Thursday, January 31, 2008

What I love most about blogging...

Is that I can come here and be as insecure as I want to without the worry of my competency as a nurse being called into question. Today was my first marginally rough day at work. I think what is happening is that my feelings from my old job are complicating my ability to focus on my new job as I should. I am worried that I am not learning the new job fast enough and that my hesitancy in being viewed as an inability to do the job. Then there is learning all of the paperwork, personalities, physicians, protocols, passwords, preferences, practitioners, pumps and pregnant patients...all of which is making me dizzy. Plus I am tired as hell and behind on my class work, but that is another blog entry.

Okay so I was in a delivery and my baby came out floppy. For one, this institution doesn't seem to freak out about anything. The baby nurse just casually came over and rubbed the baby's back. The midwife handed me the bulb syringe and I started helping with baby resuscitation. The worst thing of all was that I was in the way, and not very effective at prioritizing my interventions. I was a little embarrassed, but it was a defense mechanism from my county days. I was never allowed to participate in my own baby code situations. I was pushed aside, instead of being guided. Those neonate resuscitation classes are great, but it is a totally different ball game when you have a human, blue, floppy infant on your table. I was previously precepted by a maniac that freaked out over everything…to the extreme.

My preceptor reminded me that I am not the baby nurse and that I needed to focus all my attention on taking care of Mom. I just wanted to be everywhere at once. Then it was the end of my shift and I wanted to stay and finish the delivery, but my preceptor sent me home. She was totally nice. It wasn't at all hostile. She did mention that I know what I am doing, but I need to present myself in a more confident way or I will have problems with some of the other nurses who have a strong personality. Here we go again...

I have to learn to put on a better game face. I must come across as unsure of myself. I think it would be really hard to be walking around like "Nurse-know-it-all" but at the same time I guess I can't be looking for approval for the things that I do. Maybe I should re-think my idea to work and go to school. I was warned, but then once someone tells me that I can't do something, I feel a subconscious need to prove them wrong. I think I'll be alright. Pray for me...

DiVa...I am not giving up on this job, especially since I saw my first check!

Thursday, January 24, 2008

Close Encounters of the Roach-kind...

It seems like lately,roaches have been making their presence known. Not in my house. My house isn't as clean as I would like it to be but no roaches. An occasional ant or flea weather permitting, no roaches. Ever. I have heard of people seeing roaches at establishments. For instance, I was in my theory class the other week and the cafeteria at the school was closed. So everyone went to the hospital across the street to get breakfast. The dude in front of me said his friend stepped up to the counter and the cook asked her what she wanted. She told the cook, "I want two pieces of french toast, two pieces of bacon. By the way there is a roach on the counter behind you crawling on a Styrofoam cup." According to the dude, the cook kept on cooking and the roach lived to see another day. I guess she figured that the roach wasn't hurting anything. Either that or the cafeteria doesn't pay her enough to cook and kill roaches!

That story reminded me of when I took my daughter to get her hair done. This is a process that takes hours. So she asked me to get her something to eat. She took a break to eat her food and I closed the bag and set it on the table in the shop. When the stylists reached the two hour mark, my daughter decided that she wanted to finish her sandwich. She opened the bag and I heard her shriek. I was like, "What is wrong with you?" She said, "Mom, there are beetles on my food." I knew instantly that she was talking about roaches. I picked up her bag, tiny roaches still crawling out and threw it in the garbage. Then, as they were finishing her hair, I saw a HUGE roach crawling across the floor. I wasn't the only one, my daughter saw it too and started to cry. The stylist took a cup of boiling hot water and poured it on the roach and then asked me, "Is it still moving?" I would imagine not. Next time we will have to get to the shop before nightfall.

Last week, my FOB came home and said, "You look tired, let's go out to dinner." I was like, "Hell yeah, I don't feel like cooking anyway!" So me, him and the kids all piled into the car and we went to the Chinese buffet. We were all walking around putting our plates together and I decided that I wanted to try the hot and sour soup. A friend of mine had me try some of hers and I thought it was pretty good. I walked around the buffet table and grabbed a little saucer when something shiny caught the corner of my eye. It was a HUGE roach walking right towards the hot and sour soup. At first I was like feeling sorry for the roach and decided I wasn't going to kill it. After all, it wasn't MY house. But then I thought, what if someone else EATS this roach after it fell into the soup. Eww! I grabbed one of the saucers and killed the roach. The guts were smeared all over the underside of the plate. I called my FOB over and said, "I think we should probably leave." He said, "I ain't paying for this shit, that's nasty!" I agreed, then I called one of the servers over to the buffet table.

I showed her the roach and she picked it up with her BARE HAND and rubbed it between her thumb and index finger to be sure it was dead. She was like, okay and she took it back into the kitchen. I don't know what she did with the roach but our family left that restaurant. There was a lady sitting at another table. She was finishing her food and paying her bill. She wanted to know sooo bad why we were leaving when we had only been there for about five minutes. There was a guy at the buffet table the same time I was explaining to the server. I don't know if he left too, but damn that's nasty. The server tried to act at first like I planted the roach on the table, but I told her to review the roach guts on the underside of the saucer. She couldn't say ANYTHING after that. We walked out and went to another restaurant. My eyes were peeled the whole time. I was kinda freaked out because the carpet was brown. The design had me thinking that there were roaches everywhere, even though there were none. Basically, my appetite was ruined.

The scariest encounter I had with roaches was probably the night at the county hospital. I had a busy night and the shift was over. I had to go the bathroom really bad and I had already left the floor. I was in the basement. The nearest bathroom was the janitorial locker room. I opened the door and ran in. All of the toilets were filled with this putrid blackish brown water. I turned around and notice a field of dead roaches all around me, lying on there backs and all dried out. I was in such a hurry, I didn't even notice. There were hundreds of roaches everywhere. I ran out of the bathroom. I didn't have to go to the bathroom anymore. I rode home the whole 45 minutes and went to the bathroom in my own home.

How the Hell do these public places stay in business with roaches like that?

DiVa...grossed out with all this roach talk!

Wednesday, January 23, 2008

New Job, New Semester

A New Job

My new job is cool! Luckily, my training manager didn't tell Nurse Evil that I didn't want to be precepted by her. I could see immediately why she might have had a problem at the county. She runs her mouth constantly, is a bit of a gossip hound but is a very skilled nurse. The whole precepting thing is going much smoother having an basic understanding of labor and delivery. I guess I need to understand what they do when emergent things happen. For example, if I had a patient with a fetal heart rate in the 60's at the county, we would watch the first brady and doing the basic interventions. By the second brady we would be pulling the bed out of the wall and running to the Operating Room. By the third brady we would be getting ready to cut. At this institution, they wait to see if it comes up. If it does, they continue as usual. If it doesn't, they check to see if the Mom is ready to push. If she is, they try to deliver a baby and call code pink.

This new relaxed way of looking at a tracing is foreign to me. If I just turned the patient and put on O2 with the first late deceleration and only called the doctor on the second late, I would be in huge trouble. Huge. They would be talking about me in the break room and the doctors and nurses would not trust me to watch a patient. Seriously. The county was a hostile work environment. Not here, at least not yet. They only come if you call for help. I appreciate that. And when they do come, it is not in the spirit of making you feel inept, it is truly to help. This time, I am adjusting my attitude. I am approaching this job as a skilled, experienced nurse. I am confident in the things that I know. I am not going to have a negative outlook, I am going to leave my past behind me and look forward to the learning opportunities that exist. Besides, I am only going to be there three days a month. I believe I can do it.

A New Semester

This past week I had more intensive courses. I am taking classes to prepare me to be a clinician. This is where I am not as confident. When we were learning about how to prescribe insulin it hit me that I am going to be responsible for diagnosing and managing patients with chronic health conditions. What if I prescribe a medication and my patient gets hypoglycemic and has to be hospitalized. Scary thought! I know that I will be supervised in the beginning and I will not be turned out into the wide world of medicine without passing a certification but it is still a bit daunting.

This semester I am taking advanced pharmacology, my clinical course and theory (boring). I am supposed to be working on a paper. This week and next week are going to be devoted to getting that together. I am already a little bit behind on my reading. In my clinical course, they don't assign chapters, only subjects and it is your responsibility to read the chapters that pertain to that particular subject. We had our first quiz. This particular quiz they gave us a patient's information, demographics, symptoms etc. and then we had to organize and prioritize the information, develop a differential diagnosis (what you think they have), develop a real diagnosis, a plan of care and then follow-up. All of this using no resources. No books, no medication guides, nothing but your mental mind. I don't think I did too bad. Clinicals at this point are at a standstill. My preceptor is on vacation until February which means I will be going to clinical almost everyday.

Well, I should try to get back to work. The kids will be here in a few hours bugging the heck out of me!

DiVa...suffers from study inertia

Wednesday, January 16, 2008

Will I ever have a life...again?

I am so crazy. By the time I finish this doctorate, I will have spent a total of almost seven continuous years in school. And now I've added a job to the equation, what quality of life will I have? What made me think I would be able to do graduate school full-time and work three days a month and do 20 hours of clinical a week and have clean clothes for three people and prepare home-cooked meals and mother my children and maintain a sane mind all at the same time? I mean it can be done, but I don't know if I am the DiVa to do it. I manage to keep a smile on my face and a bounce in my step but damn, damn, damn am I tired.

Between pharm class, clinical, my theory paper and Adult health lecture one question remains...Will I have time to watch American Idol? It is my comic relief, until the real competition starts. I absolutely HAVE to make time for American Idol. It will probably be the only thing that I get to do that is unrelated to nursing, besides my regular activities of daily living.

I bought myself a PDA as a Christmas gift. At first I thought it was a total waste of money. It was on sale for $199 and I thought what the heck, why not? I am so glad I did because all of my classes and clinical require it, mainly for Epocrates. I'll have to keep you posted on whether or not it was a worthwhile purchase. It seems that every APN I've run into this semester says they don't know how they ever made it without a PDA. We'll see...

Well, got to get ready for the old am routine. As far as my resolutions go I have been pretty close to on target. I am planning to start the flylady thing in February.

DiVa...Has an 11pm bedtime but my inner perfectionist won't let me go to bed without everything done!

Tuesday, January 15, 2008

I need to silence my inner idiot!

When I worked at the county, I heard many a tall tale. Well I don't know if they were all tales, I imagine some of the stories were true. I have always thought that if more than four people tell the same story, then the story is true. Most of what I was told were a first person accounts so I doubt that what I was told was a rumor. Anyways there was legend of Nurse Evil that circulated on our floor. She was the most cruel of labor and delivery nurses as the story goes. She ate new nurses alive and people shuddered in her wake. She had an entourage. The three nurse team was called "The Trifecta" and when all three of them worked the floor, anyone who was not in the good graces of "The Trifecta" would call in sick. It was because of "The Trifecta" that everyone began the ritual of printing the entire schedule instead of only printing the page that pertains to your hours worked. I only know of this because one of the members of "The Trifecta" told me about it. She wasn't proud because being a member of this elite group almost cost her her job and she didn't want me to report her for being nasty. I digress...

Nurse Evil left just a week before I started and I was told that if she knew me, she would ridicule me because of my unique appearance and sense of style. There was a nurse that worked on the floor that wore her hair in a style that Nurse Evil didn't like and she was able to convince those in her favor to wear a cartoon character sticker on their lab jacket that was supposed to represent this particular nurse's style, (or lack thereof). They said she was insensitive to the patients that were too needy, poor or just plain uneducated and discourteous to their families. Nurse Evil was only PRN, which was surprising. I guess not too surprising since PRN means that you can work whenever you'd like. Nurse Evil sealed her own fate when she was a no call no show, or something like that. It was rumored that she tried to get her job back but the management would never allow it because she created such a hostile work environment.

I have found that working in labor and delivery, it is a small community. There are only so many places you can work before you run into someone, somewhere that knows someone who knows you. I happened to be in the lunchroom and began to ask me if I knew random people from the county. I knew them all, and to my terror I did not know the nurse personally, I only knew of her legend. It was Nurse Evil. Shit! How bad can it be? I work PRN, what are the odds that I would run into Nurse Evil? I received my preceptor assignment for the week and who is my preceptor? Nurse Evil. She was assigned to be my preceptor for a whole freakin' week and I politely asked that it be changed. After I said it, I immediately wanted to take it back. It was risky, but my inner idiot wouldn't let me be quiet. I thought of all the times that I had bad experiences in training and I wanted nothing to distract me from learning. The legend preceded her and there is no way that I would not have been second guessing myself the entire week and she would have said something out of the way and I probably would have quit right on the spot.

But then I thought about it some more and I realized how immature and silly I am. I am judging a person based on unsubstantiated gossip. I never even met her and I let a story scare me into missing out on a potentially rich learning opportunity. This makes me just as bad as the people who kept the legend going. Nurse Evil, I am issuing you an apology. What if she has changed? Or found God? I work three days a month for crying out loud! What if the manager of training goes back and tells her that I requested another preceptor? She asked me why and I told her that I knew of Nurse Evil from my previous job and that one of my colleagues had a negative experience with her while in training. I went on to say that I felt I would be distracted from from learning the job properly. I think my reasons have merit and at least I didn't repeat the WHOLE legend. Ahh screw it, it's better to be safe than sorry, and besides if I had agreed to be trained by Nurse Evil and it was going bad, I would have been stuck for the whole week. Whatever, it's done now. I should be glad, that is if they could find someone else to train me. I don't know if I have escaped the gauntlet. I need to grow the hell up...

DiVa...I can do ANYTHING three days a month!

Monday, January 14, 2008

Like riding a bike!

Being a nurse is like riding a bike. You never forget how to do it, once it has been ingrained into every fiber of your being. This L & D unit is okay. I won't get too excited because it is only my first day. All the rules seem to be relatively the same, except the charting system is a pain in the butt. Otherwise, this hospital is labor and delivery utopia. The rooms are very nice and clean. I was so comfortable, it was hard not to jump in and get started. I think I want to take my time and really make sure I know my job before they turn me loose on my own. I can tell already that they trust me. Being in this environment really has me questioning my choice of clinical focus. Am I really a family practice nurse? Or a midwife? I will probably end up being both.

I can tell already that there are a few bitches that I am just not gonna like. That's a shame. I have already decided that I am not going to get caught up in the office drama. Besides, I only have to work 2-3 days a months and I have too many other things to worry about. I am focused on what I need to do for a change. Also, the clientele seems to be dramatically different. More affluent people than at the county. I will certainly miss that as well. I am excited to get back into the clinical area. I just wonder how I will balance work, school and motherhood...

Tomorrow is my first day of school. I am planning to start clinical in three weeks. The FOB is going to help out until February. Things are slowly falling into place. The house is starting to look like it is inhabited by human beings again. I am nervous about being on my own, especially since my baby sister asked me to keep my five year old niece for a few weeks until she can get herself together. This is a luxury that I have never been afforded when I was a young mother trying to figure out some direction in my life. I have no idea who is going to watch her while I go to school and work. I am still trying to figure out what I am doing with my kids after school certain days of the week. Today I was caught up in a delivery and I couldn't leave on time and my son was stuck at bowling practice with no ride home. I know there will be more days like this. I am thinking about having my brother help out. We'll have to see what he says.

Well, gotta get ready for tomorrow. Just thought I'd stop and make a few notes. I am happy for the most part and I can't wait to see what class will be like tomorrow.

DiVa...finding ways to keep myself busy, unintentionally!

Friday, January 04, 2008

The one that got away...

There is a resolution that I should have added..."Be on time, DiVa!"

I cannot be on time. It doesn't seem to matter how early I wake up, if I lay my clothes out the night before, Hell, if I slept in the car I would STILL be late! Why can't I make it anywhere on time? I am late to school. I want to be on time, but I live 45 minutes away from school. My kids have to be at school by 8am and most of my classes start at 9am. If I run into a traffic jam on the way to the University, I am definitely going to be late which is totally beyond my control. My family knows that if they are waiting for me to show up somewhere, I will be there 1/2 hour later than the time I am supposed to be there. Will I like it when I am a clinician and my patients are late? Or a professor and my students are late? Probably not. I am really going to have to work a bit harder to be on time. I am so inconsiderate of others. (This is a HUGE area of opportunity for me.)

And as of late I can't sleep. I am tired, but I can't sleep at night. During class is when I get sleepy. That is so BAD! I really need to get my shit together because it is such an insult to my instructor to be sitting in class nodding. Usually it is after lunch break that this phenomenon occurs. I even tried to stand up because I could not stay alert. Then I thought maybe if I participated in class I would do better with the awake thing, but I can't even put my thoughts together properly because my mind is tired. I guess one could say that as much tuition costs for a graduate program, it is an insult to me that the course content should be engaging to say the least. But in saying that I am justifying my inability to stay awake, which is RUDE! I am going to be a teacher one day. I will want to KILL someone for falling asleep in my class, especially if I spent time and effort putting together materials. Tonight I am going to make my best effort to get to bed at least by 11pm. (Not so worried about this issue as I think it is situational.)

As far as school goes, all of my books have arrived. Next semester is gonna be GREAT, however, this intensive class is kicking my butt a little, (nothing like the Advanced Physiology). We are cramming a 12 week class into 5 days. My mind is still on Christmas break. This is a class on nursing research and nursing theories. Very dry content. I am currently developing a paper and a group presentation, both of which I need to get started on soon. Our theorist is one of the hardest to find current research development on. The theory is so complete that no one can add anything to it to expand the research. We cannot find any current journals articles that reviews or revises the theory. In a way that is a compliment to the body of work. Not good for the presentation though. And the research area is so narrow, it will be a challenge to apply the theory to nursing practice. But the DiVa will make it happen. It's what I do...

At least I don't have this sinus infection draining all of my energy anymore. Breathing through the nose is an underrated experience! Now that I can breathe through my nose it is like all of my creative energy has been restored.

Well, might as well get started on the projects.

Ta-ta for now!

DiVa...Gonna get herself together for the last few days of her intensive!

Tuesday, January 01, 2008

Happy New Year!

I have been sick for the past day or so. Luckily, I let the kids spend the holidays with the in laws and I spent New Years Eve alone. Well, not really, the resident jerk was here, but since I was sick, he has been keeping his distance. Not that he even cared to begin with. I asked him to take the dog out and run to the grocery store and get me my favorite sinus remedy and he actually stomped his feet and sulk like a huge baby! It was amazing to see a grown ass man throw a tantrum about doing what he should be doing anyway...

I feel a little better now, and I have no choice but to get my butt in gear because I have to be back to school tomorrow. I ordered my $400 worth of books and have proceeded to get my crap together for clinical. I have also planned my days down to the hour. I turned the leftover turkey into Turkey noodle soup. No laundry yet though. I still need to make arrangements for my children. I found an after school bowling program for them, that's one day a week down, at least 4 more to go! I am a work in progress...

So now on to my New Year's resolutions.

I have 10 things that I resolve to do in the coming year.

1. Love DiVa to the fullest, no matter what the year may bring!
I think self-love is at the core of all my insecurities. If I love DiVa, everything else will fall into place. That means making time for my manicures, pedicures, hair appointments and date night! Not with a man, just me the bubble bath and relaxing music.

2. Lose Weight
My goal was 30 pounds a year, but my personal trainer told me that was not aggressive enough. Even though she is a crazy biotch, I love her and I hope that we get the opportunity to work together again. Diet and exercise will become my best friend. At 5am every day I will attempt to be at the gym. And I am seriously going to have to get my self started on the Beck Diet Solution and Dash Eating Plan. I should be at least 20 pounds lighter before swimsuit season. If I can only find the time...

3. Set Boundaries
This is another thing that is the very essence of my problems. If I set boundaries I will be able to lose weight. That goes for my relationships too! The kids, my ex-dude, friends and family, most importantly my mother. I love her to death, but she is going to give me a freakin' break for crying out loud! I have already started by ignoring the phone calls from my crazy cousin. Do you know she has reduced herself to using the kids to work on me?

4. Get Organized
I tried to get the house together over break. I found this person on the net called the FlyLady (http://www.flylady.net/index.asp). I have been threatening to start her program for almost 2 years now. This is something I really want to make time to do. She guarantees that your house will be presentable to company within 30 days. You begin with shining your sink and move up from there. I will let you know how this works out!

5. Stay Focused
I have a tendency to get off track. I once talked to my advisor about problems I was having at the beginning of the semester. She told me that there are things I have time for and things I don't have time for. She went on to say that right now the two most important things in my life right now are my kids and finishing my doctorate. I am going to put that on my motivational sticky notes.

6. Be a Better Mom
I don't think I am a bad mother, but I do need to set some boundaries, clean up my kids diet and set a better example. They need a decent bedtime, healthy meals and snacks and some serious home training. They need chores and someone to spend some time teaching them the facts of life. And that someone is me!

7. No More Fast Food
This one is going to be really hard because it is much easier to stop at McDonald's and pick up some .99 double cheeseburgers than it is to make a real dinner. I am really motivated to making this resolve stick. For the sake of my health and the health of my children.

8. Quit Smoking FOREVER
Alright. I will be honest. Occasionally, I like to have a cigarette. I like smoking. There, I said it. I know it is bad for me, smoking has been banned inside bars and restaurants, it should be simple...right? WRONG! When I feel stressed out, I want a cigarette so bad it kills me. I have been able to hide my little smoking habit from my children. I have stopped buying my own cigarettes, I just smoke my sisters or my friends. I really want to quit for good. I don't want Cancer or COPD. Now I need to JUST SAY NO!

9. Get back to church
When I was going through my valley phase of life I felt like God had abandoned me. I thought, if God really loved me like they say He does I would not have all this suffering. It is my belief that all of the suffering that I have endured has been for a bigger purpose. Maybe, it is a blessing and something I have gone through will help someone else. I know for sure that I have been blessed because I have everything I need and then some. I want to give back. More importantly, my children need to have a religious foundation. I am embarrassed at the fact that they know nothing about religion.

10. Balance all that stuff
I was talking to my personal trainer after she sort-of fired me. I won't say she truly fired me, I just had a lot of at home catastrophe at the time (broken fridge, bad grades, broken heart...etc.) and she wanted me to resolve some of my at home stuff and resume training at a later time. Now, I was supposed to be continuing to go to the gym every Tuesday, Thursday and Saturday. I haven't been going because school had just gotten out of control and I needed to get things back in control. After I missed the first day or two she called me, and I explained what was going on. She told me not to let school take over, and of course I did. But this must not happen anymore. When I was working on my undergrad, I didn't watch TV, do anything not related to school. I didn't even visit family or friends. This can no longer happen. Life is too short, and I wanna have some fun!

DiVa...Have a Great '08!