More on things that Challenge me at work.

Ok, I feel totally stupid at work and feel like I am doing just enough to get by.
Well that is not fair to me. I do what needs to be done and If there is something I am not sure of I ask...no matter how stupid I may sound. For instance.. Last night, my patients blood pressure was 179/113, I had no idea what to do..... I asked..I was told to retake it and make sure the cuff was the right size..and guess what. The cuff was too small and when I re took it it was 143/73...LESSON LEARNED. Thankfully the nurse I was working with was kind enough to then fill me in on what to do when a patient has a high BP. Now I know.. The aids are still the same. I started to do more "aid" stuff with my patients until I realized that the more I did the less the did and the more SLEEP they got at night...UGGHH!! sooooo last night I simply and very sweetly said things like..."oh I am sorry to wake you but room # ____ had a bowel movement can you go clean them and if you need help let me know"....It seems to work..Did I mention how much every one complains!! There are two respiratiory therapists who do nothing but COMPLAIN and when they work together..thats all they do!!!!COMPLAIN!! from the minute they walk in the door to the minute they leave...OMG STOP COMPLAINING OR FIND ANOTHER JOB!!! IT is not that bad... SHUT THE FUCK UP!! (sorry) I really like my job and I am learning alot... It makes me mad when people are nothing but negative...If you are unhappy CHANGE WHAT IS MAKING YOU UNHAPPY!! or SHUT UP...I find that if you are positive people respond to you positively ..after a while...Negativity is contagious.....By the way dilaudid is the DEVIL!!! It changes little old ladies into junkies who beg for it and will do anything to get it. ( just a little side note) Still trying to figure out how to change the name of my blog. I dont even know how to change it with out loosing all my posts. Name suggestions are welcome to all my millions of readers....(lol)

So Much to Write About!! Where to Start??

Well the job is going well. I just worked 5 ,12 hour shifts in a row !! Wont do that again. Lets talk about nurses aids for a minute...I hope and pray that they are not all like the ones we have a my job..Ours are LAZY!! I dont say that about many people because I am sure that they all have a bad day here and there and need to "slack" a little..and I know that this is a very hard job!! BUT come on!! It is not your job to remind patients that they will not have anyone to help them clean themselves when they are discharged.. THEY ARE HERE TO GET BETTER AND IF THAT MEANS YOU CLEANING THEIR FACES ...THEN DO IT! . When you yell "can you help us turn you!"at the patient who can hardly move his arms and legs because he is so weak , it makes you look like an ass!! Oh yeah !! and when you are in the hospital and the only joy of your day is getting ICE CREAM!!! with your dinner... It would be nice if your nurses aid didnt ...STEAL IT OFF YOUR TRAY!!!!UGGHHHH!! I am sure there are lots of good ones..We have a few or ONE!

People Die...

Wow. 2 patients died today. How sad. Well, one was, The other was a blessing. The one guy was ready to go any day. It was not unexpected. He was unresponsive for too long. His family was waiting for it and today it happened. The other was sad. She was my patient. She was transferred to be with her husband who was in a nursing home with Alzheimer's. All she/her family wanted was to get them together. She was transferred only to die with in minutes of arriving at the nursing home with her husband. She had been progressively getting more confused and then lethargic. There was a bit of a fight at discharge as it was suggested that she not be discharged as she was not stable enough for transfer. The family insisted so she went and then she went.
I thought I would be more affected when people die but when you see them laying there tired and old and weak, some with pressure ulcers, G-tubes, trachs, ventilators..you wonder what they were like when they were healthy..would they want to end up like this? I pray that they go peacefully..because no one should be forced to live after their bodies give up.

The NCLEX/The Job/EWWWW

It has been about 4 months since I took the NCLEX and the more I think about it, the more I realize the worst part of it is the stress. If you take away the stress and the anxiety over the test and just apply what you know it isnt difficult. The test I took had no anatomy and physiology, I am not sure if it never has A&P, but mine didnt. Very few peds, maternity. I dont remember any questions on any of the specialties. But keep in mind that I dont remember any of the pain of labor or childbirth ....So maybe my mind has a great way of blocking out things that are too painful.
MY JOB,,,
My job has been up and down the past couple of days ..Just when you think you are starting to understand or get the hang of things something else comes up that you dont know how to do . We had a meeting today. It wasnt good. Luckily I havent worked there long enough to be included in any of the complaints. I hope I am never included in any of the complaints. I still like the job. I guess the honeymoon is coming to an end. The real world begins.
Oh and I have a new EWWWWWWWW.... I really think that it is gross when nurses wear every peice of jewelry they own to work..Come on!! Really. Those bangle bracelets you are wearing are probably covered in MRSA.. Or Shit at the very least. I know that the gloves dont cover them. EWWWWW..Those Rings you are wearing when I see you doing stuff with no gloves ...yep, I bet they are also cover and caked with all kinds of germs!! EWEEEWWWWWW..I stopped wearing earrings. I refuse to wear my contacts as I feel my glasses protect my eyes from flying sputum.. ( and we have lots of trac patients and I have see lots of flying sputum) And really who are you trying to impress! OH and dont get me started on nail biters or Acrylic nail ( fake nail) people. I cant even touch my face ...god forbid I put my hands in my mouth!!

Work ....LOVVVEEEE ITTTT~~

Well, So far I really like my job. Eventhough I am still on orientation. It is an easy comfortable place to work. It is a small unit. Because of the way it is set up you get to see the same patients for long periods of time. The nurses are like a family. They fight and complain about each other but still talk to each other. I will be on days for a while until I am able to stand on my own. Night shift is going to be interesting. From what I have heard there are alot of codes at night... Hmmmm, scary.
I cant wait till I am up to speed and know what I am doing. I know this will be a while but I am anxious to get there. I am so glad they are giving me as much time as I need to train. This job is such a great opportunity...So far as a RN I have.
Finally inserted a foley catheter on a man and a woman..(285 lb woman ...thank you very much!)
Gave lots of injections.
Did an EKG
applied wound vacs ( one on a leg and one on a sacrum)
I have to talk a minute about wounds....
YUK!!
Believe it or not the sacral wounds didnt gross me out as much as the foot wound...
for some reason the foot wound..(not really a wound.It was an amputation..all toes gone..only half a foot left.)really got to me. It is the first time I actually felt like I could throw up.
Sacral wounds are the WORST!! Really devastating. So close to the poop shoot.. not good. The person who invents a device that will prevent these will be a very rich nurse!! Hmmm....
Pain... I wish I had the confidence to ask questions like..."Can we give this patient something for pain before we insert a flexiseal, change a dressing, get them out of bed? I dont want to step on toes or maybe they cant have these medications. I wish I was more experienced. I am going to do it when I go back to work.,.What the hell .. I am not sure if it is that they dont have an order for pain med or if it takes to much time to get it from the doctor or maybe they have a pain patch I dont know about.
I as a nurse you sometimes have to cause pain, but it is hard to watch someone who is in pain.
Oh, FLEXISEAL ...Barbaric but necessary. Think foley catheter for poop ..same basic mechanism but instead of being inserted in the urethra it is inserted into the butt.
It is for liquid stool, uncontrollable liquid stool..There is so much more... Cant think of it all right now I will post again soon...

First Day.. of Work

My first day was really more like a first 1/2 day. I was there from 8am till 11:30am
Kinda like an orientation. Everything seemed nice. All was in order. I guess. The people were friendly enough. OF course when I got home a got a call for another interview.. For psych floor. I think I will pass on that one. Only because I want to get some experience first before and if I decide to go to psych. It isnt totally out of the question later on. We will see. I would like to find a job and just stay there till I retire...On an unrelated topic...The weather today was FABULOUS!! absolutely beautiful.....I love spring!! On another topic, I have been spending up a storm...Money that I dont have...CRAZY!!! I bought Dansko sandals, so comfy yet so unattractive!! I also bought a pair of merrels sneakers and another pair of fancy shiny sandals.. HMMM total amt...$266.00..yikes might have to do some returning...

More Details on the Job...

Ok, Lets see ,it is a company that owns mostly nursing homes that rents out a floor of a local hospital ..It is labeled as a Long term acute care unit. Average length of stay is 25 days. Because they are a "nursing home company"they have a bit of a bad reputation. The benefits arent great. Nothing like I would get if I worked for a hospital. But it is a great opportunity to learn and it is considered critical care because the majority of the patients are coming from ICU but not ready for a step down or rehab AND they pay really well!! ( always a bonus)I will be working nights 3 Twelve hour shifts. I am not sure what the average pay is where everyone is at but I will be paid a base amount of $32/h plus 3 nights diff. and another $2 for weekends.
The local hospital in a near by town is starting new grads at $28 plus I guess similar diffs. I would be curious to know how much other states are starting new grads..Now I know California (Heather..yay) pay is really up there. New york is pretty good as well. but I am happy with the experience mostly, the money is just a nice bonus.Cant wait to start!! ( remind me I said that when I post my first bitch fest)