Sunday, April 29, 2007

Why can't I sleep?

I'll tell you why, it's a beautiful day. The sun is shining, the birds are chirping and I am going in to work for my 3rd twelve out of four straight twelve hour shifts in a row. I want to sleep, but spring is beckoning me out of my bedroom window, glowing through my room darkening blinds. New life is on the horizon, and I am at the helm.

Last night I learned how to cover my butt so to speak. I was in the back, all by myself with a lady who was a grand multiparous (G6,P5) precipatous deliverer of babies. Being that I work in what is know as a teaching hospital, we have residents in various levels of training. This one particular resident was a family practice resident, which means that she does obstetrics for fun and not as a specialty. It is not her primary discipline, she provides a potpourri of services to her clients. Anywho, my patient was 6 centimeters dilated, 90 percent effaced and at a -1 station. She was huffing, puffing and used to having babies with no anesthesia. The family practice resident and attending came by to get her checked in and left me to manage her labor. As always I told them not to go to far because I had a feeling that this lady was gonna go really fast.

I received the patient at 8:50 pm. At around 9:25 pm that she felt like she had to have a bowel movement. I told her absolutely not and I explained that she could very well deliver the baby while it was still encapsulated in the bag of waters. Fishing a baby out of the toilet is not my idea of a good time. I explained that I would rather her poop in the bedpan and clean up the mess. She wasn't exactly pleased with the idea, but went along as she realized I was not going to give her any other option. As a precautionary measure I had the family practice resident and attending paged to assess her pressure because I just knew this lady was going to deliver any minute. At 9:30pm her water broke. At 9:35 the resident showed up she only had enough time to get sterile gloves on and say the patient was completely dilated. I covered my patient who was sitting in a pool of amniotic fluid and poop with a sheet and began to assemble supplies.

The patient was involuntarily pushing and I could not remove the soiled linen. I ran to the intercom and called for any attending physician and our charge nurse to come to my room for the delivery. Before I could hang up the phone good the baby's head was out. I swear, the attending peeked around the corner, saw that it was family practice and turned around and left. My charge nurse never showed up.

My delivery resident doctor said something cute like, "I've never done this before." I was thinking "Oh shit, I don't really know what to tell you to do. But hey, I have seen it done a million times. Here goes." I pulled the delivery cart over to the bedside. We placed the baby on the Mom's abdomen. She clamped and cut the cord. I told her to do some fundal massage and wait for the placenta to loosen. In the meantime I took the baby over to the warmer and worked on him. He was stable which freed me up to do other things.

She was kind of holding the cut end of the remaining umbilical cord and when she felt the placenta loosen she had the patient push it out. I started the pitocin to clamp down the uterus. I was doing like 5 things at once, pushing medication, doing apgars, assessing baby and mom when finally the charge nurse and attending came around the corner. Everything was already done. Then about ten minutes after all that, the family practice attending came. For a moment, I finally felt like a real nurse. I handled that delivery like a seasoned professional nurse. Or at least I thought.

The attending had a problem with my performance at the bedside. She felt that I should have called her sooner. I don't know how I could have done that, but she failed to realize that I was in the room when she told the resident that saw the patient involuntarily pushing on the EFM at the nurses station and decided not to come in to help. She must not have noticed that I saw her shoes under the curtain and her head peeking in to see what we were doing while we were getting the baby delivered. I imagine that this is going to turn into another episode in the nurse manager's office. But I don't care because I am a NurseDiva dammit! Oh yes, I'm still that bitch and I haven't forgot how to get nasty when I need to. Wish me luck!

DiVa...gettin' down and dirty when she needs to!

Thursday, April 26, 2007

I think being a nurse has made me a lunatic!

I can't really describe what is going on with me, but I know I am not alone in my condition. There are other people who are suffering along with me, the only difference is that I have no problem putting myself on blast. This morning, one of the other new nurses confided in me about her situation on the floor. She isn't even out of orientation yet and they have already told her she is not going to make it. I feel bad for her because I know what it is like to be under their scrutiny and criticism. There is no way to please the "senior nurses" who have only been nurses less than 3 years themselves. Nursing can be a very tough job. you have to be a high riding bitch because your kindness will be easily mistaken for weakness. Thank God I have finally become in tune with my inner bitch.

Anyway, I have mixed emotions about my job. First of all, our hospital pays one of the lowest salaries ever. Given that, I worked there because I felt that I would get the best nursing experience because of the high acuity level of the patients. And this is true, I am getting really great experiences. However, given the nature of our unit, many people who started the same time as myself have quit. Even I have debated about quitting. Not even a few days ago, I wrote an entry about how I planned to stick it out and about two days later I applied for a new job. And the crazy thing is that the new job would entail me following the very people that I was trying to get away from. Crazy isn't it?

I don't know what is wrong with me. In one breathe, I am tired of working the night shift. But at the same time, God is answering my prayers by moving all of my enemies out of my way and making the job so much more tolerable. People are becoming increasingly more friendly. The stress level is decreasing. Teamwork and morale is on an upward trend. My schedule is getting worse because we are understaffed. I am seriously becoming bipolar. I go from one extreme to the next. I am elated because my skills are improving and I am really beginning to know what I am doing, but I am becoming more depressed because summer is coming and I HAVE to sleep all day. I signed on to work three twelve hour shifts, but rarely do so because business needs require me to work more hours. I wanted to get another job working PRN "nursing for dollars" and I have no time.

My dream of buying a new house is getting further and further away. I am spending my time right now trying to rebound from the financial pit that I am in as a result of nursing school. I am trying to get used to the student loan payment. I have tonight off, but it doesn't even really feel like a night off because I am off in the night time, not the during the day and tomorrow, I begin a stretch of four twelves in a row, and none of it is overtime because it is stretched over two pay periods. (How sneaky!) And most of the time I don't feel like I truly have a day off because I am on call. I refuse to take overtime because I want to have at least a few days off in a row and besides, I am on call, so I will be there anyway. And what difference does it make if they hire new people, they are just going to quit in a few weeks anyway. The funny thing is that when I was hired, my boss said that turnover is low and that people have been there over 20 years. In the time I have been there 9 new people have quit. I may make it 10...

DiVa...seriously losing her mind, seriously!

Friday, April 20, 2007

Finally, a moment to blog!

It has certainly been a very long time, hasn't it?

I am still a labor and delivery nurse. Somehow I found a way to hang in and make this job work. It's funny, I have almost been a bonafide RN for just about a year and I've come a long way baby.

Since the last time I stopped in to drop a line, a few things have happened. Most importantly, I found my voice. One night a doctor decided that she would dress me down in front of a patient. I waited until we left the patient's room and told the doctor exactly how I felt about her attempt to make me look like a complete idiot in front of the patient. I advised her never to do it again and in the future she should treat nurses the way that she would like to be treated. I guess I surprised the crap out of everyone because for the rest of my shift, no one said anything to me. Not one word. But now, people nurses and doctors alike give me just a little bit more respect than before. Interesting. So all I had to do was act like I was going to kick some butt and people change their tune.

A few of the other new grads have come out of orientation. I realize that there has to be someone to pick on or work just isn't fun. I am glad that it isn't me anymore and also sad that we can't treat each other just a little better. Just a few nights ago, I heard a few of the nurses discussing a new nurses performance and just how stupid they thought the person was and it was at that moment I realized that this must have been the way they talked about me. Hmmm. So they don't particularly care for nurses who are trying to be therapeutic. I guess it can go overboard a bit like begging a patient to move their feet or lift their butt one hour after having their belly sliced open but I can say that I don't blame the patient for not wanting to move in the first place. It is much better appreciated to get a patient out of the unit as quickly as possible.

It is also pretty funny that two of the same people who suggested that I give the unit at least a year have left our unit to pursue new opportunities in other areas of nursing. I am pretty glad that I decided to tough it out. Things are getting a lot better. My kids still don't like it that I have to work so much, but they LOVE being able to do the things that my new job affords us. And they are also looking forward to me buying a new house. Yes. I have been looking at houses and I am working on making an offer. According to my realtor, I could possibly be moving in to my new home in the next two months. The new mortgage is a lot more than the old one. But I will get used to it.

Time to start getting ready for work. I promise to blog more often!

DiVa....quite the nurse extraordinaire!