The End of a Tough Week

So today marks the end of a very long week for me. I worked Tuesday, Wednesday, Thursday this week and it really was a landmark event. To explain, Tuesday was my first day of taking patients completely on my own. Although I am not yet counted as a full nurse and technically still considered on orientation, I still am able to take on 3 patients all by myself. And let me tell you, I had a very rude awakening into the real life of a nurse. And while I feel very comfortable being on my own, it seems as though God decided to challenge me the best he could on my very first week of being on my own. It wasn't so much the acuity of my patients that challenged me, it was the ethical and social issues that really gave me a run for my money. The good thing was that since I worked 3 days in a row, I got the same patients back each day so I got to know them really well. But I'm not gonna lie, feeding pain pills to a lady with an infected spinal surgical site just so she could make it outside to smoke every 3 hours was real tough for me. I'm not kidding, she wanted her 12 mg of Dilaudid right before she would go outside, then the rest of her 4 mg when she got back. And only to wait 3 hours (the minimal amount of time that she had to wait for her next 12-16mg) and promptly ask for her next dose. And this continued for the next two days...only to discover yesterday as I was listening to her belly with my stethoscope a small bug that did not resemble any bug I had ever seen before. After I snatched it up on a small alcohol wipe, (ugck, it makes me itch to talk about it) I took it out to the nurses station for everyone to exam. After one of the old hippie nurses proclaimed that it might be a louse,we proceeded to look up a picture online of a louse, and sure enough: there in my very hand stood a louse. For those of you not familiar with this term, louse translates to LICE.

So on top of the slowest, weirdest nursing student that was assigned to me that morning with my other patient who is an 87 year old alcoholic, (don't worry, story to come) my day had just got a jumpstart to "sucky" as Cathleen, the "old hippie nurse" put it. After what seemed like a bazillion phone calls, I had initiated contact precautions and summoned the doctor to prescribe some medication for my lice-infested, drug-seeking smoker.

So on to my 87 year old alcoholic. Ya know, this lady really was a peach, but man she had some issues. She somehow couldn't get in her head that whenever she needed to get out of bed, she needed to let us know so we could unplug her IV pole and role it with her. Maybe the fact that when she was admitted, she had a serum alcohol level of 200 had something to do with it. ("Normal" is between 15-30 for someone who is probably fairly intoxicated.) Apparently she likes her white wine-a lot! And really this patient wasn't that difficult, but throw in a student who is in his first semester of nursing school and has never charted anything before, let alone document every 2 hours for someone on alcohol withdrawal, this patient suddenly became more and more difficult. While we were in the process of discharging her home, we discover that she has no shoes and needs to somehow get a hold of her neighbor to come pick her up from the hospital. So in conclusion, we could summarize just those two patients by solely saying that the social worker and I got to know each other very well this week.

Unfortunately, that was only the first half of my day. The second half begins by the doctors making a roundabout decision to to send my lice-infested, drug-seeking smoker lady home. Well although that was all fine and dandy, as I was getting her paperwork started, I realized that none of these doctors appeared to be talking amongst themselves. There were numerous bits of paperwork that weren't signed, medication scripts that needed to be written, and about 3 different specialties that needed to ok her discharge. Seriously I was discharging this patient from about noon till 8 pm, when I finally left.

Oh, and did I forget to mention that my [lazy] charge nurse decided to give me an admission. And at the same time that I'm trying to discharge the lice-infested, drug-seeking smoker. Ok fine, I can handle this. After my patient arrives (at least he walked in his room instead of being wheeled up on a cart-that's always a good sign!) I'm trying to finish up admitting him by filling out paperwork and assessing him, but every doctor known to man decides that they get to do their "thing" before me. Thanks guys. So I ended up leaving my shift without finishing up noting off all the doctor's orders or even getting to do a complete assessment on him. The worst part about it was that the nurse taking over on this patient is really a royal snot head and of course was NOT happy about the situation I had left her. But to tell you the truth, I worked harder than I have ever worked in my life yesterday, and at 8pm, I decided that I deserved to go home.

Ya know, I've always heard about days like yesterday, but never really comprehended my abilities to work so hard. I've always heard of new nurses going home crying because they feel so worthless, and Wednesday I finally had my first introduction to the going-home-crying experience. And yesterday I had the urge to breakdown, cry, and crawl into a corner MULTIPLE times. Welcome to the real world of a nurse! Whatever happened to the days where I was still on orientation with my preceptor and somehow I was bored because my patients were so easy! Hopefully next week will be better!

On a more positive note, I did buy some new shoes this last week for work. They're the popular nurse shoe and I'm so excited to finally own a pair myself! Supposedly they're going to improve my posture and help my body realign itself. And they're very comfortable to walk in for 12 hours! (Or 13.5, as evidenced yesterday)

Alex comes home today from Seattle. I'm very excited to see him! I'm picking him up at the airport then we're headed home, to McPherson that is. Yep, that's right-we're headed back for the weekend. I guess this will have to be my Thanksgiving weekend. And yes, I am VERY excited to see my family and be away from my job for a few days!

Well I guess I'll close. I'll see most of you this weekend!