Saturday, July 22, 2006

Down to the nitty gritty...

I am finally in my clinical area. Today I received my first paycheck and I must say, nursing school has certainly paid off. I am in orientation, and will remain in orientation for the next 11 weeks. The upside...I have two awesome preceptors that love their job and are excellent teachers. The staff is an interesting cast of characters that support each other the way that nurses support each other in hospital utopia. Keep in mind, all this is coming from an observation period of approximately 4 days. Case in point.

On my third day as a bonifide nurse, I had a patient that had been pregnant 14 times with 4 living children and 10 miscarriages, one of which was induced. (For those who follow the OB short hand that's gravida 14, para 4, T=4, P=1, A=10, L=4) She was an interesting case with a history of cocaine abuse and a laundry list of sexually transmitted diseases. The funny thing is that she REFUSED to sit on the toilet. My nurse said the toilet seat should have been afraid of her ass instead of the other way around. Anyway, after her delivery, we were preparing to send her to post partum. She was in her wheel chair and everything when she decided she had to go to the bathroom. Her estimated blood loss was 150cc. Which is unusual for a multipara. I assessed her before multiple times we put her in the wheelchair and each time her uterus was firm, except for one assessment where I kinda thought she was a little boggy but even then my preceptor went behind and re-assessed the uterus which was firm and at the umbilicus.

So the patient was in the bathroom, squatted over the toilet looking at her butt as she was peeing, leaking blood etc. She said, "I want to get out from over the toilet, but I am still bleeding." At the moment, my preceptor was at the nurse's station giving report. I re-assured the patient that some blood loss was normal. I asked her to stop looking at her crotch and put on her mesh panties/pad and return to the wheelchair because the way she was bent over looking at her crotch could cause her to become lightheaded and faint. She finally sat down and then she started complaining about the bleeding again. She complained and I checked her, she complained more and then I went to check her for the 10th time and she was gushing a little blood around her pad. I thought perhaps it was because the blood was pooling from the way she was sitting so I walked to the nurse's station and asked a few of the nurses to come and take a look. They asked her to return to the bed and palpated the patient's fundus/uterus.

*This is the point where you would want to stop reading if you have a weak stomach!

As the nurse rubbed her abdomen, about four to five very large clots shot out of the patient followed by a very large volume of gushing blood. It was like a horror film. The nurse said, "Go get one of the attendings." At that moment, my preceptor turned the corner and she took over. I was so glad, because I had no idea what to do next. I was so glad that the other nurses were able to jump in and help with my patient in the absence of my preceptor. What happened when the attending physician arrived was something I have never seen before in my life. The doctor put on a rubber glove and inserted her entire hand almost up to the elbow inside the patient and proceeded to perform what I imagine to be a manual D & C.

They were pulling stuff out of the patient and pulling it apart in an attempt to assess what is was. The placenta was expelled hours before, but they thought that perhaps there was more tissue inside of the patient. The patient was sitting in a pool of blood and other miscellaneous stuff. The patient thought that she was dying, her blood pressure was 67/25. So then we gave her a huge bolus of lactated ringers. Then they gave her a bunch of pills rectally. I left before they decided what to do next.

*The gross stuff is over now!

There are a lot of sad stories on my unit. Women laboring alone. A 250lb 14 year old in active labor with chronic hypertension, type 2 diabetes and a 23 year old boyfriend who gave her trichomoniasis and genital herpes. A 16 year old having a baby with a 17 year old boyfriend who has a 2 month old daughter with another girl. These kids are too young to be having these sort of problems, but this is only week one. I am sure that the stories get even more astounding. Everything is going well. I guess it is to early to say for sure, but I think I am really going to like my job.

DiVa...surprised that she is adjusting to work so well!

Wednesday, July 12, 2006

This was too funny not to share...

Foreword: I can't take credit for this, my aunt sent it to me today!


From a strictly mathematical viewpoint it goes like this:

What Makes 100%? What does it mean to give MORE than 100%? Ever wonder about those people who say they are giving more than 100%? We have all been to those meetings where someone wants you to give over 100%. How about achieving 103%? What makes up 100% in life?

Here's a little mathematical formula that might help you answer these questions:

If:
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


is represented as:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26.

Then:

H-A-R-D-W-O-R- K
8+1+18+4+23+15+18+11 = 98%



and


K-N-O-W-L-E-D-G-E
11+14+15+23+12+5+4+7+5 = 96%

But,

A-T-T-I-T-U-D-E
1+20+20+9+20+21+4+5 = 100%

And,

B-U-L-L-S-H-I-T
2+21+12+12+19+8+9+20 = 103%

AND, look how far ass kissing will take you.

A-S-S-K-I-S-S-I-N-G
1+19+19+11+9+19+19+9+14+7 = 118%

So, one can conclude with mathematical certainty that, while Hard work and Knowledge will get you close, and Attitude will get you there, it's the Bullshit and Ass kissing that will put you over the top
Don't you just Love it!!!

Three down, two to go!

I have been pretty busy here the past few days, so I'm gonna get ya up to speed. I have found out some very interesting and exciting things about all the new training that I am about to receive, but nothing gets to happen until I finish this dreadful orientation. My initial thoughts were, "Ahhh, orientation class shouldn't be too bad. I am getting paid to listen to lectures and such, how could I miss?" Oh yes, I can miss, I miss being busy on the floor.

Yesterday
We sat through about 6 hours of lecture. Because we were a mixed group of aides, techs, supports, LPN's and nurses our training was remedial. When I say remedial, I mean like "Intro to Nursing" simple. We talked about HIPAA and patient safety and stuff like that for hours and hours and hours. The delegation lecture was pretty informative. Everything else is a huge blur. After about the first three hours of lecture, our manager came down from our respective units and met us for the first time since the interview. I thanked my manager for hiring me and she told me what to expect and what I need to do to prepare for my first day on the unit, which is next week.

She told me about my training. I have to renew my adult CPR, take a neonatal CPR course and a Code Pink course where (get this!) I learn how to run a code on a preemie and they will be teaching me how to intubate a neonate by practicing on a real live CAT in the lab. That's right. A feline. My Auntie told me I better hope it's declawed. I am hoping that the cat will be sedated! Then I have to take classes on perinatal loss and become a lactation consultant. I am going to be so well trained that the NICU that turned me down before will be dying for me to work for them. In this moment, I can't imagine working anywhere else. Our unit is required to wear navy blue. After school/work I went to the uniform store and bought myself pretty new scrubs for my first real day. I can't wait to wear them.

Today
Mundane is putting it lightly. I feel so bad because there were people in our class that probably never did a blood draw before that had to pass a proficiency after only watching a demonstration ONE TIME. They didn't even get a chance to practice. This part of the orientation has been like the abridged version of nursing school. All day the teacher talked, and talked, and talked. I am so happy I am home because here, there is peace and quiet.

I took my med math test and passed it 100%, which means I can pass medications. I passed all of my other competencies 100% as well. I wasn't so lucky with my test on restraints. I'll be honest, I didn't really read the material. There, I said it. It was a very dry read, and you know I am suffering from that "Nursing School Induced Anhedonia" which I really gotta do something about. I brought the book home and perhaps I will read it while I do laundry and then take the test first thing in the morning. Then I have a few more independent studies and a class on the hospital computer and then I am free to go onto my unit. Thank God!

Well, that's about all.

-DiVa...Tired as hell from doing nothing at all!

Tuesday, July 11, 2006

Orientation

It is the middle of the night after my first day of orientation. Why am I awake at 3 o'clock in the morning? I am washing an outfit for today. My first day of orientation was great. I was on time, which is a huge feat for me. I arrived early enough to get my fingerprints and ID before going to the classroom. They offered a breakfast of pastries, muffins and bagels. There was also coffee and juices, which was very nice. There was a mountain of paperwork regarding benefits and at least 8 speakers.

I learned that ANYTHING can be misconstrued as sexual harassment. I am not going to tell anyone that they look nice, I am not going to look at anyone for longer than 2 seconds or read any magazines because God knows that Louise or David might see a picture of a swimsuit model or bodybuilder and feel uncomfortable enough to report me. I was wondering why this guy one time when I was working nights looked at me so strange when I said his aftershave smelled nice. They were saying that even a glance that makes someone feel uncomfortable is sexual harassment. Two employees sharing a dirty joke amongst themselves in the break room is sexual harassment. Kicking the vending machine and saying F---! is sexual harassment. I was sexually harassing him! Sexual harassment is EVERYWHERE. Watch out...

Besides that everything was okay. The rest of the week, the hospital has devised this mini-skills lab that will teach us everything we ever wanted to know about nursing but was afraid to ask. Our first lessons include delegation (that we never really covered in nursing school and I needed for the NCLEX), customer service, and skills (which are my favorite). Just when you thought that nursing school was over, they bring it all back with your first job. We are re-learning phlebotomy, body logistics for turns...Everything! They are teaching us how to order things in the computer and a have to take a med calculation test. (Yay?) I get to meet my boss today (for the first time since she hired me), and my preceptor. (I am trying to stay optimistic!) I don't get to dive into the REAL nursing stuff until either later this week or on Monday. But I will be back to tell you more about that. Alright, I am going to put my clothes in the dryer, pack my lunch and go back to sleep.

Until next time...DiVa!

Friday, July 07, 2006

Pre-employment and such

Today, I had to go to the hospital to complete some pre-employment screening type stuff. Even though my drug test is going to be negative, I still worry a bit. I was at a party near a window where some guys were smoking weed outside. I was freaking out. I hope that second hand smoke doesn't generate a false positive. I wasn't like concentrating and inhaling or anything, I just happened to notice an odor of burning marijuana leaves. I should be fine because that was over a week ago.

Then I had to get a TB test. No big deal. I have to get another one done next Friday because the hospital needs to have a history of one negative test within the past year. No prob. After that I had to go to the lab to have blood work done. As I was instructed by the Blood donation people, I extended my right arm. The tech couldn't find my only two good veins. She decided to go for one of the faint blue lines on my left arm. She had to go deep to hit it and she used a butterfly needle. She made it on the first stick, which is good, but now I have a bruise the size of Texas on my arm.

Then I had to go get an ID made. It was a great picture, amazingly. Then I needed to get fingerprinted. I gave my driver's license, but the officer needed an ID with my social security number on it. Since I don't carry my social security card, I was out of luck. After that I decided to go home. Today, I had my daughter with me and she was so spoiled. Everyone couldn't stop telling her how cute she was and the gave her a light lunch, candy and coloring books. She said, "I like your job!" I wonder why.

So I start my job on Monday. I am not ready. I can't believe I am using this combination of words together in a sentence, but I would almost rather write a paper. I hope that I don't disappoint the unit, or screw up something. I mean, I don't worry that I will kill anyone, but I am more concerned that I will not be what the nurse manager expected. That is really silly, but that's my big fear. I wanted to ask the nurse manager why she hired me just so I could try to meet her expectation, but I thought that was kind of weird. So I will just do my best to be a good little DiVa.

I know I am probably not going to like everyone that I work with, but I hope that I work with marginally nice people. I am also hoping that work will be nothing like nursing school at all. My biggest weakness is time management, so I hope that I will be able to make it to work on time everyday. I live almost an hour away from the hospital and I have to get dressed in the facility because they don't allow you to wear your scrubs or shoes in from home. I imagine that all of my questions will be answered soon enough. Well I have a huge stack of papers that have to be filled out before my first day.

DiVa...I don't wanna let em' down!

P.S. I got a new microwave for $40 at Best Buy.

Monday, July 03, 2006

You never know how much you need your microwave...

Until it breaks down. I NEED my microwave. If you want to skip the updates, scroll down.

Updates
For the past few weeks the kids have been at Grandma's, which has been a great thing because I have had some time to myself. Saturday, I made an appointment to go to the salon and got my hair trimmed and dyed this amazing shade. Later I will get more highlights. I spent the whole day with my son and his Dad. His new girlfriend can't stand it that we don't hate each other. I don't know what these ladies need to hear to reassure them that I do not want him, for nothing! I think he should try to make up with his current girlfriend because I really like this one. She is always polite and she doesn't try to replace me. The last one thought for some reason that my son needed another mother. Sigh...

We went to see the movie CLICK. This movie was a surprise. It was really a good movie. I highly recommend it. While I was at the movie theater, I noticed that a few guys were checking me out. It has been a long time since a guy has expressed an interest in me. I liked it. After the movie, my son's Dad decided that he wanted to go out. So I stayed to babysit. Ha-ha! I babysat my own child. I realized that I could never be a weekend Mom because my son said he wanted to come home and I said okay. When he got home he didn't know how to act, he was all over the place. Fidgety, I wish I had energy like that. And then it happened.

Microwave Malfunction
I was taking a nap, when my son decided that he wanted to make a bag of microwave popcorn. He woke me up because the microwave was making a weird noise. I came in to check it out and smelled a burning, electrical-mechanical smell. His bag of popcorn was half-popped. I thought no more of it. Then later I was trying to heat up a Lean Gourmet entree, it didn't heat. In fact it was still frozen. The microwave is the center of my cooking life. Everything in my freezer, with the exception of the ice cream, is microwaveable. I take that back, I once put the ice cream in the microwave for about 15 seconds to soften it. I know I am crazy, but I need another microwave. A good one. One I can rely on. The last one was either a Sharp or Panasonic. It's going on the curb.

DiVa...going shopping for new appliances!