time's a flyin.

It's March 21st. In two weeks my acceptance packet to the ESC is due. In a month and a half I'm quitting my hospital job. In 4 and a half months I'll be moving to NC. I know that the last stretch of work is going to go really fast. Night shift just has a tendency to put everything in a time warp. I mean, the time I've spent at this job has royally sucked, but it has still gone really fast. I mean I've been working here over a year and a half. It sucks because it is time I'll never be able to get back, and I spent it dazed, distracted, and depressed. On the flip side, I will never have to be a new graduate nurse again. Which is really huge. I mean, it really doesn't matter if I have to switch specialties even. I will be a real nurse from the get go. I've already got a foundation of the critical thinking, prioritizing, waitressing, delegating, and the handling doctors skills. Not to mention the fact that my floor has a lot of pain in the ass patients who all have multiple medical problems that have to all be kept in mind at once. It just serves to remind me to constantly look at how body systems are connected and how they affect one another, especially if parts start failing. Of course specialties are just that, but without a solid foundation in the big picture, it makes things much more difficult.

It's funny, in the beginning of 2008, I was still pretty set on getting into the NICU immediately after graduation. And I'm pretty sure I'd be happier if I had, but that is neither here nor there, because I also probably wouldn't be on this cool Chapel Hill adventure in the fall. ANYWAY. I was in my management clinicals, which were some of the worst 120 hours of my life for sheer boredom sake, and I went to some meeting where one of the managers got on a soapbox about new grads specializing immediately instead of doing a year or two of plain old floor nursing, preferably med-surg. That was one of those few times in my life that I just sort of knew where things were headed, for better or worse. The other times in my life it has happened have been: when I realized that I could take care of babies AS MY JOB and be a nurse (that was in high school, sometimes it takes me a while to see the blatantly obvious), the next was when I visited Samford and talked to my advisor (ah, Jan Paine, you rule), then came the paid internship with Princeton one Jan term, then that management meeting, and most recently the ESC. Anywho. So that meeting put the spark in my head that perhaps a solid general foundation was a good idea, and I had survived my Princeton internship, I actually enjoyed my preceptorship in the ICU, which showed me that I could take care of adults (and even keep up a conversation with these patients without melting into the floor!). Because I wanted to work at Camp after graduation, and because I was COMPLETELY unaware of job market type things, I postponed the job application process til I got home, and ultimately put off real adult employment for a year unintentionally. In the process though, I got to nanny for Baby Patrick. I am sure I'll never forget those days; I miss that baby!! So in part because of that conversation with that manager, I am where I am. Once it is over, the war stories will be kinda fun to tell, it's still just anxiety inducing for the time being. Hopefully, the ESC will be more meaningful because of my traumatic nursing job. I'll try to keep that in mind. As well as fostering the positive traits I've acquired. I sure as hell don't procrastinate like I used to: you procrastinate on taking care of some issue with a patient and it inevitably gets worse and totally bites you in the ass.

Speaking of not procrastinating, last night I had a patient who had a 10 beat run of v-tach, and after getting ahold of the cardiologist, I was instructed to draw labs on her. I was going to try to pawn it off on to Keith, partly because I knew she was a hard stick according to dayshift-- even the lab guy couldn't get it (granted, he still seems kinda new... or maybe phlebotomy just really isn't his thing). I thought about it though, and I realized I'd be anxious for Keith to draw the labs, hoping he'd be able to get them, then I'd have to wait for him to return the tube to me to send down, and he really doesn't have much sense of urgency. So in my head I was like "Ugh fine. I'll try to just get it done myself." I went in there, picked a vein, immediately got it with no trouble. First try, first stick. I even got a high five from Keisha when I got back to the desk, since she had had to be the one to get an IV in here the night before last, and she is kind of magic at IVs. It seemed a little silly to make a big deal out of it, since labs really aren't tough, but at the same time, it was nice to just be able to barrel through a task that can be troublesome (and therefore frustrating and a little embarrassing at times). But the payoff of having the task done and taken care of was such a good feeling and helps reinforce me against procrastinating, which I still need even though I've vastly improved.

Speaking of new grads, so I picked up on a conversation and email Keisha had about the current new grads, who have been off orientation for about 4 months at this point. Apparently one of them is at a 5 patient limit. I don't know if it is like, a new thing that she is going back to 5 as a limit, or if she never went to 6... I feel like she couldn't have stayed on 5 this long, so I wonder if something happened that she felt was a patient safety issue when she had 6 or what. I have really mixed feelings about the whole thing. Well, not so much now that I am home, but when I was there, thinking about someone having a limit, and seeming to get more understanding treatment than when I was a new grad, it made me almost indignant. Which in turn made me feel bad, because I felt like I'd already turned into the nurses that threw me under the bus so many times. At the same time, I felt like it wasn't fair that I'd been pushed into 7 patients, and badgered about not working overtime from really early on. Now that I am home, I feel like I can be much more sympathetic as well as protective over her. I know how alone I felt, and for so long, and I don't want anyone to have the traumatic experience I had. And I know there was some protection over me, which probably caused others to be LESS sympathetic when I got flustered. I do know though, that when we make the patient assignments for dayshift, there is actual forethought into it: don't give one person all isolation patients, try to have new grads report to seasoned nurses who can pick up after any issues left behind, rotate the difficult patients, etc. And during the day? Usually the secretary makes the schedule, and that means it is frequently the one who kinda sucks at her job. Some people are good at sorting, I feel like, and some aren't. Like she just can't keep things straight-- which patient goes where, who is next to get an admission, which patients are too heavy and need to be split up, etc. I think I'm a natural sorter. I just tend to group things, and use their differences as identifiers. I don't know if that actually makes sense or not other than in my head. But usually by the end of a shift, I know a LOT of what is going on on the floor. And that isn't my job really, my group is my job. But anyway. Whatever.

Apparently it's nearly 4, and I've rambled far too long.