Sunday, August 7, 2005

Easy come, easy go

I got a call from the other hospital informing me that since I don't have a full year of nursing experience, they can't hire me on as "per diem" (higher pay, no benefits).  Instead he offered me a full-time or part-time position.  The pay is lower...around $23-24 per hour which is basically what I'm making now at the hospital I'm at.  Sigh!  Oh well, the good news is that I am not too, too far from having a year of experience.  Just depends on what they consider the anniversary of one year - is it from the date I was hired as a nurse or is it from the date that I passed the nclex & officially got my nursing license?  We're talking about a 60 day difference.  Regardless, it's something to look forward to if this new hospital works out.  If not, there are plenty of other hospitals out there to explore.  So now the decision to be made I remain at my current hospital full-time (3 days per week) & work at the new hospital once or twice a week?  Or do I go part-time at both places?  I guess in the beginning I'll just work one or two days a week there to see if I like it.  The thing that stinks is that working one or two days extra at my current hospital would result in overtime pay, while working at this other hospital keeps me at the base pay.  I am grateful to have the opportunities & to be making the wages I am, but I also know I need to be careful as to not get burnt out from working too much.  So time will tell & I truly believe that God will lead me to where I belong. 

I had an ok week at work this past week.  Gina & I were on the same floor although Gina kept whining about feeling sick the entire first night (ya baby Gina!). 

I only had 3 patients the first night - it was nice!  One is in with pancreatitis/cholelithiasis (sp).  Basically he has gallstones so he'll need his gallbladder removed, but they also suspected that he might have a stone in his common bile duct therefore causing pancreatitis.  They did an ERCP - no stone nor infection found.  So who knows what was causing his liver enzymes to be really out of normal range.  I believe he was going to have surgery yesterday or today if his enyzmes had improved.  The surgeon on the case is a great one.  If I ever need surgery, he's who I would want operating on me.  He was badmouthing the gastro doctor.  I just have to laugh at how these doctors talk about one another.  While he was talking to another nurse & I, he got a phone call from a patient of his that told him her primary doctor left a message on her answering machine saying her cancer had spread to other parts of her body.  What kind of doctor leaves that type of message on an answering machine???  Needless to say, the surgeon was also badmouthing the primary doctor.  I'm beginning to wonder about these "primary" doctors.

My second patient had an MI a couple days earlier & was a transfer from ICU.  He was very anxious to get home.  It's like he had no clue of the seriousness of his condition.  He was refusing any invasive testing or procedures...he just wanted to go home.  When I got there, he says to me "I feel like I have a sore throat starting & also a post-nasal drip.  Get me an aspirin, dissolve it in water & I'll drink it."  I told him I couldn't do that, informed him I need a doctor's order to distribute any medications."  He accused me of being resistant & unhelpful.  I offered him hot tea, soup, tylenol, etc.  He asked for mouthwash - I got a bottle of it but on the label it said "alcohol free."  He said he needed Listerine - wanted me to go & get him some.  I told him we don't carry it here at the hospital.  He thought I was lying to him.  So he says to get him a bottle of rubbing alcohol.  As if!  I finally get him to take some Tylenol & drink some hot tea, then he went to bed. The next night I came in & he starts telling me about an FAA warning - that pilots are not allowed to eat or drink anything with aspartame in it because it causes memory loss.  I'm looking at him like "Why are you telling me this?"  He wants me to inform the hospital that all of their products should be aspartame free.  Ok sir, no problem.  Why he was still in the hospital, I don't know.

My third patient that night was a 59 yr old man that came into the hospital mid-July with an intestinal blockage.  They did a hemicolectomy to remove the blockage.  As a result, he had a surgical infection that turned into sepsis.  To make matters worse, he aspirated while eating & that turned into a code blue.  Poor guy!  I had to do a dressing change on his abdominal wound.  It amazes me that they don't sew these wounds up.  Once I got all of the 4x4's out of it, I was wondering what exactly I was looking at.  You could see his internal organs.  I'm surprised they don't fall out!  I redid his dressing that night, but the next night we applied a wound vac as he was having a lot of fluid draining out.  I think the wound vac is really neat - amazing how it works & how it looks.  Through the night I was watching to see how much drainage there was & was surprised there wasn't all that much considering how drenched his previous dressings had been.  That all changed when I got him up to use the bedside commode.  The wound vac fluid container filled up in about 10 minutes!!!!  I was rather impressed. 

The second night I also had another patient...a 24 yr old male that came in with a blood sugar over 700 = DKA...otherwise known as diabetic ketoacidosis.  While in the midst of this, he also had a heart attack.  He was an ICU transfer & well on his way to recovery.  He only spoke spanish.  I am going to have to make an effort to learn some spanish in order to communicate with some of these patients.  I didn't spend a great deal of time in his room because I couldn't communicate with him.  He had a cardiac cath done that day which was negative.  I had a spanish speaking nurse tell him that if he wants anything, to call for us.  I also made sure he wasn't in any pain & that the cath site looked good & his pulses were fine. 

It was another week of having no patient care tech to help out & not even a secretary to help with orders.  I'm beginning to think I have the right to add these other jobs to my resume:  nurse/patient care tech/unit secretary/transporter/furniture mover, etc.  Our meetings at the beginning of the shift are a joke/waste of time.  The information they are telling us isn't even accurate.  Not to mention it delays us getting report from the day shift.  My first night - I was in report until 7:45 pm.  That's way too long.  They don't even want to let us know what patients we are getting until 7pm.  So I get there at 6:30 & am supposed to just stand around until 7.  Waste of time! 

I have started doing something I swore I wouldn't ever do.  Last year as a PCT, I noticed the nurses looking at the obituaries to see if they recognized any names of past patients.  At the time, being a PCT, I barely even knew the patients names, much less be able to recall them at a later date.  That is different now - I do know my patients names & my memory is usually pretty good.  While looking at the obits, I saw that the lady I had written about a couple of weeks ago with the stroke & high heart rate passed away last Monday.  I sorta knew that she didn't have a lot of time left.  Oh well, at least she's in a better place now. 

Today also marks a year since the murder massacre in Deltona (just a few miles from my house).  For those of you not familiar with the story, last year 6 people were killed by 4 guys with aluminum baseball bats & knives.  They broke into these people's home around 1 am & slaughtered all 6 of them, one so bad that they couldn't even identify her with dental records.  Sickos!  The reason they did this = an X-box game!!!  I'm glad they were able to catch them quickly & they are now in jail.  The trial starts in January - hopefully they'll all receive the death penalty & never be allowed back on the streets.  If you want to read the full story, here you go:

I'm finding that working nights really screws up my sleep schedule.  I had a hard time falling asleep last night so I took a couple of tylenol pm around 1 am.  I ended up sleeping the entire day!  Now it's 12:30 pm & I'm wide awake.  Oh day I'll figure it out.  Maybe I'll run up to Wal-Mart & do some food shopping.  I'm so much fun, aren't I?  :)

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