Monday, September 27, 2010


So last night when I was bored around 0400, I discovered that blogger has a "stats" section for your blog, which includes information on how people discover your page.

There's a section that says what website (mostly google) sent people here, but there's also a part that has what people searched for to find you.

Some of the things make sense:

"does full code mean you don't have an advance directive?"
"food in the lungs"
"can nurses wear converse"

Some of them are cute:

"never send a doctor to do a nurse's job"

But this one just plain baffles me:

"anaisthisia doctor porno"

.....bwah? I would really like to know what person googled that term and found me. I mean, I understand Rule 34 and all that, but who would look that up? Really?

I'll definitely be keeping an eye on my stats from now on... looking forward to future hilarity :)

Thursday, September 23, 2010

Time to compare and contrast!

So I've done 5 shifts on Mom/Baby so far. The first day I shadowed on the floor. The next two I was in the Well-Baby Nursery (shadowing/helping out). Fourth day I took one patient, and the fifth I took two.

So I feel like I'm getting the hang of this place.

The Good

-No more demented old men peeing on my shoes and then asking if I'd get in bed with them! The only poop I have to deal with is meconium, which comes in small amounts and has no smell. Bye bye CDiff!!

-Night shift is very chill. I thought it would be a real issue adjusting to the schedule, but so far so good. I've even got the start of a daily pattern. Get report, do vitals and assess, and then the first cup of coffee (3/4 coffee, 1/4 milk). Then chart and wait for something interesting to happen. Maybe give a pain med here or there. Remind moms to breastfeed, then take "dinner" around 0300 or so. Before 0400 I have my second coffee (1/4 coffee, 3/4 milk) just to keep me going. I've been warned that coffee after 0400 can be detrimental to sleeping when you get home. Then just sit around waiting for something to happen until 0600 pain meds. So far, so good :)

-Management actually cares! The NOC shift ANM comes around every couple hours to do a "wellness check" to make sure the nurses aren't drowning, and that people have gotten their breaks, and to see if anyone needs a hand. Sometimes the ANM did that on Tele, but it was more like, "Why is this med overdue? What's going on? What do you mean you haven't taken your break?" Very different approach lol...

-Management does things to make the unit better. Apparently the nurses were complaining about having to get snacks and ice water for patients, and it would be nice if the patients' families had access to the kitchen. For infection control purposes, the kitchen is code-locked. So the management brought it up with the Powers That Be and they are working on a "family snack station" so people can serve themselves. I didn't even know you *could* complain about having to get food for people. I spent at least an hour each shift running back and forth to the kitchen lol.

-High quality frozen yogurt at the staff meeting. Plus the meeting was interesting and interactive in an organic sort of way, not in the kind of way where your manager calls on you like you're a student and expects you to answer a question like you'd been paying attention. Apparently they do a 2-hour meeting every other month rather than a 1-hour meeting monthly. Saves on the boring lack of news. It went well enough that I didn't mind staying three hours past shift, and that's saying something.

The Bad

-The (perceived?) lack of autonomy. One of my patients had an order for Norco (5/325) q6h around the clock. Makes sense, s/p c-section. So I gave it. The nurse I was working with said "Oh no, you have to verify with the anaesthesiologist first. Look here:" and then showed me on the computer system, where the orders said "No narcotics via IV or IM route for 18 hours after Duramorph. Said nothing about PO. Plus the patient had a stronger PRN Norco (10/325) ordered by anaesthesiology, so obviously it's not contraindicated. Another example: if a patient on Tele has antibiotics ordered, but no continuous fluids running, we set up our own primary line so we can piggyback the various meds without having to start from scratch every time. Standard practice. When the med is done, we run saline long enough to flush the line and then disconnect. No biggy. One of the nurses I was working with actually called the doctor to get an order for a primary line at TKO so she could piggyback the med. If I did that on Tele, the doc would probably yell at me for wasting his/her time with a stupid question.

-Apparently the various medical teams (mainly OBGYN and Anaesthesia) don't talk to each other. One patient had three separate orders for PRN Norco (10/325). That's just *asking* for a mistake, people...

-No CNAs on NOCs (dunno about the other shifts) and there aren't enough dynamaps to go around. People stake them out before even getting report and then treat them like private property; I've seen names labeled on them! But that brings us back to "the good" and that the manager has ordered a few more machines.

The Weird

-People will bring their patients' babies into the nursery, and ask the nurse on duty there to do their assessment and charting on that baby. WTF? I can't even *imagine* asking someone to do that with an adult patient. The assessment is the cornerstone of nursing care, and passing it off to someone else just blows my mind. Vital signs and weight, sure. But I wanna *know* that my baby's lungs are clear and that he has normal heart sounds, not just take someone's word for it.

That's it for now, more stories to follow, I'm sure :)

Saturday, September 11, 2010

Movin' out....

I guess I should start from the beginning.

Once upon a time, Big Shiny Hospital decided that there were some problems with RN staffing, and having enough people at the right times of day. For example, our unit was mixed, having 8 hour and 12 hour nurses. That meant there were shift changes at 0700, 1500, 1900, and 2300. There were times of day where we were understaffed, and people were called in early, and other times where we were overstaffed and people were offered the chance to go home early (which I'd *always* accept lol).

This setup makes for confusion, and poor distribution of nursing resources. So they thought "Why not make everyone 12 hours?" The problem with this idea is that you don't need as many nurses when they work 12 hrs instead of 8, so jobs would be lost. Having the kick-ass Union we do, that was *not* going to happen. So they decided to turn all the units to 8 hrs only, with a couple exceptions like ICU.

Because of the 12 hr jobs going away, positions were being created all over the place. This was an opportunity for my escape.

There are three telemetry units in the hospital, and they decided that two of them would go to 8hrs and one (ours) would go to 12s only. As you are all aware, I wasn't thrilled about working that unit 8 hours, let alone going up to 12.

So I looked into my options. Couldn't go to L&D, because their training program is too long to qualify for a realignment transfer. But lo and behold, Mom/Baby had openings!

Happy people with babies? I'll take it!

They only had night shift (2300-0730) available, but really, I'd do anything to get out. So I put my name down on the list to bid for the job, positions being given by seniority. No one else wanted it, so....

The realignment was supposed to take effect mid-July, with people moving to their new positions then. Mama decided she didn't want to let me go, and got permission from the M/B manager to keep me around a little longer... Well, a lot longer.

Tonight was my last night on Telemetry. It was a pretty standard shift. Nothing notable. People told me they'd miss me, but the unit hadn't been the same since so many other people had already left for greener pastures. I'll miss everyone there, since most of the people were pretty darn cool. But ya gotta take an opportunity when it presents itself.

So here goes. New unit, new shift, new coworkers.... I imagine there will be many adventures to share with you.

I'll keep you all posted :)

Wednesday, September 8, 2010


So in order to transfer to mom/baby I had to get up to speed on the latest and greatest in postpartum information.

Apparently, this means three 8-hour days of watching VHS tapes on breastfeeding from 1994.... I watched more VHS tapes in the last 3 days than the last 3 years. I'm not a morning person to begin with, seeing as I work(ed) swing shift, so getting up at 0800 for a fun-filled day of video watching was nothing short of exhausting.

And I'm honestly not sure that I learned anything, except that the hospital cafes do have pretty decent food. (Yay for grilled portobello with couscous) I read so many nursing blogs and keep up on the latest news about maternity-related issues that I think I could've gotten away with watching maybe half the stuff they had me go through.

But now I am full of knowledge, and ready to hit the floor!

Monday, September 6, 2010

For those of you who were getting concerned....

No, I'm not dead and I haven't fallen off the face of the earth.

I have many half-blogs written, and ideas floating around my head. I just have trouble putting pen to paper (or fingers to keyboard, I suppose).

I've been accepted to transfer to Mom/Baby. I'm finally getting out of Hell. Only four shifts to go, and it's happy people with babies instead of old people dying slowly over many visits.

"I can't wait" doesn't *nearly* convey the excitement here.

I anticipate more stories to come... don't worry :)