Night Shift Lessons

I survived my first night shift...barely. There were tears, there were threats, and in the end there was a broken person who used to love working in the hospital. But along the way, I learned a few gems that I thought I would share with you.

1. Working "nights" sucks just as much as Princess said it did. You should always believe Princess.

2. Don't piss off the person who control when you get your drugs in the first two hours she is there, because while you feel vindicated right now, remember there are still ten hours left of her shift.

3. When your preceptor tells you, "Now this is the way I do things", you should put your fingers in your ears and hum, because invariably, whatever she has to stay is idiotic.

4. Bacon wafting out of the cafeteria at the end of shift is not the heavenly aroma it is at the beginning of shift; it just kinda makes you think about how gross and greasy you really feel.

5. When they tell you that the cafeteria is open from 12pm - 3am, don't get all excited like you get to chose what day shift does, because all they really have for you is what you can get at a 7-11 at the same time of night.

6. You will always hate day shift and their full night sleep when they come in.

7. Just standing in front of the elevators will not make the elevator come. You might forget this when you are as tired as I am.

8. You might also forget how to get off the round-a-bout on the drive home.

9. Did I mention hating day shift?

10. Night shift does not sit around, catch up on their pleasure reading, or surf the net all night as I was once lead to believe. Turns out all that asinine paperwork that has to be done in the hospital, yeah, guess who gets to do that. If you guess the nurse who went to nursing school so she could secretly be a secretary, then you guest right.

11. Preceptors never tell you that you are expected to do stuff at certain times until it is like two hours after you should have already done them. So then you have to do them while you are supposed to be giving report to the hated, stupid day shift.

12. While we did baths on days at my old hospital, we do them on nights here. Why am I doomed to wash old people?

13. Quadruple charting must be super fun for everyone else, otherwise why would we do it so many times a night.

14. Lab, pharmacy, radiology, and dietary all hate you like you hate the day shift.

15. The new hospital you work at does everything it can to make your job just that much harder.

16. I am not as nice as I think I am at 0400.

17. Till midnight, I had the hardest time telling what time it was because I was not used to the military time. If I can't understand it, how is an 80 year old with glasses as thick as coke bottles? Oh, right, trying to use logic again.

18. You should never try to die in our hospital. Turns out we do no have code buttons....anywhere. You are supposed to, and I quote, "Scream bloody murder, and people will come, then we call the code". Awesome.

19. Walking out into a beautiful, warm spring day just pisses you off.

20. I used to say I was going to burn things to the ground as an expression. I now know what it feels like in reality.

21. Night shift will steal your chance to watch the "Lost" series finale. Which makes me hate the schedule.

22. One patient is hard when you are not used to how the unit is run, where things are, or the equipment. Two patients are eight times harder. How does that math work?

23. Night shift makes me hate everyone and everything. In case you did not catch that from the rest of the lessons.

24. Apparently I will do anything for money.

I am on the next two nights and I just have to hope that things get better. Next time you see me, just ask me how it is going. Then again, you might never see me, after the incarceration and all...

Hospital Orientation

Monday morning I started my new job. Well, to be fair, it was my first day earning a paycheck, but I have not really started working yet. Hospital orientation is a necessary evil that scares some nurses so much that they work at the same hospital their entire careers. A far as hospital orientations go, the one I have been in this week is not half bad.

Monday we started off with company wide orientation where you learn about just how large the system you work for actually is. No one except CEO's really care how the company started or it's humble beginnings. The funnest part of this was finding out that company headquarters are in King Of Prussia, PA. I was more interested in how this city got such an obtuse name as King Of Prussia and how it landed straight in the middle of Pennsylvania.

The next segment was on a "Culture of Care" and it was tag team taught by a truly Southern couple, complete with ya'lls and drawls. The husband portion of the team has a pitch and roll to his voice that harkened me back to my Baptist days. As colorful as he was, when he ripped into his 25 minute sermon on compassionate care and teamwork, I was on fire with spirit of the message. I could feel the pull of long forgotten joys associated with bedside care. I remembered that not only did I love working in the hospital, but that I was good at it. While the regimented grind sometimes pulverizes others, I thrive in an environment of order and near obsessive adherence to a schedule. I cannot express the internal satisfaction that I get from meeting the clear cut expectations required to be a hospital nurse. I know at 7 I must do assessments, 9 is morning meds, 10 is hygiene, 12 is lunch, 2 are procedures. My neurotic nature is perfectly designed to thrive in that setting.

After a deli counter lunch that left something to be desired, we did an additional four hours of no real note, except for one thing. I know you all know what a huge nerd I am, and this was typified at the sheer excitement I felt when I found out our facility uses Zoll defibrillators. I normally try to scrub my blog of any personal identifiers, but the picture at the top of this blog is me in 2007 at the Critical Care Nursing Conference in Atlanta. They were demoing the then new Zoll Defibrillators. The Zolls are just like in other standard defibrillators in that they deliver shocks through pads place on the chest, but what makes Zolls so special is that they give constructive feedback on how well your chest compressions are being given. At the conference, you first do one minute of CPR with no instruction and it gave you a rating on how well you did on rate, depth, pressure. I am ashamed to say I got a 39%. Then you do another minute of CPR with the verbal correction on and I this time I got a 97%. I am sure no one person who reads this cares, but I am simply salivating for my first code (and by that I mean so we can save them, not that I am cold hearted and wishing for people to die).

The second day was a bit of a snooze. We did every module that I had drilled into me while in the SNAP program like the Braden scale, core measures, restraints, organ donation, scope of practice, Accuchecks, etc. I seriously could teach these modules, and in the case of the Braden scale, I have. But, as Flip pointed out, it is better to bored to tears because you could take the test without the module presentation and be just fine than to feel overwhelmed and behind. I am just hoping that all the anxiety about lost knowledge when I get to the floor flows back just as easily. Interesting side note I learned on this day, techs cannot do finger sticks in the state of Nevada. Super, my first shift with a patient who needs them every hour should be awesome.

Today we did our computer training. The worst part of computer training is that fact that the entire class has to go as slow as the slowest person. I tend to be that person who is first done with their test, whom you actually secretly hate, so it was a bit painful doing 4 hours of work in 8 hours. Despite the snail's pace, exploration of the system unleashed my excitement. I cannot wait to get on the floor. I have not felt this kind of job excitement in quite a few years. I am ready to blast forward with plunge in head first.

I feel like I spent the first few years of being a nurse pulling myself up to a certain level of proficiency, constantly relearning things that were only words on a page before. I am now ready to build my career. I have a plan (then again, don't I always). I am going to start on night shift, which will be a great way to ease myself back into the swing of things and will be a great opportunity to learn what happens on the night shift because the next part of my plan is to be transferred to days. Days involves, three meals, morning meds, the bath, doctors orders, and all the procedures, and let me tell you is a whole other ball game. After about a year I hope to sit for my certification exam, the PCCN, and then apply to be a charge nurse. It is all very exciting.

Tomorrow with be another day of modules, and I am going to try to resist the urge to bring a crossword to class, and just focus on the fact I am getting paid. Monday morning I will get to see my floor for the first time. I am really excited about this new chapter in my life and honestly hope that it will be the kind of place that will cultivate a continued love for the hospital and the kind of nurse I want to be.

First Vegas Update

I know I have not been posting as regularly as many of you would like. The move became all encompassing, and it was hard to make time for anything, let alone reflection. I have gotten several requests for new posts to keep everyone updated on what is going on in with me right now. Being the good friend that I am, with some extra time on my hands, I thought I would oblige.

I arrived in the valley on March 22 and spent the night at my parent's house out in Henderson. The feeling was surreal. For as much time as I have spend there, I was now there not for leisure. With my dog scamping around, finally free of the confines of the moving truck, and my own car parked out front, the ephemeral feeling of childhood that the house usually held was not there. Twelve hours later I was off to my new apartment all the way across town. I now live about 35 minutes away from them, closer to where I went to high school. For those who don't know Vegas is a huge city in comparison to Austin and everything is much farther away than I am used to. Due to it's size, even though I grew up fairly close to here, I am not familiar with this part of town at all.

My dad came earlier in the day, and some guys from the ward came later that night and got everything moved in. From there, it has been all me. It is mostly all together now, even though some errant boxes are still littering the floors and all of my knick-knacks with no place to go are cluttering up every flat surface in the place. In the move I lost a floor lamp (dad's fault), a table lamp (my fault), a drinking glass, my Sonicare toothbrush, the bamboo vase, and a bedspread. All in all, I am no worse for the wear.

My hospital paperwork is all filled out and ready for me to start work on April 12th. The day I went over there to sign my offer I was blown out of the water. Summerlin Hospital is roughly the size of Brackenridge and St. David's combined, for any Austin nurses that should really impress you. As you crest the hill and the hospital comes into view, I could think of several casinos that are not this big. Keep in mind this is one of 12 major hospitals in the area. After I signed the offer I had to drive all the way across town and submit to the standard hospital hire of a drug test, a physical, and TB test. The weird thing is that they do a two part TB test here. So it was four trips back to the miserable occupational health clinic total. As if this was not painful enough I have a full week of hospital orientation next week. If I have to sit through one more ADEIT class, or restraints check offs, I might just have to jump off the top of the overly impressive hospital itself. Then again, at my new hourly rate, I think I can manage to restrain my areal ambitions.

Making new friends has been more successful than I thought it would be at this point. Some of you may remember me telling you about meeting up with Flip and we did as planned. He is a really quality guy, and has been invaluable in the process. My social awkwardness is still trying to sabotage me every now and then and I end up with my foot in my mouth. Like when I said, "Let's ask those drunk people to take our picture" and someone said, "They are not drunk those are our friends". This is not the way to win friends and influence people. I am trying to keep the advice that Red gave me before I left when she told me that moving gives me a blank slate, where no one remembers the social scars of the past here and I can reinvent myself. Frankie told me that I may have had problems making friends in the past, but that he thinks I have grown since then and he thinks I will be just fine. Who knew he would be right?

One of the best parts of the move is I now live in a city with a temple. I have not lived in a city with a temple since I was endowed. Although the temple could fit easily into one of the wings of the hospital, compared to the San Antonio temple, it is still large and impressive. Tonight we had a ward baptism trip, and I was saddened by how few people where there, both in our own baptism group and in the temple as a whole. I think San Antonio's small size and the fact that you have to book weeks in advance to do work for the dead had my expectations skewed on what to expect here. The member of the temple presidency who came to speak to us said that they do the same number of ordinance completed today as they did when it opened in 1989 despite there being three times more temple recommend holders in the valley.

Moving into the baptistry, I was filled with irritation at this and that, but after I was redressed and sitting on the bench, the feeling that I go for finally washed over me. The stress of moving, money, making friends, and starting a new job finally melted away. That sense of peace and confirmation that I had done the right thing came to me and I had not realized how much my soul was in need of it. I made a goal to recommit myself to do the things I have let slip in light of life changing events. I need to recommit myself to daily prayer and need to be more committed to scripture study. I know that He cannot do for me unless I am obedient and moving forward spiritually. It is not enough to simply take the leap of faith to come here without continuing to do the work. For now I am looking for answers on what the purpose of my move was, why did He prompt me to move here, at this time?

I am going to try to keep you more up to date through the post and just wanted to remind everyone how much I really do miss them. Until next time....