Catch up!

So I have worked a round of day shifts and a round of night since I last updated, bad Jennie!

I'll start with my days. Things went better, I was still there a little on the late side but I knew what was going on and felt more in control for the most part. I did manage to work so late all three nights that I missed visiting hours and missed going to see someone I needed to. Sorry.

There are three things that I got to do on my day shift that are pretty common around here. An admission to the unit, a discharge and a DNR (do not resuscitate) discussion.

I'll start with the happy times and then move on from there. When a patient gets discharged from the floor we have a full out confetti parade. We line the halls with staff and the other families and patients and the kids get to walk out the door while getting showered with confetti. I cry most the time. It's such an awesome accomplishment, and then again there is still so much for the parents to take on. Once they leave the parents draw the labs from the central lines, run the IV's and give the meds. They are going home to be a parent and a nurse. Scary. Those confetti steps are the first steps back to normalcy and yet there is still a long road to walk. The job of the Nurse in this situation is to be sure all the instructions have been given out, clinic appointments made and to answer all the questions the parents have. My patient was a second time discharge so things were a little easier on the education and question front!

The admit was interesting just because it was a lot of paperwork for me to learn and a ton of labs. We drew so much blood that I wasn't really so surprised when the labs came back and the patient needed a blood transfusion. The main thing with all this going on was that I still had a third patient during all this. He was easy too. At 2:30 I realized I hadn't given him his 2:00 medication, which is fine, there is a one hour window either way but I was so mad that I had missed it I didn't even see that I could hang his 3:00 medicine at the same time. It's the clustering of care that I need to work on to make me more efficient. I struggle with that, mainly because I am so overwhelmed with what I need now I can't look that far ahead!

The DNR. Wow. I have found that having patients that don't speak English makes me feel more helpless than I would in a given situation anyway but when a parent is hearing that there is nothing else that can be done for their child with the aid of an interpreter while other people like myself are in the room ya really feel helpless. After the doctor spoke with the parent they were left without any support, I was very happy when they got on their cell and called someone. The do not resuscitate talk - someone saying there is nothing but comfort care that can be done. Horrible. And needless to say a common reality on this floor.

Nights.
Working nights is hard for me because I don't see anyone for 3 days in a row, I mean really, no one. I make myself stay up the night before, sleep all day, go into work at 6:45 come home and sleep until it is time to go back and then sleep all day again. It's crazy. I do however get all my TV shows caught up on while I am trying to stay up to switch my body clock around. We'll call that the advantage!
Nights are a little slower paced. The patients I had were great and one of them has some interesting medication issues to figure out with timing so that is good for me. I was done on time both shifts and I don't think I came close to having a panic attack! We will have to see how things go these next few nights. I work tonight, then Thurs and Fri night. I'll update over the weekend.