So busy

Wow, worked 3 - 12s and they were incredibly busy. My second day was sad... one of my younger patients had cancer that had spread to the brain, and the doctor told the patient that hospice was the best option. Oh but then the doctor didn't tell either the internal med doc or the oncologist, so the hospice person and I had to do the honors. The internal med doctor was not too pleased about not being told this important piece of information. Don't shoot the messenger!

And then I never know what to say to people who are basically being discharged to go home to die. This is my second patient that has left for hospice care. I just tell them that it has been a pleasure taking care of them and they will be in my thoughts.... argh.

A Week Off

I planned a week off of work because I thought I might be going out of town with my boyfriend to Hawaii. Well, this wasn't the time his work decided to send him to Hawaii, so we went to San Diego for a couple days. He's probably going to move there for his work, and wants me to come with him. I applied for a few jobs to see what was out there. Why is it that companies always want applicants to have 1-2 years experience? Who am I going to get this experience from if no one will hire me? I want to get into L&D which requires 1 year experience, and the HR recruiter told me to apply for their new grad program that starts in June. I honestly don't mind starting at the bottom, in fact I love learning and think this would be a great opportunity, but I do have a little experience. I hope they see that. Plus, the application process starts the end of February, and I would probably move in April. Do I wait to hear about this program, or do try and accept another job? I haven't even told my family that I'm thinking about moving.

My boyfriend tells me something like 'I looked it up and there are 11,000 nursing jobs in San Diego [or CA, can't remember what he said]' Okay, well a lot of those I'm not qualified for with either education or experience (i.e., NP, ICU, ER), and a lot of those I probably don't want to work at (i.e. home health, nursing home), so don't always believe the statistics outright. :)

I will find a great job at a great company, I will find a great job at a great company, I will find a great job at a great company.

Back to work tomorrow!

Emotionally draining

I tend to avoid emotionally draining patients, so much that I asked another nurse to switch a patient. She was designee and could have had 4 patients but insisted on 5 so she didn't get an admit. I actually don't mind getting admits because they usually don't come until the afternoon and by then I usually have most of my meds, assessments and charting done. The admit didn't even come until about 6pm. And I even got the admission health profile done, so I was happy with that. She ended up being impulsive, climbing over the 4 side rails so had to go into an enclosure bed (this was figured out on night shift; I had a feeling she wouldn't stay in bed, thank goodness for bed alarms and her being fairly steady on her feet).

These 3 days of work went fairly well. I lucked out with not having any patients on contact isolation. I'd rather have restraints than contact isolations. :)

Two lovely ladies from Face in the Mirror came by to pamper our patients with a history of or current dianosis of cancer. They were so pleasant and compassionate, and I'm sure the patients appreciated it.

Another day...

It was a better day than last Friday and Saturday! One day I had a patient leave AMA with an external fixator! Craziness. I won't go into details out of respect for the HIPAA gods, but it was a difficult patient that I did everything to satisfy her to no avail. I'm sure she'll be one of the lucky ones to get a satisfaction survey.

I really don't mind patients that have feeding tubes because then you can put the meds thru the tube and most of the time they don't eat anything PO. Granted, you have to remember to turn it on for the lunch bolus, and then in the afternoon, but that's usually not too difficult.

Off to eat dinner... rice krispies! Yum! I'm on the cereal diet due to waking up early and not wanting to cook; and getting home late and not wanting to cook. At least I usually eat something better for lunch.

Feline Diabetes

I found out a few months ago that my cat has diabetes. I switched to a low sugar food (of course that I can only get at the vet), and every two weeks I bring my cat into the vet for a blood glucose curve. So far he's up to 4 units, and I know based on how he's acting that he needs at least 5 or 6 units, if not more. It's been interesting because I've definitely seen the 3 common signs firsthand: polyuria, polydipsia and polyphagia. Man, this cat is hungry! He's even started to eat the dog food when his food is gone. And even though he is eating a bunch, he's still losing weight which is common in uncontrolled diabetes. Due to the lack of insulin, the cells aren't able to bring in the nutrients, and even though he's eating, his body is still telling him he's hungry because the cells are starving.

Also, I've got yet another cold sore (HSV1 - oral, not HSV2 - genital). I know my triggers - not enough sleep, caffeine (soda & coffee), wine, decreased immunity - and yet I continue to partake of these beverages. I'm even on a daily valtrex (anti-viral), but if I drink too much caffeine and alcohol, the virus will overpower my body. Luckily the daily anti-viral helps to keep the cold sores small. Plus, the accutane does not make the situation better because it drys out my skin so much that it creates tiny fissures, which I suppose allows the virus to spread to the outside. So I've put on my morning abreva, and will use the Aquaphor since the dermatologist said to keep it moist, and hopefully it will go away soon.

I HATE having a cold sore and going to work. I just feel dirty or contagious, and I'm afraid that my patients will judge me or think I am less competent because of this sore on my mouth. I am so good about not touching it and washing my hands a lot though. I get these because my mom kissed me as a child when she had one - *sigh*, life's not fair. But then I remember that this is only temporary, I've survived these before, and things definitely could be a lot worse because I've seen "worse" and "unfair" at work.

Days off

I work three 12 hour shifts each week, and I prefer to work 2-3 days in a row, so that I get to know the patients better. However, this leaves me with 4 days in a row off, and while I am definitely not complaining, I sometimes am at a loss for things to do since everyone else I know is usually working. I have plenty of magazines to read and cleaning to do, and I enjoy taking my dog to the dog park (probably more for me than him). I shall make a sidenote that I am currently on isoretinin (accutane), and during this last month of being on it, I have noticed a decreased motivation to do most anything, which can be a major side effect of the medication, and subsequently part of the reason why my doctor has decided this will be my 6th and final month, even though she wanted me to do one more month. Other side effects noticed that I was promised would go away: increased dry eye, nighttime blurred vision, hair loss... but, oh, the clear skin is all worth it (granted, if these side effects truly do reverse). I still have some minor scarring and am wondering if microdermabrasion is a good option once the accutane clears my system.

Off to meet a friend for lunch... I'd better finish getting ready so I'm not late.

New to blogging

I decided to jump on the blogging bandwagon, and use this as a way to keep track of my experiences and lessons learned as an RN. Being a nurse definitely has its ups and downs, but when a patient thanks you, it is all worth it. I learn something new every day, and as I have only had my license for about a year, I still have a lot to learn. Please join this journey with me, and feel free to offer advice, feedback or lessons you've learned throughout your journey.