Growth

It's been 8 months since I was hired into the ER, and four months since I've come off orientation. I was thinking about this because today is the first day of college classes, and it's pretty crazy that such a short time ago I was wondering how in the world I would make it though nursing school.

I find it amazing how much I've learned in a small amount of time, but the even more amazing thing is that the more I learn the more I realize just how much I don't know.

I have gotten to the point where I don't want to vomit every time I show up for work, although I do experience the feeling of my stomach wanting to drop out of my butt more times than I care to admit.

I've had good days and bad days. On my best day so far, I handled two priority 1 vented patients back to back for multiple hours by myself. On my worst days, I've made errors, missed things I shouldn't have, and made small blatant mistakes that make me feel three inches tall.

I have days where I feel on top of things, able to anticipate and answer the docs' questions before they ask, anticipating the next orders, what the patient needs, and what to do first. Then I have days where I feel constantly behind, have no idea what to do next, and don't know what the heck the doctor is asking me to do.

I have found which staff I can ask questions of, and which ones won't laugh at me when I ask something stupid. I've found that even if the staff member might laugh at me for asking a stupid questions, it's a good idea to ask it anyway.

I have discovered which nurses are lazy, and I groan inwardly when I work with them. I feel bad for the great nurses that I work with, because I bet they groan inwardly when they see me on the assignment sheet next to them. I mean come on, I'd groan too if I had to work with me in Traumas.

Overall, I still have to calm myself down a bit when I see I'm in traumas but I feel more and more confident every day that I'm not going to kill anyone. Of course, not killing anyone and superbly treating them through a life-threatening issue are two different beasts.

I'm still in slight disbelief that this is my job, but every day I love it more and am so thankful to be working where I love.

I can't imagine myself doing anything else.

Let's just hope that I can continue to grow past the point of simply not killing someone, and one day be a great nurse.

Prank

So, the other night I did it. All on my own, with no prompting. It was a glorious moment for The First Prank.

It was about 4:30 am, we were slow, and I was looking to cause trouble. I decided to screw with one of the docs, since she's very genial and has a wicked sense of humor. So I thought back to my enlightening blog-reading, and decided to make Fake Bedpan Poo to go under her desk.

Iodine + tissue + bedpan = very real looking poo.

I enlisted the help of my fellow new-nurse in alerting me to the departure of the doc from the nursing station. Alas, she wasn't busy either and didn't leave.

Then EMS came in. And left their ambulance doors open while nowhere near the rig...Eureka!

Fake Bedpan Poo on the front seat of the ambulance is funny.

Even funnier is watching their reaction on the video feed from inside the ER.

The funniest of all is when they finally decide to pick it up, realize it's not real, and walk back inside with a mixture of fury and appreciation for a well-played prank.

***
Edit: From ImpactedNurse! Thanks, anon!

It's like I planned it...

I find it incredibly ironic that on the weekend I went camping and professed my love for it, Stuff White People Like posted this:

Stuff White People Like #128: Camping

Wild wonderful West Virginia

I went camping and tubing this weekend in Harpers Ferry, West Virginia. All I can say is this: I love the mountains!

More to follow, once I'm rested and up for posting.

Does a bear...?

Overheard today in the Trauma M&M, whilst discussing arterial injuries from a buckshot blast at close range:

Vascular Surgeon: "They teach you the five "P's" in med school: pallor, pulselessness, pain and so on, but I usually just skip all that and go right to the Charmin Test. I give the leg a squeeze and see how soft it feels."

***

And looky here, Nurse K posted this, and I just love it. So I'm stealing it shamelessly and reposting!



I hope this is me in 65 years. Except maybe with different skills. I can't play any instruments to save my life.

Dream

So last night was a hot mess, again.

Walked in to get report, and waiting for me was a vented patient with a pressure of 54/crap - asked the doc for something to counter her propofol drip but "nah, just hang some more fluid" was the response - when the day shift RN peaced out, two other patients (of mine) getting admitted, 9 admissions out of 12 rooms total (all tele/critical care) and a patient who wanted to keep coding in the room next door.

Since my patient was very close to dying but the patient next door was actively dying, all the available help went to that room. I'm sure it was mildly interesting to watch new-nurse-me run around and try to keep my patient from pulling her vent out ("just give her 1 of ativan, and up the propofol drip" [?!?]) and titrate her propofol and keep her pressure above crap and get the blood cultures and start another line and find the pressure bags and explain everything to her family and call report and everything else.

Finally, the admitting doc wrote orders for levophed, and magically her pressure shot up to 90/60 and life was good.

But that's not what this post is about.

I'm really here to tell you that I had my first frequent-flyer dream today! I dreamed that one of our oft returning nausea/vomiting/I'm pregnant patients came in with 3 of her friends, and all we had open were trauma rooms. So the four of them went into the trauma rooms, and all of a sudden we had vented patients in the itty bitty rooms, and traumas in the hallways, and codes in the storage room, but nobody would move the frequent flyers out. "They're really sick, they need those rooms!" is the response we kept getting.

It was a traumatic dream, for sure.

Scary.

1:1

Sixteen hour shift tonight and for 10 of those hours, I took care of exactly 2 patients.

Redcode #1, didn't leave the room until the patient went to ICU. Bring the dirty stretcher down from ICU, charge nurse tells me, "you're getting another one, get ready."

Maybe I'll have time to pee before they get h- nevermind. Here they are!

Redcode #2, didn't leave the room until the patient went to ICU. Bring the dirty stretcher down from ICU...sigh. Still have 6 hours left of shift.

Whew. I'm relaxing with a slice of pizza and a beer. Off to bed and then to do it again tonight!

***
And this little haiku ditty from Ambulance Driver just made my morning:

A Transfer Haiku

Demented old folks
chasing Phenergan faeries.

It's like herding cats.

Gratitude

I took care of a lady the other night who came in for a bothersome but ultimately minor complaint. After getting her pain under control she was discharged, and I wheeled her out to the lobby to meet her husband and the car. While waiting for her husband to drive up, she starts reflecting on her visit.

"You know, as I was waiting in the hall for my CT scan, they wheeled a man past me who was hooked up to all sorts of tubes and on a breathing machine and he didn't look very good. I thought to myself, 'People drive by this hospital every day and don't even realize what you all do for us.' You all are really something. I know I'm hurting, but some people are a lot worse off than I am. You all still take care of each of us the same. So thank you, for caring about us even if most people have no idea what your job is like."

All I could do was smile, say thank you, and try not to cry on her. And when I helped her into the car, she leaned out of the door and gave me a hug - and she's the first patient who I didn't automatically defer to sidehug instead.

I hope she knows how much that thank you means to us.

Somehow, I think she already does.