orientation

I'm precepting tonight. Wow. This is horrible. Time management fail. I haven't been this overwhelmed since I was a new grad - it's like it's contagious. Sigh.

Yeah, it happens

I've read a thousand medical oriented blogs and I know a lot of people, so I generally know this happens.  It doesn't make it any less bizarre when it happens to me.

I had a patient that told the next shift's nurse, the next shift's charge, and my unit manager that I was "cold" and "Uncaring" and "didn't show empathy".  The kicker - this was my "easy" patient that night, and I did not have an ounce of trouble with her.  My other patient was insanely needy and constantly testing my nerves (is that OK to say? ).

I seriously have no idea what I said or what I did, because I feel like I had a great rapport with this lady.  We talked about how hard it is to be stuck in the ICU especially for someone who's young and active (this lady was a runner, and it sucked that she was going to be stuck there for almost another week for intense monitoring, but was not going to "feel" sick or deserving of an ICU bed, and I always feel horrible when that happens).  I talked her into accepting pain meds numerous times because it was helping her rest to do so, and she was otherwise lying awake whimpering in pain. 

I am not taking it personally or anything, but I feel like I can't figure out what I did or didn't do.  I keep replaying my interactions with this person and I can't make anything out.  I know this is common, but it kind of sucks when it happens anyway.

The night after, though (but before I was told about this patient's complaint) I cared for a young guy who had had an excruciatingly painful surgery.  Several times that night we kept needing to change his pain medications around to give him some semblance of control.  I felt awful because apparently pain service hadn't been able to come see him after his surgery and at the hospital, pain service is 9 to 5, so the pain control was left up to us bumbling nurses and neurosurgery residents (not that we're not good at it, but this was a complex case and this guy had been seen at the pain clinic on an outpatient basis before his surgery).  I apologized to him lots of times about the pain service issue and the fact that he wasn't getting decent pain control.  He told me at the end of the night I was the best nurse he had had ever in all his hospital experiences.  Which was awesome to hear, considering I was about to get ambushed for being a bitchy nurse to my other patient before.  So. weird.

The corollary to having nine days off in a row....

Is apparently nine or so days of utter and complete hell. 

Friday: work night shift 7p-7a

Saturday: work night shift 7p-7a

Sunday: Day "off" but weird one because I got home at 9 am

Monday: go to training for new job, 8a-4:30p

Tuesday: go to training for new job, 8a-4:30p

Wednesday: go to training for new job, 8a-4:30p

Thursday: go to training for new job, 8a-4:30p AND work night shift 7p-7a

Friday: work night shift 7p-7a

Saturday: work night shift 7p-7a

That's 92 hours of work in ... 8 days? 9 days?  Do I give a fuck anymore? 

Whatever.  Anyway, I have six hours left to go (whispering, so as not to tempt fate) and all I have to say to this week* is: Fuck you.  Don't let the door hit you on the way out.  Suck my left nut.  Got that? 

One other thing: Shout the fuck OUT to all of my family and friends. I fucking LOVE you people. I feel like every time I was about to lose my shit completely, I would get an awesome text from someone or someone would make me laugh really hard, which was so much needed. You all rock and you absolutely collectively saved my sanity this week. I owe you guys.

I've been completely climbing the walls.  I went from posting on facebook every 3.1 days to posting 8 times about dumb shit no one cares about - and what did you guys do?  You were awesome.  You kept liking and commenting on shit.  I texted all day incessantly about dumb shit no one cares about.  You not only replied, but totally put a smile on my face every time. 

For that, I think you're all awesome.  You know who you are.

Peace out, bitches, I'm going to bed.

*(And yes, I'm aware that I set this up myself. Completely, horribly stupidly aware of that)...

Weekly update? Yearly? Oh well...

So I've made it two years. Someone apparently thinks I'm good enough at this job that I should be allowed to teach the new grads. I hope it's someone who is familiar enough with my irreverant sense of humor that they don't get upset when I laugh at things I'm not supposed to laugh at.

I start a new job soon, but only PRN (defined as working at least 2 nights per month or so). It's in a unit that is VERY different and uses technologies and such that we never use on my ICU. I'm terrified because they only give us three nights of orientation. THREE nights.

I've transitioned to nights only. For a long time it was weekends only, (Friday, Saturday, Sunday nights) because I was homeschooling my kids for the year. Next month they go back to public school, and they are all excited and so am I. So now I'm sticking with nights only, but I get to be off more weekends! Hells yeah.

Part of this is because I can't stand the people who work day shift in my ICU. Part of it is that I do better at night - less people around, less management, more independence. So, a number of things.

I'm looking at starting a program next year for grad school if I can put away enough money from my PRN job. I'm planning to have them deposit my checks into an account I don't use that's not connected to my regular checking account. I really hope that works out for me and it's not just a stupid bullshit strategy. I feel like whenever I work overtime I just spend the extra money away as quickly as possible. The idea of never going to grad school in this is really scary and sad for me - but the idea of not having enough money to, you know, live on and send my kids to school - that freaks me out too. My oldest is going to be 14 next month, so it's not a faroff concern either.

Neurosurgical Intensive Care Unit

So, as you may have gathered from my silence, I didn't get an offer from new grad day. They called me back and explained that I didn't have a bachelor's degree and that's the tiebreaker they had to use because they had so few openings. Sigh.

So a few days later the department of nurse recruitment called me and asked me if I'd like to interview on the Neurosurgical ICU. Whoa. I had never thought of a critical care area as a new graduate, mainly because I was worried about not getting enough training since so many hospitals are so bottom-line oriented that they regularly give nurses too many patients and stop hiring nurses in a down economy. But this hospital's orientation seems to be top notch for this kind of department. I left the interview thinking I could really do it, and I loved the unit from what I saw.

I scheduled a time to shadow (today, later) and was offered the job!!! I asked for a few days to make up my mind and I am going to decide after shadowing - but I am 95 percent sure it's what I am going to do. I just want to give it the shadow time to make a thousand percent sure it's what I want. It's a 2 year commitment to the unit plus 6 months of orientation, which makes it a fairly significant decision. The schedule isn't completely what I wanted (4 days a week instead of 3 for the first year, but they have done research and found that new nurses achieve competency faster if they work 4 days a week as opposed to the typical nurse schedule of 3, for their first year). So it's for my own good for better training, etc, but it's more day care costs for us.

I loved it though - the high acuity, the types of patients, and I love the nurse manager I met with. We really seemed to get along.

I think I'm pretty sure I am going to do this. It's crazy that such a cool position just fell into my lap like this, it's been a good week!

Job applications, again.

I shadowed this past Wednesday at a pediatric hematology/oncology unit and I loved it and felt so at home on the unit. I stayed for 5 hours (even though the original shadow was only supposed to be 2 hours) because I wanted to see a stem cell transplant.

I love that place so much. I would kill to work there. It's too bad I don't have much of a chance - they are having budgetary issues and don't know how many people they will be able to actually hire. They should know by the end of the month.

Tomorrow I have an all day new-grad nurse hiring event. It's for a position on an adult oncology unit. They do say up front that they do 90 percent of their new grad hiring for the year at this one event, and many times people leave tomorrow's event with a job offer. I am cautiously hopeful about my chances. I am really lucky because I signed up when it was very early and I was able to get a spot. I know people who have called up and asked to register and were told there were 250 people on the waiting list for the event. I feel vaguely guilty because I am sure there are people on that waiting list more qualified than I am, but it was first come, first serve and I didn't cheat or anything, I just called them early.

All day in a boring business suit and pantyhose. Bleh. I am NOT looking forward to that part of things. And the uncomfortable shoes. :( Maybe I'll get an awesome job offer and it'll all be worth it. Stranger things have happened!

The first hospital (peds oncology) told me that if I got an offer before they had their budgetary info and really wanted to know what their position was about hiring me, before I accepted or declined the other offer - to call them and see what they would be able to tell me.

My scariest scenario right now is having to make the choice of one or the other of these places. I already know both units have almost near zero turnover and the nurses are so happy they stay on both units for years and years. So I know I wouldn't be unhappy either place. But the idea of having to make the decision between both these places makes me panicked just thinking about it. So right now, I am actually hoping at least one of them turns me down so I don't have to be in that position.

So, if I leave tomorrow with no offer in hand, it could well be a blessing in disguise. We'll see.

Oh, and the first test of the semester - I got a 90, even though I took the test with bronchitis and was afraid I'd gotten my first failing grade in nursing school ever. So I'm still good for this semester. I just have to not lose sight of school. It's hard to keep my focus with the job stuff going on.

So they did get my application. Clinical started again.

Remember when I said I was afraid to start normal (read: non-psych hospital) rotations again because I felt stagnating in Psych? Yeah, so. That happened, and good hell, I felt STUPID my first day back on a regular floor.

I did a few cool things like give an IV push med (in this particular instance, Lasix). As soon as I gave it I thought I should get her up to help her to the bathroom. Then I thought, nah, I'll give her until she is ready and she'll let me know. I should have known better, and so I had to clean up. A bunch of little things I was just STUPID about. LOL. We got out early and I am tireder than ever. We did get to chart on the computer, though, for the first time, which was cool.

I just wonder if I will ever feel competent in a nursing environment again. I am sad because reading some of my old posts, I was really starting to feel good at this whole gig, and today I walked out feeling 10 kinds of stupid, and 20 kinds of unemployable as a nurse.

Then on my way home from clinical, the hospital from the interview a couple of weeks ago called, and they wanted me to come shadow after all! Woo-hoo. So that helped me feel better today.

Whew. Hell of a week.

So I had my first nursing interview. After I left there, I felt awesome about it - I felt so much rapport with the people I talked to and one of the managers reminded me of my cousin and lived down the street from my high school, etc.

They won't know how many openings they have until at least Feb, maybe even March. So it'll be a longer process than I'd like.

And even though I felt awesome right afterward, the longer I get from the actual interview, the more things I can think of where I said something completely fucking stupid. Why is that always true? WTF?

They did also say that they're telling people that if they get another offer somewhere else and I want to know whether they would hire me or not, to call them. So if I do get an offer, I can see what they say. They are supposed to be calling me to schedule a day when I can go shadow someone on the unit. I really felt so at home there, and I'd love to work there, but I really still want to shadow to just get more information and talk to more people and reinforce my impressions if I can.

I also started clinical again. And class. And lab. I am not used to doing this many things at once again yet. I know I was good at it just a few months ago, but it feels very rusty right now.

So... job searching.

I have an interview next Wednesday. No one else in my program has been on any interviews yet so no one can give me any idea what the fuck they will be looking for. It's really early to be called for an interview, maybe they are just really into my resume and stuff.

It's at probably one of my top 2 choices in places I want to work - on a Hematology Oncology unit at a Children's Hospital. I am surprised they called me because I just drafted my resume and put it out there and I still feel like it sucks. But anyway, they called and I have an interview.

So I have a week to prepare/crash course/freak out. What do I doooooooo???