WEEK ONE DOWN 12 TO GO!!!

Well I must say this has been a week for the BOOKS!!!

So the hospital orientation was one day only! We skipped the founders and culture mumbo-jumbo and went straight into taking tests and learning the computer systems! The tests consisted of general pharmacology, dysrhythmias and general nursing knowledge type test. They were extremely basic and straight to the point, you either knew it or you didn't! I did very well on the ecg test and only missed questions on the other tests related to facility specific type of questions i. e. when dressings were changed, when IV tubings were changed etc. Their charting system is very similar to my facility back home in Houston: Paper charting except for medication administration and initial screening assessment (home life, blood transfusion reactions, vaccinations etc). This was a relief because I am used to the "dual" charting methods. I think the biggest sigh of relief was learning they used the same IV pumps as my "home" facility (actually they use the upgraded version)** Overall orientation was short to the point and they expected us to be up and ready to go (There were two other travelers with me both doing 8 week contracts). After the classroom/computer training I met with the education who then blazed through a "guided" tour of the unit and the different facilities. I couldn't remember anything she said except at what time was clocked as being late and where the actual physical location of the unit. The unit 12 bed medical ICU with 2 beds reserved as "code beds". There are a few other ICUs: Cardiac ICU (CCU/CVICU) Surgical ICU, Trauma ICU etc...Any ICU nurse can be floated to any of the units and on rare occasions to the progressive care unit. Each unit does their own scheduling AND staffing. Charge nurses take patients and make assignments and decide on staffing needs. So about my 1st night on the unit....

My 1st impression of the unit was a positive one! By the end of the night I knew that I was working with a good team with great fellows, residents for back up (Mind you, all of this changes this summer...hopefully im gone by then!!). The night started out kind of slow because of all the "orienting" process...I just felt like there were so many steps in doing things, same steps as any other night but in different directions! The patient care was basically the same, I just had to adjust to all of their systems/policies/procedures! (That was until I learned the "real" way to do things ;-) I picked on that by the 3rd night trust me...) I dove straight in, we admitted the patient i drew labs, she did paper work....my preceptor was impressed. "Well usually when I orient people they just stand around"...I told her standing around doesn't accomplish anything, lets get R done! LMAO! I was on my way to get meds and this nurse who floated from CICU whispered in a very very soft voice "I need a crash cart" and of course my  eyes grew and I was like "HUH?!", then she whispered again "I need a crash cart:"...yall know it was OWN then!!! I jumped on that cart and did a 100 meter dash to that room where they were debating a pulse...so of course while they were debating, I was snatching those drawers open getting the meds ready! (If you have to debate a pulse, clearly there isn't one!) The nurse was trying to give meds and I told her "No, you go I will give meds!" As I "grew" as a nurse it was explained to me if your patient codes "we" the staff will code your patient (WAIT: that's if there is proper staffing lmao). I jumped on the meds and started pushing away. Half way threw I asked for a med, and this guy who happened to appear was standing next to the cart, so I asked for a bicarb...this fool hands me a BOX of bicarb...(Yes, a closed BOX) I had to imagine the tassels on Jesus' cloak brushing across my face not to tell him what was REALLY on my mind! You guys would be so proud of me, "I need a bicarb, opened, and assembled PLEASE". L:MAO!! BUT HOWEVER, if looks could kill...i would be in jail for murder one...! I was trying so hard not to let BRANDON shine through because after all...i need them they don't need me! No need to burn any bridges, so other words BRANDON=best behavior! So this patient ended up on all the pressors and on a pronator bed, very very sick! It really does take an emergency type situation to see how a staff works together...Overall I give them a A! They worked that code like a well oiled machine! I was sooooo impressed...not as quite as oiled as 6A (smile). I feel very blessed and fortunate to be working with this group of nurses because im sure it could be a whole lot WORSE! But I think universally night shift nurses are more efficient and work well together because: WE ARE ALL WE GOT! No managers, no attending MDs...JUST US...and the fellows, lmao!

The facilities are exceptional! I could tell the building was probably built within the past few years and the technology is pretty up to date. There is a monitor between every couple rooms to see the patients telemetry. GET THIS: nurses do not draw their blood, lab techs do! Respiratory draws the ABGs and they have unit secretaries to input all of the orders! THIS gives me a high level of anxiety because I am used to DOING EVERYTHING for my patients! My biggest fear is something not being done therefore making me look stupid or lazy...Definitely a different experience but at this point and time, I am pretty much open to anything that is not a danger to my patients. The unit is a solid ICU meaning, if you aint a ICU patient you GO OUT. There isn't any guessing or I just want my patient there one more night, oh no! ICU beds are SACRED AND VALUED! It makes me feel proud to be a ICU because the patients there are very critical i.e. vents and pressors. They move these patients fast too! If they are extubated that day, and fly through the night then they are going to be transferred that morning no questions asked. I commented on this and a doctor said bluntly "Yes they can deal with SOB on the floor, unless they need to be retubed, they can go from there". Pleasantly surprised definitely!

I am looking forward to the remaining 12 weeks! Only thing is I still have a commitment to my hospital in houston, at least 2 weeks out of every month I will be working 5 days in a week in two different facilities! So we will see how long I can tolerate this! LOL! I completely underestimated the acuity of this hospital, but I am trained to work and work hard! Just have to keep my eyes on the prize and not piss anybody off on either end LMAO! I am on my hustle mode so I can be in the area to see little Lucia when she comes into the world! Do I have any regrets?...nope! I am enjoying the change of scenery even though its hard work! Mailed off my NYC license packet yesterday, praying that every i was dotted correctly as well as the t's. My tail has been whipped! Now to rest and prepare for my drive tomorrow back to H-town!

If you have any questions or want me to touch on any specific topics just comment and I will make it happen! Next entry: Hints tips, charge nurses, experience and my greatest love of all...patients!

B.S. RN

**I will not refer to any specific brand or facility in this blog, if you would like specifics contact me personally...or until we can monetize this piece!