today's highlights

earning the wide-spread reputation of The Evil Nurse

being asked if i'm the Head Nurse because everyone else seems to defer to me

free butterscotch pudding

having a patient stroke my face

being offered a part in the summer shakespeare production (based solely on my reputation?! and without anything resembling an audition)

the price of whine

work was good.
then hectic.
then painfully slow.
then insane.

last week i was whining about how long i had to work there before they'd give me a mailbox/cubbyhole like everyone else. i got one 2 hours later.

today i was whining about how i dont get any mail in my mail box but a piece of paper i put in there so my box wouldnt be empty. i came back from lunch to find not one, not two, but THREE letters for me in my mailbox. it was like warm fuzzies. it was like Camp love notes. There were stickers! And Official Mailbox Secret Initiation notes from the LPN students.

and we had a cookie taste-test.
and i made us all tea.

and then everyone suddenly turned really sick. but you cant have it all go swimmingly along all the time, now can you?!

Dr. T tried to convince me to do a procedure for him. No way, josé. He tried to make me do one for him during my second week at the hospital. And then he kept whining. Finally i said to him "why are you so whiny today? suck it up. act like a man. and do your job."
the ER nurse said he was looking for sympathy.
i told the doctor "you arent going to find it here. i'm the mean one. i'll give you 2 minutes to read the procedure, get organized, then i'm coming back and we're doing it." Sometimes you just have to be firm with them. Like with children.
He looks like shit. I told him he looked awful. He does. He took all 3 ER shifts today and tonight. I think he's avoiding his family.

then they will put on the lights and the sirens

this is how my day was supposed to go: wake up early in prep for dayshift tomorrow, lounge about reading, go to the grocery store, go to crafts day, go to the library, do some cooking to take to work for lunches and dinners this week, watch tv, go to bed early.

this is how today went:

0625. the phone rings. i am already awake but looking for motivation to stay awake so i can sleep early tonight (going to bed at 2am before a dayshift is not good).

me: hello?
person: oh hi its so-and-so from scheduling. would you like to work 4 hours of overtime this morning?
me: uh... at 0700?
person: yes.
me: so, in like 30mins?
person: yes.
me: ok.

i have 15mins to get out the door for work. this includes an absolutely necessary shower, dressing, and breakfast. i agreed to the shift because i knew the LPN students were in so they'd have my patients, its OVERTIME, it would keep me from going back to sleep, and i would be done early enough for crafts day and grocery shopping.
i had a considerably smaller breakfast than i usually do but i wasnt worried because it was only 4 hrs and i could have a yogurt on my coffee break.

i get to work. my boss strongly encourages me to apply for her old position.
i'm on surgical side (no cardiacs! woohoo!). the students have all my patients. my boss gives me the maternity patient. argh! no panic! i'll just read the chart and ask her for help on running a non-stress test and interpreting fetal heart rhythms...

my patient is a minor, its her first pregnancy, she's 30 weeks along, with possible rupture of membranes (her "water" may have broken). great.
she was supposed to be flown out last night but the air ambulance couldnt land. the plane was coming back this morning to send her to kamloops. i only had to keep her stable for 3 hours, tops.

my boss showed me the monitor. the baby doctor came in for a report and took her off the monitor (phew. i dont know how to read that thing anyways) and said i didnt need to take another printout from it before she left. good good.

i'm waiting for the ambulance.
the RN that's supposed to take over for me after 4 hours calls to say she's running behind and i'll need to stay 5 hrs. this is ok because Dr. Bushman was going to do a thoracentesis (poke a hole into the chest to remove fluids) on one of the patients i was supervising (the students did all the direct care except IVs) at lunchtime so if i stayed 5 hours i would get to see it. this could be a good day!

the air ambulance doesnt show up.
i'm getting antsy for my coffee break but i dont want to go until my patient is shipped out.
i call them and they are in the process of landing at the town airport and will arrive at the hospital in 15mins. sweet! i get my patient all ready. our local ambulance team shows up. the plane didnt land in town. they landed in The City and now we have to send the patient by road ambulance on an hour and a half trip down a very bumpy road.

road ambulance girl (rag): does she need a nurse escort?
me: oh, i dont know. i'll ask my boss.

me: hey boss, does she need a nurse escort to go to The City?
boss: i dont know. best call the doctor and ask her.

me: hello doctor. the plane didnt land in town so we have to send your patient up by ambulance to The City. Do you want a nurse escort?
doctor: has she had any cramping or contractions or tightening or pressure?
me: no.
doctor: who's the crew? is it one of ours or is it from The City?
me: its one of ours.
doctor: do they feel comfortable taking her all the way to The City themselves?
me: uh....
doctor: would you like me to speak with them?
me: YES!

RAG doesnt feel comfortable taking a 30week maternity patient down a bumpy road without a nurse. many a thing has happened because of the length and severity of the bumpy road.
The doctor suggests an ambulance from The City meet them halfway with the special Baby Team. The local crew say ok.

my boss says i can go too since they are only going halfway and since the patient is pretty stable and since i've never been on an ambulance transfer and this would be a good one to go on for a bit of an idea of what to expect if i am ever required to go on one.

me: really? i can go?
boss: yes. i'll just get you the Disaster Bag...
me: WHAT?!?!?!?!?!?
boss: ha ha! i knew you'd say that. i was just kidding.

and then she got out the Disaster Bag. Officially its the "infant emergency transfer bag" but essentially its in case a disaster happens along the way.

me: hey boss, what should i watch for? what could possibly happen on a 90-min drive?
boss: she goes into labour and you have to deliver the baby at the side of the road.
me: oh.
boss: i'll pack the Doppler too so you can listen to the fetal heart rate.

and then she told me what to do if she starts going into pre-labour.
and how to deliver a baby.
and they will put on the lights and the sirens.

i figure, no problem. i know what could happen. i know what to do. we're only going halfway to town. and i have extra hands because one of the LPN students is coming along to observe.

we load the patient into the ambulance.
we all climb in.
their radio goes off and Dispatch tells them they've cancelled The City ambulance that was to meet them halfway with the Baby Team since they now have a nurse with them. whoa. surely they'll tell them we still need the Baby Team. I'm not a maternity nurse. I've never been in an ambulance before. But no. They close the doors and we pull out.

RAG: so we're going all the way to The City.
me: will you bring me home? i dont have any money (if it isnt the local ambulance, they dont always bring you home and then you are stuck in The City or on the other side of The Pass or in another province because who brings money to work with them when there is nothing to buy at or around the hospital?)
RAG: ok.
me: does the hospital know i am going all the way to The City?
RAG: hey! RAB (road ambulance boy)! Tell the nurses station that we're going to The City.

we made it to The City. No one puked (i was starting to feel green though. combination lack of sleep, insufficient breakfast, no coffee break, no lunch, and sitting sideways). The patient remained calm and uneventful. they loaded her on the plane, we watched them take off, and headed for home.

one of the most important duties of an RN who goes on an ambulance transfer to The City is that she must bring back Timbits for the nurses. AHHHHHHH! I DONT HAVE ANY MONEY. I'm the most juniour RN on staff. The most inexperienced. There was no way they would have ever sent me on an ambulance transfer so i never packed emergency money.

luckily RAB is a nice guy and he bought Timbits for us to give to the nurses back at the hospital.

i was sitting in the back chatting to the LPN when suddenly, i felt positively vile. i had a sudden flashback to Christmas 2002 (the awful spanokopita food poisoning incident). i think i am going to puke. i was so embarassed. i didnt want to puke. especially in the back of the ambulance on my first transfer. its ok if its the middle of the winter and your an 8-month pregnant RN who's tranferring a patient. but i'm not. the LPN passed me the barf container and switched seats with me.
no puking.

i got back to work and reported in to my boss.

boss: do you hate me?
me: what? why? boss.... why should i hate you?
boss: i stressed to them that you were a nurse with not a lot of experience but they insisted on cancelling the Baby Team's ambulance. when i heard them say you were going to go all the way to The City i thought you would hate me.

ha! the patient didnt crash. i didnt puke. i've experienced my first ambulance ride-along. i got 7 hours of overtime. why be mad?

gee thanks

this is how i started off my shift:
as i was heading to work, a boy on the street yelled across to me that i was ugly.

naturally i showed up feeling fabulous about myself. especially remembering the whole stupid junior nurse thing.

and there was a locum on last night (a doctor from out of town who was working here. one night only) and she was super nice and friendly and i just felt like a big dork. Especially because she would ask me all these questions about my patients that i couldnt answer because they were new to me that night and there wasnt any history on them and the report from the previous shift was shoddy and i cant read into the rationale behind the messed up orders of other doctors.

but my patient who was essentially comatose last i saw her, said HELLO BEAUTIFUL, HELLO GORGEOUS, HELLO SEXY every time i entered her room.

.... rant??...

it started out ok.

"JV, do you want to go work down in emerg with betsy?"

Yes!

"JV, can you assist me with this procedure?"

Yes!
I assisted Dr. Chicken Legs with a surgical procedure. A minor one. I got to hold the ear while he cut part of it off, including the cartilage. And he was in a good mood and explained it all to me. I still cant always understand him for his foreign accent and porn moustache.

And i gave lots of kids stickers and then they all loved me.

And then Dr. Bushman said he was sending over a patient from his office for a test that he figured was negative and to send him back if it was. We treated him immediately but not as seriously as we should have since Dr. Bushman had only ordered a minimal of tests. Turns out the guy had been having chest pain for over 24hrs and had had a major heart attack and we needed to thrombolyze him which meant he had to be moved STAT to the ICU room and be specialed by a nurse.

"JV, they want you to go special the patient being thrombolyzed"

Are you kidding? Me? What?

"well, it would be good for you to watch. And your old mentor will second you."

So i went. And it was ok. And i wasnt scared. And i asked lots of questions. And was a dork because of it, i'm sure. And asked for help. And my patient was alive when i had left.

And i left 4 hours late (alright overtime! boo 16 hour day!) because they couldnt find an extra staff member who could come in and be the Special Nurse for nightshift. And since i was planning to stay up all night tonight as i switch to nightshift tomorrow night, i said i would stay until 2300. The unit clerk gave me lime sherbert for dinner.

Only

the thing is

other nurses kept asking me how i felt being the ICU nurse and specialing him. it seems some of them thought i should have refused to do it. apparently because i am a JUNIOR NURSE i should have said no and made my old mentor do it and taken over her entire patient load. but apparently i'm not supposed to feel bad about it and its not a question of me not being a good nurse but i shouldnt let them push me into i because my license isnt worth it.

Ok. They want me to work in emerg. I shouldnt work in emerg because i'm a Junior Nurse and dont know what they do and dont have the same experience and skills that they do. But if i dont go down there and experience things, how am i ever to be able to do them?

If i dont learn about specialing, how am i to be able to do it when i am no longer a Jr. Nurse?

I feel stupid because of all the mistakes i made today. I feel stupid for being a Junior Nurse. I feel stupid for not saying no to specialing. I feel stupid for being really argumentative with the new Doctor today (but i thought he was wrong and being a jerk about it and he friggin wouldnt make a decision. MAKE A GODDAMN DECISION. YOU'RE THE DOCTOR. YOU GIVE THE ORDERS. NOT THE NURSES. i shall not look into your eyes. you shall not distract me with your inebriating blue eyes.). I feel stupid for being too tired to figure out if i am upset or not about being a Jr. Nurse and specialing and doing things wrong and not knowing things.

fresh meat

there's a new doctor in town!

he started tonight.

i was the first nurse to meet him. i told him to be nice to the nurses and learn their names. he can stay since he was ok with that and he brought cookies.

i also like him because he doesnt tower over me like the other doctors. in fact, i may just be taller than him. and i'm not afraid to tell him what to do. but i'm a little embarassed to admit that i actually caught myself checking out his butt. i couldnt help it! it was in my way! it was at eye level! i think it's been a long day.

apparently he only works tonight and tomorrow and the he goes back to some other ER hole. maybe we can wow him into coming back. this would be good as there is talk of the doctors withdrawing their services from the ER.

speaking of ER, yours truly was in the ER all day today. The LPN students were here again today and since i had sent out my one patient yesterday, i had zero of my own. They were short an RN in emerg so i went to help out. and never made it back. Dr. Chicken Legs and i were in an argument over whether the ER was busy or steady. He said steady but he doesnt do all the stuff we do. Doctors! Geez!

but it was a really great shift. There was an LPN in emerg with us so for once i wasnt the least knowledgeable person there. and i'm starting to learn where things are. and 2 of the doctors were really good at teaching me things today. and Dr. Bushman, who can be a strange strange man, didnt scare me. The LPN student told him he scared her. He asked me if i was stressed and i said no, but are you going to make me stressed? He promised he wouldnt. Great. And then i was mean to him. and i had to yell at him to focus. it was a fun time. seriously.

and there was cake! it was the birthday of the other ER nurse. mmm free cake!

tomorrow i am back on the ward. when i left tonight we were in the process of admitting patient #22. We are a maxiumum 20 bed facility.... hmm... 20 beds... 22 patients...
and there are no students tomorrow. I shall have at least 10 patients. I am highly skeptical that tomorrow will be a great day.

nine minus eight

one!

ONE ONE ONE ONE ONE!

The LPN students took 8 of my patients today. That left me, most gratefully, with one whole patient. And boy, was he a cutie! He was a 6 month-old who was the size of a 2 or 3 month old. He was in isolation (and in the hospital) because his scar from the open heart surgery he had in edmonton (for tetralogy of fallot, for those who want to know more) was infected. We hung out while his momma was in the shower. It was the best!

He started fussing while i was changing his sleeper so i picked him up and was trying to lull him into complacency when the Dr. stuck his head in and said to me "you have to get a husband first" and then left again. Freak! He just came back from holidays. I think he must have gone camping because he clearly hasnt shaved in several days and his looming tallness and hairyness makes him look like an urban bushman/sasquatch relative (henchforth he shall be Dr. Bushman). I think we are in sasquatch country...

My baby was sent back out to edmonton by air ambulance. AIR AMBULANCE. Finally, i can meet a Dave. Or so i thought. Apparently all the air ambulance guys are named Dave and are easy on the eyes. The one i met was not named Dave and he didnt exactly fit that description. Nice enough fellow though.

EUREEKA!

i would like to have been able to report that i found the missing box of nails. i have not. In fact, i have put it down for dead and finally gave in to buying another box.
i went to the crazy tropical general store to buy some nails... and they gave them to me for free! sweet! free nails! and they arent even rusty!

Small Town Trees

During some recent walks about town, i have come across a few things which i found fascinating.

#1) walnut tree.

I'm not ashamed to admit that i didnt know that walnuts grew on trees. I've never know anyone with a walnut tree. I figured they grew on a mysterious shubbery-plant thing like peanuts. I cant wait for it to come into season so i can marvel at it!

#2) people tree

Yes, there is a tree with people on it. Lots and lots of people dangling eerily from the branches. I of course had to make this discovery when it was dark and i was on the wrong side of the tracks, behind the brewery, quasi-lost.

Its a good thing it was Dr. Chicken Legs...

i picked up a nightshift last night. i thought it would be ok because when i left in the morning yesterday, we had a good census (low number of patients) and some of them were scheduled to go home. And my friend C-A was the LPN on duty and i hadnt worked with her in forever and she plays games with me so we were both excited.
i forgot about the friday factor.
there always seems to be a whole whack load of admissions on fridays during the day. its extra work because pharmacy is gone so they dont have their own meds poured and we have to be the pharmacist and there arent regular Dr rounds in the morning so everything is messy and make-do.
my side of the ward wasnt full but it was full enough. and i had a patient in isolation. such an inconvenience. and things kept coming up (like the incubator for the premie with jaundice kept alarming) so it was 10pm before i had given my 8pm meds. and one of my patients wouldnt come out of the bathroom.
but we were managing.

and then.
a nurse called from home to say she heard an ambulance go screaming past her house. this is not a good sign.
and then the ER nurse called down to ask the other RN for backup because the ambulance was bringing in an MVA (motor vehical accident).
and that left me with the whole ward. i hate when this happens. especially when there are people with bad hearts.
but we were managing.

the RN came back from ER after a rather short time and i started grilling her for info. i'd never had an MVA or any sort of trauma patient come in before. why dont you go down and look? she said.
friday nights are extra paper work nights and i was far behind. but all my patients were in bed and medicated so i passed them off to C-A and went to see my first MVA!
I've come to help, i said.
Great! The RN put me to work right away. Besides the MVA, she had a lady with a possible broken leg and the doctor, Dr. Chicken Legs, was in the process of draining blood from around her knee. i was a little sad that i had missed it. I always miss the cool things, like the night before when the doctor pulled a piece of metal out of someone's eye.
but then i got to assist with the MVA and that was very educational because he had a severely dislocated elbow and Dr. C-L used this crazy contraption from the OR to freeze his arm and then he pulled it back into place!
It was a good thing it was Dr. C-L last night because things got busier and he's a pretty calm guy (unlike the Dr. on dayshift who's highstrung and admits everyone. Because of him i had a patient in with a slight fever!! Who does that?!) and he's very resourceful and he was in a teaching mood so he patiently explained to me the different layers visible in the MVA's head laceration as he sutured it up. And that was cool. And very nice of him. I didnt like when he kept asking me to get him things. It was nice that he knows my name and doesnt ignore me because i'm the newest nurse, but not nice because i dont know where anything is in the trauma room. i've never been in there before. i dont know what he means when he says he wants some 2%. you want some milk? or when he says he wants some 2% without. Without what? But my mentor says this is how you learn. and she's right. i should be grateful. he never yelled at me or lost his patience and i did experience quite a lot.
The MVA was a drunk driver. I had no sympathy for him or his injuries. Does this make me a bad nurse? The ER nurse says no. I'd like to agree. I mean, i'll still treat him to the best of my abilities but there will always be a little part of me thinking that he brought it upon himself. Maybe the loss of his finger will be a motivator to clean up.

A momma called to warn us that she was bringing in her 5 month-old with breathing problems. She's all yours, the ER nurse said. (she doesnt like babies). The baby was super sweet and she seemed to be breathing ok to me. I liked that it was my responsibility to triage her. And the next child that came in. He sliced open his finger trying to cut a mango by himself. He wasnt supposed to be using knives alone. After seeing his finger wide open, i think he'll think twice about doing things without parental supervision.

I never realized that the ER nurse didnt like the ER. She had always seemed like a very competent and capable individual to me. Mind you, she also gets rather anxious. And doesnt like babies. She wont touch them at all. Categorically refuses. And bloody things like gaping head wounds make her ill. But she doesnt like the ER. And neither do i (come on! I've only been an RN for a week and a half! Does it really seem like a good idea to stick me in my obivious green-ness out there?! Critical thinking, people!).
But we managed.
Essentially what neither of us like about the ER is that they stick you out there ALL. BY. YOUR. SELF. And this just seems like a really bad idea, no matter how skilled you are. But since i was there, that made two nurses in the ER so it ended up being ok. And she didnt baby me. She trusted me to attend to new patients as they walked in and trusted my judgment to ask for help when needed. And she's right. I can do that. I dont need her supervision for someone coming in for a pre-scheduled IV antibiotic treatment. I do those all the time on the ward independently.

i returned to the ward and my paperwork several hours later. i was tired and headachy from dehydration and low glucose. but i was excited for all the new things i had experienced and the patience of my colleagues.

it was 2am. the doctor had just gone home. C-A informed me that one of my patients wanted a sleeping pill. I am not calling a doctor at 2am for a sleeping pill. no. no. no. But the other ward RN had just called him about insulin and told me he was still awake. i gave in and paged him.

Dr: yes?
me: oh hello doctor. are you sleeping?
Dr: no
me: oh good. can we get a sleeping pill for my patient in with pneumonia? (actually, this was the patient that was admitted with a fever. Its beause Dr.A.P had been on. The "a" is for admission.)
Dr: no.
me: NO?
Dr: fine. What's he like? Is he a big man? A little man?
me: uh... well... (shoot! shoot! shoot! how do i describe someone i've seen once briefly several hours ago and i'm too tired to think of how to even spell my own name?) well, he is shorter than you, but wider than you!
RN standing behind me: ha ha ha ha ha!
Dr: tell her i heard that! ha ha ha!

it became the best joke of the night. He's shorter than you, but wider than you!

and then i did all my paperwork and C-A and i played crib. she cheated.

you know it has been a busy night when you go home and then have strange anxiety dreams that you are still at work.

the way it should go

last night was an nice example of how nightshifts should go:

- patients were all in bed by 2130

- no one puked

- no one coded

- no one was admitted overnight

- the doctor on call actually slept in the On Call room instead of trying to go home in between calls (maybe he was in a tiff with his wife. he's strange man. he was sleeping on the floor when i went to wake him up about a patient in the longterm care facility with chest pain)

- i went down to the LTC facility in the basement to assess a patient in the middle of the night. Isnt that a doctor's job? Med school?

- we spent several hours doing a math puzzle (it was fun and i did mine all by myself, unlike my one coworker who copied off the other RN) all the while holding the gassy baby. go us! multitasking in cool ways!

- i got to hold the gassy baby!

- he farted so loudly when i was holding him that apparently i blushed!

- lime sherbert!

Confession II/Things I Think About Lately

med school

houses

babies

scary things

this morning i was making breakfast. (that is not the scary part). i cracked the egg into the pan and turned to the sink to wash my hands. but i espied something as i was turning and it made me pause. i turned back around. and screamed.

dangling from the middle of the ceiling was a spider. he was either going for my head or he was suicidal and aiming for the hot frypan.

later i was sitting in the art room, minding my own business when suddenly i felt like going jogging. so i went. i put on some shorts. hey, if Dr. Chicken Legs can do it, so can i. Dont worry. I wore my blindingly white runners to detract attention from my legs so sexy.

i returned from my random exercise excursion and decided to satisfy my orange craving. i had one innoncent-looking orange. i sliced it into small, attractive wedges and sat down to enjoy them. the first one was tasty enough. as i was about to grab the second piece and eat it sight unseen, i stopped and looked at it. something was not right.
something was very wrong.
disgustingly wrong.
the inside of one end of the wedge looked like baby spit up (that chunky oatmeal-esque regurgitation). ewwwwww!

lions and tigers and bears, oh my?

the day proved sunny yet again today so i set off on a new adventure.
there is this road a few blocks away that winds up into one of the mountains. i was excited to follow it to the end today. i packed some provisions (a scarf, mittens, first aid kit - no bouillon cubes, water, powerbar, and gummiebears) and set out.

the walk was nice.
though everything is rather brown and grey/gray right now.
the paved road turned to dirt.
oooo things should get good now, i thought.

there was this huge white display of excessive wealth hidden up the side of the mountain. i wondered who lived there because the house was so different from the other types in town.
and then the road ended.
private drive.
no trespassers.
drats.

i turned around and headed back down the road to home.
a little disappointed that the road was so uneventful. it didnt even curve.
one straight prairie-like road.
but things got interesting on the way home.
no, there were no lions.
there were no tigers.
there were no bears.
but there was a band of WILD TURKEYS!

turkeys are odd to watch.

i continued walking down the hill, distracted by thoughts of wild turkeys (do they attack?!) and avoiding breathing in the dust of passing vehicles, when i spied a man walking up the hill on the other side of the street. i stared at him a little. I couldnt tell if he was youngish or not. Or tallish or not (tall, married, incomprehensible?). Suddenly the man spoke.

Hello JV.

uh... hello.

how could he tell who i was from across the street? creepy. maybe i need better glasses. maybe all caucasians look the same to me.

it was Dr. L. He was coming back from a run. He asked if i was taking a break. Uh... yes? I'm standing in the middle of a road that goes nowhere in the middle of the day. From what am i taking a break? Did he think i was on a coffeebreak from the hospital? I'm not wearing scrubs. I'm in civilian garb. Why didnt i say i was catching some vitamin D?

I took a last look as he walked past and then i giggled all the way home. I know i shouldnt laugh at people, particularly their physical selves. But i just couldnt help it. It was a classic case of CHICKEN LEGS!
oh man oh man oh man!
Skinny, gangly, hairy, male chicken legs. In 80's style striped cut-off shorts! With bluish man socks. Why do socks look so funny on men when they wear shorts?

I know, i'm mean. Really, you dont need to tell me. But CHICKEN LEGS!!!!!!! Come on! Its so strange to see the chicken legs of a dresspant-wearing health care professional. I'm sure i'll get over it eventually.

Speaking of doctors, this is my beef with them. Well, its not really a beef but more of an awkward ambiguousness. What do i call them? If i'm approaching them at work with a question about a patient or calling them at home or the office, i'll call them Dr. So-and-So. But what about the in between times? If we're joking around or just passing in the hall or on the street, they all say "hello JV" but i never know what to do. Can i call them by their first name? They've never introduced themself by their first name. Or any other name. WHY DONT THEY TEACH US THESE THINGS IN SCHOOL?

the joys of saturday mornings free from obligation

in the early afternoon i went for a walk
down the hill,
across the highway,
past the grain bins,
and across the tracks
to the public library.

Usually i go back across the tracks,
past the grain bins,
and across the highway
and walk along it to the store.

today i decided to take a new way.
the long way.
and i was rewarded for my effort
i found the TRAILER PARK!!

PNS

Post Nightshift Syndrome.

That restless nauseated low tolerance high irritabilty state of being that occurs after working a nightshift and then only sleeping for 5 hours so that you can try to get back on a more traditional sleep schedule and not screw up your natural circadian rhythms too badly.

Last night was my first shift as a Real Nurse. It was also my first nightshift after an unusual stretch of nine day shifts.
My old mentor was working and decided to try to make it as interesting (read: challenging) as possible for me.
Thanks a lot.

The third nurse says it was my fault because i had declared at the begining that we were not going to have any deliveries.
I also said NO ADMISSIONS, NO BARFING, NO CODES.

At the start of the shift i was talking to Dr. T, the doctor on call for the night.
Me: Dr. T, are you stressed?
Dr.T: Yes. Are you stressed, JV?
Me: No.
Dr.T: Are you married?
Me: No.
Dr.T: Ah, well. I am married.
Me: Well Dr.T, that was your choice. You are going to have to learn to cope with the decisions you make.
Dr.T: Yes.
Me: And i shall die a Happy Spinster!
Dr.T: ha ha ha!

This is what happened.
Agatha the frustrating aggravating bell-ringing patient with dementia had been tranferred to the long-term care unit in the basement before the start of my shift. We were all relieved.
I didnt have the 5 cardiac patients i had had on sunday. Well, 2 of them were still with me but they were my sweet old ladies so its ok. I also had two extremely hard of hearing men with dementia who kept coming out into the hall and insisting that it was time to eat. (It is 4 o'clock in the morning. GO BACK TO BED.) So far not too bad. But there was still one more patient. He wasnt being Specialed. But he was still in the ICU room. We dont put people in there without really good reasons. Damn.
My mentor had a very nice woman come into the ER about to have her third child. We called in the Obstetrician On-Call who tried to convince Cranbrook to take her but they wouldnt so then we got to call in the OR staff and the back-up doctors for an emergency c-section.
The Third Nurse took care of the maternity patient and baby so while she was down in the OR and my Old Mentor was in Emerg, i was in charge of the whole ward. Great. It wasnt bad because we only had 11 patients instead of 20. But my patient in ICU was keeping me busy and i had to pee the whole time. Surgery never felt so long.

The mom and baby came out of surgery just fine and the Third Nurse took back her patients and i was left with my 2 cardiacs, my 2 patients with dementia, and a man in ICU.
I was so tired. That "its painful to be awake. its painful to not be horizontal" sort of tired. I spent the whole night praying that i wouldnt have to call a code. I would put my head down on the desk to rest and then jump up every time the cardiac monitor made the bad beeping sound. And that happened rather frequently. One of my ladies had a very low heartrate (in the 30's). My gentleman in ICU also was having a very low heartrate. And he was also having a low blood pressure. As part of the cardiac protocol, if the heartrate is below 50 (which it was) and the systolic BP is below 90 (which it was), atropine has to be given as a cardiac stimulant and a code has to be called.
Every time the bad beeping happened, i would look at the monitor to see if it was ICU man or Cardiac Lady and run into their room to see what they were doing. I was in and out of ICU all night. And every time my ICU man would open his eyes and say he felt fine and wasn't having any chest pain.
I called Dr.T at 3am (boy did he sound out of it) to tell him what was going on with ICU man. I really thought we should have been doing something. Like shipping him out someplace. The Dr wasn't that worried. My Old Mentor wasn't impressed. She made sure i charted everything the Dr said to cover my arse because she said he hadn't really been on the ball so far that night.

A short while later i put my head back down on the desk.
And jumped up when the bad beeping went off and the monitor said my ICU man was in ASYSTOLE! (flat lining).
Beat heart! Beat!
I ran into his room and stood over him.
Suddenly
He grabbed my hand, opened his eyes, and said "good morning".
Freaky.

The other problem with ICU man, besides his slow heart and low BP, was something called sinus pauses. He would have these pauses where heart beats normally would be but weren't. When the computer said that he was in asystole, it was because, technically, he had been. For 4.2 seconds. My ICU guy had a 4.2 second pause. The guy totally needs a pacemaker.
CAN WE PLEASE SHIP HIM OUT?!

In the morning, at the end of my long long shift, i went in to see how ICU man was doing. I was curious to see how he was feeling after being woken up randomly all night and having funny heart things happen.
He said he had an excellent sleep.

Legal

i look the part.

its funner than senior year.
(i think)
( i hope)

and now it's legal!

i am now legally allowed to use the titles "RN" and "registered nurse". I can wear them on a pin or sign them after my name. Finally! So tired of the blank stares when i say i'm a "GN".
Good. Nurse.
Good. Night.

sometimes its 130am and i'm doing the dishes.
and then "oh my love's like a red, red rose" jumps into my head.
is it in your head now?

i was reading my medical dictionary earlier tonight. I love that book. My old roomate in Edmonton and i used to always read them. We are so cool it hurts.
Anyways, i was looking up the correct spelling of "pruritus" (because everyone always says it puritus which makes me think of Puritans) and i came across the "Emperor of Pruritus" and i thought it was really funny.

pruritus means itching.

Emperor of Itching.

ha ha ha ha.

And then i read what the condition actually is and it wasnt funny any more.
And that's all i have to say.

la grande séduction

(seducing doctor lewis)

un bon film.

one and two and three and four ...and five?

i'm sitting down.
i'm eating pizza.
the pizza is really good. I made it yesterday. It was my first attempt at making pizza dough. i used ZM's yeast-free oregano crust and it is nice and easy. Added some spinach, specially spiced potatoes, tomatoes, havarti, and pine nuts and its yum-my.

i am reflecting on my day.

sunday is supposed to be Lazy Day.
there is only one doctor on call to do rounds for the whole hospital and ER.
no one seemed to understand that it was supposed to be mellow.

in retrospect, my day was awesome. i DIDNT have a 2 yearold girl with seizures or a 11-hour old baby with absence seizures who kept going cyanotic and was air-lifted to edmonton (still no meeting of Dave or Dave or even Dave).
all i had was five cardiac patients.

yes, FIVE.

and one Agatha non-stop-bell-ringer patient with Dementia.

i had more cardiac patients than we had cardiac monitors.
they beeped all day.
and were on crazy IV infusions.
and i'm not scared of them any more.
they were awesome.
and were all sad when i told them i was going home for the night and wouldnt be back til tuesday night.
and i did two IV starts. Bam! Bam! I nailed them!

the doctor on call today, Dr. G, was one i had met a few times but didnt really know because she's not on call that much due to health reasons. She was a hoot. Hoot! She started running down the hallway away from me. Or she'd yelp when she saw me and try to hide in a storage room. At one point, she came down to the unit and said "JV, i have a new patient for you. I'm going to be giving you a sick child. And there is another cardiac patient". Cardiacs are automatically mine because i was on the medical side of the hospital. And i looked at her and i said "No. You are not. I already have FIVE cardiacs and an Agatha (which she thought was really funny and a fair point) so you are just going to have to send them out some place. Besides, we dont have any more monitors for cardiac patients". Ha! I got her on that point.
I saw her a few hours later and she proudly announced that she had listened to me and the sick child had gotten sicker and was sent out by ambulance and the cardiac patient was sent out by ambulance and she had no new patients for me. Now wasnt that nice?!

And i got to bring home lemon pudding AND flowers!

And because there was a problem with my RN registration (they are slow mofos at processing) and they wont renew my temporary permit which expires tomorrow, i dont have to work tomorrow night now. So i can kick back and relax. Or go to band practice.

confession

i swoon for tall, incomprehensible, married men.

truth?

the reward for getting off work early

mini
cream
eggs