Things I am currently thankful for:

• fantastic friends
• an absolutely epic birthday weekend
• my birthday crown
  
• my camera for capturing the last 2 nights and allowing me to piece together my weekend
• Matt's photography skills
  
• ADVIL/gatorade/water/any other hangover cure
• dance party
• naps
  
• having today off

Reasons today rocked

• Bacon egg and cheese on a croissant + coffee
  
• I precepted today so basically I made H. do all the work :)
  
• Quality time with K.
• Teamwork --> prepped a patient for the OR in about 15 minutes
• We got our resident to take vital signs for our patients

That last one is pretty bombass. :)

insomnia

I am awake at 12:45am and I have to be at work in 6 hours. Lately I either barely get any sleep (usually nights/days immediately before a shift) or I sleep 13 hours. I'm not really sure what my deal is, but I guess I'm just kinda stressed about what I want to do with my life. I know, I know. I'm a nurse and I love it and that is absolutely what I want to do in life. Even after some of the shittiest days, when it comes down to it, there really isnt anything else I could picture myself doing. BUT, I do know that I want to go back to school eventually. I dont think I want to be a floor nurse for the rest of my life. I just dont know which direction I want to take my nursing career. As much as I love teaching I dont want to be a nurse educator or a professor; I'd rather be a clinical instructor or something more hands-on, but you cant really make a career out of being an instructor. And I'm not sure I really see myself as a nurse practitioner... maybe... I just don't know. I think the issue is that I still really enjoy floor nursing. I'm not jaded and over-worked yet, so I dont feel the need to find something new. And even if I do reach that point, there's always the option to go to a different unit - another med-surg unit, the PACU, ICU, anything. (Although I dont think I want to be an ICU nurse. I want the knowledge but not the job.) There's so much you can do as an RN. The problem is most Masters programs are being phased out and becoming a Doctorate program. So for example, if I wanted to be come a nurse practitioner (NP) I would be required to have a PhD, not just a Masters. Now, if I graduate with my Masters and become an NP before 2015, I can just be grandfathered in and not have to do the DNP program. Yes, 2015 is still a ways away, but in order to get the hospital to pay for my graduate education, I would have to go to school part-time and work full-time. The NP program is 3 years if its done part-time. So, that significantly decreases the time I have to figure life out. That also would mean I would have to stay at Georgetown for another 3 years, which I'm not opposed to, I just dont know if I want to try someplace else- a different hospital? a different city perhaps?

Anyway, it's now 1am and my alarm will go off in less than 5 hours, so I should stop rambling on and try to get some sleep...

Life Update

It's been awhile since I last wrote so I suppose it's about time to post an update... Lets see, August was filled with birthdays (my roommate's and DJ's) and weekend trips. Of course, it started out with my road trip to SC, which apparently I'm going to have to do again soon seeing as 2 of the Ocho now live there!! Woot! The weekend after was my roommate's bday, which was properly celebrated in a drunken state down in Adam's Morgan. The following weekend, C., L., and I flew up to Boston for the weekend. I went to Fenway for the first time (YAY!) which was everything I imagined it would be. Greatest place on earth. :) We went shopping downtown and saw a man shooting up in the street (literally - needle in his arm.) Went to the Harpoon brewery, an improv show down at the north end, Faniuel Hall and Quincy Market. It was fantastic. But I think I'm over the whole 'I totally want to live in Boston for a few years' phase. Dont get me wrong, I loved it and its a great city -- to visit. Being there just made me realize that if I'm going to live in a major city I think it's gonna have to be DC.

Work is going really well. There are definitely still days when all I want to do is cry and/or punch my patients in the face, but I guess that's all part of the job. :-P I had my annual evaluation (my first as a nurse) and everything was really really good. My manager said I'm doing a great job and that I had a really good first year! So yay! :) I am charge nurse capable now, which is pretty exciting. It's kind of nerve-wracking to think that during those shifts I'm suppose to know what to do; I'm the one people will turn to for help/advice. As scary as that may be, I think the hardest part about being Charge is having to diffuse situations and deal with angry, irrational patients/family members. Its so hard to advocate for a patient when they're screaming at you because of a situation you had no control over. Oh well. I am also precepting a new staff nurse, which is also kind of scary to know that I am responsible for teaching this person how to be a good transplant nurse. It's my job to make sure she can realize what's important, knows how to respond to certain situations, anticipate what to do next, and of course make sure the doctors are ordering the appropriate things. But its been a really good experience. You never know how much you know until you have to teach it. Plus I've realized that I LOVE teaching. So we'll see if maybe teaching will have a role later on in my career.

conversations from night shift

Patient: I dont know how to get positioned comfortably. I guess I'll try this for a while but if it doesnt help, I'll want to go back to the way I was before. Just lay me so I'm kind of floating.

Nurse Tech and me: [look of complete confusion]

Patient: You know what I mean?

...um, what?!

Patient: okay, I'm going to go for my walk [off the floor] now.

Me: Mr. C you cant go off the floor, you need to stay hooked up to wall suction.

Patient: NO. I'm going for my walk!

Me: Mr. C, I'm sorry but I just spoke to the doctor and he says you have to stay on the floor.

Patient: I dont care what he says! I'm going for my walk!

Me: Well you just got that chest tube placed today and in order for it to properly work, you need to be connected to suction, otherwise we might as well not have put it in.

Patient: You dont understand. I'm going for my walk no matter what. I take my walk everyday.

[the doctors walk onto the floor and here the patient screaming at me]

Doctor: Mr. C, why are you yelling? Why are you yelling at the nursing staff?

Patient: Because she wont let me take my walk!

[turns to me]: Its not your fault. You dont understand. You're new.

[I am fuming and about 3 seconds from punching this guy in the face.]

[Arguments between them continue for a minute or two.]

Doctor: Ok fine, you have 10 minutes. You can go.

...are you F-ing kidding me?! I spent 5 minutes arguing with him that he cant go and then you're going to just cave in like that?! WHY?! now this patient is going to think he can do whatever the hell he wants. And everyone knows the only reason he wants to go for his 'walk' is so he can smoke outside. Not to mention the fact that now I look like the idiot/bad guy for insisting he cant go (per YOUR orders!) and then you go ahead and change your mind. ughhh. doctors.

Doctor: I know you're really busy, but just when you get a chance, Mr. M wants you to go in there and give him his pain meds right away.

Me: Okay, I'll get there.

Doctor: Well, you know how he used to be in the military? Well he wanted me to "order" you to go in there.

Me: HA!

Doctor: yeahhh... so just whenever.

Doctor: Oh, and how's Mr. C? --Wait, you have both of them tonight? Who did you piss off to get stuck with that assignment?

...1st of all, patient, you dont get to tell me what to do. you can go ahead and try it and see how well that works for you. 2nd, you know its bad when even the doc feels sorry for your patient assignment...

Doctor: So, Mr. M is still complaining of pain. Can you go ahead and just give him his Dilaudid?

Me: Sure, you want me to give him his dose early? Or give him a one-time now? He's not due for another 2 hours.

Doctor: We'll give him an additional one-time dose. And go ahead and give him his Phenergan now too. Hopefully that'll just knock him out.

...haha such good patient care. and SOOO necessary at times. :)

Patient: Is there someone here above your charge nurse?

Me: You mean as far as nursing staff? No. Our manager comes in at around 0630.

Patient: So its just you, the charge nurse and the doctor?

Me: During the middle of the night, yes. But more people will come in in the morning. Why?

Patient: I want to talk to someone. I want to leave.

Me: What do you mean?

Patient: I want to leave!! I dont feel like I'm getting good care here.

Me: Can I ask why you feel that way?

Patient: Because! No one seems to care. No one cares about my pain.

...Meanwhile I am in the process of administering his Phenergan (a potent anti-nausea drug that has a really strong sedative side effect) and I just handed him his extra dose of pain medicine, AND I have barely seen my other 3 patients since starting my shift b/c I'd been in his room all night long. Yeahhh. You're getting terrible care. Shut the F up.

Me: Hey, did you guys talk to Mr. M about decreasing his pain meds?

Doctor [rolls her eyes and gives me attitude]: Ugh, yeah. Dr. G had a long talk with him yesterday about weaning him off the pain meds.

Me: ...okay... its just that I've been giving him pain meds round the clock and he's still been complaining of 10/10 pain.

Doctor: Well, yeah. He's gonna do that. Do you not know the patient?? Come on, Nikki. Is this your first time dealing with him?

...listen, bitch. 1st of all, dont talk to me like I'm stupid. I've been working on this floor a hell of a lot longer than you have and I know how to handle drug-seeking patients. 2nd, I would bet my entire life savings that neither Dr. G nor any other doctor on the team had a "long talk" with the patient seeing as you are never in the patients' rooms for more than a minute and a half. 3rd, dont you find it a little weird that you decide to decrease the frequency of his pain meds to every 6 hours when we've been giving it to him every 4hours on the dot? And then when you go in and see him in pain, decide to give him his meds an hour before his 4hr time is up. Yeahhh. Cant even make it the full 4 hours, but go ahead and decrease him to every 6. Makes perfect sense to me.

ahhh the joys of your first shift back from vacation... :-p

southern shenanigans

This past weekend I decided to take a little roadtrip down south. I spent Thursday night in Winston with my friend Adam (aka Egon), who goes to med school there. Then Friday I drove down to Charleston where Katie lives and met up with her and E-Beth. The following is a list of quotes that resulted from the 3 of us spending 3 days together. (Sorry a lot of them dont make sense to those who werent there, but this post is primarily for K & E):

• "Back off, tool!" (so versatile. can be used in almost any situation!)
  
• "It's like real people live here!"
• "I can sign this paper and it's, like, legit."
• "Excellence is never an accident." (possibly the new Ocho motto?)
  
• "I love petting people."
• Moth to a flame.
  
• "Sometimes I'm shocked when people dont talk to us. They must be gay."
• "Someone needs to get me a beverage!"
• "I don't think I'm drunk enough for this bar."
• "I can maybe pull it down a little, but I'm NOT taking it off!" (ahh, so classy. :-P)
  
• "Y'all are leaving me with the chubby one!!"
• "Lot's of shenanigans but no offspring." --our tour guide
  
• "They're gonna be like, 'who are these hot women with the man voice??'"
• "Two-handed game! TWO-HANDED GAME!!"
  
• "Sorry if I sodomized you."
  "...I'm not."
• "Nikki, you have to hook up with him so I can hook up with his roommate."
  "Is he cute?"
  "...Well... he's the one who said he couldnt tan..."
• "What if he's a troll?"
  "Whatever, then he can talk to dump truck."
• "Aw, he's so nice!"
  "It's gonna be so nice when I fuck his roommate."
• "Poor gal."
  "...Um, I said 'gal' not 'cow'"
  "That's what I said! "GAL!""
• "It surprises me that no one from our group has hooked up with him."
  "Why, because we're a bunch of sluts?"

I stayed in SC till Sunday afternoon, when I left to go back up to Charlotte to stay with Danielle and Mike. And I was lucky enough to hang out with Ben, who I hadnt seen in forever as well. It was a nice little Ocho abridged weekend -- very much needed. I want another one ASAP. Seeing everyone almost makes me want to move to NC. ...Almost. Sorry kids, I love me some DC life. Anyway, other highlights from the trip:

• Listening to the Glee soundtrack during all 4 car rides
• awkward med students
• realizing how much I dont miss college drama
• also realizing how glad I am that my circle of friends is primarily unmarried and childless (no offense to my married friends, I love you!)
• getting our pic taken by the paparazzi and making The Ocho that much more famous :-p
  
• carriage ride through Charleston
• Running into D. Cross in downtown Charleston. small world!
  
• bringing back the man voice.
  
• flip cup on quite possibly the tiniest table EVER.
  
• dancing at Off the Hook and intimidating every guy there (no but really, my quads are a little sore and i'm pretty sure thats the reason)
  
• D's adorable little home (seriously, since when are my friends "real people"?)
  
• catching up with Dr. Morel (so weird to call him that!!) and hearing about his ED adventures
• Bojangles for the first time in about 3 years

Soooo... is it homecoming yet??

SYTYCD

I enjoy watching SYTYCD but I have never followed a season as closely as I have this one (blame my roomie) and I'm obsessed with this season's contestants. Every time I see Kent I just want to hug him. He's totes my fave. And Lauren is so ridiculously talented. (Not to mention that I totally have a girl-crush on All-Star Courtney. :-p) But this performance by Robert last week is legitimately the most moving performance I've ever seen. It's SO amazing. I bawl like a baby every time I see it.

Robert, along with All-Star Allison, performs a contemporary dance to Fix You by Coldplay....:

ps - Adechike's performance tonight was AWESOME. i love this show.

:-D

Conversation I had yesterday afternoon with 2 doctors who have previously worked on our unit:

Andy (to my roommate Caroline in regards to working as a nurse on 6 Bles): "So are you off orientation and all that?"
Caroline: "Yeah..."
Me: "Of course, seeing as she's been there for a year now."
Andy: "She's already been there for a year? How long have you been there?"
Me: "A year."
Andy: "You guys started at the same time?"
Me: "Yeah. We both started in July."
Matt: "Wait! You just started last year?"
Me: "Yeah. You didn't know that? I'm technically still a new grad. We actually started when you guys started."
Matt: "I didnt know that! I didnt think you were new."

Later that night....

Me: "I cant believe you didnt know I was a new grad."
Matt: "Yeah, I had no idea."
Me: "Well, I guess that's a good thing right? That you couldnt tell I was new?"
Matt: "No, absolutely. You didnt seem like it."
Me: "Really? Well good, that makes me feel better about myself, about me as a nurse."
Matt: "Oh yeah, definitely. You're a good nurse! I never would've thought you were new!"

:) Totally made my day. :)