Wednesday, July 24, 2013

It's been a while.

Things around here have been a bit tense lately.
I haven't been able to find the words to write.
I've started and scratched this post like 7 times in the last week.
A week ago, Roger lost his job.
It's been one big stress ball ever since.
It has definitely not been peaceful under our roof.

It's amazing how one small event can change your lives so much.
So. Much.
Things change.
Security isn't as secure anymore.
Stability topples over.

My husband works hard for our family.
He worked hard so I could go to nursing school.
He's a very honest man.
He lives his life according to God's word.
He's not afraid to be vulnerable or sensitive. 

On top of all this mess last week, I hurt my back.
And let me tell you, when your back is out, there's not a thing that you can do for yourself.
Thank GOD he was home with me - I couldn't have done it by myself.
And thank GOD that my father is the best massage therapist in the South.
I don't know where I'd be without his multiple sessions of deep tissue massage over the weekend.
IT HURT, but did what it was supposed to do.
I'm still sore, but it gets better every day.

I'm working as much as I can in my new job.
I still love it - there's something new every day.
It still can be scary.
My night shifts start next weekend.
That will be another change to prepare for.

Roger will be fine. 
He's already talked to several people and worked enough to make up for last week.
Pray for the discernment to choose the right job for our family.
With my work schedule as all over the place as it is, it may help that he's able to have a more flexible schedule. 

Even though we have been at each others' throats the last few days just from me allowing stress to take over - he's an amazing father.
He's so good with our child.
And she adores her father like nothing else.
So as I critically pick apart all his flaws and demand things to happen that aren't necessarily going to happen over night, he does his best to keep everything together while I work 13 hour days.
We are still the richest we have ever been  - rich in health, rich in family, rich in communication and hopefully rich in our faith.

This is just me being transparent.
This is me failing at giving mercy and grace to people I love.
It hurts.
I'm sorry, maybe I'm being stubborn and just don't want to accept that this is happening. 
This is me trying to cling to some sort of stability and not turning to God for upholding His promises for our family.

I'm going to go spend the day with my girl, soaking up all the time I can with her.
And wait for the rain to come.


































































Thursday, July 11, 2013

just a few things.

Okay, a few things.


1.
So far, I haven't had a full day of 3 patients.
I'll start out with 3, then one will be discharged.
So, there's that...
I want the 3 patients.
I NEED the 3 patients...
I have to figure out this whole time management thing.
2 patients is good for spending time with them, but it can get rather boring.
And I'm LOOKING for things to do.


2.
Another thing I've noticed very closely in the 3 weeks I've been working with patients:
Aging.
Everyone does it.

*stay with me now - I know this one's a no brainer*

Some age more graceful than others.
Truth is: our bodies were not made to last.
And we see this in the slow (or fast) decline of our senses.
We see this in the change in our skin texture.
We see this in the change of our activities and endurance level.
We see this in the mirror, as an aging face stares back at us.
Is that me?
Because that is NOT how I feel.
That person staring back at me; with wrinkles, age spots, grey hair, crow's feet - is not the "Me" that I feel like.

Ok, so personally I don't YET have grey hairs/wrinkles/age spots...
But Y'all... it's coming.

The only thing we can do is start to take better care of ourselves.
Because I have -first hand- seen the effects of aging in my patients.
I've cared for and loved on those people from 30 years old - to people in their 80's in the last 3 weeks.

The aging, weathered faces of the elderly usually are peppered throughout my days.
Bedpans, and chux pads are in abundance.
It's SO IMPORTANT to do the best I can to maintain someone's dignity.
It's not so easy to do that when you have to rely on someone to bring you a bedpan to use, then wipe you.
I often wonder what is going through their minds when I'm doing this for them.

*I'm going to pause here for a minute and say - it's usually our AMAZING certified nursing assistants that do this - but with me not having a huge amount of responsibility at the moment - I help whenever and wherever I can.*

And even when I will have a full patient load, it will NEVER be below me to assist my pts with their activities of daily living.

Usually, it's not that uncommon to go on multiple prescriptions and treatment regimens as we age.
As systems become tired and worn thin, they rely on outside methods to regulate them and keep them focused on their main functions.
It's my job to make sure they are getting these medications - and to monitor their vital signs as they are taking these medications.
BECAUSE... it's not like a normal, ordinary day for them - they are in the hospital for a reason: be it stress related to illness or surgery - and that alone throws everything off.

I'm on the Orthopaedics (that's how my work ID badge spells it) // Trauma floor.
We see not only people in there with external fixators attached to pins that are screwed directly into bone [an easy access point for any kind of microorganism to enter], patients who came to the ER for traumatic injuries, and also we have to treat whatever comorbidities {the presence of 1 or more diseases/disorders that is also going on with them} come along with whatever surgeries or trauma they have going on.
It's not exactly like just medical surgical nursing.
It's that and a lot more.
It's so interesting.
I've already learned so much.
I've started to get comfortable with things that I do on a more regular basis:

  • Hanging IV fluids
  • Messing with the Alaris pumps {IV's)
  • PCA pumps {Patient Controled Analgesia}
  • PICC lines/ Central lines
  • Lovenox/ Heparin shots
And sky's the limit from here.
I'm looking forward to learning more and more.
My official "night shifts" will start in August.
and THAT will be a whole new world.


3. 
After working a 12+ hour shift, I am T I R E D out.
There is NO cleaning that goes on once I get home. Nor cooking.
It's all I can do to eat dinner, hang out with Roger and Hailee for 30 minutes, then get in bed.
It's a long day, y'all.
REALLY.
So, I spend my days off getting caught up on the cleaning/laundry/cooking that I'm not able to do when I have my long hours.


4. 

Okay, I'm not going to hold out on you - my first paycheck was only half a paycheck's worth of work.
I got an Erin Condren Life Planner.
I've been planning and thinking about and deciding on which one I wanted for a good loooong time now.
{since nursing school}.
It was my graduation/got a job treat to myself.
AND it will be here by this weekend.
I'm so excited!!!
When things went on sale a few months ago, I got the Take Note, Notebook.
And I LOVE it.
Just waiting for that planner to come in...
I cannot wait to sit and Fill it out for the next year!!!!
More on that later...

and finally,
pictures.


5.

Work shoes.
I WON these from Anna's blog over HERE.
And I have gotten SO many complements on them.
Yes, they are Dansko's
and, YES, they are MUCH more comfortable than my white nursing school Dansko's.
I promise.



























And Now, I'm going to Introduce you {again} to Sara Broski, from Tiny Galaxies
All of her jewelry is handmade with love.
and I LOVE it all!
She matched my latest pair exactly to the color of my scrubs.
and THAT is GOOD!!!






































On the 4th of July, our church's annual fireworks extravaganza was simply, out of this world.
And Lucky Us... we live RIGHT behind the church.
Front row seats to amazing.



























































Did I mention this is a professional show - SET TO AMAZING MUSIC??!!

and finally..
Workflow.
My pockets are stuffed with this stuff.



































Looking forward to my 4 day week next week.
two days of Classes + two 12 hour shifts.
with super amazing childcare.

and have I mentioned God is good??
Because he is.
All the time.





have a blessed week.




Friday, July 5, 2013

What's your story?

Everyone has a story.

Anyone that is living and breathing - beyond a shadow of a doubt - has a rhyme + reason as to why they are who they are.

Some people wear their stories softly on their sleeves.
While others... securely tuck them away beneath layers and layers of protective coating.

In a hospital, people are usually at their most vulnerable.
Down to their innermost layer - they are exposed, hurting, sick, at their worst.
I am blessed enough to be able to serve them in their times of need.
It is an honor and a privilege to be able to sit with a patient who needs an ear to listen to them, a shoulder to lean on, a heart to care for them...
It's not exactly what we do that helps people - it's more how we do it.
What we put into it.
How much of ourselves we offer to someone who is going through a particularly difficult time can leave a lasting impression on that person.

It's easy to remember all of this when the patient load is light.
For the last week, I've had a total of 2 patients a day.
I've had the time to physically offer my presence along with everything else I'm providing.
Soon, the patient load will be going up.

And in the midst of all the hustle and bustle of getting assessments done, charting in the computer, keeping medications on time, staying on some kind of schedule - the time we spend one-on-one with the patient rapidly diminishes.

I think it's so important to really listen to what is going on - not just listen with my stethoscope as their chest bilaterally rises and falls, as their heart beats a steady S1 and S2, as their bowel sounds rumble in all 4 quadrants...
But to listen to their story - make sense of who they are outside of this hospital bed, hooked up to monitors, totally NOT in their own environment.
Maybe, just maybe, it will help a little in the healing process as they can feel more like themselves for just a moment.
For someone to understand.

I think it's so important to really look at them and take in their responses to certain therapies - not just look over their skin, searching for evidence of redness, irritation, unpadded bony prominence's; inspecting mucous membranes for evidence of dehydration, look for jugular vein distention as they lay back in the bed...
Of course that is all so important, but watching someone get better - watching them physically improving, is such an amazing sight.
Maybe, just maybe, it encourages them as much as it encourages me.

Just like all the other nursing skills I'm learning and have learned, listening to them and responding in an appropriate way will also take practice; watching them and using my nursing judgment will also improve.

So far, I've had several great experiences - each one totally different from the next.
Each patient with their own story, support systems (or lack thereof), set of needs, tolerances...
I've been able to be a shoulder to cry on.
I've been able to actively listen to them pour out their stories in a most vulnerable way.
I've been able to touch them with a comforting hand, soothe them in their time of pain.

13 hours is a long day, but sometimes, that time flies.
May I always remember that each patient is a person
With a story of their very own
Who is not in their own element, and may be hurting, scared, unsure, and most importantly, NOT in control.

I'm going to tell you right now that SO FAR, I'm loving what I do.
Who woulda thought...
It's all a learning process.
I'm just trying to figure it out.


Lord, thank you for giving me the chance to be involved with people at a point in their stories where there is chaos and vulnerability. Please help me to keep this in the forefront of my mind as I nurse them back to an optimal point of health and provide them with a chance to feel some sort of normalcy.
Amen.





Monday, July 1, 2013

Orientation to 8 West

I'm currently learning my new profession.

Not that all of Nursing School wasn't a learning experience in itself... BUT...

now I'm stepping easing into my new role as a registered nurse.
Because y'all, this isn't nursing school anymore.
There is no Nursing Instructor checking behind all that I do.
I have a licence!
I'm a workin woman! ;)
I am responsible for all that I do.
Every single bit of it.
Someone's life was in my hands last week.
Literally.
But let's start at the beginning, Shall we?

_________________________________________________

It was an early sunny morning that Monday, June 17th.
0700 to be precise.
My child was staying with Mimi and Papa.
I was dressed in my business casual attire and ready to go.
I was on my way to my very first day of orientation at PHR's corporate office on Greystone Blvd.
It was a day full of speakers, following the 1st day itinerary, learning the key values and pillars of the company, and filling out all the fun Pre-Employment paperwork.

This was my 1st day.

It was boring.
But, it was OFFICIAL!!
The first day in over 2 years that I was getting paid for something, anything!
And sitting in a chair, listening to people talk?
You wanna pay me for that?? Why sure!
No argument here.

For the days following the day at corporate, I was sitting in a classroom in the basement of Palmetto Health Baptist {where the old radiology department used to be located thus NO phone reception. At All}.
Tuesday   -   Wednesday   -   Thursday   -   Friday   -   Monday
There, we did modules on general information as well as orientation information for our own units.
There were 21 of us in my orientation class, and we were packed into that room like sardines.
It was Such a comfort to be going through orientation with 4 others from my graduating class.
We went over all our basic skills and hospital policies on them.
We walked through the charting computer system, which was already familiar because the computer system where I did my clinicals in Orangeburg was nearly identical.
The BEST part of orientation??
I got to wear my scrubs every day.
So far, Grey's Anatomy and Koi are my absolute faves - but I need to try Smitten now.
Any other suggestions??

Oh, the pressures that are relieved when knowing the exact thing you're going to wear to work - not having to plan outfits, coordinate shoes/jewelry... We have srub colors - Royal blue and White, and our trusty nursing shoes.
A fail safe.
I should probably get a few more sets of scrubs after my next paycheck - I only have 3 pair right now and I'm still finding which ones are most comfortable and wear better when working.

Ok, getting down to the nitty gritty now!
Thursday, June 27 - 1st 12 hour shift.
I had one patient from 7am - 7:30pm (give or take 20-30 minutes on both sides)
That was a LONG day.
We started our day with a "huddle" - where all the RN's and techs come together to talk about the night before, then break out to get report from the RN that had our pt the night before.
We do bedside reporting (which is great) so, I was introduced to my patient and away we went!!!
There was NO mad dash for the glucometer's or Dinamaps to get the AM vitals/blood sugars like there used to be in clinicals.
Why? because the nurse tech's get all that for us.
How NICE!
There was time to look in the computer at my orders, labs, previous vital signs/blood sugars and get all my med times written down.
At one point, I had my meds in my hand, my computer ready to go, waiting on my preceptor - JUST LIKE I used to wait on my nursing instructor to give meds - then realized: I got this.
I'm a nurse.

There are 2 of us new grads orienting right now on the floor.
It's so good knowing there is someone else there going through the exact same thing I'm going through!
We find each other in the parking garage in the mornings, walk in and get lost trying to find our way through the hospital together, have each other to ask questions to during the day, eat lunch & people watch together, then get lost walking back out of the hospital together on the way to the parking garage.
AND, on a good day, we actually make it to the right parking garage FIRST ;)
I wonder how long it will take before we know our way around that hospital...
We do so much walking, I should probably invest in a pedometer just to see how much it is. I'm curious to know...

YET, I digress.
While we both have a light patient load, we are orienting with the same preceptor - who is pretty amazing, by the way! I'm so glad to have been put with her! I've already heard horror stories of some preceptors.
At one point in the morning, my new buddy RN and preceptor went into her pt room and I was told to get started on my Head to Toe assessment by myself.
No Problem!!
I will have to get used to finding a computer and pushing it into the pt rooms - in Orangeburg, there were computers in every room and THAT was WAY convenient.
This assessment was pretty easy and within normal limits.
I gave some pills, and checked them like 5 times to make sure they were the right ones - made sure I knew what they were for - gave some insulin, and gave another SubQ shot that day.
It went SO smoothly.
My pt went down for surgery and was gone for about 3 hours.

For the most part, my day was spent getting acclimated to the new schedule, checking my tasks, meeting nurses, techs, doctors, and everyone else that works up on our unit.
It was a good day.

We went back the next day to follow a nurse tech and the unit secretary - each half the day.
THIS DAY - totally different.
It was Friday, but it might as well have been Freaky Friday, the way it seemed like chaos was totally ensuing.
ALL of the nurses were running around, it did have me a little nervous about encountering that sort of day.
They were all telling us how NOT normal days like that were.

So, tomorrow and Wednesday are my 1st back to back 12 hour shifts.
2 patients each day.

Just breathe.
And check those medications over and over again.
Oh, and I forgot to mention - my very first 12 hour shift, JACHO was in the hospital.
This is the accrediting company who is the end all/say all to all hospital - everything.
I don't know how else to explain it, but they are scary.
At one point, these 3 people in business suits sauntered up to our unit, and Erin and I made a B-line to the nurse's station.
They like to corner (licensed) people and ask questions {that are probably a lot easier to answer than I think - like... what do you do if there is a fire/how do you use a fire extinguisher} then, there are questions about stroke protocols// Heart attack protocols that I am just NOT familiar with - yet.

So, here's to tomorrow and Wednesday.
My I keep my patients alive, keep them breathing, and provide them all that they need.
12 hours is a long time to be ever so vigilant.

Amen.





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