I know nursing school is all about that whole "don't feed into your patients' delusions" thing but sometimes you just gotta say fuck it. Like this morning, for example. My nice hallucinating patient flat out refused to give me any information or cooperate in any way - unless his doctor approved of me first. I tried to reason, I tried to nicely ask permission, and I tried to be firm. This got me nowhere except back to the fact that I had to be approved by the doc. The patient gave me a rundown of the MD's qualifications, where he studied, and why he comes with the patient to all ED visits. I was then asked my qualifications and my favorite movie. Apparently I passed the test with flying colors, because the patient then happily sat down on the stretcher and put out his arm for vitals and bloodwork.
The only problem?
There was no MD to be found in the room. Just me, the patient, and his hallucinations.
Also, I searched for an unreasonably long time to find a video of the title quote. Alas there is very little SW to be found on the youtubez. It's probably George Lucas' fault; you'll have to make do with second best.
Thursday, August 30, 2012
Tuesday, August 28, 2012
Friday, August 17, 2012
Rule #2: The Double Tap
You guys, the History Channel is a dangerous thing. I was innocently watching a show about pandemic illness and the collapse of modern society (I know, just some light entertainment) and that got me thinking about the Zombie Apocalypse. I'm convinced this is how the world is going to end and damn if I'm going to be caught unprepared. Even if the world doesn't end by Zombies eating your face off it's still probably going to devolve into chaos at some point and survival skills will be necessary. Just think Zombieland, or maybe Mad Max.
Thoughts like these inevitably lead to the interwebz and suddenly I found myself researching state knife laws (switchblades are a no-no, fixed blade knives mostly can be carried but have to be in plain sight, most penknives are okay regardless of length), the proper amount of bleach to water ratio (10 drops for a gallon of non-cloudy water, 20 if it's cloudy. Let it sit for 30 minutes, 60 if it's real cold), useful plants to recognize for food and medicinal uses (spirae seems particularly nice to know), and farming skills (well, 3 out of 4 isn't bad).
I then ransacked my closet to see what survival products I had. Fortunately, I have plenty of hiking clothes and shoes, a serious backpack and additional daypack, water jugs, and a small ration of useful medications. Unfortunately when I went travel nursing a lot of my camping or hiking supplies were stored in my parents attic - things like tents, cooking utensils, and fire-making implements. Far away and not at all useful to me if disaster strikes, in other words. A lot of the other supplies are lacking too. Which makes me hope the end of civilization holds off for a couple more years until I'm done with this travel nursing gig; I'm not trying to get arrested for having a bowie knife when crossing a state line.
It's weird to think about the end of civilization. Even weirder is that I find myself thinking about the fact that I'm thinking about the end of civilization. I don't really believe it's going to happen anytime soon, but there's always that thought of what-if. I don't want to be caught with my figurative pants down. This doesn't mean I'm going full out and building a bomb shelter with large quantities of useful stuff...but I might try to make friends with someone who did. Be Prepared, y'all. Girl Scout Motto. And also, know the rules.
Personally I'm holding out for the Zombieland scenario because then I get the badass name of Winchester. Seriously, that's the best possible nickname to have short of being born in the town of Smithandwesson.
But whatever. I think I'll just have a beer and go back to watching the History Channel. Programming has moved on to conspiracy theories, anyway.
Thoughts like these inevitably lead to the interwebz and suddenly I found myself researching state knife laws (switchblades are a no-no, fixed blade knives mostly can be carried but have to be in plain sight, most penknives are okay regardless of length), the proper amount of bleach to water ratio (10 drops for a gallon of non-cloudy water, 20 if it's cloudy. Let it sit for 30 minutes, 60 if it's real cold), useful plants to recognize for food and medicinal uses (spirae seems particularly nice to know), and farming skills (well, 3 out of 4 isn't bad).
I then ransacked my closet to see what survival products I had. Fortunately, I have plenty of hiking clothes and shoes, a serious backpack and additional daypack, water jugs, and a small ration of useful medications. Unfortunately when I went travel nursing a lot of my camping or hiking supplies were stored in my parents attic - things like tents, cooking utensils, and fire-making implements. Far away and not at all useful to me if disaster strikes, in other words. A lot of the other supplies are lacking too. Which makes me hope the end of civilization holds off for a couple more years until I'm done with this travel nursing gig; I'm not trying to get arrested for having a bowie knife when crossing a state line.
It's weird to think about the end of civilization. Even weirder is that I find myself thinking about the fact that I'm thinking about the end of civilization. I don't really believe it's going to happen anytime soon, but there's always that thought of what-if. I don't want to be caught with my figurative pants down. This doesn't mean I'm going full out and building a bomb shelter with large quantities of useful stuff...but I might try to make friends with someone who did. Be Prepared, y'all. Girl Scout Motto. And also, know the rules.
Personally I'm holding out for the Zombieland scenario because then I get the badass name of Winchester. Seriously, that's the best possible nickname to have short of being born in the town of Smithandwesson.
But whatever. I think I'll just have a beer and go back to watching the History Channel. Programming has moved on to conspiracy theories, anyway.
Wednesday, August 15, 2012
Orientation
So I'm done orientation. I now know everything I need to know about this new ER. I'm a BAMF with the computer charting, I know every single staff member by name, they all trust me implicitly, I know the phone numbers for every assignment and department in the hospital, I know the layout of all the floors, and people actually ask me where things are.
Not.
Way, way not.
I go in this weekend, on my own. I can't believe I'm on my own in a strange ER. I couldn't find a bedpan the other day. How am I supposed to function as a competent nurse if I can't even do basic tasks easily? If someone honks (even with a no-honk guarantee), I have to search for a bucket - and then probably clean them up because I wasn't quick enough. I guess it will get more familiar over time, and everyone so far has assured me that I'm doing well but it's still crazy to think that Friday I will show up, take an assignment, and be just another staff nurse there with all the expectations of one.
We'll see how it goes.
Not.
Way, way not.
I go in this weekend, on my own. I can't believe I'm on my own in a strange ER. I couldn't find a bedpan the other day. How am I supposed to function as a competent nurse if I can't even do basic tasks easily? If someone honks (even with a no-honk guarantee), I have to search for a bucket - and then probably clean them up because I wasn't quick enough. I guess it will get more familiar over time, and everyone so far has assured me that I'm doing well but it's still crazy to think that Friday I will show up, take an assignment, and be just another staff nurse there with all the expectations of one.
We'll see how it goes.
Tuesday, August 14, 2012
I didn't grab no shoes or nothing, Jesus
I shit you not, people. I took care of Sweet Brown's identical sister last night. Actually, it might have been SB herself. And I also shit you not, the phrase "I got bronchitis" really came out of her mouth. If I'm lying I'm dying.
And if you're not a fan yet of the Autotuned version...you will be after this.
And if you're not a fan yet of the Autotuned version...you will be after this.
Friday, August 10, 2012
First impressions
So now that I've had my orientation and a few hours in the ER, I have been able to sort out some of my thoughts and first impressions.
The overall theme? Overload. In every way. I spent 8 hours in HR orientation on Monday, which was long and boring but not difficult. I came in again on Wednesday for the start of ER orientation, although it was still just computer stuff and some emerg-specific learning packets with a bonus 2 hours of following a nurse around since we were done the packets early. I think I'm getting on well with the staff; I was introduced to most of the important people and I seem to have made a good first impression. One of the educators mentioned that I seemed very bright and willing to learn, and that is the most important thing to them. I hope they remember those words when my first shift on my own has arrived and I'm drowning...
I think the hardest part so far has been the computer charting. We complained a lot about the system at the hospital I came from, but now that I've been introduced to another way of charting I can see that we were actually very spoiled. I am pretty good with computers and I'm sure I'll pick it up after a few days, but in the meantime I'm petrified of missing something important like new orders or making a big error like not signing something off because I didn't know to do it. It's also a more complicated and less streamlined system, with a lot of redundancy. I admit I had some snarky things to say about our previous system, but for all it's flaws it really was inherently easy to use. This new one will take some learning.
Second most difficult thing? Not knowing where anything is. And I mean I don't even know my way around the damn department yet. I've gotten turned around pretty much every time I try to walk somewhere. I look like a lost puppy 75% of the time, and the other 25% is only because I'm following after someone. I also don't know where supplies are located, both in the overall department and again in the supply cabinets. There are little details, like the IV carts being locked - I have to learn the codes, to those carts and to everything else. Looking back I knew all the codes in my previous hospital but I did have four years to learn them - this time I have two days. I'm thinking that the most difficult part of locating things will be the not often used items. Oh, you need a Christmas tree for the O2? Hold up, Imma get it for you but first I need to go ask someone. At the previous hospital, I knew where it all was. I knew where shit was that even the stocking people didn't know about. I knew the secret closets, the drawer boxes with random but occasionally very necessary items. I knew where the hidden respiratory supplies were. Here? I can't even point you to the front door. I've never felt so useless in my life. Actually that's not true. I just feel like a nursing student again.
The last major difficult thing to handle is that no one is color coded. Previous hospital had a scrub color assigned to all types of staff - RNs wore royal blue, techs wore maroon, transporters wore olive green, and enviro wore black. While slightly boring, it made life incredibly easy both for staff and patients. You knew who was in your room, you could spot a tech from down the hall, and it was easy on new staff. Here, everyone wears what they want to. Good for individuality, bad for knowing who you're talking to. I spent five minutes talking to someone I thought was a nurse, and then enviro was paged overhead and she was like "hey I gotta peace, that's me." Right on. Good to know. I also had a conversation with someone I thought was enviro because he was wiping down the countertop, and then his badge flipped around and he was actually one of the MDs.
So it's a lot. I didn't exactly think I would waltz in and be a badass at everything, but I also didn't quite expect the complete information overload that I got.
My first full shift is Saturday night. Wish me luck.
The overall theme? Overload. In every way. I spent 8 hours in HR orientation on Monday, which was long and boring but not difficult. I came in again on Wednesday for the start of ER orientation, although it was still just computer stuff and some emerg-specific learning packets with a bonus 2 hours of following a nurse around since we were done the packets early. I think I'm getting on well with the staff; I was introduced to most of the important people and I seem to have made a good first impression. One of the educators mentioned that I seemed very bright and willing to learn, and that is the most important thing to them. I hope they remember those words when my first shift on my own has arrived and I'm drowning...
I think the hardest part so far has been the computer charting. We complained a lot about the system at the hospital I came from, but now that I've been introduced to another way of charting I can see that we were actually very spoiled. I am pretty good with computers and I'm sure I'll pick it up after a few days, but in the meantime I'm petrified of missing something important like new orders or making a big error like not signing something off because I didn't know to do it. It's also a more complicated and less streamlined system, with a lot of redundancy. I admit I had some snarky things to say about our previous system, but for all it's flaws it really was inherently easy to use. This new one will take some learning.
Second most difficult thing? Not knowing where anything is. And I mean I don't even know my way around the damn department yet. I've gotten turned around pretty much every time I try to walk somewhere. I look like a lost puppy 75% of the time, and the other 25% is only because I'm following after someone. I also don't know where supplies are located, both in the overall department and again in the supply cabinets. There are little details, like the IV carts being locked - I have to learn the codes, to those carts and to everything else. Looking back I knew all the codes in my previous hospital but I did have four years to learn them - this time I have two days. I'm thinking that the most difficult part of locating things will be the not often used items. Oh, you need a Christmas tree for the O2? Hold up, Imma get it for you but first I need to go ask someone. At the previous hospital, I knew where it all was. I knew where shit was that even the stocking people didn't know about. I knew the secret closets, the drawer boxes with random but occasionally very necessary items. I knew where the hidden respiratory supplies were. Here? I can't even point you to the front door. I've never felt so useless in my life. Actually that's not true. I just feel like a nursing student again.
The last major difficult thing to handle is that no one is color coded. Previous hospital had a scrub color assigned to all types of staff - RNs wore royal blue, techs wore maroon, transporters wore olive green, and enviro wore black. While slightly boring, it made life incredibly easy both for staff and patients. You knew who was in your room, you could spot a tech from down the hall, and it was easy on new staff. Here, everyone wears what they want to. Good for individuality, bad for knowing who you're talking to. I spent five minutes talking to someone I thought was a nurse, and then enviro was paged overhead and she was like "hey I gotta peace, that's me." Right on. Good to know. I also had a conversation with someone I thought was enviro because he was wiping down the countertop, and then his badge flipped around and he was actually one of the MDs.
So it's a lot. I didn't exactly think I would waltz in and be a badass at everything, but I also didn't quite expect the complete information overload that I got.
My first full shift is Saturday night. Wish me luck.
Wednesday, August 8, 2012
Friday, August 3, 2012
Traveling
Remember that time I got a job in New England? Yeah. I show up for work Monday morning. Eeep. I've kinda liked unemployment - wake up when I want, go on vacation when I want, be productive when I want - or not at all...all great things. And then I looked at my bank account, and was like "oh snap, I should probably go back to work soon." Apparently, one needs money to buy the appropriate amounts of vacation supplies. Who knew.
So here I am. All my crap is packed up in the car, and I hit the road at the crack of dawn tomorrow. I plan to swing through the ER on my way out of town to say goodbye one last time, and most likely cry one last time too. My best friend (paper towels) is riding up with me to help with the unpacking and inevitable Target shopping when I've realized how much I left behind.
This is it. New era in life. It's overwhelming. A good overwhelming, but a lot to take in. Whew. Whew. Ready, set, go.
So here I am. All my crap is packed up in the car, and I hit the road at the crack of dawn tomorrow. I plan to swing through the ER on my way out of town to say goodbye one last time, and most likely cry one last time too. My best friend (paper towels) is riding up with me to help with the unpacking and inevitable Target shopping when I've realized how much I left behind.
This is it. New era in life. It's overwhelming. A good overwhelming, but a lot to take in. Whew. Whew. Ready, set, go.
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