Thursday, March 22, 2012

Bon Voyage

Quick update before I leave on my road trip to Miami to take a cruise to the Bahamas over the weekend. :)

I interviewed with my old hospital last week. The manager (who is someone I helped train when he became a nurse) said he would love to have me back. That was last Wednesday. He called on Monday asking if I wanted full time or Baylor (weekends only option). I told him I preferred Baylor. He said he was hoping full time. I ended up telling him I could be flexible & do full time if that was what he needed. He said he had to talk to "them" & would be in touch. I haven't heard a word since. I don't know who "them" is either. Oh well, whatever is meant to be will happen.

And wouldn't you know it...the last 2 weeks at my current job have been really good. Figures!

Anywaysssssss....taking a much needed vacation with my two best friends. We have never done this before. I defintely need it! Bon Voyage everyone!

Thursday, March 8, 2012

Thank You!

Just wanted to thank my fellow blogger nurses for your kind words & understanding. While I'm glad to see that my emotions/reactions are appropriate, it also saddens me that others are in the same frustrated positions. I wish the public could understand all the pressures a nurse is under instead of assuming we hardly do anything but talk & play on the computer. Your support helps me tremendously!

I got a call from my old hospital yesterday....yessssss! Although I'm not convinced that this is going to be an amazing transition, any change right now would be helpful. One of my friends from nursing school is ready to quit the old hospital cause she's sick of management. She won't give me specifics though. I would just be grateful to have some help from patient care techs. I have to call the recruiter back this morning & hopefully set up an interview for next week.

I just realized that I self-scheduled myself to work the next 5 out of 7 days...ugh. Oh well...I have a day off inbetween on Sunday & Tuesday. I'll get thru it. I'm in a better state of mind...after having the last 9 days off. :)

I turned 43 yesterday. It was an easy, relaxing day......dinner at Red Lobster. Time with my family. Much better than last year when I was worried about my niece being around her mother's loser bf.

So once again....thank you....you know who you are. :)

Monday, March 5, 2012

A little better

I'm still recovering from the emotions of last week. I've also been rereading my blog...the past year & seeing how I've tried my best to make this work, but seems things are getting worse instead of better. That reinforces my decision that it is probably best to change things up. Changing my attitude simply isn't enough in this situation. Hard to believe that my "hope" is that my old hospital will take me back. I still remember the frustration I had there. I also remember shortstaffing wasn't one of the reasons. So my priorities have shifted, but my focus has not. All I want is to go to work, do my job & come home. I don't care about the corporate ladder or becoming a charge nurse. I want to clock in for 12 hours, clock out & live my life. No drama, no b.s., no administration type stuff.

I applied online at the old hospital. Got my fingers crossed they give me a call or an email or however it is done these days. The ad had just been posted on Feb. 28, so I figure they should at least give me a shot, right? I'll keep you informed.

I had my 15 yr old niece over for the weekend. She is good at distracting me from the realities of life. Our main focus was food & what to watch on tv or at the movies. Well, we had planned to get some sun as Saturday was beautiful.......instead we got our haircut & watched Lifetime. It's the simple things in life, isn't it? I also changed the cabin on our cruise in August. Got one a little bigger. What the heck? Why not? August 4th can't get here soon enough. Luckily, my 3 night cruise is less than 3 weeks away. Yessssssss! March 22......getting away with my bff's for a girl's weekend. Definitely what I'm needing/focusing on right now.

I'm off until Friday. My 43rd b-day is on Wednesday. Nothing too special planned. Lunch or dinner with the family. I'm not one for making a big deal out of b-days. I'm actually looking forward to a day or two of time to myself. I do need to get a massage...only because I was given a gift card on my last birthday for it.................it's not that I don't like massages, I just am not crazy about them. I guess now is when I really could use one though. So Monday or Tuesday I will get it done. Hoping to get a little bit of sun too...need a pre-tan before the cruise. The weather is supposed to be really nice the next few days. See....I'm simple. And I know I'll get through this. Just a bump in the road. :)

Have a good week everyone!

Thursday, March 1, 2012

Lost It. Sigh.

I officially lost it....at work that is. Last night was a combination of pms + disrespect + work overload + whiny drug addicted patients = me crying at work. :( It is pretty safe to say that I am approaching that dreaded nursing burnout phase. Sigh.

I can't change pms.....it seems as I get older, the symptoms get worse...especially the crying & hot flashes & sweating. Ugh. It isn't pretty & the 40's definitely are NOT better. Sigh.

Disrespect....that came from an idiot cardiologist. We are required to report all critical lab values....doesn't matter what time it is. Well, last night I had a critical Troponin to report. The patient is renal & I have learned at this hospital that if a patient has renal issues....the doctors really disregard the Troponin results. Leaves me to wonder why they even order it then, but anyways.........our normal value is below 0.03, my patient's result was 0.5. It wasn't extremely high, but nonetheless...it comes up as a critical value. So I call it to the cardiologist who immediately gives me attitude. "Why are you waking me up for this?" Because the hospital requires me to report all critical lab values. "This is ridiculous. You call & wake me up to report something you already know will be elevated?????????" Yes, the hospital requires me to do so. "This is INSANITY!!!!!!!!!!!!!!!!" At this point, I wanted to hang up...but I didn't. Next time I think I will. I'm the messenger, dude. I didn't create the problem, I am just doing what I am required to do. This isn't anything new. The doctors know this & they know not to be rude to us. While I may agree with him & I really didn't want to call him...it had to be done. A simple "thank you" & hang up would have sufficed. Sigh.

I had two new admissions who were begging for pain medication. By begging, I mean screaming as loud as they could & continuously begging/whining. One I was able to meet his needs. His blood pressure was good, I managed to talk the physician assistant on call to give me some options to work with because I was not going to let my patient scream out in pain all night. It was my third shift in a row & I'm pms'ing = no tolerance. Gave him 1 mg of Morphine & everything was good for about 6 hours with him. Thank goodness. Sigh.

My other patient....not the same story. She is a frequent flyer & while she does have back issues that no doubt cause her pain, I prefer her to be alive with pain than to be dead with no pain. 10 days ago at one of our other hospitals her heart stopped because they gave her too much pain medication. Somehow they managed to save her (she coded 3 times) & she had zero brain damage in the process. I'll never understand that. Anyways, the good ol' ER nurse promised her that I would give her whatever pain medication she needed when she got to the floor. Not a good sign. Her blood pressure when she got to my floor was in the 70's as was her 02 sat as she didn't feel like wearing oxygen anymore & they said ok. Sigh. All she's doing is begging for Morphine. I explain to her that until she's stable, NO PAIN MEDICATION. After about an hour, her blood pressure was back up to about 116/70 and her 02 sat on 3L was 95%. Ok, here you go....1 mg of IV Morphine. Not super strong, but like I said earlier - I prefer my patients to stay alive. Amazingly the doctor came by around midnight & was able to order me the things I needed.....nebulizer treatments, Tylenol (for fever), pt's home meds. She asks him to increase her Morphine dose...which he does to 2 mg. She's happy, until I recheck her BP & now she's in the low 90's. Sorry, honey....no more pain medication for you. She's crying that she wants to go home if this is how I'm going to treat her. Sigh. It's so great to be a nurse!

Every half hour she's asking me to recheck her blood pressure, which never makes it above 99 systolic. She finally stops asking when it reaches 89/44. Well, she stops asking me to check her blood pressure, but it doesn't stop her screaming out for pain medication & how awful I'm treating her. So much for patient satisfaction. I guarantee our scores next month will be awful with patients like these. I go in at 6:45 am to empty her foley cath & draw blood out of her central line. She asks again about checking her blood pressure & I tell her we are just about to go into shift change & her next nurse will have to assess her first. Now if this were a normal patient with a normal blood pressure.......I would have given her pain medication. But knowing 10 days ago she coded from pain medication....I wasn't about to medicate her & then go into shift change for 20-30 min with no one checking on her. That's why I deferred it to the day nurse. My patient again started demanding to go home.......saying what is the purpose of being here. I don't think this lady could stand on her own two feet at this point, so I don't know how she was planning to get up & leave. Didn't matter, by this point...I was mentally checked out. Sigh.

I broke down around 12:30 am. I literally had not sat down since 7 pm except to chart my patient's vital signs. Nothing else was done. None of the admission stuff, none of the assessments, none of the plan of cares...nothing. I pictured I would be there till 10 am doing all this stuff & after being yelled at by the cardiologist.....I went into the bathroom & just started crying. :( I couldn't help. Jeez. I could cry right now...which makes me even more aware that it is pms & stress & not directly related to any one incident. Luckily, my good friend was the charge nurse last night & helped me quite a bit as far as she got my patient's vital signs at midnight and another nurse checked a blood sugar for me so I could just sit & catch up on charting. She also gave me a hug, which made me cry more. She gets it though. She & I were the ones that left our old hospital first because we were fed up with the stress & just recently she has been wanting me to get on board with going back to the old hospital together. I was hesitant, but after last night & the last month/year........I am just about to re-apply to the old hospital. Cause even though administration sucked over there, the patient load was not this bad. Sigh.

I am soooooooooo sick of primary nursing. We, nurses, need help. I shouldn't be doing respiratory treatments or emptying trash or cleaning up the patient's rooms or reminding doctor's to do their part or making sure lab is on time or putting in orders. Just because "I can" doesn't mean "I should be required to do everyone else's job." I am all for taking care of my patients, but it has to be balanced with all the charting we have to do. And lately with all the emphasis on patient satisfaction, it is taking away from our ability to be nurses & to use our critical thinking skills. Even last night as my patient is begging to be overdosed on pain meds, in the back of my mind I'm thinking "our hcahps scores are gonna suck next month"........I shouldn't have to think about that crap. I have been so forgetful lately that I thought it was all just a part of aging or I'm beginning early Alzheimer's..........but I totally think I am just overwhelmed at work. And all we hear back is that we aren't doing enough....the patients must be "ALWAYS" satisfied. That is impossible. Who is ALWAYS satisfied with everything...especially in a hospital? Correction...a purposely understaffed hospital? We floated our nurses to another floor because they were short.......which left our floor short. Is that fair?????????? Sigh.

And one more thing to vent.........we have no patient care techs. So our patient ratio is supposed to be 3 patients to 1 nurse. Mind you, these are usually total care type patients with multiple issues....so don't think having only 3 patients is a breeze. It's doable, but it isn't easy without any help. They told us "occasionally" you might have to take a 4th patient. By "occasionally" they mean just about every shift you work as well as every other nurse on the floor will have to do that too. So now we have 4 total care patients & no help. It's too much. And then they tell us we still have to do more to make the patient's and their families happy because 60% of our patient satisfaction surveys are filled out by a family member. WTF? How can they judge patient satisfaction if they aren't the patient? That should not be allowed!!!!!!! Sigh.

I don't know that going back to the old hospital is the best option, but it is pretty much my only option - if they'll even have me back. All I know is that they do have patient care techs and the nurses are not doing the respiratory techs jobs either. I'm also wondering if nursing is something I'll be able to do the rest of my working life. Not if this is what it's going to be like. I don't thrive off stress. My mind is worn out & my body physically aches. I'm moody, I complain. This is not me. I'm usually the easiest going person in the world & full of smiles. Now I absolutely dread going to work & count the hours until I can go home. I love my co-workers, but it isn't enough to survive. Wish I could work from home. Sigh.