Happy Nurse's Week!

If you didn't already know, or couldn't guess by the title of this blog, I'm a nurse. Why am I a nurse? I wanted to be like my grandma. So much like my grandma that I ended up marrying a farmer too! I think it's why I've always had such a special bond with her. As I was nearing the end of high school and childhood dreams were left behind, just as that - a dream...I had to become serious as to what I wanted to do with my life. I wanted to go to university and I wanted to have a good, steady job. I knew I wanted to work in health care, also encouraged by my grandma. In high school I had my heart set on pharmacy. After acing chemistry 10...and struggling a bit with chem 20, I decided that I had better focus my energies on a different career path! After challenging my grade 12 bio and social studies diplomas to get even better grades, my hard work paid off and I got into nursing.

I actually did my first 2 years of school in a rural program (it was meant to be!) made life-long friends, and then transferred to the University of Alberta to finish my degree. I like that Nursing Week is in May. It always reminds me of my nurse-iversary! I graduated and have been working as an RN for 7 years already! How is this possible?! I was in shock that it was my 10 year high school reunion last year, well 7 years working seems a lot more unreal than 10 years out of high school! I could not imagine myself in another career. Seriously. I don't know what, or who I'd be, if I wasn't a nurse. I'm very proud of it, and absolutely love my job.

I get the best of both worlds, you see. I get to work part time as a nurse in my dream job in ER, and part time as a stay-at-home-mommy. I'm a nurse for the stereotypical reasons, you could say. I love to help people, I love to teach my patients, and I have a very soft spot for the pediatric population. There's many moments where I do not like my job as a nurse, but the good always outweighs the bad.

Here's some funnies I found to celebrate Nurse's Week!

Source: someecards.com via Sarah on Pinterest

Source: someecards.com via Sarah on Pinterest

Source: someecards.com via Sarah on Pinterest

Source: someecards.com via Sarah on Pinterest

Source: someecards.com via Sarah on Pinterest

For my ER girls:

Source: someecards.com via Sarah on Pinterest

The truth:

Source: Uploaded by user via Sarah on Pinterest

And...sorry my children, but it's true!

Source: sn123w.snt123.mail.live.com via Sarah on Pinterest

Happy Nurse's Week to my friends & family who are nurses and to my wonderful blogging friends who also share this profession!

That Time I Was Nurse #1

Don't fool yourselves. That doesn't say "That Time I Was #1 Nurse"....I was written up and named as "Nurse #1" in an incident. Yup. That's right, Nurse Sarah got written up for the first time in her career. I guess working for almost 7 years and only 1 write up ain't so bad? And it was practically the whole shift that got written up, so misery loves company right?

[source, also a very funny read]

So what did I do? Did I finally lose it and tell someone off? The answer is no. I did not tell anyone off. Did I hurt someone purposefully or not? Nope. Make a medication error? Nope. So what was my wrong doing? Well, I'll just write down the incident the way that I saw it, which is what really happened.

*Note: The events that took place are true but to protect myself and the privacy of this patient no names or identifying details will be made*

It was a wonderful day at work. I was working the shift that I've been working a lot of lately, the 10 AM - 10 PM shift. The doc that was on call tends to be a shit magnet, for lack of a better term, for drug-seekers for some reason. Drug seekers are probably my least favorite patients. They are always right, they are not doing anything wrong, and worst of all...they LIE like a side walk. In Alberta, we now have a computer system that we can obtain all medical records, including mecial prescriptions, online. So it's much easier to catch these liars red handed. You're allergic to Tylenol, Advil, codiene, morphine, Toradol, and pretty much every pain medication under the sun except oxycontin and you're in pain? Oh, well we discovered that you were prescribed 200 tablets of Tylenol #4's last week! WHAT'S UP WITH THAT!? Sigh.

Okay, I'm off track.

So anyway, that particular night we had 4 drug seekers in a row. Three of them were seeking prescriptions for Tylenol #3's. For those of you who aren't familiar with narcotics, this is just plain Tylenol with codeine (the narcotic) in it. As far as I'm concerned, this is a rather mild narcotic and not even worth the fight to seek it! Anywho, our doc is very firm on not giving into the seeking types, so he told the first 2 absolutely not, no way you aren't leaving with a prescription, go see your family doctor. The third patient is the one who filed a report on all of us.

They have been to our ER before. They very distinctive and I'll never forget them. They stated to the nurse in triage that they do live in [The Big City] but he likes to come out to our rural hospital because we are so nice to them. They can't go to [The Big City Hospital] anymore because they don't treat them nicely there. We were really busy that night, I mean like a 6 hour wait from the day shift stretching into a few hour wait for the evening shift. So they finally get into a room, the doc sees them and tells them he doesn't write prescriptions for chronic back pain, but he will treat the pain in ER. So the doc tells me he's ordered some Toradol for this patient by intramuscular (IM) injection. Meaning I get to poke this patient in the butt muscle with an anti-inflammatory/pain killer med similar to Advil. The doc also mentions to me that the patient has a needle phobia.

Here is where I will write the truth as it happened in and what the patient and/or the mother reported, the lies in red.

I standing at the nursing desk, looking over all the orders for all 6 patients, seeing which order is a priority at the moment. My colleague is on a break, the other nurse is in triage, so it's just me for the 6 patients in the ER at the time being. 


The mother comes up to me and says "is someone coming to deal with my child's pain?"


I replied, "Yes, I have 6 patients to look after here, I will get to your son as soon as I can".


This translated to her as, "SETTLE DOWN! I have 8 patients to deal with before your child!"


Not but 60 seconds later, I am in the medication room, drawing up the injection, and the mother comes to the desk again to ask "where is my child's medication?"


I replied, "I'm drawing it up right now, I'm working as quickly as I can"


I then walk down to the room with the needle clearly visible in my hand, I approach the doorway to the room and they state, "there's no way I'm taking that!"


I was in no mood to argue with this patient, so I put my hands up to my shoulder level, palms up in an "I give up" motion and state, "I'm not arguing with you" in an "I'm not about to convince you to take this, whatever" kind of tone and turn around and walk away.


This is how they wrote up the incident: "Nurse #1 then walked into the room, threw her arms up in the air and said 'I'M NOT ARGUING WITH YOU!' and stormed out the room."


Really? Really?


I may talk big about what I think about certain patients, but I always strive my hardest to maintain professionalism and treat my patients with the respect that they deserve, but also the respect that they treat me with. They went on to lie profusely about Nurse #'s 2 & 3 in the incident...but I won't bore you with the details. They also told us many times they cannot afford the physiotherapy that's been prescribed to them  by many different doctors, but they can afford a lawyer to sue the [Big City Hospital]? So now they have no faith in our province's health care system and they are, get this...using alcohol to treat the  pain. So now we're going to be responsible for this patient's addiction to alcohol too? Grow some and take some responsibility for your life.

So I replied to the report by writing the truth and I don't know what happens from here. The good thing is, is that my bosses completely support the nurses in this incident. This is just a patient that is out to make some money or something, and not dealing with his health the way they should and the way that has been recommended to them over and over again.

I think my nursing colleagues will find these amusing...this is exactly what kind of patients drug seekers are!
 (Be warned....there is a LOT of profanity in this!)

Nurses hate the diagnosis of fibromyalgia. To us, it's just a diagnosis for an excuse for pain meds!


Are you a nurse? How do you deal with these patients?

A Night in the Life of an ER Nurse

Awhile back Rachael over at Letters to Ames did a post about one of her night shifts as an orthopedic nurse. I thought this was so interesting and that I would love to do this sometime and hope that my readers would have some interest in this as well! I would like to document for you 1 of my 8 hour night shifts (2330-0730) that I worked. To maintain confidentiality and professionalism, patient and staff names will not be discussed.

2245 ~ All freshened up and ready to go to work. Leaving early so I can grab some Tim Hortons coffee and a snack or two for my shift

2315 ~ Arrive at Tim Hortons, order my large french vanilla capuccino, and the rest of the conversation goes like this:

"What bagels do you have left?"
"None."
"Ummm...okay. Well, do you have any muffins left?"
"No."
"Seriously?!? I work the night shift, man! I'm hungry, why don't you have any food?"
"Sorry. That's $1.64." 

I proceed up to the drive through window, little TH dude won't even look me in the eye, my coffee is sitting there waiting for me, I plop some change on the window counter and tail off. At this time I'm contemplating stopping at McDonald's next door because I am hungry and also now grumpy because Timmy's has failed me in their "24 hour" service. If you're open 24/7 you should provide all items on your menu, just sayin'!

2320 ~ Ah crap, better get to work!

2330 ~ Arrive to work, all of our 6 rooms are full with a few in the waiting room. Get report from the evening nurse who's leaving, and decide where I should go.

(By the way, in report I learn that we have a male in his 20's who's wife called 911 and was brought in by ambulance for an evening's worth of gastro symptoms. So, essentially he has "man" gastro and just didn't want to keep his pooping and puking to himself at home like a sane normal person would. Not only was an ambulance abused, in my humble opinion, but then I find out he has shat himself. Yup. 20-something years old, pooped his pants and didn't care. When I did my rounds he was wearing a pull-up diaper. 20-something years old - just in case you missed that).

2345 ~ Discharge a patient, clean the room, finally get to my coffee to take a sip of french vanilla goodness - wrong coffee!!!!! Are you effing kidding me, Tims?!? You don't have any food for me and you screw up my coffee order? Official boycott of Tim Hortons begins.

0005 ~ Ring ring. The ambulance is coming with another person with gastro symptoms. Awesome...I better not get gastro!

0020 ~ The ambulance shows up with female patient in her late 30's with gastro since after supper. Right away my bitter nurse brain, again, is thinking "why don't these people just want to stay at home to poop and puke in the privacy of their own home?" But anyway, I admit her, do her assessment and hook her up to what would be the cocktail of the night - a 1 litre saline bolus with 10 mg of Maxeran infusing.

0100 ~ A young male with suspected viral meningitis is transferred to a city hospital for further testing.

0130 ~ The gastro lady from the ambulance's lab work is out of whack with a very high white count [indicative of infection] so she also gets sent to the city for further management of care, since in our small rural hospital we don't have ultrasound at night or a CT scanner.

0200 ~ Check on our overnight patient who's awaiting bloodwork for repeat troponins in the morning to see if the SVT they had earlier has raised the enzyme, or if they're also having a heart attack, a NSTEMI. (Too wordy? Yeah....so essentially her heart was in a really fast rhythm of 220 beats per minute [normal is 60-100] and we were keeping her to see if she also had a heart attack which will show up in the blood work and with a repeat ECG).

0230 ~ I'm starving, things are slowing down, so I'm making a McD's run for me, the other nurse, and the doc.

0245 ~ Get back to ER. Crap. They forgot part of my order. I'm going to boycott drive throughs in this town!

0300 ~ Another round-trip and I've scored some free pies. The girl was really apologetic and felt awful, at least! McD's you're on my good list still.

0330 ~ We get another ambulance come in with a drug dealer in his 20's who is drunk, high on cocaine, and has also been assaulted. Medically, he's fine, and was going back to "cells" which is essentially the holding area for residents of this town until they get released or transferred to a prison in the city. We get a lot of patients from cells who are looking for a "get out of jail free" card - literally...sorry, buddy - not for you! We always enjoy talking with the RCMP officers, they've got lots of good stories to tell!

0345 ~ I triage a patient with man cough.

"So what brings you into emergency this morning?"
"My wife couldn't sleep, she made me come here because I'm coughing."
[I take a deep breath, do a silent sigh, and think to myself...#1 why didn't you just go sleep in the guest bedroom or #2 why aren't you on the couch at home???]
"Okay. When did your coughing start?"
"4-5 days ago."
"Okay, well the doctor isn't here right now [white lie] so I'll give them a call and call you into a room when they're here to see you."

[source]

0415 ~ A pregnant patient comes in with an ear ache....and gastro symptoms. IV, saline, Maxeran...getting the hang of this?

0430 ~ A guy in his early 30's staggers up to the triage window "gasping" for breath saying that he's "really sick". (Oscar-like performance here, people!) I go triage him...any guesses as to what the diagnosis is? Yay - you're getting good - GASTRO! Don't you worry, folks, he tried really hard to tough it out at home for the last 5 hours, but his girlfriend made him come in and to stop being so stubborn. ::eye roll:: So he gets the IV cocktail and after some convincing that he has a virus that just has to get out of his system, we can't really "cure" him, all we can do is treat his symptoms (which we've done), he goes home about 1 hour later.

0500 ~ We get another guy from cells come in in shackles looking for his get out of jail free card. He literally said "someone pushed me down and broke my ribs". That's all he said. X-rays proved he did not have broken ribs and back to cells he went.

0530 ~ A 12 year old kiddo comes in...do I even have to say it? I'm getting sick of it. If anyone else comes in with gastro, I'm literally gong to start puking...not from a virus, just because I'm physically sick of all the gastro. He's a tough kiddo, has a touch of a fever, is a superstar when I start his IV and we send him home in about 1.5 hours when his bloodwork comes back good. Maybe his pain will develop into appendicitis...let's hope not!

0600 ~ Make sure all our night shift checklist items are completed...stocking linens, supplies, etc. And IV therapy patient shows up and is triaged and treated.

0700 ~ Start coffee for the day shift, tie up loose ends, wash hands profusely and pray that I don't get gastro. Do the narcotic count, tidy up...

0730 ~ Day staff is here, give report...

0740 ~ On my way home, put in my hands-free ear set thing for my cell phone and call my Mom to help keep me awake on my 25ish minute ride home.

0810 ~ Walk through the door to see this...

...and immediately smile and get hugs, snuggles, and kisses as we watch a bit of the Curious George movie (we need a Thomas and Bob break!) and he enjoys his milk!

I just also wanted to note, that in spite all of the obvious bitterness in this post, I truly do love my job and wouldn't trade it for the world. It's just very frustrating to see people come into the emergency room time and time again when they really don't need to be here. BUT, we have a universal health care system and everybody deserves to, and will be treated, regardless of what we think. Work's a lot more fun when the people that truly do need to be here, are. But, having said that...if the other people didn't come, I wouldn't have a job now, would I?

Hope you enjoyed this post, if you have ever written or want to write a post about a day/night in the life of your job, I'd love to read! Link back and/or leave me a comment!
 

Y3W: Love/Hate Nights

My three words this week are love hate nights. I've been working a lot of night shifts lately, more 12 hours shifts than 8's even. I love the diversity of a night shift, you can be busy all night, you seem to see more trauma-ish patients, you can have a super slow and relaxing night,or a busy run-off-your-feet night. But I also hate nights. I do not sleep well, as a general rule, during the day. I can't even blame it on my baby elephant darling son who loves to run and thump around the house, it's all me. I can be exhausted, barely keep my eyes open on the drive home, but for some reason I perk up as soon as I walk through the door and get hugs and kisses from my little sweetie. I usually dawdle around until 9 or past that, and then seem to sleep only until 2. Not much fun to work all night and then do it again with only 5 or so hours of sleep (if I'm lucky). But the huge benefit to working nights is the money. Especially on the weekend. The shift differential for a night shift is $5 extra per hour and on the weekend it's an extra $3.25 per hour on top of the $5. To be making and extra $8.25/hr is kinda hard to turn down! I figure it's only for the summer and then I slow down when hubby goes back in the field for harvest time.

Sorry that this wasn't a Braden post, but I haven't spent that much time with my little man lately :( I'm so excited to go back to Edmonton to visit my parents and friends there with Braden next week. If I get brave, I might actually leave Braden there with my mom and she can bring him back as I work 24 hours next Friday/Saturday to close off my summer shifts. I 100% completely trust my mom, she knows Braden pretty much as well as me and Jay do, and we've left Braden before when we went to Vegas...so it's not so much about being "brave" per say, just that it's hard to leave the little guy behind even though I know he loves his Grammie very much! I guess we'll see!


*This blog entry is my own personal opinion and I freely choose to write about my profession*

56 Hours

That is how much I'm working this week. I've had an EXTREMELY busy last two days at work which makes it 24 hours down an 32 to go! I'm getting allllllllll the hours that I can now as I know my days are "numbered" with spraying and harvest quickly approaching and Daddy Daycare will be on the combine, also Mom goes back to work and my summer babysitting will be gone too.

There are a lot of unfortunately sick people in this world. For confidentiality and ethical reasons I can't tell you all of what goes on in my job and at work, but just count your blessings and make smart choices. Talk to your kids about drugs and alcohol and how horribly life destroying they can be. To divulge a bit, in the last 2 weeks I've had an idiot teenage boy who has overdosed on drugs 3 times in less than 2 months which has resulted in being intubated and sent to ICU. I also dealt with a patient my age who is so deeply lost in his alcoholism that he came in after binge-ing with abdominal pain and ended up so deep into withdrawals that he was delirious, aggressive, and mean when he normally is not. He is so sick from his disease that his pancreas is literally "dying" and exploding inside him. One sick man.

I wonder what the next 32 hours will be like...!

Back to Work!

I am proud to support that I've survived my first shift back at work in almost 11 months. I was very nervous that I would have lost my skills, especially my assessment skills. But I worked with two wonderful, "veteran" nurses last night, and it really was just like that old adage of "riding a bicycle". I got my first IV last night and my confidence came back and I was off to the races. We weren't terribly busy last night either so that was a nice way to ease into things. I figured if there was a code last night I always could be the recorder...someone has to chart! I had a wonderful patient last night and he was so kind to me and made me realize why I am a nurse and that I truly have made the right decision and confirmed to me that I couldn't be a stay-at-home-mom 100% of the time. I'm very blessed, and will never take for granted, that I get to do both jobs. I am still casual, hoping that I can work 2-3 shifts a week and obviously be at home with Braden the rest of the time.

Lately Braden has REALLY taken to Jay, which is truly amazing to see. He's always, always loved his Daddy, but he's becoming quite a Daddy's boy lately! He's not turning away from me, or anything, but their bond has gotten really strong the last few weeks. Braden really looks forward to when Jay comes home from work and crawls as fast as he can over to see him. It melts my heart! I'm also happy to report that they had a wonderful morning! I got home a bit early from my night shift, Braden had some whole milk to hold him over, then I nursed him and off to bed I went. I slept like a rock, only until 12:45 unfortunately, and got up to a giggling and very happy to see me boy. Jay said Braden had a 2 hour nap and he had lunch and everything went really well. Jay even cleaned up a poopy diaper - WOW! Good job, Jay!

Well...Braden is stirring a bit early from his afternoon nap so I'm going to go see if I can settle him for a bit longer.

No More 12's!!

What a silly girl I am. I worked a 12 hour shift today and while to use the expression "it just about killed me" is definitely over-exaggerating...IT JUST ABOUT KILLED ME!!! We were sooooo incredibly busy today that I was hopping around and didn't get a break until I was 4.5 hours into my shift. I was able to sneak away and snack on some trail mix and have some water...but man oh man it was the first real day of lower back ache and my hips are starting to bug me, mostly at my SI joints. Somehow I've managed to skip the swelling, so that's nice...but I definitely cannot work 12's anymore. I only have 5 shifts left now....thats the countdown I'm mostly looking forward too. Baby sure had a good day kicking and wiggling about. And to top it all off...I think my lack of sleep and hustle and bustle over the holidays is catching up with me and I have my first sore throat in literally over 6 years. :( I haven't had to deal with that since I got my tonsils out...until now. Yick. Hopefully it will be better tomorrow.

Just had to vent. I guess that's what I get for trying to work 12 hours when I'm 36w2d pregnant! On a happy note, the baby is moving around like cRazY right now and Jay are enjoying the show...I think it wants to bust out, or maybe is just trying to get cozy for the night. A little funny to make you smile (as I've gotten this same comment from plenty men!)