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A weekend of firsts...

My weekend started off on a Saturday. I had Friday off so I knew I would be getting a whole new team of patients. I get my team and begin to look my patients up and realize I am starting the shift with an empty room! Only three patients to start my day WOOO! 

I go out to the floor to print my papers for my shift and I hear night shift talking about this patient in the ED with all these incomplete orders. The nurses are calling down to the ED to get information. It sounds like I train wreck. Well, having only three patients is too good to be true, that trainwreck is going into my empty room! The charge nurse tells me to let her know when the patient comes up so she can help me. 

The patient comes up at 0700! I haven't even gotten a report on my other patients! We get the patient settled in, check her labs and find out, she should have been sent to the ICU. We call the doctor and the rapid response nurse comes up to check out the patient. [Rapid Response is one or two nurses who come when your patient has any sort of major change]. This patient had an insulin drip going with titration orders and Q1h blood sugar checks. Luckily we did get it turned around.

My second new experience happened on Sunday. During my morning rounds/ medication pass, I notice one of my patients seems different. I met the patient the day before and he did not look the same. When I first walked into the room he was talking to me but not making sense and he slowly became more lethargic. All vitals were stable so I was really not sure what to do and of course, the charge nurse was at bed huddle so I grabbed a senior nurse to come to check out the situation. The patient had ZERO response to all painful stimuli! I paged rapid response and paged the doctor! Got a set of ABG’s- Normal, Blood glucose- Normal, STAT head CT- Normal. At this point, we were thinking it was psych related. I tried the ammonia capsules- nothing. About three hours later the family came in and he began speaking to them. It was the strangest thing I’d ever seen.

I surprised myself this weekend. My first crazy ED admission and my first rapid response. I was able to keep calm and voice my concerns. I had SO MUCH support and I am so grateful to be on a floor where the senior nurses are caring and ready to teach.

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Update

I’ve been on my own as an RN for two months now. The past two weeks have been challenging for me, as I have had a vent/trach patient on my team each shift. We are supposed to only have two other patients with a vent/trach patient but we don’t have the staff to accommodate that rule. I don’t exactly feel comfortable doing trach care. Taking them off the vent for like 10 seconds to remove the cannula and put a new one in is terrifying. I guess the more you do it the more comfortable you get. I’m trying. 

The holidays are also here. Silly me I thought it would slow down during the holidays. Turns out that people just get crazier. Our unit has been feeling more like a psych unit. We had 3 sitter cases and have been on lockdown the past two weeks. Our ED has had to close twice due to overflow and low staff. 

Now I have five days off. WOO! I need it. Time to reset and refresh. 

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Nervous wreck.

I’ve always been a worrier. I worry about anything and everything. Having someone’s life in my hands takes worrying to another level.

As I’m settling into my new career, I’m starting to see how being a nurse is taking a toll on my body and my mental health. 

It started with having a tight chest after work. I felt like I couldn’t breathe. I just ignored it, went home took a shower to wash my day off and went to sleep. Except, I never really sleep before or after work nights. Instead, I replay my day over and think about all the other things my patients could have had or what else I could have done for them.

More recently, I’ve been getting an upset stomach before work. I feel like a kid before the first day of school. The stress of this job is going to cause me a stomach ulcer. Is it worth it? Does it get better? Are the stress and fear what makes me a good/cautious nurse?

I don’t know the answers to those questions. All I know is that I will continue to take time for myself in order to fill my cup back up so I am able to give.

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Another work week done. I worked October 30&31. Happy Halloween to me. It was a crazy two days. I had my first trach/vent patient on my own along with four other patients. On my unit when you have a trach/vent you are supposed to only have a total of three patients. Unfortunately we don’t have enough staff for that. I was caught up all day but could feel the pressure from my patients and their families.

I also worked the weekend. I had my first “not so stable” patient. I thought we were going to have to intubate and send to the ICU. With a lot of help from my charge nurse and the physicians the patient remained on my unit and was doing a bit better. This weekend was also the first time i didn’t have to chart on my lunch break. Woohoo!

I will never be a perfect nurse but I will always be a caring nurse.

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Self Care

Hello nurses! 

Going to work every day is tiring, but going to work every day to care for people is even more exhausting. I love my patients (yes- even the rude, grumpy ones)and I am always trying to provide them with the best nursing care. 

Being a nurse is hard, energy-draining, and stressful! You go in one room and get your head chewed off then go to the next and get called an angel. Your other patient down the hall has told you the same story 40 times and the other one thinks they are staying at a 5-star hotel and you're their assigned servant. It sucks but we stand there and get yelled at, we listen to that story again, and we serve our patient to their liking because we are givers.

The basis of this little note here is to remind you to care for yourself. Serve yourself the way you serve your patients. Let yourself feel your emotions. Find your way to decompress.

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FOUR DAYS OFF!!

I worked the weekend (Friday, Saturday, and Sunday), had Monday off then worked Tuesday, Wednesday, and Thursday! I am exhausted!

I have always liked working for the weekend. Fewer people are running around the unit which is helpful because it means less distraction. The downside of working a weekend is short staffing. Turns out even though we are required to work every other weekend, everyone would rather call off.

A little bit about how my work week went. The first day of work is usually the hardest because you are meeting your patients for the first time. On the second day, you can anticipate their needs and be more on top of everything. 

Friday was my first day of the weekend and it was rough! I didn’t have time to take lunch and was playing catch up all day. I’m not sure what I could have done to make the day go by better ( I did feel better when I had noticed that no other nurse on my unit had gone back to the break room- it must have just been one of those days). The rest of the weekend went smooth.

It's weird how patients come in waves. For example, you don't see something for months then all of a sudden you have all the same patient for a week. My patient of the week was psych. I had three or four psych patients. (I am on a surgical floor and we have been getting a lot of overflow lately). I don’t mind psych patients but as a new grad, it is hard to work with some of these patients. In nursing school, we learn all these therapeutic communication techniques but I am not a master at using them. 

I am not a confrontational person, especially when it comes to patients who are often really sick. I just want to be there to listen and care for them. So with that being said when a patient starts yelling at me and cussing at me because I am unable to give them something without a doctor's order I shut down. I didn’t know what to say to get myself out of the situation except for let me get the charge nurse. I later found out about her psych history and previous behaviors, but it was too late I had hurt feelings and also felt like I was unable to handle my patients on my own. Long story short, the charge nurse was unable to reach this patient and the manager had to step in. 

So after a crazy past week at work, I have the next four days off and I can not wait to relax and re-energize myself <3 

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I needed this. I hope it helps you too.

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What did I learn in 4 years?

I’m finally off of orientation! Four years of nursing school and what do I have to show for it? I can take a manual blood pressure (which I will second guess). I can pass medications (but do I actually know what I'm giving? Do I really have time to look up 40 medications before 8am when they are due?). Being a nurse is SO much harder than I thought it would be. I thought well I’m good at talking to patients and making them feel cared for. You feel like well I have 12 hours to get this done but nothing goes as planned. As soon as you have a plan something else needs to be done first. I can call a doctor but I can’t remember all the questions I’m supposed to ask. Did nursing school really teach me how to critically think? I feel like I have so many tasks to do I don't even have time to think! I’ve heard it gets easier, I am just counting down the days until it does!

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New Grad RN

So I started this page as a place to keep my thoughts as I start my new career as a new grad nurse. This will be my place to decompress my thoughts from my work weeks and eventually see a progression (hopefully)!