Tuesday, August 26, 2008

Another Update


The storm is gone, but the damage is not. My house made it through just fine - there are some minor roof leaks, but I know the roof needs to be replaced soon. What isn't fine is all the flooding locally. I've lived in Florida for 28 years and have never seen the St. John's River overflowing like it is. It's usually way low in fact. It's kind of scary to think of what could happen if "all" that water comes pouring out.

My hospital is continuing to look like an island. There is nowhere to drain the water because the river is obviously at full capacity. I'm not kidding when I say in some parts of the property, the water is up as high as a stop sign. I've enclosed a picture so you can see just how bad it is. Look at how high the water is on the guy that is simply standing in the hospital parking lot.

I worked Sunday & Monday nights...it was pretty easy - went by so slow though. I was supposed to work tonight, but they were cancelling people due to overstaffing. I volunteered to be off as I did not get much sleep today. I keep wondering what all this water sitting around the hospital can do. I mean...can a sinkhole start because of it? Can the building collapse? It scares me because I know to some degree - anything is possible & nobody knows for sure.

It's 9 pm and I'm heading to bed. I need sleep....obviously.

Friday, August 22, 2008

Update = Still Raining

When will this rain stop? I am not kidding when I say it has not stopped raining in the last 48 hours. Roads are flooded, schools have been closed for the last 4 days, my yard is handling the water - but I do have a few leaks in the roof. I am thankful though - I did drive around town a little bit and there is a lot of flooding. I have never in my life seen anything like it. I mean you see it on tv around the country, but this is the first time I have seen with my own eyes - roads closed due to flooding. I am thankful that it's ok around my home.

I've heard conflicting reports regarding my hospital. The news was reporting that the first floor was flooded and patients needed to be moved to different floors or transferred to other hospitals. I haven't been to the hospital, but according to their emails, none of that is true. I guess I'll find out on Sunday when I return to work.

Speaking of work, I have finally had enough with shiftchange report taking on average an hour to two hours because dayshift is so unorganized. I communicated (nice word) my frustrations with my manager and director. It seems the manager took it to heart because an email was sent to everyone yesterday regarding shift change report and organization. I doubt that will do the trick, but at least they are aware of it.

I have to come up with another strategy to decrease the lenght of time it takes. I think I will start using the Kardexes as my report sheet - that way they will be filled in & up to date at least. I am pushing hard for them to bring back "voicecare"...which is basically where you record the patient's history, what they are there for, who the doctors are, etc and then an update as to anything pertinent going on. That's all I need to know. I feel like the dayshift nurses I deal with fluff up report with many details that I don't need to know. It wastes valuable time. I can only wish that one day evening shift change will be as smooth and calm as morning shift change. I absolutely hate getting out of report at 8:30 pm (when I start my shift at 6:45 pm)...and I have a discharge to do, a new admit is being brought up from the ER and my remaining patients are wanting their medications so they can go to bed - not to mention the orders missed, the orders that need to be clarified, dealing with pharmacy, dealing with the lab...ahhhhhhhhh....I just want a nice start to my shift.

Dayshift may say nightshift is easier because the patients are sleeping.....which isn't true.....but nightshift starts out like crap because of all the loose ends we have to tie up that didn't get done during the day. Ok, enough venting & I am not generalizing or stereotyping. We have some good dayshift nurses who are organized and know how to use time management to their advantage. We also have those dayshift nurses that are looking to milk the clock and waste valuable time. I'm sure we have some disorganized nightshift nurses also. All I'm asking is for a decent shiftchange report that doesn't take 90 minutes on 4 or 5 patients. That's not asking too much, is it?

Maybe that's my sign to try out some other aspect of nursing. There's not a whole lot to choose from at my hospital.....but other hospitals have different fields. Perhaps ER or Labor/Delivery would be worth venturing into. I'm sure all areas have their problems & I'll gripe about something........but I can't see it taking 90 minutes to get report.

My other gripe for the past week...I come in last Sunday evening and see that there are 4 isolation patients on the floor. Three of them have c-diff (nasty frequent diarrhea) and one is on respiratory isolation until they rule out menningitis. I think "Ok, there are 3 nurses tonight, surely they will divide up the c-differs between us."

Ummm...wrong. Guess who got ALL FOUR isolation patients......ME. I immediately began to investigate who the dayshift clinical leader was & why doesn't she like me? I think for a moment that I could complain about this assignment, but figure...nah, we have a patient care tech who will help me clean up my patients when they frequently go to the bathroom. Wrong...another patient on the floor became a Baker Act (patient is threatening to hurt themself or others) and they pulled our patient care tech to be a sitter for him. So I lost our tech for about 5 hours. Luckily they found someone else to come in & help out. It turned out to be an ok night. The next two nights were also ok.

Time to get some sleep - have a good weekend every one! Say a prayer that the rain lets up here in Florida!!!

Thursday, August 21, 2008

Tropical Storm Fay

Ahhh, it's hurricane season again in Florida and we have a live one! Actually, it's just a tropical storm - so nowhere near the power of a hurricane, but it sure is making up for the rainfall we were lacking all year. I posted a pic of it - I'm near Daytona Beach. The storm seems to be swirling around & around and not really moving much. We've gotten a lot of rain, but luckily it's not flooding near my house. And there's no lightning - hopefully no tornadoes.

I worked Sun, Mon and Tuesday - those were the days they thought it would hit my area. I am so relieved to be off of work until this coming Sunday. I think I have some kind of education class tomorrow at the other hospital - but if it's continuing to rain like this, I'm not going anywhere. I hate driving in the rain, plus I need new tires. I'm glad I don't have to be anywhere the next few days. Just rest and relaxation. I'll update more later!

Friday, August 15, 2008

Did I Do the Right Thing?

I haven't done a good job at keeping up with my blog. Sorry! It seems like the older I get, the faster time goes by. Let's do some updates...

I started my new job at the other hospital. It's ok. It makes me appreciate my hospital. I'm not sure it's so much that my hospital is better, just different and what I'm used to. Not to mention the other hospital just started the team nursing concept and the staff there is not very enthusiastic about it. So I have only been there 2 days for orientation - which really isn't much of an orientation since they are not even sure what they are doing yet with this team nursing concept. I think I actually would prefer not being on orientation so that I can do my own thing without having someone checking up on me every hour. This is what I like about nursing - the independence. I don't want someone looking over my shoulder or secondguessing my choices. I am not shy about getting opinions if my patients needs require more than my own opinion...but I don't want someone telling me what I should or shouldn't be doing. Example...I had a patient at the other hospital that wanted an antacid....at 1 am. Sorry, I'm not calling and waking a doctor for an antacid - it just isn't happening. My "preceptor" wanted me to call. I'm not calling...nope, never. So she discussed this with our medication nurse (another person on the team) and they decided to give the 9 am dose of Prilosec. Fine - it's your decision, I'm not having any part of it. Not more than 30 seconds after they gave her Prilosec - she was asking for food. FOOD! Now did she really have indigestion? Did she really need medication at that point? I would have offered her ginger ale and crackers or something of that sort. I think they ended up giving her coffee and who knows what else. And to think they wanted me to wake a doctor over this. @@

I have to call tomorrow and let them know when I can work again. My main focus is my hospital, this other hospital will just be to fill in. It works - and it shows me that I do have the confidence it takes to make it somewhere else. It also helps that they use the same computer charting that we do.

I appreciate my co-workers even more now that I have spent a couple of nights with virtual strangers. I spend more time with my co-workers than anyone else (isn't that a sad fact?), although I doubt I'm the only one that does this. Seems like anyone with a 40 hr or more work week can say the same.

We had a code last week that was just plain sad. I'm still thinking about this gentleman and it's over a week later. I had him as a patient on a Sunday. I had been warned he loved the call light and used it non-stop. I was hoping he would get some sleep that night, but as it turns out, he felt miserable. Nauseous, constipated, dry mouth, uncomfortable, etc. He wasn't a big guy, but he did have a big belly and no matter how we situated him in bed, he didn't look comfortable - his belly just seemed to make it difficult for him to breathe. I believe he was in with congestive heart failure and respiratory failure. I offered to get him some nausea medicine and he turned me down. All night long he was calling and reporting how miserable he was feeling, but no matter what I offered - he didn't want it. After 12 hours of that, I informed my clinical leader that I did not want him back as a patient the next night. We are allowed to do that - to request not having the patient again. Monday night he did much of the same with the other nurse he got. By Tuesday night, he was in worse shape than ever. The pulmonologist came in around shift change and ordered for him to be transferred to ICU.

Right as the nurse was getting ready to move him in his bed to ICU...his heart rate dropped from 115 to 52. A code was called and although they managed to save him, it was only temporary - he passed away about 2 hours later. His family was able to get there before he passed, but there are no words to really comfort them. It stopped me in my tracks and made me reevaluate my decision to not want to be his nurse after the first night I had him. Does that make me a bad nurse? Or a bad person? I know I'm human and one can only take so much...but was it fair of me? Was I fair to him? I reflect back on the things he talked about to me that Sunday night - about how he was the one that usually took care of his wife and that he was afraid he wouldn't be able to do that anymore - that he would end up in a nursing home and who would care for her? I tried to be encouraging and tell him that he would get better and be able to return to her, but was that the right thing to say? Should I have said anything? Should I have simply encouraged him to talk more about it? I don't know that there is a right answer. I guess, like life, nursing has it's learning curve....live and learn. Try to do better next time. This is the hard part of nursing - the emotional side - the stuff you can't learn from a book.

I've been off of work since last Wednesday - it's been a nice break. I've enjoyed the Olympics - go USA! If there's one thing I've learned about the Olympics...it's that the Chinese women sure do like to put a lot of hair clips in their hair...lol. Am I the only one noticing this? Michael Phelps is amazing - he makes it look so easy. I love the Olympics!

Have a good weekend everyone!