***ALL POSTS REFLECT MY OWN PERSONAL OPINION AND DO NOT REPRESENT ANY COMPANY INSTITUTION OR PRODUCT***
Ok I worked 5 days total this week and it was HELL. I do not know what I was thinking but hopefully when the direct deposits start rolling through all will shine! Mama always said you have to work smart and not hard, so I need to go back to living the simple life! PHILOSOPHY: Quality of life supersedes everything! Why work 6 days a week for "stuff" and not be able to enjoy it!? I would rather live reasonably; drive Lucy, live in my little apartment, lay up on the couch and chill than to try to kill myself at a job. I am currently rethinking my situation, I will probably tough it out through the end of this contract then go from there...
Everything that can and will go wrong will go wrong right @ shift change. Granted, things in ICU can change at any time but the witching hours are from 0615-0730 and 1815-1930. Even if a shift has gone "perfectly" I always get uneasy during these hours! Maybe we should change the start of shift times or something because I HATE IT! LOL! So I entered the unit found out my assignment and proceeded to look at my patients. I always make a point to look at the patients while the day nurse is still around just so I can ask questions about what is going on. I was a little irritated this day so usually when i feel that way (which is the usual at the beginning of most shifts for me) I just let the day nurse talk, nod my head, say uh-huh just so they can leave so I can read and find out whats really going on with the patient. I proceeded to do this and I noticed the patient was breathing "funny", so I was REALLY ready for this nurse to leave to I could go do a focused assessment and proceed to make some phone calls...this nurse JUST WOULD NOT LEAVE. She was fixated on the patient having an odor and needing a bath...in the back of my mind I was thinking: You have got to be kidding me, this patient is breathing like a fish on this bipap and the most you can think of is a bath!? PLEASE GET THE HELL AWAY FROM ME AND GO HOME AND TAKE A NAP. So once I ignored the nurse enough for them to leave I did my focused assessment and found the patient to be very hypoxic and having a very mottled appearance. For you non-medical and new nursing folks...mottling is a LATE sign of being deprived of oxygen! Ok, if you want to see a mottled "look" get a ice pack put it on your knee or thigh for a minute or two then look: its balmy, pale and has an appearance of "spider" looking veins/vessels come to the forefront. ANY WAY: I looked at the bipap machine and noticed that the patient's tidal volumes were between .100-.200 (inspiratory capacity; normal is about .600), oxygen saturations were in the lower 90s. JUST BECAUSE THE NUMBERS LOOK GOOD DOESNT MEAN THE PATIENT IS GOOD, TREAT THE HUMAN BEING AND NOT THE NUMBERS. So I call the physician on-call and while i was on the phone with them, they walked up and immediately called for a intubation tray and vent. I just love starting out my shift like this...The patient was intubated and because the drugs given(paralytics and sedatives) they had to be resuscitated with fluids and vassopressors. It took almost 5 hours to get this patient stable, then we had to go to CT, THEN I got another admission. Thank god they were stable because at this point I was finished! Not only is it difficult to find a patient unstable, but to walk into something like this in a strange place. The strange equipment the strange people, its terrifying! I just opened my mouth and asked for help, and everything sort of fell into place.To say the least, it was a rough night! But the patient was ok, and all involved were great! I made the physician on-call laugh because I just continued to thank them and their associates! "why do you keep thanking, its what we are supposed to to" "Well, I learned early on in my young career the more appreciative you are to folks, the faster they come when you call!" We chuckled a good while on that one! But its the truth! I also feel like I earned the respect of the doctors and the nurses on the unit because they were able to see me in "action".Its not I a different person when a patient is unstable or during a procedure, I just cut out all of the bull, pick up the pace and focus on doing what I can as the nurse to help the patient make it over their "hump". So one aspect of the night....
I do not want to go into great detail about this but, whenever you are in charge of the care of the patient...make sure to always double check with each department who is participating in the patient care. Make sure physicians are talking to the right patient, going to operate on the correct limb, draw blood on the correct patient etc. What sucks the most is if there is any breakdown in the communication it always falls back on who was the NURSE. lmao.
Why are SOME day shift nurses so up tight, mean and type A? I can't stand getting or giving report to them! They always concentrate on details which are VERY UNIMPORTANT! Yes t he kardex is important in patient care but before you give a medication you do not check the kardex you CHECK THE ORDERS IN THE CHART! So type A day nurses please get off my back about a kardex, get a life and get a pencil to update it after I leave. Thanks. If I update it, fine...if I don't ok. But I tell you one thing, everything in the patient's room WILL be correct. My focus is and will always be patient care, I will do whats required paper work wise, but my priority is HUMAN LIFE. Yes, I am being bull headed but paper work doesn't save lives excellent prudent nurses do...however my narratives in notes always are on point! LOL!
I am so grateful for these experiences! Its a roller coaster physically mentally and spiritually! However, I couldn't imagine myself doing anything else in life! I keep checking the New York state board of nursing to see if they issued my license! This 1st experience is ok, but I WANT TO FLEE THE REPUBLIC OF TEXAS ASAP! LMAO! 11 more weeks to go!!!!!!!!! YAY!
Please leave comments questions qualms!
BS RN
***If you find any content offensive please email me and lets discus it!***
What do you see as the difference (personality, work ethic, styles) between day nurses and night nurses? ---of course this is heavily relative
ReplyDelete-Baby RN
In my personal experience (which doesn't speak to or for everyone)day shifters are more uptight, have bigger egos, and don't always work well as a team. Work ethic wise, they work hard, but don't seem to be as particular and thorough as night shifters. Leave patients a mess (hygienically and some times hemodynamically) leave orders undone, tests undone, and just have lots of excuses. I usually find myself "cleaning up" after certain day shift nurses either cleaning a patient literally or getting on the phone to make call physicians to clarify orders or report changes in the patients conditions. Night shift seems to be more laid back independent autonomous! We don't have much to rely on, just ourselves and a resident/fellow. I guess it make be we have less "interference" and have the extra moments to comb over orders and give that extra TLC to patients. Every unit I have ever worked on the night crew have been tightly bonded and work as a team...but I am extremely biased!!! I haven't worked a day shift in almost 2 years! But Nights rock out with little to no recognition but hey, when are nurses really recognized??? Hope this gives you incite to my thoughts lol. What do you think???
ReplyDeleteI think some points are valid but I think you have to give credit to the fact that majority of the "business" happens during the day. Meds, meals, hygiene, procedures, consults, etc....It's impossible to get everything done. Unfortunately, night RNs have to play catch-up and clean-up.
ReplyDelete-Baby RN