hi ho, hi ho, its off to work we go

I love being a nurse, I really really do. And for the most part I love the hours - relatively flexible schedule; work 3 days, off for 4, and because of it, you can essentially get a week off without ever taking vacation time. What I do not love is the fact that the hospital never closes. I have worked the last 4 Thanksgivings and tomorrow will be my 4 Christmas I've had to go into work. (Not to mention the fact that I had to work during the blizzard last weekend when everyone else in the DC area was snowed in. They shut down everything from office buildings to public transit to the bars. But obv not the hospitals.) And this year my Christmas schedule is particularly crappy: work Wed, Thurs, Fri (Christmas day); off Sat; work Sun, Mon, Tues. I am just slightly depressed that instead of being at home with the fam and the little cousins right now, I'm alone in my apt trying to fall asleep b/c I have to be up in less than 5 hours to go to work. I just keep telling myself that I'm lucky I have a good job, I have fun co-workers and cute doctors to spend my days with, and for the most part I like my patients. Plus I get 5 days off for New Years. Siiiigh... I love my job. I make a difference in people's lives on a daily basis. I love my job, I love my job, I love my job...

This is where I work

In case you havent heard/seen the news, GUH just finished up a 13-way kidney swap. Yes, if you're familiar with the Grey's episode where they did a kidney swap it's kind of like that. Only this is real life. (I get annoyed when people are like, "oh thats no big deal. they did that on Grey's." Riiight. If they thought it up for some primetime drama then clearly performing the actually surgeries is no big thing.) PSHT.

Anyway, it was originally going to be 16 or 17, I think, but for various reasons a few didnt work out so the final number was 13, which is still the largest ever in the country, and the only one to involve a child. Pretty cool. And yes, I personally have taken care of a number of the patients including the ones mentioned in the article and the ones interviewed in the video, which is also pretty cool. :)

Check out the video of their press conference too. It just warms my heart. :)

doctor love

Instead of writing about how much I hate doctors I thought I'd write about this one doctor I love. Well, actually there are 2 doctors I love:

The 1st doctor (Dr. V) is actually a 4th year and I have known him since he was an intern and fresh out of med school and he's a lot of fun to work with. It amazes me how much he's improved as a doctor. All the other doctors turn to him for the answers and for advice and approval. I had an issue with a patient and when I walked into the doctors' room he was there along with the intern, the med students, and the 2 fellows. No one knew what to do so they all looked at him and he very calmly, nonchalantly just threw out the answer and they all agreed. Then the other day we were in the middle of a code and I was the recording nurse. The code was not very well run and everyone kinda seemed all over the place, plus the medicine resident couldnt get a fem line in the patient. Dr. V walked into the room, calmly asked for an update, and took control. (His confidence makes him all the more attractive.) He got the line in and then took the time to teach the other doctor and give him some pointers. He is awesome and I love him.

The 2nd (we'll call McCutie b/c that name fits him perfectly) I legitimately have a crush on, but for real reasons - not just because he is sooo cute. :) He's sweet, funny, and sarcastic. AND he is so freakin smart and even though he's just an intern he doesnt take shit from the other doctors. But he's not one of those arrogant, condescending doctors. He actually knows his shit and therefore has a right to not take shit from other doctors (which is hot :) ). Plus it doesnt hurt that he actually cares about the patients and has great bedside manner. Whenever I had an issue with a patient I knew that he would actually address situation. One night I had a patient who had a HR in the 130s and respiratory rate of 40 (40!!) while he was asleep but otherwise stable. I told him about it and within 10 minutes he was in the room with me assessing the patient. He's only an intern and already such a good doctor and it makes me sad that he's not on our service anymore. He actually reminds me of a younger version of Dr. V, which means he'll grow up to be a fantastic doctor, which again is just plain hot. :) Siiiigh.

Why cant all doctors be as good as these 2? Or better yet, why dont these 2 just stay on our service forever? :)

ACLS certified!

I finished a 2-day Advanced Cardiovascular Life Support (ACLS) class today which was really great! It basically incorporates Basic Life Support (which is essentially means CPR) and takes it one step further and teaches you what to do in an arrest situations: how to read a heart rhythm, how to treat said rhythm, when to shock, when not to shock, when to give meds, what meds to give, etc. Like a BLS class there's a written component and a demonstration. The demonstration part was kind of intense. Its one thing to read a scenario and decide what action to take based on multiple choice answers. Its completely different when you're given a simulation patient who can talk, breath, provide vitals, is crashing, and you have a team of 3-4 people just waiting for you to give them orders. Its only a simulation, but it still kinda gets your pumped up and makes you nervous. Plus, its not like ACLS is basic stuff; there is a ton of info to know like which drugs to give when, what doses to give in the various situations, when you can and cant shock, at what intensity do you shock, what if you start in one rhythm and your patient decompensates into something worse, what do you do then, etc etc. So you have to keep it all straight. If you dont, your already crashing patient will die. Like I said - intense. But it was really good, really interesting. Now I can put together all the stuff I learned in my EKG class and the cardiac drug class and know how to treat the various rhythms.

...but, as awesome as this class was and no matter how well you think you know your stuff, you'll never really know till you put it to use. And of course you only get better at it with practice. ...so, I kinda want a code situation to happen so that I can see just how prepared I am... As long as I'm certified though, I essentially could run a code! Pretty exciting!! :)

Christmas Songs

Why is "My Favorite Things" considered a Christmas song?

...just curious

thankful

Yes, I know this is a week late, but this is what I am thankful for this year and why. Here we go:

• Family.... who live nearby and I can go see whenever I want, and aunts and uncles who wont stop having babies and continue to give me tons of adorable cousins :)
  
• Wonderful friends.... monthly dinners, late night chats, DC shenanigans, and of course The Ocho.
  
• A (well-paying) stable job.... yes, jobs are hard to find these days so I have been thankful for this ever since last january when I knew that I'd have a job for at least the next 2 years. But I also found out that my aunt, who recently bought a new house, just got laid off... 3 weeks before xmas... So yes. Thankful for employment
• A job I LOVE... because really, how many people can say they truly LOVE what they do? I honestly cant imagine doing anything else with my life.**
  
• My health and the health of my family and friends... not only do I get a daily reminder while at work of how lucky I am that we are all healthy, but 3 weeks ago a girl I was friends with in high school passed away from non-Hodgkin's lymphoma. She was 26 years old. 26! (RIP Elizabeth.)
  
• Living in the Washington DC area... fast-paced, great night life, you can always find something to do or see, beautiful scenery - what more could you want?
  
• A great apt in a great location
• An awesome roommate with whom I get along perfectly
• Great co-workers who make going to work that much more enjoyable
• Good doctors... unfortunately, our team currently isnt the strongest we've had, but I am thankful for the good doctors we do work with.
• Shoes... and dresses... and purses... and all the fun things I have spent entirely too much money on the last couple months. :)
• Really good wine... yes, I have abandoned my signature bottle of Andre and am currently exploring wine. Its quite delicious and I'm a fan.
• Movie nights
• Warm, sunny days
• Friendly patients
• Free drinks out at the bar

There are tons more, but right now that is all I can think of. Hope everyone had a great Thanksgiving!


**sidenote in regards to the job i love: keep an eye out in the news b/c yesterday was the start of a 17-way kidney swap that we're doing at our hospital.

One of the many reasons I love my job

There are plenty of days where I just kinda go through the motions of handing out meds, doing assessments, charting and such that I sometimes leave work feeling as though I wasnt a very good nurse. Other days - like today - I really enjoy and appreciate what it is I can do for my patients. Today I was able to help out in my first code, which was pretty awesome, but what really made me feel like a good nurse is all the educating I did for my patients. A lot of people think that all we do IS just hand out meds, do assessments, and chart, but we do so much more. One of the things we are in charge of is educating patients and making sure they understand whats going on. I did medication teaching, discharge teaching, plan of care teaching, activity expectation teaching, diet teaching, you name it, I taught it.

One of my patients was being discharged home today and she needed to take care of her wound. The doctors have been the ones doing her dressing changes and so when she was told she was going to have to do it herself, she had no idea what to do. She had never even LOOKED at her wound (she's a super anxious patient and the thought of seeing staples in her abdomen terrified her). So I had to talk with her, calm her down, and then proceed to sit with her for the next 45 minutes showing her her wound, familiarizing her with it, teaching her about it, and doing wound care AND drain care teaching. I had talk her though it so she felt comfortable enough with her body to be able to handle packing/changing her dressing. When the doctors came in an hour later to try to explain the importance of wound care and that she would have to do it herself, she was able to tell them that she already got teaching, she knew what she was doing, and she felt confident and comfortable doing the dressing changes herself. Successful teaching done! My other patient was going to the OR and was super anxious. You could just see the fear in her eyes (behind all the tears) so I sat on her bed with her and just held her hand for 10 minutes while she calmed down. When it was time for her to go she just squeezed my hand, looked me in the eye, smiled, and said thank you.

Days like today, I feel like I made a difference in someone's life. I reassured someone, I educated, I comforted, I cheered someone up, I taught someone how to improve their quality of life. Days like today are why I love my job. They're why I became a nurse.

My First Code!

I took part in my first code today!! Having worked in the hospital for over 3 years, I've been on the floor during a good number of codes, but now being a nurse I actually was able to take part and really see what happens and how it's run. I didnt run it and it wasnt my patient, but still it was pretty exciting! Ok, I realize that in all honesty, the fact that we had to even run a code, sucks. But being a new nurse it was really intense and really exciting. I've realized though that I def need more practice in order to feel comfortable and confident. (Guess its a good thing I'm taking ACLS in a couple weeks!) I was so flustered when they were asking me for supplies that I felt like I was taking forever. But in the end it all worked out fine, all the nurses were helping out and we all worked together. They intubated the patient on the floor and transferred him down to the ICU. It all happened so fast. We called the code at 1800 and the patient was rolling off the floor by 1825. Intense. I would love to be part of a code response team or even do something like trauma. I find that stuff so fascinating (um, has anyone watched the show Trauma?? I've moved on from Mercy, mainly because the drama is too getting to be too much. But Trauma = awesome! I seriously want to BE Nancy!) But I dont think I'd be very good at it, to be completely honest. As much as I like the excitement, and adrenaline rush, and as much as I love to stay busy, I can get overwhelmed somewhat easily. More than anything I just want the knowledge, capability, and the confidence that comes with working in that field.

Girls

If you know me, you know that I dont like most girls and get along much better with boys. I dont like the drama that girls naturally create, I dont like their shallowness, and I dont like the stupid games they play. There is a boy who I think is cute and super fun, but I never really thought much of him, he's just fun to hang out with. Plus, he's a friend of Laura's, so more than anything, we're just friendly. At our party he and Laura were being pretty flirty, and even though Laura denies liking him, I know her. So I decided to have a drunken heart-to-heart with him and see what was going on there. It was during said heart-to-heart that I realized he's not so much into Laura, but instead he kinda started hitting on me. Not gonna lie, I kinda liked the attention (McCutie didnt come to the party, so I had to focus on someone else :-p) and he IS cute and he IS a ton of fun, but I wasnt sure what the deal was with Laura so I asked her. Again, and again. And every time she swore they were just friends. So, I talked with him for a while and then I could see that Laura was starting to get jealous. She was trying so hard to jump into whatever convo we were having and trying to playfully sit between us on the couch. It just got on my nerves because I had asked her multiple times if she liked him and she said no, so technically - TECHNICALLY - he's fair game. I realize that she probably does like him at least a little, but she should just admit it, right? If you like him, say so and I'll back off. I gave you multiple chances to say so, and you didnt step up. So if I like him and anything happens there, you have no right to get upset.

ugh, girls.

clarification: nothing actually happened between this boy and me, and nothing will at this point b/c I'm a better friend than that. BUT, its annoying b/c technically she has no claim on him so normally, I'd put a little effort into it and see if something could potentially happen. But in this case I cant, even though she's too stubborn to admit that she likes him.

Party Recap

Laura and I threw another party this weekend randomly just for fun. It was ridiculous.

- Flip cup tournaments
- 21 CUP!
- Our neighbors called the cops
- people who I havent seen in months came
- completely random people showed up
- i think at one point we must have had literally 40 people in our apt (if you've seen our apt, you know that is a lot of people to squeeze in!)
- one guy couldnt bring beer, so he brought us McDonald's instead
- dance party!
- jello shots
- Joe PT and his Boston-accented friends came and stayed till 7am
- 5am fist fights
- Caroline and I discovered our mutual love for Lance from NSync

I dont think this party was the drunken mess that our last party was, but it was definitely crazier and more random. And tons of fun!

"MD was notably absent"

Last night's shift was one of those where you look back on it and say, "Seriously? Did that really happen??" Mr. M had been slightly confused and attempting to get up and wander around during the day so at night we turned on the bed alarm so we would know when he tried to get up. The alarm went off no joke, every 15 minutes. At 11pm he ran down the hallway to the back stairwell trying to escape. At that point the nurse gave him some Ativan to help calm him down, and it worked for a tiny bit. At quarter to 12 he got up out of bed and walked over to the window to "try to escape." We got him back in to bed and thats when things got a little crazy. He started hallucinating and because of it, was swatting at us. We tried to calm him down and reorient him, but nothing worked. He was getting more and more agitated so we paged the doctor. No response. Vitals were stable, but he was just SO confused. There were times where you could reorient him, but for the most part he was mumbling nonsense. Pupils were unequal, but reactive. The patient started swatting and throwing things so much that we just ordered the restraints. when the MD finally returned the page, we had 3 nurses and a tech in the room trying to hold the patient down. The doctor took a quick glance at him and said, "ok, give 5mg Haldol." We gave the Haldol, nothing. We gave another Haldol but then realized that the IV was infiltrated, so we gave Haldol IM. Still Nothing. The doctor ordered to get labs and an IV. Hey doc, how the F are you gonna get labs and put an IV in a combative, flailing patient. At this point security was there helping us. Nothing was working for the guy. The MD didnt order anything, he didnt even go in and assess the patient! He was worthless. He continued to thrash for the next 3 hours. We gave Mr. M a total of 20mg of Haldol and 15mg of Morphine and nothing was affecting him. It was absolutely ridiculous. In the morning he actually got worse and we had to call up 4 security guards to get him under control and we put him in 4-point restraints. When the other residents came in, the R4 looked at the doctor who was on last night and asked him why he never ordered a Neuro consult. ...b/c he's an idiot. Nothing too alarming medically since the patient was hemodynamically stable, but he was just SO agitated and so confused. The resource nurse said he's probably encephalopathic but I've never seen encephalopathy present like that. Confusion and anxiety, yes. But there was definitely something else going on.

It was just the most ridiculous shift. I cant believe the doctor on call didnt do anything. He literally never even went in past the door frame of the patient's room. I was so frustrated with him and I wasnt even the nurse for that patient. Thank goodness the rest of our patients were stable! We were able to spend most of our time in with that one patient. None of us got a break during the night AND we didnt leave till 9am. Ridiculous. Not in the sense that my patients were unstable, but everyone was just in disbelief of what was going on and how crazy the patient was. Oh fun times. :)

Stick 'em.

Usually when we need to draw blood from patients we ask the techs to do it because they have more down time during the day thus they're typically better at it. Now that I'm not a tech anymore, I dont get as much practice, so this morning when it was time to draw morning labs, I had 3 patients I needed to stick for blood, all of whom are really hard sticks. And I got all 3 of them! I was super excited. Plus one of them needed to get stuck twice for 2 different sets of labs and I was still able to get all the blood! I know that doesnt seem exciting and I remember in nursing school my professor said, "Getting an IV, drawing blood, thats a basic skill. Everyone can do it. No one should be getting excited about a blood draw." ...Bullshit, professor. Come work on my floor where every single patient is a hard stick b/c their veins are completely shot from having to draw blood multiple times a day. On one of the patients this morning, I drew his blood from a tiny little vein that popped out over the knuckle of his right thumb. Is that the ideal spot? Nope. Did it hurt? Probably, but it was the only vein I saw. Did I still get the blood in one stick? Fuck yeah.

Thats all. I'm just super excited about my lab draw luck this morning. :)

tv break

I turned on my computer today to watch last night's episode of Glee online and I'm so disappointed that it was a repeat last night! Dont get me wrong, I thoroughly enjoyed watching baseball, especially since the end result was the Yankees LOSING (hahaha, sorry Ally) but I totally didnt put 2+2 together and realize that I was watching the game on Fox instead of Glee. (Besides, I love Cliff Lee and his behind-the-back catch in the 8th was amazing. Siiigh, baseball makes me happy and I cant believe the season's almost over.) BUT, House wasnt showing on Monday, NCIS was a repeat on Tuesday, and now Glee and Mercy werent on last night. I need my TV fix!! They really need to schedule all these sporting events around prime time tv. :)

Side note: I love Mercy! The hospital drama can be a little over the top, but this show totally makes me want to be a better nurse.

Team work

I love the people I work with. Our unit (as I'm sure you can tell from some of my recent posts) tends to be pretty "heavy" at times and sometimes just because of the way the patients are, some nurses end up getting really busy assignments. The fabulous thing about our staff is that everyone is always willing to help out. There are a lot of other units where nurses just watch their coworkers run around like a chicken with their head cut off while they're sitting around doing nothing. Our unit is absolutely not like that.

Last night one of our patients blood pressure started to drop (the same pt. I talked about who got pain medicine every hour is and extremely sick, needing 1-to-1 care). His heart rate was in the 130s, and his BP dropped to 80s/50s while we were giving him blood. We actually ended up pulling the code cart next to his room because we were certain we'd have to code him. We had all 4 nurses in his room at one point and after the first hour of this going on (because yes, this intense ICU-type care went on for more than a hour), we all kind of tag-teamed it so that we were able to have 2 nurses in his room at all times. It was fantastic team-work and I love that on our unit you can automatically count on the other nurses helping you out. You never even have to ask - help is always offered. Believe me, it makes all the difference in the world. Our patient population can be an absolute nightmare, but ask anyone who works on our unit - the nursing staff is what helps you through the day. (Danielle, when you're looking at where you want to work, definitely look out for how helpful the staff is and how all the nurses interact.)

_________
In case you were wondering about our patient... His pressure initially dropped and we brought the code cart over starting at about 0245. We woke up our doctor, Dr. V and starting hanging more blood (he has 2 IV ports and we had blood going in through both of them). He took one look at him and said, "I'll go write the transfer orders so we can get him to the ICU." He came back 10 minutes later and said that the ICU attending did not want to admit him yet - he wanted to wait and see if he responded to all the treatment. Hey Doc, of course his pressure will hold steady if you're infusing 2 units of blood simultaneously at an ungodly fast rate (although really, I wouldnt exactly call 90s/50s all that great). But what happens when we stop pumping all that fluid into his system? Do you really think his pressure is gonna hold? Considering that his g-tube proceeded to put out 450mL of frank red blood, I think not. Dr. V called the guy back at 0400 and gave him the recent update and the doc still said dont transfer. Mind you, we've had at least 2 nurses by his bedside for the last hour trying to keep this guy stable. This continued for HOURS. The stupid doctor refused to transfer him. Thank goodness all other patients were stable and we were able to help out, but its not like we didnt have other things to do. At 0630 we got the managers involved and the patient was FINALLY transferred to the ICU at 0730. FIVE HOURS after all this started. ugh. Have I mentioned that I hate doctors sometimes?

My feet hurt.

I kinda want to get those step counter thingies that calculate the distance you've walked so I can see how much running around I do at work. Today was ridiculous and it just reminded me of how I strongly dislike doctors sometimes (sorry Egon). It's so frustrating that regardless of how much we know/do and how well we know our patients, nurses cant do shit without the okay from a doctor. Are the doctors the ones providing hands-on care to the patient 24/7? I fully appreciate the knowledge doctors have, but sometimes they don't understand what is going on with patients because they're just not around enough.

We have a 24yo patient on our unit who had 2 small bowel transplants gone bad, he had the 2nd one removed a few weeks ago (yep, he has no small bowel) and just had major heart surgery 3 days ago. He is in awful shape and is not exactly the most stable patient. But, not only is he medically "heavy" but on top of that, he is also obnoxious and super needy. Yesterday he started vomiting liters - LITERS - of blood. The doctors were like, "oh ok, just monitor him and we'll probably give him some blood." FYI docs: if your patient is vomiting liters with a blood pressure that is dropping, he needs constant care - something he cannot get on a regular in-patient unit. Each nurse on our floor has 4-5 patients to take care of, and when you have a patient like Mr. H, your other patients tend to get neglected, which unfortunately happens and you deal with it, but you find ways to remedy that (i.e. transfer him a unit where he can receive 1-to-1 care). We tried to talk to the doctors to get him transferred to the ICU where he could get that, but noooo, the doctors didnt want to. Today I was the lucky one who got to take care of him. Overnight he got 4 units of blood, 2 units of FFP, and his H&H were still only 9 & 23. I came on to my shift and his heart rate was 110 and O2 sat was 82%. (That number should never drop below 92%.) He gets pain medicine every hour, Benadryl every 4, nausea meds every 6, Ativan every 6, labs drawn every 6 hours, vital signs every 4 hours, and IV antibiotics every 8. Of course none of those are scheduled for the same time, so everything is spread out during the day so its not like you can take care of more than one thing with each trip into the room. And that's just what was scheduled, that doesnt include added interventions. For example, halfway through my shift he started having irregular heart rhythms which required interventions and thus more care, and his lab levels were low and needed 4 hours of electrolyte replacements. I was probably in his room every half hour, and I had 3 other patients. He wouldnt be such a handful if he didnt get the pain medicine every hour. Typically patients who require pain meds that frequently get put on a pain button, which I convinced the resident to do, but then the stupid fellow who I absolutely CANNOT stand, said no. I'm sorry, are you going to come in and give this guy meds every hour? Are you going stay in his room for 20 minutes to try to get his pillow positioned just right so he doesnt scream bloody murder? Are you gonna sit there and listen to him when he starts talking about how he doesnt want to live anymore? No. We have to do that. You just write orders of a piece of paper and never go in to see your patients. Yeah, you're a fantastic doctor. (sidenote: why the hell is this patient still a Full Code? Because the doctors are too stubborn and refuse to admit that this kid is dying? oh ok, thats a good reason.)

I really think that med students should be required to do a rotation following a nurse. Even for just a week, just so they can realize exactly what it is we do all day. Siiigh.

Crazies always make the day interesting

Liver patients always intrigue me. Its amazing what kind of effect a failing liver has on the body. One of my patients today has End Stage Liver Disease (ESLD) and because of it, is completely jaundiced (to the point where his skin actually looks like its glowing, its so yellow), his abdomen is enormously distended, and he is encephalopathic (confused). Apparently overnight he pulled out his feeding tube that he had inserted thru his nose (a Dobhoff) not once, but twice. He gets his nutrition thru the tube and all of his medications crushed and pushed thru the tube as well. Naturally, he couldnt get any of that. Then when he went down for a procedure, I get a call from the radiologist informing me that my patient had decided to pull out his Quinton catheter, which is essentially a large IV that is inserted into the internal jugular and used for dialysis. Thus, my patient not only lost all IV access and could not get dialysis today, but I'm assuming was also bleeding profusely from the site. Thank goodness the radiologist decided to walk out and check on him, otherwise there's a good chance he could've lost quite a bit of blood laying there on the stretcher. Anyway, he was quite the handful the first 2 hours of my day. But then all of a sudden he did a 180 and was a completely different person in the afternoon. He was totally lucid, cracking jokes, compliant, and so pleasant. I swear, liver disease is one of the most puzzling things.

PS - totally random, but as I was driving out of the hospital parking lot today I saw a guy who I'm assuming is a Georgetown student, undergrad or maybe even med school. He was wearing khaki pants and a blue blazer.....and wearing a bright pink and purple backpack. It was awesome.

HC highlights

I was debating whether or not to come back for homecoming this year, but I'm so glad I did! Great weekend! ...Aside from switching back and forth between hungover and drunk all day Saturday. Totally worth it though. :)

- "Um, there's no flight suit involved in that equation. EW."
- Boxer switch (so disappointed there was no documentation of this)
- Egon's awesomely uncomfortable pull-out couch
- "That girl's not wearing any pants!"
- Gin Bucket!
- Man voice
- "Oh hey. Would you like to join me in section FFFFF?"
- "Hi my name is Ricki."
- Drunk Brandi
- Being Katie's wing-woman (which I will gladly do any time) :)
- Angry Egon threatening to kill everyone
- Kreg's awesome moves
- Drunk, late-night heart-to-hearts :) :)
- "I dont need to hook her up. Nikki hooks herself up."

Siiigh, I always get so depressed when its time to leave. I never want to have to say bye. I miss everyone already! ...So, who wants to go back to NC? :)

October

Click on the pink button everyday!

patience

I've noticed that I have far less patience during night shifts than I do during day shifts. It could be because I'm awake at a time when I should be sleeping, or b/c my patients are awake and needing things at a time they should be sleeping. Either way these last 2 nights have been particularly difficult. I'm pretty sure my patient assignment contributed. I had 2 incontinent, massive patients who cannot move on their own (one of whom is Spanish speaking only, which gets really old and really frustrating when she does not understand or speak one single word of English). But my other patient was the worst. I walked in there and this was our first encounter:

Me: "Hi Mr. J, my name is Nikki and I'm gonna be your nurse tonight."
Patient: "Yeah. I've been waiting... Look. before you do anything or give me any of those meds, this is what is going to happen. You need to get me my 3 PhosLo pills."
Me: "Ok, well Mr. J, you can only take those pills with meals, and you're actually not supposed to be eating. You're NPO because you have a proce----
Patient: "No. I dont care, I'm eating damn dinner. So just get me my pills and when you come back you can help me change out of this gown, get back into bed, and you need to empty all my drains. But I'm going to eat my damn dinner."

...lovely. And of course all you can do is smile at them and do the best to accommodate. I dont ask for much from my patients, just some effort and a little pleasantness. I understand being in a hospital sucks but you're not there to get pampered, you're there to get better. I have no problem helping you do something you clearly have difficulty doing. But, if you're going to demand stupid shit from me (me, your nurse, aka the person who brings you pain medication) like pulling the blankets over you when you're capable of doing it yourself, OR if you're going to ask for my help wiping your own ass (b/c yes, the next thing he needed me to do was literally wipe his ass) then you better F-ing ask me nicely.

For anyone who's ever regretted a drunk dial/text/conversation... :)

"Telephones are, without question, useful devices. But they are also, it seems to me, the verbal equivalent of houses without toilets. Telephones allow minds to communicate with minds (or tongues with ears, at least) in clarity or turmoil, in semisomnolence or drunkenness, in lust, joy, hysteria, stupefaction or any other state that fails to render a human physically incapable of holding up a quarter-pound chunk of perforated plastic - which is most every state there is. That telephones can connect us in seconds to any creature on earth foolhardy enough to lift its own chunk of plastic is wonderful. But it's also terrible, given what a lot of people think and feel about each other. That's why, until they're equipped with some sort of flush or filter or waste-disposal system for the billions of words that ought not to be spoken, I'll not trust the things."
--The Brothers K


(Not that this relates in any way to my weekend. My birthday weekend was awesome and full of drunkenness and fun. It just so happens that I read this paragraph today and thought, "hmm, i can totally relate." :) )

I have amazing friends :)

Thank you to everyone for all the birthday messages, texts, and phone calls! Even though I am slightly bummed about turning 25 and entering the quarter century club, today was a great day. I did have to work though, which was kind of a bummer, but I actually love my job, so its all good. Caroline had the cutest hand-made card waiting for me when I came in, PLUS Lisa baked a DELICIOUS cake: super moist yellow cake with this creamy vanilla frosting with a hint of lime. (Sounds kind of odd, but trust me, it was amazing.) Then when I came home, Laura made me dinner, bought me flowers, and went to Georgetown Cupcake and got me 2 red velvet cupcakes - my absolute favorite!! Have I got a great wife or what? :)



I love birthdays, they make you feel so special. Thanks again for all the birthday wishes! Love you!

Pre-Birthday Day

Today was wonderful. Expensive, but wonderful.

It started when Lisa came over last night to watch the NCIS premiere. NCIS + plenty of beer = random weekday of drunkenness. Awesome. Lisa ended up crashing here last night and then today was a day of pampering. Massages then pedicures. Then tonight was our monthly dinner. There are 5 girls (including me) who all started on our unit at the hospital at the same time 3 years ago. Now Kerri and I are the only ones who still work on 6 Bles so now we get together once a month and go out to dinner and catch up and stuff. Its a great tradition. And tonight we went to this fantastic little French restaurant and wine bar. Delicious. It was fun to get dressed up and go to a nice restaurant, its been a while since I've been to a fancy place for dinner.

All in all, great day. I hardly even care that I have to work on the day of and the day after my birthday. Plus, there is weekend celebrations to look forward to. :)

Day 1 of 3

Alright. I could talk about how today I worked a 13hour day and sat down for a total of 20 minutes all day to stuff my lunch in my face, or how I did not pee for 14 hours (i swear this job is going to give me a bladder infection), or how I dont even feel like a nurse anymore because I spend all my time figuring out this whole computer system and scanning medication barcodes... I could. BUT since I feel like all I do recently is talk about work, I'm not going to. (And I think I'm starting to scare Danielle with all my stories...) :)

Instead, I'm going to talk about my one patient: 50-something-year-old female, s/p liver transplant and the reasons I love her:
A.) She's a nurse practitioner (although this kinda makes me nervous - taking care of a fellow nurse esp as a new grad) and i have much respect for NP's
B.) She's in the Navy and I overheard her using military lingo, which totally make me smile. :)
C.) She's from Boston and has the cutest Boston accent. (And I'm such a sucker for Boston accents, I'm sure you can all figure out why)

So, military speak on top of a Boston accent = super cute. Plus, she was a really easy patient medically, which is always nice. Anyway, she brought a smile to my face. And thats all (the nice stuff) I have to share for now. :)

residents

I love where I work and I love that we are a teaching hospital. But sometimes I hate having to deal with residents. We definitely have some good ones - we've been really lucky because our team lately has been really good. But we currently have one doctor (a 4th year) who is... well, he's not good. He doesnt discuss anything with the team, he just writes whatever orders he wants, and he never returns his pages. One of his first days on our service he took one look at a patient's Dilantin level and decided it was too low. Had he looked back he would've noticed that that particular level was therapeutic for the patient, and he probably would've left it alone. Instead, he decided to increase her PO Dilantin to a stronger IV dose. The patient was later non-responsive and frothing at the mouth. Yep. Good decisions there. ...Another night we had a patient who was practically CODING and he didn't return his pages for over an hour because he was CHANGING A DRESSING. Seriously? ...Yesterday our patient who is ordered for IV lopressor (a beta-blocker) had a BP of 160's/70's, HR in the 70's. Nothing too crazy considering he has a history of hypertension, but he was ordered to get the lopressor so the nurse hesitantly gave it. The following convo took place:
RN: His HR is 47.
MD: okay.
RN: I had given him IV Lopressor and his BP is better, but it dropped his HR from 72 to 47.
MD: okay......? so, what do you want me to do about it?
What?? Are you telling me you're ok with a 73yo post-op patient with a HR in the 40's? How about order something that isn't a beta-blocker? How about switch his medication so that his HR wont come to a complete stop. I mean, come on. ...Doctors. They really should listen to the nurses more. :-p

Ohhh yay for work...

Yesterday/last night was absolutely absurd. First off, I got home yesterday morning at 8am from working the night before and slept from 8:30-1pm. At 1pm, my body decided it didnt want to sleep anymore so I just laid in bed for the next 4 hours hoping that I would miraculously doze off. Didn't happen. Came in to work for night shift #2 after sleeping 4 hours and these are my 4 patients:

Patient #1: Liver transplant, encephalopathic (confused), severely edematous, O2, total care (I'm talking he cant even raise his arms or move his legs), and weighs well over 300lbs.
Patient #2: 80yo female, admitted 2 nights ago for a wound dehiscence (the staples from her surgery busted open). Sweet lady, but very needy; She calls for help for the tiniest little thing and she's terribly afraid of feeling pain. This may be insensitive, but seriously, if you have surgery there's pretty much no avoiding pain. Not only is she a handful to begin with, but the nurse who had her during the day failed to take off any of her orders so I was left to clean up the mess, which meant Patient #2 was going to be on IV medications for the next 6 hours straight. (This nurse is awful. How she is a travel nurse -- no, no, how she is a nurse in general -- is beyond me.
Patient #3: Old small bowel transplant who had his ostomy take down (ask me if you want to know more) with a possible obstruction. Because he's obstructed he's nauseous and to help, he has a G-Tube (tube in the stomach) to decompress the stomach. BUT, he has major pain issues and the only thing he can get is Dilaudid pills every 2 hours (which is not enough to keep him comfortable). The thing with giving pills is that you cannot have your G-Tube suction because you will just suction out anything he swallows. So he has a tube but it's not doing its job because he's taking his pain pills so frequently. If he doesnt take his pain pills, he ends up crying (literally) in pain.
Patient #4: my easiest patient: 70yo female with an abdominal incision that is leaking and therefore needs to be packed and have a dressings applied to it. She also needs IV supplemental nutrition.

So, they're a bit of a handful. Nothing too crazy medically, just all very needy and time-consuming. No big deal. BUT, last night was our "Go Live" night with the computerized system, so the medication pyxis (the machine that holds ALL medications) was down and we had to deal with that at the beginning of our shift. I was passing meds, doing my assessments, charting, etc. and I'm all caught-up with everything by midnight. Pretty good. Well, at midnight, we "went live" and all hell broke loose. The medication machine was still not working, Patient #3 needed his pain meds but I couldnt get them and he needed something to help him sleep but I couldnt contact the doctor to get a verbal order because he was in the middle of a Code. Patient #2's blood sugar dropped down to 51 (low blood sugars = Not Good) and she needed her nerve medication but couldnt get it b/c of the system being down so the only thing I could do was rub her feet. (first of all, gross. 2nd, like i have time to sit there and give you a foot massage, i mean come on.) Meanwhile Patient #1 was confused and needed help going for an MRI (aka two petite girls trying to move very large man who cant even hold his own head up onto a tiny little stretcher with the transporter standing there, useless. Riiiight). All night long we were trying to figure out the medication system, how to chart, and how to draw all of our morning labs, how to check our orders, ALL while still remembering to care for the patients on top of dealing with the computer stuff. It was insane, to the point where it was comical and all we could do was laugh at the situation. I worked from 7pm to 7:45am with no break aka no food. I managed to shove 2 peanut butter crackers in my mouth while running down the hallway sometime around 4:30am so that my stomach wouldnt eat itself but other than that it was basically non-stop all night.

The computer system is good in theory but its all still very new and the transitioning and getting used to everything is the hardest, and at this point there just seems to be a lot of room for error... Which, obviously you do not want when dealing with patients' medications. I'm not back till Tuesday morning so I'm seriously praying that they figure out most of the kinks between now and then. siiiigh, sorry for the rant. Ok, now that I've been awake for nearly 22 hours (and havent eaten in 17), its time for SLEEP.

Can't Sleep...

I always have a hard time sleeping before my 2nd night shift. You would think that after working all through the night last night, I'd be exhausted and sleep all day, but apparently my body just wants to torture me. Today, though, I think part of the reason I can't sleep is that at midnight we switch over to our online charting system. At 12:01am we will start charting assessments online, I's & O's, our Medication sheets will be online, labs will be printed from a hand-held printer, etc. etc. I realize that in reality Georgetown is behind the times since we haven't switched to a computerized system yet, so it is pretty exciting that we're finally doing that, but its also very intimidating to learn all this stuff. I took the class a month ago and haven't really practiced using the system since then, so I can barely remember how to do anything we learned. And lets be honest, what is the likelihood of this system "Going Live" and working perfectly? Georgetown apparently hired 70 travelers just to cover the floors and have extra staff around while we're in transition. It's pretty intense and as if our shifts aren't busy enough as it is, now its gonna take twice as long to get everything done while we figure out how to use the computers. I'm actually kind of dreading having to work tonight...

9/11

To be honest I completely forgot that today was Sept. 11 until I opened my computer this morning to check my email and get on Facebook. Its hard to believe all this happened 8 years ago. I still remember walking in first to my Anthropology class where my teacher was freaking out about something. We had no idea what was going on but we were herded into our gym to listen to some announcement. I had no family in NY so I don't think the reality of it all hit me until I was sitting on our field hockey field waiting for my dad to pick me up. I'll never forget sitting at that spot and being able to see the Pentagon and all the smoke coming from it.

Reading all the articles of people making a difference in the world is touching and heartwarming, but at the same time it makes me feel so bad that I've done nothing with my life. I know countless people who are currently in the military and serving our country overseas and I have another friend who just joined the Navy 2 months ago. But I don't just mean making a difference in relation to 9/11 or serving in the military. So many people make changes in the world everyday, and this kid did it by the age of 16 (he was the feature story on CNN.com today). Sigh, I think all these stories combined with what today means for us has made me wish I had something more extraordinary to say for myself, you know?

Kitchen

I love this bar. Its a small Southern Bar, with country music, and fun people. It's in Glover Park right next to Gin & Tonic. I had never even heard of it, but Chris and Brad had told me about how it's their go-to bar -- it's their MadHatter. I went with Ally a couple weeks ago to check it out and loved it. So I took Laura there last night. Last night there was a bartender who was absolutely trashed. I mean, you just take one quick look at him and know that he's gone. He was hilarious - serenading us to any song that came on, pouring drinks left and right, dancing, etc. He grabbed Laura's drink, took a sip, decided it was no good and threw it in the trash. Then he proceeded to just make shots instead. At one point he took off his shirt and was dancing on top of the bar. He was pretty cute, too. But more than anything he was just really entertaining. Who was he? The OWNER. haha, love it. :)

For the Ocho

...because only you all would understand. :)

So, Steve-O is in town this weekend and we had planned to try to meet up at a bar last night. Unfortunately, we kept missing each other's texts and phone calls so we had no set plans. Laura and I were out at Madhatter and decided to wander over to Rumors...

A little background: Rumors is the bar that Sean and all the Sigma Pi boys used to go to allll the time. A couple weeks ago I ran into Matt Brown out at a bar and we chatted and caught up on everyone's news -- Matt is living with his girlfriend (big move!), Sean is still dating his girlfriend from about a year ago, and he took the Bar exam and moved back home to MA. Matt also told me that they never really go to Rumors anymore -- the Rumors phase is done.

Back to last night: I walk into Rumors and see a guy who looks like Matt Brown. Laura and I did a walk-by to see if we could tell if its him. Still couldnt tell, so we walk across to the other side of the bar so we could get a different view (we're creepers, I know). I discover that this Matt look-alike was wearing a Wake hat and determine it must be him. So I walked over and said hi. Then I proceed to text Steve-o and say, "I'm standing next to Brown, where are you?" Naturally Laura and I do a walk through of the bar to scope out any potentials and to see if we can find Steve-O. I see him standing next to the upstairs bar and he's talking to some guy with a baseball hat. I couldnt really tell but I assumed the kid he was talking to was this guy John (Sigma Pi, '05) who I know, but not that well, so I decide to just say hi to Steve-O and talk to him for a few minutes before saying hi to John. After talking to Steve-O for about a minute or two this other guy leans over to us and says, "umm, hi Nikki..." Oh guess who it is! Its not John. Its SEAN. I had a mini heart attack and was like, "oh my god I totally didnt realize that was you!" Followed by lots of hugs, then small talk, etc etc. It was actually really nice to chat (once I got over the initial shock of seeing him). While I'm back talking to Steve-O, I noticed that Sean was standing next to this girl (and thanks facebook I recognized her as his gf) and he introduced her to Laura, and then leaned over to her and said, "And that's Nikki over there" but we did not get a formal introduction. At the end of the night she walked over to me and said, "Hi Nikki. Sean really wants me to meet you, I'm Allie." So we did the small talk for a little bit while Sean was standing off to the side talking to Laura trying to ignore the complete awkwardness of his current gf chatting it up with his ex-gf. haha good times. :) She went to undergrad and grad school here in DC and is currently a therapist for a private practice up in MA, where she's from. Anyway, Sean is trying to find a job and just kinda hanging out till November when he finds out if he passed the Bar.

But in all honesty, it was kinda nice to see him again (aside from my heart stopping when I first realized it was him). haha, oh Friday nights at Rumors...

I'm a nurse!

Well obviously I've been a nurse for over 2 months, but now I'm actually a nurse on my own! I'm officially off orientation! Yesterday was my first day without a preceptor! Yay! And all of my patients survived. Double yay! :-p

Party Notes

• Firefly is dangerous. And by "dangerous" I mean amazing.
  
• No party should ever be without jello shots
  
• If you spill on our carpet, you will be forced to drink from a sippy cup
• Keg stands are always a good idea
• Why didnt we play more flip cup in college?
• (FYI: My team always wins at flip cup.)
  
• I am nowhere near as good at beer pong when sober as I am when I'm drunk
  
• Late night dance parties are my favorite
• Random drunk boys who want to fight are total mood killers
• Cartwheels across my living room. At 3am. In skirts.

um, I stand by my post from the 18th...... that is all.

BUT, I do love my friends for coming to our party, which may or may not have involved flip cup and keg stands... :) Fun times and a whole lot of drunkenness. :)

longest week EVER.

This has been my past week:

Thursday: 8-hour EKG class
Friday: 8-hour new grad class
Saturday: 12-hour night shift
Sunday: 12-hour night shift
Monday: fake day off
Tuesday: 8-hour day shift (during which I stayed an extra hour)
Wednesday: 12-hour day shift
Thursday: 8-hour EKG class
Friday: 8-hour day shift.

whew. Working 8 out of 9 days and finding time in between to study is exhausting. Especially when your 1 day off is a fake day off because its spent trying to normalize your sleep schedule. Thank goodness tomorrow is my last day and the start of the weekend!! :) Party on Saturday!! SO excited!

SVTs, PVCs, PEAs, oh my!

Hey, remember that time I graduated from school and thought I was done with homework, studying, and tests? Apparently it was all a lie. :-p

I had my first of 2 EKG classes today, which was actually really interesting. I would love to know all about it and be able to just glance at a strip and know whats going on, but reading EKGs is hard! I'm so overwhelmed with information. I really want to get good at all this stuff so I'm determined to learn it, but its so confusing. All the different rhythms start to look the same and blend together and its difficult to differentiate.

So, if anyone has any tricks to remembering all the different rhythms feel free to fill me in! Siiigh, back to studying...

Clarification

This is primarily for Danielle. :)

My previous post was not about you and your crazy busy schedule and inability to come to our party. I promise. I know what its like to juggle a full time school schedule, part time work schedule, and move into a new place. Hats off to you! :) Although, I am very sad I wont get to see you.

Nor was the post about anyone specific (and especially not anyone who actually reads this blog). :) It was just a general sentiment about plans falling through and my crazy obsessive Type A personality. :-p

Type A-ness

If you know me, you know I can be very Type A at times. I like to be organized and have a plan. Obviously there are times when I prefer to play it by ear like when deciding "what am I gonna do on my day off" or "hmm, which bars should we go to tonight?" But when I already have a set plan, and I've made adjustments to fit that plan I prefer to stick to it. Of course, you learn that in life things dont always go smoothly. I get reminded of that every day at work. When your patients' days can turn at the drop of a hat and when you have doctors telling you to do stuff in addition to the million things you already had written on your To-Do list, you get really good at adjusting your schedule and constantly reorganizing your day. But that is work life. And I always come into work knowing that my day will never go exactly as I plan for it to.

My home life and things like making plans with friends are a little different. I dont like when people flake. And I especially dont like it when I predict they'll flake. Its disappointing.

mreh.

Today was a little busy... and totally scattered. I've been working and taking a full patient load and pretty much doing everything on my own. I only really consult my preceptor for technical questions but for the most part I'm pretty independent. I was actually telling my preceptor and my manager that I feel like I can do more - I feel like I have had pretty standard assignments but I want to experience a "busy day" or "heavy patient load." ...Be careful what you wish for... I started out today with 4 patients, one of them was leaving so I knew I'd get an admission. I was on my way to discharge my one patient when the charge nurse asked if I could take 5th patient. I said "sure!" and was kinda looking forward to it so that I could know what it's like to take a 5th. Literally as soon as I agreed the patient showed up. So, I had to discharge a patient, admit a new one, and at the same time my other patient came back from a procedure vomiting all over the place. Slightly overwhelming. It took me a little while to catch up on everything, but eventually it happened. I was so thrown off though that I totally lost my focus and was so scattered for the rest of the day. I have no idea how I would've gotten through the day if Christy hadn't been precepting and following up on everything. Charting wouldnt have gotten done, meds probably would've been given late.... ugh.

I'm just so frustrated with myself because I totally expected to be able to handle busy days much better than I did. And whats even more frustrating is that the day overall wasnt even THAT busy - it was only busy for a couple hours. My patients were pretty easy, actually. Mreh. I realize I'm still relatively new so of course days will run smoothly, but I apparently I'm off orientation in 3 weeks! 3 weeks! Thats like 12 shifts! Actually, 3 of the days I work, I'll have class so really thats only 9 shifts! 9 SHIFTS!! Then I'm on my own! No one following up on me, making sure everything got done, reminding me of things I need to do, etc. etc. AHH!!

damn hiccups.

So, its Monday night and Laura and I decided to drink. Thankfully, we both have a nurse's schedule and don't have to work tomorrow aka Tuesday. Thus, we both got hammered on a random Monday night and it was fantastic. I don't really have much else to share except that we are drunk and I love my roommate. One of the reasons being that we share a love for random 80s love songs. :)

Also, FYI, if you have uncontrollable hiccups: Thorazine. That is the medication we give to our patients for hiccups. Which I apparently need right about now.

Yay!

I have sunglasses again! Chris apparently searched his house for my sunglasses so when I saw him yesterday, he gave them to me.

...Granted, the sunglasses he gave me are not mine and not the right color, but they're sunglasses nonetheless! haha. ...And yes, I'm totally keeping them. (What? They're really nice and they look good!) :)

FYI's

• It has been far too long since the Ocho has hung out.
• I am still trying to piece together Southern Day. :)
  
• I hate drama and the people who like to create it.
• I wish people would get married in locations that are convenient to get to.
• New episodes of NCIS make me happy and I love Gibbs.
  
• You know how sometimes when you want/chase something and then finally get it, you find out that maybe you didnt really want it in the first place? ...Ironic.
  
• I helped change an ostomy last night which was gross/frustrating/time-consuming/absolutely fascinating. (Dont know what an ostomy is? google it or ask me.)
  
• I am NOT getting along with our night tech. She keeps testing me to see what she can get away with and I do not take kindly to people manipulating me. But you know, if you have a personal issue with me, fine - we can try to work on it. What is not fine is if your petty bullshit and lazy attitude gets in the way of patient care. I am NOT ok with that. (And honestly if that's your mentality, you shouldn't be in the health care profession.)
• The good thing about working on the kind of unit that gets frequent flyer patients is that you get to know your patients well and develop a relationship with them. The bad thing is that you get to know your patients well and develop a relationship with them.
  
• I think I need to invest in Benadryl or Nyquil because my body is not adjusting well to having to switch between day and night shifts.

On that note, against my better judgment, I'm going to take a nap.

Someone I know better have a wedding like this:

Love it.

Lost my sunglasses :(

Yesterday was "Southern Day" hosted by Chris and Brad - some friends from Wake. Its an all day party with North vs. South beer pong, flip cup, case race, etc etc. Laura and I got there around 2pm and we barely made it in the door when we were told to join in on flip cup. Naturally, we couldnt turn down the opportunity and it was all down hill from there. (In case you were wondering, we (the south) won flip cup.) We met tons of people, everyone was so nice (and SO drunk). I think Laura and I made everyone we met promise to come to our party next month haha. The party was ridiculous. By 5pm they had to go on another beer run because all the beer in the fridge, most of the liquor, and the 2 kegs were gone. I dont think I've drank like that since Champong days back in college. Apparently I got tired at one point and decided to pass out in my friend's bed. I dont even remember making my way down there. I have no idea what made me pass out there, or how long I was there for, but I woke up just in time to go out to the bars with everyone. Classy, right? Good lord, the day was an absolute shit show. :)

Mark your calendars - Brad did!


Survivor Flip Cup:


View from the roof (how no one fell off is a mystery to me):


Chillin on the roof. (This is probably before I accidentally called Mike by the wrong name and he yelled at me):


New friends. Love this kid. (Note: sunglasses still in possession at this point)


Out at the bar, approx 1am and wayyy too many beers deep:


So, recap: I rocked at flip cup, met lots of fun people, drank entirely too much, Laura got locked in the bathroom, I lost my sunglasses, and I somehow stumbled onto and passed out on Chris' bed for an undetermined amount of time. All in all, fabulous party. :)

The joys of orientation

Okay, I'm sorry, but orientation was a gigantic waste of time in my mind. I have worked at GUH for 3 years now, I could probably give hospital orientation. I pointed out when one of the speakers provided the wrong information. Now, I can understand them wanting me to go to nursing orientation. But again, after working there first as a secretary, then a tech, and 2 months as a student nurse, there was zero - and I literally mean zero - information that I did not already know. 24 hours of guest speakers, lectures, powerpoints and not one new thing. A few things I did figure out though:

- I do not want to be in a classroom again any time soon
- Students (esp. brown-nosing, overachieving nursing students) are annoying
- I greatly appreciate any speaker who can get their point across in less than 20 minutes.
- I am proud to say that I work at Georgetown.
- Julie Andrews is probably the cutest woman ever (our patient advocate, not the celebrity. Although, I am a fan of the celebrity as well)

Wise words from Julie Andrews:
"After the age of 12, people dont change their behavior."
"Everyone's entitled to a bad day. ...Except if you work in health care."

"The Shack"

"Paradigms power perception and perceptions power emotions.

Most emotions are responses to perception - what you think is true about a given situation. If your perception is false, then your emotional response to it will be false too. So check your perceptions, and beyond that check the truthfulness of your paradigms - what you believe. Just because you believe something firmly doesn't make it true. Be willing to reexamine what you believe."

alcohol is bad. :-p

Apparently I have yet to learn that I should not carry a cell phone when I go out drinking. When I get a good buzz I tend to get super chatty, and when I get into a texting mood, I text like crazy. Never a good idea. Its not a good feeling when you wake up the next morning and look at your phone and realize what you did, who you called/texted, and what you said, haha. ...Its even worse when you know you texted/called people but you have no idea what was said because you were still rational enough at the time to know you'd regret it the next morning so you erase all the evidence... :-p This is also why I should never go anywhere without my wife because after about 3 texts Laura would've just taken my phone away from me. (Cassie, I still love you and last night was so much fun!)

Alright, time for damage control... :-p

Hazing

I'm aware that when you start at a new job you're at the bottom of the totem pole and some people may give you crap for being the "newbie." Our floor is absolutely nothing like that. Everyone is more than happy to help you and teach you - it is a fabulous working environment and I couldnt imagine a better place to start. Apparently our night tech, however, is not so much a fan of me being a nurse and likes to give me a hard time. What she forgets is that I may be a new nurse, but I am by no means new to my unit. I used to be the secretary - aka I practically ran the unit, so I'm somewhat familiar with how things work.

A little background: Ivonne is our night shift tech (probably in her mid-30s) and she has been going to nursing school since before I started working on 6 Bles (which is over 3 years now). She has a reputation for being unbelievably lazy while at work (reason #1 I never really got along with her to begin with). Now, she is amazing at drawing blood and putting in IVs but that is literally all she is good for. She never helps with patients, she never gets vitals done on time, and all she does is sit on the computer. I ask her to do something for me, she just glares at me and reluctantly agrees, or she'll come up with some bullshit excuse to not do it. The other night, she just didnt do vital signs on one of my patients. My other patient was incontinent and needed to be cleaned up probably once an hour and she didnt clean her once. This morning one of my patients needed labs drawn and a new IV, and she just decided to not do the IV, just the blood draw. I dont know what the deal is, but she's totally giving me a hard time and hazing me. And if you know me at all, you know that I dont put up with shit like this so these next couple months of orientation should be interesting...

First shifts as a NURSE

Got my first few shifts as a nurse done. I'm so glad I did my internship during the school year here because it definitely gave me a good head start and my preceptor didnt have to stop and explain every tiny little thing to me. My first day on the floor Ruth (my preceptor) and I had a really busy group and we didnt get a chance to sit down to eat lunch till 3:30 (our day starts at 7am, so that is a LONG morning). Since I was already familiar with the floor and how to do some nursing things, we were able to split up and kind of tag-team it all day, otherwise I dont know how we would've survived the day. I've only worked 4 shifts and already I've learned so much:

- I've changed several central line dressings,
- hung all kinds of IV medications,
- started a PCA
- accessed a mediport (so scary!)
- admitted a patient,
- and I take on a 3 patient load

I love it! I've had my share of annoying patients already (but I'm used to that). And putting up with doctors and med students is a new experience. There's one med student who is so obnoxious; thinks he knows everything and tries to tell the nurses how to do their job. Seriously kid, dont tell me what to do. Although, I'm totally in love with our intern - he's so dorky, but in a super cute way. He's adorable. :) Anyway, thats all for now... gotta get to sleep - working tonight and tomorrow night. Yay night shifts... :-p

update

I've been slacking on the blogging lately... Not too many things have happened though, which just means my life is sad. Regardless, here are a few updates:

- I guess I never mentioned that I passed the nclex and am officially a Registered Nurse!!!

- Went to NY for 4th of July to help my parents with their high school reunion. It was a lot of fun to see all my cousins and some family members I havent seen recently, but unfortunately the weekend was more of a chore than a crazy weekend filled with alcohol, bbq, and fireworks...

- Apparently when you havent seen family members in a while and/or are meeting your parents' friends, the question they deem most important to ask is not, "Where did you go to school," "What are you doing with your life"  or something of the like. Instead, the first question they ask and the one they fixate on the most is "Do you have a boyfriend?" 

- I'm slightly concerned my entire family has swine flu.

- I start work AS A NURSE this week!! (provided that I get my voice back and feel well enough so that I dont have to call in sick on my first day of work.)

Waiting Game

The biggest test of my LIFE was this morning and it turns out I apparently do occassionally get test anxiety. I was so nervous that I started freaking out on my way to the testing center because I forgot a pencil! It took me a couple minutes before I could calm myself down enough to remember that the test is computerized. Geez. I'm so glad its over but now I wont find out whether or not I passed till Friday. Thats TWO days away! How do you expect me to sit and wait for that long?! I am not a patient person. Ugh. The test shut off after about 100 questions (I stopped keeping track after 80) so I hope I passed... Its making me super nervous just thinking about it. We'll find out in a couple days.

So until then, just keeping myself busy: dinner with the girls tonight, relaxing by the pool all day tomorrow, then the Red Sox/Nationals game tomorrow night! SO excited!! Alright, I'll keep you posted...

DC bar scene

Last night we decided to go to the Georgetown Waterfront b/c it was absolutely gorgeous outside. We got dressed up in cute little dresses and went to Nick's. Within about 15 minutes of us getting to the bar, a woman started talking to us and Laura and I both kinda got the feeling she may have been hitting on us, haha. But then there were 2 guys standing behind us who had the following conversation:

Guy #1: (referring to me) She's attractive. Let's go talk to them.
Guy #2: (looking me up and down) I dont know...
Guy #1: Well, I mean, she's pretty cute. We can at least talk to them.
Guy #2: Eh... we can do better.

...Awesome. Thank you. That makes me feel real good about myself. And why the hell you would have this conversation while standing right behind us where we can hear you is beyond me. Seriously? People are ridiculous.

Skydiving!!

This weekend Ally and I went skydiving in the Poconos! It was so incredible! I highly recommend it to everyone. I was really afraid I was going to freak out but the anticipation of it all was much worse than the actual experience. Our instructors/jumpers/people we were attached to were super cool. Rob, my instructor, was awesome, kinda hippie-ish and very sarcastic which was good b/c that helped calm my nerves. (Although I can imagine his sarcasm totally freaking out a scared jumper.) We flew up in this tiny little plane that had no seats. We were just crammed in there sitting on the floor - it was so cramped I was sitting on Rob's lap. Ally and Kyle (her very cute instructor) thought it'd be fun and get into the plane first thus forcing me to jump first. Thanks, guys. So they fly up to 10,000 feet and the door opens (btw, I was sitting right next to the door. I'm talking my arm was resting on the door!) and then there's a huge gust of wind. My photographer, Pooky (also very cool), went out first and hung off the plane while I got ready to jump. Once that door opens everything happens so fast that you dont even have time to be scared. The next thing I knew I was falling; it was amazing.


our plane


Getting situated in the plane. Yep. That is where I sat. I told you, RIGHT next to the door.



Free falling.


Making it safely to the ground.


Jump Certificate.

"He's Just Not That Into You"

Has anyone seen it? More importantly, did anyone like it? This was probably the most frustrating movie I have ever seen. Granted, I should've known what to expect since I'd read the book. (Well, I read half of the book b/c I found it to be a giant waste of time due to the sheer common sense of it all, but anyway.) The movie did somewhat save itself with the few happy endings but the intense frustration throughout the entire movie that came with knowing that people like its characters actually exist in real life was so overbearing that that's all I could focus on.

Oh, and as if I didnt already have a hatred for Scarlett Johansson, this movie just sealed the deal.

2nd Degree -- check!

...now, if only I could actually work on getting my license... :-p

Life as an "adult"

Well, its been a while but thats because not being a student makes life dull. I work 3 days/week, spend weekends with the fam, and the rest of the time at the pool or watching NCIS (best show ever :)). I thought with all this free time I'd be bored out of my mind (and some days I am) but it's actually quite nice to get to relax for a change. I definitely do not miss writing pointless papers or studying for tests -- although technically I should be studying for the nclex that is coming up THIS MONTH... It makes me nervous when I tell people I havent been studying and the various responses include: "Oh...well...thats ok...", "umm...", "Nikki!!", or nervous laughter - all of which are accompanied by a horrified look of uncertainty. Thanks for the vote of confidence, guys. :-p Whatev, I have time. Or so I tell myself. I'm not too worried about it yet (not sure if that's a good sign or bad). I have a feeling I will, as always, put it off till the last minute and then cram like crazy - a method that has worked through 20 years of schooling. Why mess with it? :)

Smile.

This is a card from one of our patients. J.M. is the cutest, sweetest, elderly man you will ever meet and just seeing him yesterday completely brightened my day. I posted this because:

a.) It brings an smile to my face and reminds me how unbelievably cute he is. He and his wife are adorable. I love seeing patients' spouses care for them and this couple is beyond precious. The two of them together just warms your heart. Their relationship is like one out of a fairy tale; it almost seems like its too perfect, too happy to be real.

b.) It reminds me of what kind of person he is and of the kind of person I want to be. He has the best attitude towards life. One morning I walked into his room and asked how he was doing (he had had a rough night). He said, "Well you know, I'm not feeling too great... But, the sun is shining and I'm alive, so I guess today isnt so bad!" He's so happy and always has a smile on his face, no matter what. And I want to be just like that.

c.) I remember exactly why I wanted to be a nurse in the first place. But you dont have to be saving lives to make a difference in one. This man brightened my day just by saying hi. A "kind word or a generous act, a tender touch or a friendly smile" can go a long way.

So if you're reading this and feeling down, or havent heard a 'thank you' or an 'I love you' yet today, consider this is mine -- Love you guys :)

poolside :)

I finished school on Saturday (note: less than a week ago) and have only had 2 days off since then and I'm already bored. I am seriously going to have to come up with a hobby... But! I've discovered that my new favorite thing to do is sit out on our balcony overlooking the pool with a drink in hand. And actually, at this very moment I am doing just that while writing this blog. :) My current view:


For those of you who have not seen my apartment (which is probably about 98% of the people reading this), you now have an idea of what it looks like - the outside of it anyway. If you look closely the pool apparently has some kind of grossness growing in it, so hopefully they clean it asap or else I'm shoving Laura in the pool first to test out the waters. (Sidenote: did you know that sunscreen is bad for the environment? Yes, DJ says that apparently sunscreen in the water turns male fishes into females. I found it hilarious. He did not. His response: "How?! How would you like to grow a penis just because of what's in the water??" haha touche, little bro. Touche.)

Anyway, love sitting out here with my computer, relaxing, drinking, people watching (aka judging), etc. :) I imagine I will spend many upcoming days doing practice nclex questions out here. Joy. :-p

Bachelor of Science in Nursing :)

yay! :)

Future nurses

My school requires us to participate in a mandatory NLCEX review course, which is great in theory... aside from the fact that it's from 8-5pm for 4 days straight. (fyi, your ass starts to fall asleep around hour #3.) I honestly dont know how some of my fellow graduates intend to pass the nclex. I cant believe that in a matter of months they'll actually have patients' lives in their hands...

Instructor: "what are we worried about here?"
Student: "Eye blindness!"
...eye blindness. ...as opposed to the other kinds of blindness that exist? :-p

Instructor: "Honey is contraindicated in babies less than 12 months old."
Student: "What does that mean?"
...seriously? what about that statement do you not understand?

Student: "What is string?"
Instructor: "um, a short rope."

It blows my mind that this student will be caring for patients. Of course she represents the minority, but knowing that people like her carry a nursing license makes you question the competency of health care professionals... scary.

Anyway, aside from the obnoxious people in the class, it was helpful. And if anything, we got to listen to some interesting stories. ...Ask me about the penis story, the story about family members who lie, and how to get out of a speeding ticket. ;)

Swine flu?

This whole swine flu craziness is getting so ridiculous. Yes, it's a new strain. Yes, it has now gone global. But do you know how many thousands of people die each year from the regular flu? In comparison this swine flu outbreak is not a big deal. 300 schools have closed nationwide because the administrators are afraid of the spread. Seriously, people? Calm down. If you start to feel sick, go to the doctor. If it turns out to be swine flu, take the anti-virals and you're good to go. It's not the end of world. Everyone is freaking out about contracting the virus - Just cover your mouth if you cough/sneeze and always wash your hands. (and FYI, these are things you should be doing anyway!! You should not have to be told to wash your hands!) ...And dont go kissing any pigs.

(thanks to Danielle/Mr. V-S for the pic)


And Danielle, learn this now: if handwashing is an answer choice, the answer is always handwashing. (Just like the priority for any situation is always Safety)

Jacobyyyyy

I could talk about the fact that the Caps came from behind and forced Game 7!... Or that even though I dont like the NBA, watching the Bulls beat the Celtics in 2OT was ridiculous... Or that I'm loving that the Yankees' bullpen blows (hehehe)... That the Sox have won 10 straight, including a 3-game sweep of the Yankees... Or that I am going to a Sox/Nats game in June (yay!!)..... But I think mainly I'd like to point out that JACOBY STOLE HOME. Amazing.


(yes, the announcer says, "Jacoby Ellsbury has stole home." and yes, the grammar drives me crazy.)

Free Time

Well school will be ending very soon (yay!) and seeing as this will be the first time since I was 3 that I wont be taking classes and I'll only be working 3 days a week, I will most likely be bored out of mind. So, I'm trying to think of possible hobbies/interests that can occupy my time. Here is what I've come up with:

- POOL... um, obviously. Unfortunately, I cant be at the pool EVERY day. My body would not appreciate that, and sometimes the pool just gets too crowded (and those are the days I'd sit on my pool-view balcony watching and silently judging everyone laying out, which is actually a fun activity in itself. what, you would do it too.)

- Learn to play tennis...

- Join a softball team and/or a volleyball team... anyone who knows how to make this happen or is interested in joining me, let me know!

- Learn to play poker... because I dont even know where to begin and from what I hear its a fairly popular card game

- Start another scrapbook... I havent made a post-college one yet so it's probably time I started documenting

- Learn to cook... because right now I have about a 4-dish repertoire that I rotate through so I should probably expand that


That seems like quite the list, but we'll see how many of those I actually end up doing. Hmm, any other suggestions?

Major case of the Mondays...

Today is gloomy and rainy (and cold!) which always makes me just want to lay in bed all day, but alas, I still have classes this week. Whoever thought it was a good idea for us to take that ATI test before classes finished clearly did not think things through. I've completely mentally checked out of school mode and now being in a classroom seems like a gigantic waste of time and I find myself resenting it. I am also so not a fan of feeling like I have no control over my life, which is a frequent sentiment lately. But I guess "we cant change the cards we are dealt, just how we play the hand." (Randy Pausch reference, anyone? I know, I'm so lame, but he was a great speaker - look him up. :)) SO, instead of giving in to this yucky feeling, these are my current happy thoughts:

• Mom comes home tomorrow, which means I'll go home this weekend and I get to see the family (hopefully the cousins too!), i get presents :), see the newly painted house, hang out with the bro, and play the piano (yay!!)
  
• Our last day of clinical is this week and its only a half day!
• Three weeks from today, I'll officially be done and have a BSN.
• I finally have time to read again. I picked up a book that I started back in January and never got around to finishing. I almost forgot how much I enjoy leisurely reading.
  
• I work tomorrow for the first time in 2 weeks -- yes, this is a good thing. Work always has a way of getting me to forget whatever else is going on. You know that saying, "the best way to cheer yourself up is to cheer someone else up"? SO true! Taking care of patients is probably the best thing I can do when feeling kinda down. I dont know if its b/c you have no choice but to be cheery around them, or if being around sick people puts your life into perspective, or if taking care of people really does just genuinely make me happy. Probably a combination of all of the above. Regardless, I'm looking forward to it.
• Summer is just around the corner, and with summer comes vacations, possibly an Ocho gathering of some sort, and of course, POOL TIME. :)

Meh. Anyone else with a case of the Mondays? Or have happy thoughts to share? :)

79.3

I PASSED! :)

I have honestly never been so nervous during a test in my life! (If you know me, you know I never get stressed about taking tests, so clearly its a big deal if I had crazy anxiety about this one!) And it didnt help that we started late b/c the computer labs were still locked and THEN 20 questions into the test, the internet cut out so our tests were frozen for about 10 minutes. I mean, geez! Come on. But its over now! Such a relief. AND my test results predicted a 98% chance of passing the NCLEX on the first try, which is definitely encouraging. But we'll see! Gotta wait at least another month before I can tackle that one. ok, time for a nap followed by massive amounts of celebratory drinking. :)