apprenticetoflo

This LJ is devoted to my crazy busy experiences working as a nurse technician and as a senior nursing student, along with the odd rambling about the nursing profession. Expect happy entries, sad entries, weirded out entries, and ones where I may just say, "No more poop please!"

Name Reference:

If you haven't been living under a rock, you'll know that Florence Nightingale was the pioneer in nursing. Unfortunately, her name is too long to make a decent LJ name, so I went with "Flo," though my contemporary nursing professor would be rolling in his grave right now if he were in one. I don't think Ms. Nightingale would mind too much.

My Job:

My job title is "Nurse Technician" and I basically get to do anything I've done in lab at school at the hospital. Unfortunately I don't get to do a lot of technical skills a lot of the time because I'm too busy doing mundane things for patients like bed pans, getting food, turns, vital signs, I&O documentation, etc. Slowly but surely I'm getting lucky enough to do some dressing changes, insert feeding tubes, and bladder scans, amongst other things. One of these days I'll get to put in a foley catheter, if I have to wait until I graduate!

Disclaimer:

Obviously under the laws of HIPAA and general moral decency, I won't list any identifying patient information. However, the world is a small place. To help ensure privacy, I'm not going to list my school or the hospital where I work, but I will share that I live in Seattle. If you know who I am personally, please don't comment with more information because that would pretty much defeat the purpose :)

Otherwise, sit back, and and enjoy the ride! I am, so far!

This is not a happy entry. Just so you're forewarned.

The topic for this week are overtime shifts. Have you worked them on your current job? Past jobs? What was your experience? Here was mine:

I arrived in Seattle around 0630 in the morning ready to get on-shift for twelve hours and floated to another floor (orthopedics) for about eight hours. I've had good and bad experiences with floating to other floors and this was a good one. The staff was nice and helpful. I felt on-the-ball about things especially when one of my reports to the RN about an abnormal VS (vital signs) turned into what's called a "Rapid Response" to the patient.

For the readers who know some nursing knowledge, her O2 sat was at 91% on 3L of oxygen and they ended up calling the MDs and the Stat Nurse in to help her out.

For the last 4 hours I go back to my floor which is always nice because I know the routine and the staff, plus a bunch of the patients who have been on the floor for a few days. Then I get asked if I can work an extra four hours because the floor would be short a medical assistant otherwise, and our floor is always so busy.

I decide to go for it and the first few hours are fine, though my feet are absolutely killing me at this point. Then I make a big mistake and a little mistake. The little mistake was that I forgot to empty out three foleys (catheters) that I would've sworn that I'd done (no harm no foul since the nurse asked why I hadn't charted them yet and they weren't very full thankfully).

The bigger mistake was that we have a patient who has some psych issues and wanted to go for a walk with her friend (who is fine mentally). I said, "Okay, I'll tell your nurse." Little did I recognize that she had a PCA (patient-controlled analgesia) which CANNOT leave the floor. For those that don't know, the PCA is basically a pump that the patient can press every 6 minutes to have some pain medication (narcotics) injected into her IV site. The pump cannot leave the floor because the patient or someone else could potentially break it and steal the narcotics and sell them on the street or abuse them.

Though the nurse said it wasn't my fault because the patient should've known, it was my fault and I felt really awful about it. Luckily the patient came back without incident, but it makes me so upset with myself to think of what could've happened.

I compare that to that morning when I was thinking so clearly and good about recognizing all the little things. Had horror thoughts about what kind of damage I could do if I was an actual RN distributing out medications and the like. Even though I did make a big mistake, nobody probably wouldn't've died because of it.

Maybe there are super-hero-type people who can work 16-hour shifts completely fine, but I've found out that I'm not one of them. Better to find out now than later when it could really do some damage.

Lovely subjects I keep coming up with, no? Well, this was what struck me particularly on my commute home on the bus (about an hour and fifteen minutes to my parents house to save money for the summer). It was raining as it tends to do in Seattle (though we mostly say it to keep the tourists out of our city : ) and thus the bus was hot and foggy with circulating air.

I was trying to catch some sleep since it was so late (around midnight) but I awoke to an icky smell. Thinking it must've been somebody around me I slowly realized with some disgust that it was me. I was sleeping on my hand afterall, and with a quick furtive sniff, I was confirmed.

Having worked in the hospital for about two months now, I don't notice the smells anymore. One of the smells on my hand are simply the Purell sanitizer that we use constantly when not using heavy patient contact and the supposedly non-deodorant soap. Plus the special lotion to keep our hands from drying out. This is just the "normal" stuff.

I'm also proud to say that I am fairly used to the lovely bodily excrements to the point where I don't want to gag anymore, but I always need a moment or two to get used to it when I come back to work after a few days off.

Other smells: Teriyaki in the breakroom microwave that you oh-so-wish was yours. Sweat. Sterile instruments (yes, they do have a clean smell).

And then you have the philosophical smells. The smell of the love of a family of ten relatives visiting their fellow member. The smell of the patient who is in fierce pain but isn't due for their meds yet. The smell of the enormous tension inside the room of a patient with Mom and Dad who are trying their best to put on brave faces while they keep vigil over their teenaged daughter who was hit by a semi-truck.

Most of all, you smell the air of people constantly rushing around to help the patients, whether it's to write orders for the nurse, visiting the patient to give them pain meds, or having the medical assistants/nurse techs bring them fluids or help getting off the toilet.

While my floor is the busiest one in the hospital, I'm always amazed at the amount of work that people put into it and it's palpable in the air.

First entry. I feel compelled to write about something amazing and fantastic to keep readers enticed to read further entries, but unfortunately I have not the energy to do as such, and is due to nursing ironically enough. Without further ado, the topic for today are night shifts.

I just had my first 12 hour night shift last night and am on my second day today (7pm-7:30am). I know that many jobs have graveyard shifts, but I doubt that many of them are as busy as a floor in a hospital, especially mine since it is one of, if not the busiest floor in the hospital. The night shift is admittedly quieter than the day or evening shift, but I had enough running around that it was nice to finally get a late dinner break (during which I mostly slept).

Around 4am I felt myself starting to detach from the world as I dazedly started emptying out the foley catheters and give patients with the munchies some ice-cream or crackers. I found myself wondering in the small part of my mind that was still cognizant what would happen if the floor suddenly got busy or a rapid response was called on a patient. I'm sure that I would've been able to handle whatever came my way, but it wouldn't've my best call to action.

I suppose that night nurses are used to the odd hours of staying awake and being able to sleep during the day, but that's got to be hell trying to get back to a normal schedule. When I got home that day I found myself unable to sleep for a few hours and waking up in the late afternoon and feeling like utter crap. And I had to repeat this again in just three hours?

Though I really didn't feel like coming in again tonight, I found that this night was much better than the last now that I was awake enough to notice different things about the night shift. Namely, the staff is much more relaxed and jokes around a lot more than the day/evening shift. We even had a radio playing in the nurse station and talked about anything under the sun. One of the stat RNs came in and jokingly talked about how night nurses get the short end of the stick because the hospital doesn't host BBQs for them and how we should start having moonlight BBQs with Japanese lanterns.

There was just such a feeling of kinship amongst them and the atmosphere was less tense than during the day. I suppose if you were insane enough to work these hours, you'd want some support from your peers as well.