Saturday, September 30, 2006

Independent woman....

Thursday was the last day of new hire orientation. Now I am on my own as a professional nurse. To me, it sounds like the most frightening group of words ever uttered by man. I will be responsible for two lives now, mother and baby. Huge responsibility. I am up for the challenge. I really, I am ready.

This week I had a mom who had a BIG baby and I was doing the delivery with an inexperienced physician. She thought that she shoulders were stuck and she freaked out. I followed protocol, but damn was that intense. Luckily, I had the whole floor of nurses backing me up. Whew! Then I was delivering a young single mom with a baby's father that was a huge jerk. I told him if you are not part of the solution, then you are part of the problem. Let's be solution oriented. It did not help. Her mother was trying her best to disuade her from an epidural, which she ended up getting anyway. Then she delivered a beautiful baby boy with Down's syndrome. We have a lot of happy times, and our share of sad times too in L & D.

Right now I am supposed to be at my son's birthday party. I said I was going to skate since it is at a roller arena. Well, I'll be back later.

DiVa...blogging is my life!

Thursday, September 21, 2006

Mama's gotta a brand new bag...

With shoes to match!

I have only two weeks left until I get to work independently. I think I am looking forward to it. I can't complain so far, I work with a marginally decent group of people. My challenge is that I work with almost all women, even the men are woman-like. But during my training, I have not only learned how to be a nurse, but I have been socialized in the culture of nursing. I have come up with some hard and fast survival techniques for new nurses that I will share. Then I am going to take a nap because I have to work until 3 o'clock in the morning.

1. Avoid floor gossip at all costs.
This is probably the hardest of all because when there is a break in the day, every one gets together to talk about how "Nurse A" has migraine headaches and she calls off every week because she has a headache and how it is not fair that she can use FMLA to excuse her absences and how she coincidentally has a migraine on X-mas day, New Year's Eve, Thanksgiving and any other inconvenient time. If you find yourself talking about someone when they are not present, make sure you are saying nice things or things that you don't mind being repeated because trust me, it will be repeated and you might get confronted.

2. Get a tough skin and try not to go off in front of a patient even when "Dr So and So" is being a dick!
This has happened to me, and I act like I don't even care. Don't ever cry in front of an "authority figure" because then they know your weakness and you will get hosed every time. Sometimes, I will even laugh and say some crap like "Take it easy dude, even though I am a DiVa, I am still new." Save your crying for when you get home or in the bathroom or whatever. Personally, I went to school with a whole bunch of (pardon my saying so) Bitches (students and profs included) so I am almost numb to this sort of crap. And besides, they can't kick my ass anyway!

3. Even if you don't know what the hell you are doing, walk around with poise and confidence.
I call this my poker face. Inside I am a nervous wreck, on the outside I look like I have been doing this nursing thing my whole life. If I am confused about something, I ask a question in a way that sounds like I am confirming what I already know. I think it must be working okay because people have an awful lot of confidence in my ability to care for patients. Maybe I am better than I think I am, but I never make any assumptions.

4. Smile and say hello to everyone from the nurse manager to the environmental services personnel. Be genuine and nice. Help out whenever and where ever you can.
You will be surprised where the best help can come from when you don't know which end is up. I am always willing to help someone at all times and I have found that if I overhead page for help, not a code but just for assistance I have a team of people in my room and each one takes a job without even being asked. Seriously, it's amazing. If I feel uncomfortable with the way that anyone treats me I'll ask the person directly if they are having a bad day, or if I did something wrong. Mainly I address the behavior by saying something like "When you speak to me that way, it feels like you are yelling at me" or "Can you show me the proper way to do whatever" and I find that people give me good feedback. If there was a misunderstanding, it is okay. We talk it out like adults. They didn't beat me up or cuss me out or anything.

5. Be prepared to get crappy work schedules as a new employee. Don't complain or whine. Just smile and say something like "Those are the breaks" and move on.
It is just a fact of life. Nurses with seniority get whatever they want and new nurses have to earn their way. But there is always a nurse on the floor who knows how to work the schedule. Find that person and ask them to teach you how to make out your schedule. You'd be surprised how far creative scheduling can get you.

*Bonus! Try to have fun and remember that your job is all about taking care of the patients. If you make a few friends along the way and it is all fine and good, but if not remember you're a nurse!
You can transfer anywhere you want. We are one of the few professions with the versatility to work in any clinical area. I am giving this job two years to happen for me. After that I will re-evaluate my career and make a decision about where I want to go next. I have the ultimate power over whether or not I am going to have a good experience or a bad one. I leave my home life at home and my work life at work. And besides, my personal life is none of their business anyway. And believe me, they will want to know your business. Have a little mystery about yourself. It is fun. None of those people HAVE to be your friends, they are co-workers. The less people judging you the better.

Alright, enough wisdom for today, I will be back soon.


DiVa...A nurse with the moxy to keep it real!

Thursday, September 14, 2006

Playin' catch-up

I am excited about my new career. As a matter of fact, I got my first raise. Seeing my paychecks give me a sense of hope for the future of my family. Yeah, I know I sound crazy, but I have made some observances about making enough money to take care of my family.

1. I don't have to borrow money to take care of my kids. I spent almost $600 on my kids for school uniforms and supplies and my bank account was not overdrawn. And I still had money left over to pay my bills and put gas in my car. Wow!

2. My ex-fiance and I have been getting along a lot better lately. (Big Surprise, no?)Recently, he has been helping me out with the kids. And he realized that he needed a car to do this with. I was the designated co-signer, but I declined because I don't think he deserves it. Why the hell should I co-sign for him. I guess the most amazing thing is that the banks will actually let me, ME have a new car.

3. I buy lots and lots of pretty clothes and shoes for myself. I have better clothes than I had even when I was in high school! And I have money left over to go out to dinner and pay for my meal without taking $20 off of each bill to afford to go and have fun with my friends. I just went out this weekend and spent $60 dollars and my lights and gas are still on! My rent is paid!

I know I am silly, but I can afford to enjoy life. I have to get my credit in order and start saving now because I plan to get a new house. At least a bigger house where all of us have our own bedrooms. I am thinking of moving a bit closer to my job. The schools closer to my job are having problems with finance and quality of education. The town where I live right now are building brand new schools that will be done in 2008. I think I should stay here, but I have to drive at least one hour to get to work. I have a huge decision to make.

I know it is too soon to say this, but I think I love my new job. I especially LOVE working in the OR and triage. I know you must be thinking, are you really a OB nurse? Yes, our OB is a high risk OB. That means we are prepared for anything. We take all pregnant with things as simple as a toothache or as complex as a placental abruption. They only rule is that they have to be at least greater than 18 weeks pregnant. I think I'll be okay working unsupervised. And the people on nights are fun!

Since I am a new grad, I am going to get hosed on the holidays. I will probably be working Thanksgiving, X-mas eve definitely, x-mas day and New Year's. But since I work nights, it shouldn't be so bad. I hope.

Tuesday, September 12, 2006

With less than a month of orientation left...

I am doing remarkably well.

I can birth babies with minimal assistance. I can circulate and scrub in obstetrical and gyn procedures, I can triage. I am almost working independently. The funny thing is, I am already teaching student nurses. Today was a day that I could have choked a few student nurses. I always wondered what it was like on the other side of the fence. Now I know.

Most of the student nurses that I have run into were cute. The reminded me of myself. Inquisitive, helpful and focused. They ask really good questions. I am impressed. But there are a few student nurses that make worry for the future of nursing. Case in point. Today there was a group of student nurses in the OR observing C-sections and things of the sort. It was my second time scrubbing in by myself and I was nervous! I memorized all the instruments, and I am working on anticipating the doctors need, so I was rehearsing the procedure in my mind while I was setting up my sterile field. I don't know about you, but when I was in nursing school, I was taught two things about being in the OR, 1. Don't touch anything! Especially anything or anyone dressed in blue, and 2. Keep your hands in your pockets and stand up against the wall that way if you faint you won't hurt yourself.

I don't know what this guy was looking at but he was standing behind me. The patient wasn't draped, there were no doctors in the room. I think the nurse was placing a Foley or something. The all of the sudden I felt a bump. In my mind I said "Shit!" Out loud I said "He bumped me! Ack! What do I do?" I know full well what I had to do, I had to re-scrub all over again. I told him it was okay. It really was, because ya know, it could happen to anyone. I guess it was partially my fault because I should be aware of my surroundings, but whatever. I re-scrubbed and went back to setting up my sterile field, but then I was REALLY nervous.

My mask and shield fogged up and I was sweating like crazy. In my mind I am playing the worst case scenarios, me knocking over the entire Mayo stand with surgical instruments all over the floor. One of the doctors yelling at me like "Get this incompetent nurse outta here and get someone who knows what the HELL they're doing!" I couldn't see a thing. Fortunately, I could see the tips of the surgical instruments and I memorized where I had everything set up. All of my counts were correct in all three cases. Once I thought I had lost a Kelley clamp, but then I realized it was on my placenta. Oh, and I dropped a pair of pick-ups off the field. Simple job, HUGE responsibility! The doctors seemed to be impressed. The DiVa still can't take a compliment.

After the case, I was scrubbing my instruments and I happened to track blood on the floor. At the moment, I had an unlabeled placenta that needed to be stored properly before it got mixed in with all the other placentas and I was going to call environmental services to help me with my bloody footprints. One of the nurse assistants (i.e., student nurse that works on the floor until they graduate and take boards) called me on the carpet about the bloody footprints. Now, They were not like a forensic crime scene, just light pinkish-red smears of blood. I didn't even leave the footprints unattended. She is always screwing with me. Student nurses have some BALLS nowadays! When I was a student nurse, I respected nurses (experienced or not)and I wouldn't DARE try to say something that would piss them off. I have already said something to her about her saying, "I WOULD help you BUT YOU'RE the NURSE-IN-TRAINING and you need the experience." or "I would have started that IV differently than that, I would have went for the anticubital but do it your way." Or my personal favorite, "Hmmm, looks like you have five minutes to get dressed and get into report! Better hurry up!"

Other than that, all is well. I think I will be okay. But I just know, my first week out of orientation will be all the worst OB cases every known to man.

DiVa...The girl who went to the club this weekend and found out just how fierce she really is!