Sunday, September 11, 2005

Are there any right words?

I have had a pretty good week this week both with work & personal stuff.  To top it off, Ophelia did turn & take another direction, so it's been a beautiful Florida weekend with barely any rain.  Even though it feels as though I've slept most of the weekend, it is still nice to not hear a thunder storm outside.

The jury is still out as far as what I think about the new hospital.  Both Gina & I had an easy week as we only had 2 patients each.  The load is light since it's our first week there.  I think we both have pretty much figured out the computer system & how it works.  The only thing I am not sure about is how admits & discharges work exactly, but I guess that will come with time.  Also, I have no idea how to get a patient whose condition worsens to ICU.  We have a charge nurse, but she has her own patients & really isn't available to help out.  So it's a mystery as to how the process actually works.  At the same time though, the majority of these patients are in stable condition & the likelihood of their condition worsening is a small one unlike my other hospital where the majority of patients are in guarded condition.  I'll break it down:

PROS: the computer system is awesome: it is so nice not having to do hand-written assessments or nurses notes, having patient care techs (3 of them) on the floor is such a great help, being on the same floor as Gina & being able to help each other out if we need it.

CONS:  change of shift report - I don't know what it is, but these nurses are in no hurry to give report.  We were told to be there at 7 pm.  Gina & I are there, but there are no other night nurses around.  Where are they?  We're told "they're always late."  Huh???  Always?  I think the reason they're always late is because the dayshift is in no hurry to give report.  It seems that for most...starting report at 7:30 or 7:45 is no big deal.  I am so the opposite - I want to get report as soon as possible so I can begin my shift.  And at the same time...when it's 7 am, I want to give report so I can go home.  I have no desire to stand around & chit chat about nothing.  I am ready to go home.  So that is a bit annoying - there was one day when I didn't leave until after 8 am.  I like to be home by 8 am.  The other thing I don't like is what the rest of the staff is telling us when we ask them what is their usual patient load.  We were told the maximum # of patients we would have is 6.  The staff says anywhere from 7 to 9 patients.  Huh?  9 patients?  On a telemetry floor?  Not good.  Not acceptable for me.  I don't see how anyone could take quality care of 9 different people.  Even 7 patients is too much.  The other thing the staff tells us...that our manager decides when we will or won't work.  That isn't what he told us - he said just email the days you can work & he'll try to accomodate.  So who are we to believe?  The manager or the staff? 

Needless to say, by the end of our shift on Friday morning - we were already on the internet trying to see when the next job fair is.  There is one at the end of October in Daytona Beach - perfect.  It's a good opportunity to see what else is out there.  As far as trying to decide who is correct - the manager or the staff - so far it seems the manager is being accomodating.  I emailed him asking when he needs my schedule & he emailed back saying as soon as possible.  So I emailed back giving him the days I can work.  I'll find out this week if he's ok with it. 

I work only 2 days this week at my other hospital.  I kinda miss it - or I guess I should clarify & say I miss the staff - not the paperwork.  I also have an ACLS prep class 2 days this week.  I take the actual class at the end of the month.  Everyone is telling me not to worry about it, so I'm not worrying.  I still have yet to play any part in a code, yet here I am getting certified for Advanced Life Support...how ironic.

Aaron & I went out last night to the Alehouse.  We met up with some guys that were from England - interesting.  We also ran into a guy from high school.  I'm feeling so old...lol. 

Anyways, that's about all that went on this week.  I did have a patient this week that has bone cancer.  He was in the hospitalbecause he fell getting out of his car & fractured his femur.  As it turns out, they ran some more tests & discovered that his cancer has spread to his pancreas & kidneys = not good.  He didn't know of this prognosis while I was caring for him (did I mention that I really dislike having information that the patient doesn't have about their own condition?)  As usual in these situations, this patient started asking me questions.  It's hard to not answer what they ask when you have the information.  He had a needle biopsy scheduled for the next day & he was asking what that was for.  He was also asking why they were letting him walk the halls 2 days ago, but now they tell him he can't get out of bed & he doesn't know why.  He said to me "I wish they would stop with all of the tests & just make me better."  So heartbreaking - he was nearly in tears.  What do you say?  Are there any right words? 

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