You are currently browsing the category archive for the ‘nursing’ category.

The tragic death of a local teen was all over the news and social media. A few days later the organ recovery was scheduled.

The organ recovery team came in with their own surgeons, anesthetist, scrub, and coordinators.  They talked our scrub through setting up the back table with containers to receive the organs.  I helped her open instruments before pulling drugs for anesthesia.

I walked with the coordinator, anesthetist, and another nurse to ICU to transfer the patient to the OR.  Her parents were at her bedside giving all the last hugs and kisses and tender words.  They weren’t ready to leave her side and walked along with us to the last OR door.  I could hear her father trying to breathe and gulp back the sobs.  We paused once more for the parents, and then they stepped back and watched us push the bed down the hall and around the corner.

Preparing her for surgery was not different than any other case except for the unfamiliar faces in the room.  Monitors were attached.  Her body was prepped and draped.  A surgical time out was called. And then one of the coordinators read a prayer that thanked and honored the teen for her choice to give of herself one last time.

It was an interesting experience.  My role was to assist the recovery team with supplies, medications, and anything else that came up.

Once the clamps are applied, the heart slowly stops.  The activity on the monitor would normally call for a frenzy of action, but here the anesthesiologist simply turns off the monitor.

Each viable organ is removed, examined, and packaged by its specialty surgeon. At the end of the case, the patient is sewn up with a wide stitch.  The recovery team leaves with their precious cargo.  We pull back the drapes to see our previously pink patient now gray and blue.

The eye bank was there to collect the corneas.  The young man snipped and cut a circle around each brown iris and lifted the tissue.  He then pulled out the fluid in each eye with a syringe, packed the eye with cotton and a round form, and closed the lid.  It was during this process that she seemed finally gone.  Without her eyes, there was only a dark void in her gaze.

We cleaned and draped the body to leave on a stretcher to await transport to the morgue.

I worked on a busy telemetry floor for five and a half years.

It took about a year to feel confident in my practice.

It took a few more to start to feel that dreaded burnout.  At first it felt like I was just in a bad funk.  I would shake it off only to find myself in the same place a few months later.  I’m already susceptible to insomnia and migraines.  The increasing stress in my workplace (fewer staff, greater workload, sicker patients, faster discharges) was only making things worse. In the beginning I was taking Excedrin migraine at the end of the shift.  Soon I was swallowing those pills by lunch.

It finally got bad enough that I was having to take medicine before the beginning of my shift just to ward off migraines. On top of which those pills were not working as well for me, and I was ready to ask my nurse practitioner for something stronger.

It was time for a change.

And that is a great benefit to nursing.  Your one degree can qualify you for a number of specialties.  That change can be as simple as a transfer in your hospital.  It might mean resigning and applying elsewhere.  Or it could require you to go back to school to advance your degree.

For a simpler move, you don’t have to absolutely know where you want to go so much as know where you don’t want to be.  Reflect on what you are most dissatisfied about your position and then start looking at what might be a better fit for you.  A change that involves more school may require shadowing and more research to help you decide whether the additional cost and time is worth your investment.

In my case, I saw an opening for a operating room nurse and applied.  A couple of interviews later I had my new position in the same hospital and even on the same floor.

It was definitely a culture shock for the OR is so different from the floor that I felt like a brand new grad all over again.  It was like hitting a reset button.

A year and a half later, I am so much more happier and content in my new role.  I’m expanding my scope of practice and knowledge base.  I’ve made more wonderful work friends and contacts. My schedule and pay are significantly better.  Those pesky headaches are almost nonexistent.

And who knows?  Maybe five years down the road I’ll be ready to switch it up again.

 

 

 

 

I got my little lady up to the bedside commode.

While changing her linen, I noticed her rocking her shoulders back and forth.  She had a music channel on.

“Are you dancing?” I asked her. She just smiled with a mischievous grin.

I turned up the TV, and we danced together.

I’ve accepted a position in the main OR.

I’ve spent three days there getting some unofficial orientation.  Our hospital recently converted to a new payroll system that has left new hires and transfers frozen for the moment.  My current manager is also dragging his feet in giving the OR a transfer date.  The OR manager was going to leave it up to him, but now he’ll let him know that he expects the transfer two pay periods after I accepted the offer from HR on July 3rd.

I love it there so much already.  I had no idea it was so good.

 

A full-time outpatient surgical nurse position finally opened up!

I’ve been watching and waiting for this particular place.

I put in my application the same day and e-mailed the nurse manager.

She wrote me back saying she’d be happy to meet with me regarding the position.

There’s a banquet tonight that she’s attending, and I’ve made sure I will be there.

A chance to dress up and impress – wouldn’t miss it.

Our hospital has been in the process of doing away with written orders for over a year now. 

It’s been fun.

A group of nurses have been off floor duty during this time to help nurses and doctors transition. There are a few stations and several doctors who are lagging behind.

One of those nurses came by the station and informed us that they were actually told in a meeting to start taking pictures when they saw nurses doing things wrong.

Nice.

She has said they’re not going to do that, but such a demand doesn’t exactly inspire solidarity.

What it does do is motivate me to pose for her every time she walks into our station and, so far, pretend to be sleeping at my computer and ride an IV pole down the hall.

I’ve worked with her for 5 years and trust her, but part of me finds the idea of being called into a meeting over these and future photos hysterical. Almost as hysterical as the paranoid mind that thought to order nurses to photograph their peers.

Being off 2 months after my surgery gave me some much needed time away. I’m starting a new non-nursing job on the side next month. I’m hoping to be able to go part-time at the hospital if it works out.

I don’t expect to ever leave nursing completely. It’s a good job, and I generally enjoy the work and my co-workers. I’ve just had it with the suits.

We received an e-mail from our manager that spoke of disappointment over some nursing staff  reading, sharing and expressing agreement with this article from allnurses.com: “Dear Nursing Students/Orientees: A Love Note from the Preceptor from Hell.” He attached the link to his e-mail, so of course I had to read the article he described as “negative, and almost confrontational, almost fully endorsing ‘nurses eating their young.’ Please know that there is no way we will ever precept new hires with the nasty attitude of this highly unprofessional article.”

First off, it isn’t an article so much as someone’s essay or editorial piece that the author admits in the beginning to writing in “an exhausted, frazzled moment after an insane day and trauma call.”  As for the rest, I found myself nodding along to most of the article.  I didn’t find it that negative.  It was a nurse speaking plainly about his/her experience as a preceptor.

I’m so tired of that buzzword “negative.”   My hospital has used it in the past to mean anyone who has something critical to stay – whether or not it is constructive is beside their point.  As a very new nurse, I was in a meeting where we were actually told by another manager that among upper management “there will be zero tolerance for negativity. If you’re openly not happy with any aspect of your job, leave willingly or they’ll help you leave.  There are over 200 active applications in HR.  Those people know exactly what it is like here, and they want our jobs.”   While there has been improvement since and many changes in administration, some of those same suits are still there. I’m sure those are the suits that wanted my manager to respond to the article.

I do the majority of the precepting on my unit.  I’ve probably acted, said, or thought most of that essay, yet I consistently receive positive feedback from orientees and my manager.  Nursing students hired onto our floor regularly request me as their preceptor.

I’m doing something right.

 

the first words out of your patient’s mouth are

“I’m not hard to get along with.”

A certain co-worker is well-known for her attitude, especially at report time.  It is something that I know has been brought to management’s attention.  She’s usually okay to deal with, but she has her flare-ups.

One morning I was the recipient of said attitude.  She was giving me back a patient, and she proceeded to brag about a non-issue and her creative (and questionable) solution while insinuating that it was a problem that I and others had let fester.  I congratulated her in a sarcastic manner, but she seemed oblivious.  She smiled and pointed her feet at me.  “You all need to kiss my feet.”

I told her I’d have a crown waiting for her that night.  And I managed to find 30 minutes over the next 12 hours to do make her a crown out of the frame of a potty specimen collection “hat”, paper, and markers.  It waiting at her usual computer by 6:30pm.

I let myself burn that entire shift over those few minutes of report.  The other day shifters had witnessed the exchange and watched me steal minutes to angrily color and piece together a crown fit for the Queen Bitch of the floor.

I was eager to watch her wear the crown I’d made out of spite.  A crown she would love to wear.  A crown whose meaning was known to everyone else. She walked in, looked at crown with delight, and immediately put it on her head.  She turned to me smiling proudly.

I found all the bitterness immediately replaced with the warm gladness that she liked her crown.

Apparently I can’t do spite right.

I’m okay with that.

 

The gift shop in the hospital lobby has a little coffee bar that I frequent.  I can never remember its hours on the weekend, so I usually make at least one trip in vain.

I was on one such trip the other day and felt that familiar irrational surge of rage to see the dark shop.  I started to turn back when I heard someone say, “Are you Diana?”

I looked to see a somewhat familiar face and said, “Yes.”

She then gestured to a young woman standing beside her and told me that I had been her daughter’s nurse. “Remember?  You used to have to straighten her up all the time.”

I looked into her daughter’s eyes and suddenly remembered a young woman who arrested at home.  Her family had performed CPR until the ambulance arrived.  When I met her she had just transferred to the floor.  Alive and doing physically well, but a childlike shell of the person she had been.

“She’s about 90% recovered.  Just some short-term memory problems.”

I gave her a hug and told her how glad I was to see her doing so well.  She never said much.  I doubt she actually remembered me, but her mom continued to gush. “You were one of our favorite nurses.  I know you guys don’t hear it enough, but this is why you do what you do.”

I had gotten my fix after all.

 

My Happiness Project

1. Set a bedtime.
2. Make my bed every morning.
3. Always be reading something.
4. Move more.
5. Toss and organize.
6. Give proofs of love.
7. Leave the past.
8. Fight right.
9. Don't expect praise or appreciation.
10. Kiss more, hug more, touch more.
11. Aim higher.
12. Find some fun.
13. Ask for help.
14. Smile.
15. Realize it's possible.
16. Don't compare;be inspired.
17. Focus on what I have.
18. Beware of drift.
19. Take a chance.
20. Listen.
21. Be mindful.
22. Cultivate gratitude.
23. Spend out.
24. Do good, feel good.
25. Show up.
26. Have the courage to be imperfect.
27. Find joy in the ordinary.
28. Work smart.
29. Enjoy now.
30. Talk to strangers.
31. Go outside.
32. Start where I am.
33. Show up on time.
34. See art everyday.
35. Love with abandon.
36. Be colorful.
37. Dress the part.
38. Revel in accomplishments.
39. Learn something new.
40. Fear less.
41. Take pictures.
42. Speak with integrity.
43. Don't be critical about small things.
44. Manage my pain.
45. Surround myself with creative people.
46. Practice, practice, practice.
47. Don't force it.
48. Deal with something once.
49. Trust my instincts.
50. Avoid gossip.
51. Choose to see the best in people.
52. Take time to be silly.
53. Throw my own party.
54. Be a mentor.
55. Lean into my fears.
56. Find the others.
57. Do the unexpected.
58. Don't break the chain.
59. Do things others aren't.
60. Slow down.
61. Be cool with not being cool.
62. Be kinder than necessary and more generous than reasonable.
63. Pretend I'm good at it.
64. Keep in touch.
65. Row my own canoe.
66. Do what only you can do.
67. If it doesn't work out, find something that does.
68. Dream bigger.
69. Notice what's right.
70. Stop talking. Start doing.
71. When in doubt, choose laughter.
72. Don't let the perfect be the enemy of the good.
73. Respect everyone.
74. Be early.
75. Delete the unnecessary.

Three Simple Rules

1. If you do not GO after what you want, you will never have it.
2. If you do not ASK, the answer will always be no.
3. If you do not MOVE forward, you will always be in the same place.

All I Need

1. Someone to love.
2. Something to do.
3. Something to hope for.

What I’m Reading

Blood Meridian
by Cormac McCarthy
Their Eyes Were Watching God
by Zora Neale Hurston

U.S. States I’ve Visited

Alaska
Arizona
Arkansas
Colorado
Georgia
Florida
Louisiana
Maryland
New Mexico
North Carolina
Ohio
Oklahoma
Pennsylvania
Texas
Utah
Virgina

Countries I’ve Visited

Mexico
Colombia
Thailand
Vietnam
Bermuda (British territory)

I write about…