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. :)