ renal transport floor, and then an overtime shift on the renal floor. The floor manager and the nurses took a shine to me and asked me back, which left me flattered and, ultimately, exhausted as all hell - on my last night there we ended up coding one of my patients, stabilizing him, and then sending him down to telemetry, where I had to deal with some seriously aggressive nurses in order to finish the transfer (I felt bad for the physician who did the transfer with me - a baby doctor - as he ended up taking the abuse from the nurses mostly because I forgot to mention the lymph infection the patient had in my report. oops.).
Next was my on-weekend, then an additional shift on my off-day. I came in because I got a call from the manager (while I was out dress shopping, mind) telling me the floor was shortstaffed and asking if I could come in. Now, I hate working short, and I know that other nurses hate working short, so I figured I'd do the kind thing and come on it. But, even with me there, we were *still* short: we worked in fours, meaning we had between 9 and 11 patients each. Not. Fun. And not something I'd walk into willingly, all the good intentions of the world be damned. I had a demoralizing night, which began promptly at 7:25PM with a family shitting on the care given in the hospital as my aide and I attempted to change a combative Alzheimer's patient.
Mind, my shift started at 7PM, and aide's shift started at 3PM. The aide comes to me telling me the family is giving her the third-degree and she needs my help to change the patient. She needs my help anyway, because this guy punches and kicks when you come around him, utterly refusing to roll over and facilitate being cleaned up, but as the nurse I'm supposed to answer questions re: patient care while on the floor. We go in there, pull the curtain, and start trying to clean the guy up - he is full of urine. But that's understandable because he's on 100cc of NS an hour, so he's putting out a lot of that. Also, we cannot be expected to change patients all the time. It's impossible to expect a wet diaper to be changed immediately, particularly since we (as in nurses and nurse's aides) have other duties. Nurse's aides on our floor take vitals, do fingersticks, transport patients, perform phlebotomy, and distribute dining trays in addition to changing patients. Nurse's give meds, verify medication orders, enter labwork, give/get blood, and do all the things nurse's aides do. So, let me tell you, it's *unreasonable* to expect us to hover over *your* family member waiting for him/her to urinate/defecate so we can change him/her, PARTICULARLY since we have at least 8 other patients to care for. That kind of attention can be *purchased*, and we have a list of private aide or private nursing companies that will send workers to take care of your family members on a 1:1 basis on your own dime. Tell this to the motherfucker relative of the patient who boldly sat there on the other side of the pulled curtain as the aide and I struggled to get the patient to turn over while dodging his fists and legs (and this guy was *strong*), telling whoever that the patient was "struggling because he knows they haven't changed him in forever, [he] can't wait to get him out of this hospital". Yeah, way to endear yourself to the nursing staff. I was sorely tempted to turn righ the fuck around and say "Jackass, my shift started 30 minutes ago so I am in no way accountable for the way you believe you saw your family member when you walked through the door. I haven't even had a chance to finish my *rounds* yet! And, what?, do you want to come and change this guy? Because I don't take well to being punched in the stomach." I avoided them for the rest of their time their, and I didn't give a fuck. But the experience obviously hurt me, otherwise I wouldn't be ranting about it.
Rest of the shift was okay, but little things kept hitting me where it hurt. Like, in the morning one of my patients had a blood sugar of 42, so I pushed 50cc of dextrose 50% quick as you please and asked her to eat, then rechecked her at 7:30 (know that shift officially ends at 7AM, but if you have things to finish you can't very well leave until you finish them) to find she'd moved up to 229. So, like I'm *supposed to* (see the emphasis), I call the NP to tell him/her what transpired. I tell him everything and he says okay, then throws in a (IMHO) thoroughly sarcastic "good job". Nurses have licenses, but we must follow orders. That's how things run. This is not to say we are automatons - we can (and do) have the right to refuse to follow orders, and we can do some acts independently - but your ass is only really safe from the fires of upper management chastisement when you follow through on an order as written. The standing order for a patient with a low FS generally is "push 50 of d50, recheck BG post 15 minutes, and CALL MD". Or, in this case, NP. Which I did. When we do things like that, informing the NPs of actions we have taken per standing orders, I'm quite tired of getting denigration or sarcasm from them. Because it's not the first time (or second time OR third time) it's happened. They acknowledge that being a nurse is "dog work", but yet they seem to have forgotten how it was to be one, because we take a good bit of shit from them as well, on the occasion. You'd think they, of all people, would be more sympathetic.
Fine, so I suck it up and start writing my note. As I'm doing that the nurse I gave report to comes over, semi-irate, to point out an order that had been incorrectly picked up by the previous day nurse. Of course, she doesn't first point this out to *me*, the night nurse who had to do the 24 medication check and should have picked up on the error, but to her dayshift co-worker and then the manager, as I hover around paranoid trying to figure out how exactly I fucked up now. I mentioned to her when I finished report, I said "if there are any problems, please, tell me". Because it doesn't tend to happen. Sometimes nurses, overwhelmingly female, are catty bitches, and the only way you can learn about a screw-up is through the whispers of people around you or, if it's serious enough, when you're called into the manager's office, NOT from the horse's mouth. The error made was less intentional but more of a confusion with the new medication time policy and common sense, so the other day nurse had a way out, but I heard the nurse I'd given report to murmur to her co-worker that I didn't change it because it meant I ended up giving less medication to the patient which...ARGH! At that point, I'd had it. I'd taken care of 10 patients, I'd dealt with annoying family members, I'd ended up helping out the newer nurses during the course of the night, I'd gotten NO SLEEP the night before because I hadn't expected to go in to work at all...it was too much. I found myself with no ability to concentrate on finishing up the progress notes I had left to update and very close to tears.
I wrapped up what I was doing and walked into our lounge to try to take a second to, I don't know, relax? blank out all the emotion swirling? After a few minutes spent staring into space I took a deep breath, grabbed my stuff, and started walking out to catch the bus, when I ran into the manager...who wanted to speak to me. Joy. I went back into the lounge, where she spoke briefly about how well I was received on the renal transplant floor where I'd worked the week before, and then how my "dedication in going to conferences" and whatnot makes me assistant manager material, and it's something she'd look into for me in a year or so. What I don't hear from her, and what I want to hear from her, what I have *yet* to hear from her - you're a good nurse and we appreciate the time and effort you put in on our floor. And, oh, thanks for coming in on your night off to help us out. So whateverthefuck. I had an angtsy bus ride home, but I managed to not think about it long enough to get some sleep under my belt.
I come home and I'm OUT - I fall asleep at 10 and sleep until 5:30PM...the time at which I'm called by the job. See, they're shortstaffed AGAIN, and they desperately need me to come in AGAIN, on my night off. This would be my fourth night in a row, something no one does by choice. But I'm feeling sort of rested and I'm a blasted fool, so I agree to come in. When I get there, lo and behold, we are NOT shortstaffed, as I make the 6th nurse. I hear whispers about someone having to float and I ask the assistant manager if she wants me to go home. She says she wants to keep me, but I can head back home if I want. As I don't have a car and my ride's just left I sort of don't have a choice about the matter, so I decide to stay. And I'm there working my ass off until 11PM, at which point I'm asked to go home and told I'll only be paid for four hours and will have to use the rest of the time as personal time. Which, you know....if I was another person I'd rant and rave and be pissed off, but I sort of didn't care at that point. I had to deal with the bitchiness from my fellow nurses as I attempted to divide up my patient load between them and get the hell off the floor, then wait for someone to come pick me up, because LI Buses suck donkey nut and actually stop running after a certain time. I got home around 12:40AM.
How things work out now - I'm not scheduled to work until next week Tuesday. And, screw them, I'm not going in before then unless they start offering overtime.
I went to Bestbuy yesterday and bought "Planet Earth" after hearing![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
atraxia rave about it as we walked though the Museum of Modern History last weekend, along with 30 Rock S1 and S2 of The Wire (the new season? good, but a bit heavy-handed it spots. I keep meaning to sit down and write long entries about each new eppy, but my concentration is failing).
Something is rubbing me the wrong way. It's taken me a full day to put something here, I'm reading books with fits and starts, I can't even make it though TV or video games without having to take occasional breaks. Work related, perhaps?
No LJ or real internet time in the last week, because my work schedule has been horrendous. I worked three days straight, had one day off (which, as my fellow nightshifters know, means exactly nothing: you sleep through the day, wake up in the middle of the night, and basically waste time until it's time to trek back in), then worked three point five days straight. The three days straight broke down to one shift on my floor, one float shift to the renal/ renal transport floor, and then an overtime shift on the renal floor. The floor manager and the nurses took a shine to me and asked me back, which left me flattered and, ultimately, exhausted as all hell - on my last night there we ended up coding one of my patients, stabilizing him, and then sending him down to telemetry, where I had to deal with some seriously aggressive nurses in order to finish the transfer (I felt bad for the physician who did the transfer with me - a baby doctor - as he ended up taking the abuse from the nurses mostly because I forgot to mention the lymph infection the patient had in my report. oops.).
Next was my on-weekend, then an additional shift on my off-day. I came in because I got a call from the manager (while I was out dress shopping, mind) telling me the floor was shortstaffed and asking if I could come in. Now, I hate working short, and I know that other nurses hate working short, so I figured I'd do the kind thing and come on it. But, even with me there, we were *still* short: we worked in fours, meaning we had between 9 and 11 patients each. Not. Fun. And not something I'd walk into willingly, all the good intentions of the world be damned. I had a demoralizing night, which began promptly at 7:25PM with a family shitting on the care given in the hospital as my aide and I attempted to change a combative Alzheimer's patient.
Mind, my shift started at 7PM, and aide's shift started at 3PM. The aide comes to me telling me the family is giving her the third-degree and she needs my help to change the patient. She needs my help anyway, because this guy punches and kicks when you come around him, utterly refusing to roll over and facilitate being cleaned up, but as the nurse I'm supposed to answer questions re: patient care while on the floor. We go in there, pull the curtain, and start trying to clean the guy up - he is full of urine. But that's understandable because he's on 100cc of NS an hour, so he's putting out a lot of that. Also, we cannot be expected to change patients all the time. It's impossible to expect a wet diaper to be changed immediately, particularly since we (as in nurses and nurse's aides) have other duties. Nurse's aides on our floor take vitals, do fingersticks, transport patients, perform phlebotomy, and distribute dining trays in addition to changing patients. Nurse's give meds, verify medication orders, enter labwork, give/get blood, and do all the things nurse's aides do. So, let me tell you, it's *unreasonable* to expect us to hover over *your* family member waiting for him/her to urinate/defecate so we can change him/her, PARTICULARLY since we have at least 8 other patients to care for. That kind of attention can be *purchased*, and we have a list of private aide or private nursing companies that will send workers to take care of your family members on a 1:1 basis on your own dime. Tell this to the motherfucker relative of the patient who boldly sat there on the other side of the pulled curtain as the aide and I struggled to get the patient to turn over while dodging his fists and legs (and this guy was *strong*), telling whoever that the patient was "struggling because he knows they haven't changed him in forever, [he] can't wait to get him out of this hospital". Yeah, way to endear yourself to the nursing staff. I was sorely tempted to turn righ the fuck around and say "Jackass, my shift started 30 minutes ago so I am in no way accountable for the way you believe you saw your family member when you walked through the door. I haven't even had a chance to finish my *rounds* yet! And, what?, do you want to come and change this guy? Because I don't take well to being punched in the stomach." I avoided them for the rest of their time their, and I didn't give a fuck. But the experience obviously hurt me, otherwise I wouldn't be ranting about it.
Rest of the shift was okay, but little things kept hitting me where it hurt. Like, in the morning one of my patients had a blood sugar of 42, so I pushed 50cc of dextrose 50% quick as you please and asked her to eat, then rechecked her at 7:30 (know that shift officially ends at 7AM, but if you have things to finish you can't very well leave until you finish them) to find she'd moved up to 229. So, like I'm *supposed to* (see the emphasis), I call the NP to tell him/her what transpired. I tell him everything and he says okay, then throws in a (IMHO) thoroughly sarcastic "good job". Nurses have licenses, but we must follow orders. That's how things run. This is not to say we are automatons - we can (and do) have the right to refuse to follow orders, and we can do some acts independently - but your ass is only really safe from the fires of upper management chastisement when you follow through on an order as written. The standing order for a patient with a low FS generally is "push 50 of d50, recheck BG post 15 minutes, and CALL MD". Or, in this case, NP. Which I did. When we do things like that, informing the NPs of actions we have taken per standing orders, I'm quite tired of getting denigration or sarcasm from them. Because it's not the first time (or second time OR third time) it's happened. They acknowledge that being a nurse is "dog work", but yet they seem to have forgotten how it was to be one, because we take a good bit of shit from them as well, on the occasion. You'd think they, of all people, would be more sympathetic.
Fine, so I suck it up and start writing my note. As I'm doing that the nurse I gave report to comes over, semi-irate, to point out an order that had been incorrectly picked up by the previous day nurse. Of course, she doesn't first point this out to *me*, the night nurse who had to do the 24 medication check and should have picked up on the error, but to her dayshift co-worker and then the manager, as I hover around paranoid trying to figure out how exactly I fucked up now. I mentioned to her when I finished report, I said "if there are any problems, please, tell me". Because it doesn't tend to happen. Sometimes nurses, overwhelmingly female, are catty bitches, and the only way you can learn about a screw-up is through the whispers of people around you or, if it's serious enough, when you're called into the manager's office, NOT from the horse's mouth. The error made was less intentional but more of a confusion with the new medication time policy and common sense, so the other day nurse had a way out, but I heard the nurse I'd given report to murmur to her co-worker that I didn't change it because it meant I ended up giving less medication to the patient which...ARGH! At that point, I'd had it. I'd taken care of 10 patients, I'd dealt with annoying family members, I'd ended up helping out the newer nurses during the course of the night, I'd gotten NO SLEEP the night before because I hadn't expected to go in to work at all...it was too much. I found myself with no ability to concentrate on finishing up the progress notes I had left to update and very close to tears.
I wrapped up what I was doing and walked into our lounge to try to take a second to, I don't know, relax? blank out all the emotion swirling? After a few minutes spent staring into space I took a deep breath, grabbed my stuff, and started walking out to catch the bus, when I ran into the manager...who wanted to speak to me. Joy. I went back into the lounge, where she spoke briefly about how well I was received on the renal transplant floor where I'd worked the week before, and then how my "dedication in going to conferences" and whatnot makes me assistant manager material, and it's something she'd look into for me in a year or so. What I don't hear from her, and what I want to hear from her, what I have *yet* to hear from her - you're a good nurse and we appreciate the time and effort you put in on our floor. And, oh, thanks for coming in on your night off to help us out. So whateverthefuck. I had an angtsy bus ride home, but I managed to not think about it long enough to get some sleep under my belt.
I come home and I'm OUT - I fall asleep at 10 and sleep until 5:30PM...the time at which I'm called by the job. See, they're shortstaffed AGAIN, and they desperately need me to come in AGAIN, on my night off. This would be my fourth night in a row, something no one does by choice. But I'm feeling sort of rested and I'm a blasted fool, so I agree to come in. When I get there, lo and behold, we are NOT shortstaffed, as I make the 6th nurse. I hear whispers about someone having to float and I ask the assistant manager if she wants me to go home. She says she wants to keep me, but I can head back home if I want. As I don't have a car and my ride's just left I sort of don't have a choice about the matter, so I decide to stay. And I'm there working my ass off until 11PM, at which point I'm asked to go home and told I'll only be paid for four hours and will have to use the rest of the time as personal time. Which, you know....if I was another person I'd rant and rave and be pissed off, but I sort of didn't care at that point. I had to deal with the bitchiness from my fellow nurses as I attempted to divide up my patient load between them and get the hell off the floor, then wait for someone to come pick me up, because LI Buses suck donkey nut and actually stop running after a certain time. I got home around 12:40AM.
How things work out now - I'm not scheduled to work until next week Tuesday. And, screw them, I'm not going in before then unless they start offering overtime.
I went to Bestbuy yesterday and bought "Planet Earth" after hearing
atraxia rave about it as we walked though the Museum of Modern History last weekend, along with 30 Rock S1 and S2 of The Wire (the new season? good, but a bit heavy-handed it spots. I keep meaning to sit down and write long entries about each new eppy, but my concentration is failing).Something is rubbing me the wrong way. It's taken me a full day to put something here, I'm reading books with fits and starts, I can't even make it though TV or video games without having to take occasional breaks. Work related, perhaps?
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no subject
Date: 2008-01-17 03:06 pm (UTC)no subject
Date: 2008-01-18 01:36 pm (UTC)no subject
Date: 2008-01-18 01:10 am (UTC)i hope you enjoy planet earth. if you want to have a marathon..... give me a call :)
no subject
Date: 2008-01-18 01:36 pm (UTC)And most definitely. I'll give you a holla. :)
no subject
Date: 2008-01-18 09:13 am (UTC)Nursing is a very high stress job. I did it for years, and I loved my patients and hated the hell out of the people I worked with. Some of the Docs were OK and some weren't. I've had my share of head to head confrantations with doctors, heh.
Any time you get that many females working together the "Bitch" will out as my nursing instructor told us many, many times, when I was going through nursing school. I have found that nurses can be the most judgemental, bitchy people in the world. If it isn't the night shift talking about the day shift it's something else. Gossip runs like fire through a hospital:)
I never complained or whispered about someone else, by golly if I had a bone to pick I went to that individual talked with them about it and got over it.
The only reason I stayed in nursing as long as I did, is that like cops, you have to learn to leave home at home when you go to work, and leave work at work when you go home. I got very good at that.
It helps if you have day clothes to change into when you leave the hospital, and it also helps if you don't put on your scrubs or uniform until you get to work.
I always went in 30-45 minutes early to get my head space right.
You MUST find something to do to relieve stress hon, swimming, walking. A good physical activity that will burn the stress off. Most nurses burn out long before retirement age, because of the stress. Emotional stress and physical stress. If the hospital doesn't do it for you, if you have at least two years of experience, the stress is less at a doctor's office or even HHC. Heck even a school nurse doesn't get the same stress as a floor nurse in the hospital. That's the roughest nursing job to work. If you're not happy there, there are many, many other positions for nurses. Did you know insurance companies employ nurses to look at patient records? The health department employs nurses. The best Paying jobs though are at retirement complexes. Not Nursing homes but retirement communities. The elderly thee are generally able to get around on their own and come and go but they need their meds supervised and they have different tx's ans procedures and may need health instructions for various things.
Continued:)
Date: 2008-01-18 09:14 am (UTC)As far as the meds go, you made a mistake, and no one was hurt. But I'll guarantee you remember it from now on:)
You're gonna have to find a way to deal with the job stress or it's going to cause you a lot health problems:)
Cops, firefighters, nurses, EMTs, flight control folks, and similar, all these people are in high stress jobs. I really believe that's why a lot of them drink too much or fall for drugs. They don't deal in healthy ways with the stress.
Find something you like doing, that you'll stick with, to let off steam:) As far as your coworker goes. Let her know in no uncertain terms that if she has a gripe with you to talk to you about it and not every damn body else but you.
That kind of crap makes a stressful job MORE stressful than it has to be. No need to ne nasty or mean about it, just have a chat. Be assertive but not aggressive:)
I know about patient loads. The hospital doesn't much care about that. They care about the bottom line. In my time I've seen nurses loaded with as many as twenty patients/clients on a shift. How the hospital even dares to think that a nurse can do a good job with that many people to care for I don't know. By the time meds are given, procedures and tx are done, there's not time for anything else. That doesn't even include pre op prep, or post op patients, or unscheduled tests and sudden changes in orders or meds, or stat blood, or any number of other things during a shift. You end up doing charting catch as, catch can. The stress of dealing with very ill people is bad enough, without knowing that you're not doing the best you can because you just don't have time.
So chin up:) You'll be fine:) But your restlessness is due to unrelieved stress and overwork. If you find something physical to do to deal with it, things will improve.
And don't expect a thank you from any of these people that you work with or for. They will use you until you burn out if you let them. Your next day off put your answering machine on and don't pick up the phone. Because believe me they won't appreciate you giving up your day off. YOU need those days off to rest and recuperate.
Errr, lecture over:) LOL, sorry bout that. I was very into patient instruction and my sister-in-law is currently director of staff education at a hospital in Tennessee. We jabber at each other a lot:) Three of my aunts were nurses, and my uncle was a police detective. Soooo I know about stress and nurses, and the job:) LOL.
Re: Continued:)
Date: 2008-01-18 01:38 pm (UTC)Re: Continued:)
Date: 2008-01-18 06:34 pm (UTC)So he was just being a dick. Sometimes doctors will change the insulin to one that is longer acting while the patient is in the hospital and then ask for sticks after each meal and prescribe a small dosage of a short acting insulin for glucose spikes.
I had a problem once with a little old lady. She was hardly bigger than a bird. She was in for gangrene in her big toe. Her glucose levels kept spiking at odd hours during the day. It was driving me batty. I thought she was a fragile diabetic but there was nothing in her chart indicating that was the case.
Then I noticed that it was only after her relatives visited that her blood sugar spiked. So I made it a point to keep watch and the next time her relatives visited I went into the room and yep, I caught them red handed, they were bringing her sweets, and then taking the wrappers and stuff with them when they left.
They got a lecture from me about the problems the unstable blood sugar was causing in the treatment of the gangrene. And did they want granny to lose her foot? After that there were no more glucose spikes, LOL.
Nursing is part physical care and a lot of mental, and sometimes you have to care for the family too;)
It's definitely not a walk in the park.