Well, I've finished my first week of orientation at the ER. It's been mostly computer modules as the Emergency Nurses Association recommends all ERs have the same orientation process. The first day we did a lot of the HR crap and I ended up with a new photo ID, plus a nice red lanyard with the hospital name and Emergency printed across it. This was basically the defining moment for me really. Something I can display in front of everyone saying, "Yes...I work in the ER."
I am ahead on all the modules since I'm missing a week of orientation due to my fantastic trip to New York for my @%th birthday. That way when I come back I can spend more time on the floor.
Which I did for the first time on Friday, in what they call...The Pit. Which is basically the lower acute areas AKA not requiring telemetry, even though all the rooms have monitors. It was great finally getting into things but I always have a hard time adjusting to the process of how things are done when it's so different from a med-surg unit. Also policies can be quite different not only because it's the ER but it's also a different hospital (though it's under the same jurisdiction so they SHOULD be the same). And to complicate things even more, the Pit of this section (there are two main sections both with a telemetry area and a Pit) was designed later on as it was converted from an old OR recovery space. Thus they asked OR nurses to help with the design, so it is a TERRIBLE ER space. It's effectively like two testicles, compact testicles, and patients get hidden behind others so you can't put really sick patients there. I'd also get maddeningly confused as to which testicle I was in. But that will come with time I'm sure.
I am itching to get back, mainly because I want to learn and become great at working there. I should enjoy my weekend though cause it's only two days off before five 8s in a row like most normal people.
Saturday, June 14, 2014
Sunday, June 8, 2014
The Night Before
Well this is my last day before I start my new job. Judging from the huge list of modules I think orientation is going to be quite long. Nothing but in class work for a couple weeks...yet I'm pretty excited.
I'm so happy to not have to wash my own scrubs anymore. That in itself is worth it! I am a bit nervous about the job but I think once I get into it more it'll be ok. It's also a new hospital and I don't know my way around it but then again I didn't know half of the old hospital either. I almost got lost trying to find ultrasound on the weekend with half the lights off.
Leaving my old job was a bit sad, and I know the other RN on my team felt a tad hurt. She's been having to be charge a lot since her last RN partner retired a year ago and she's been burning out. They didn't post the job until 6 months later and even then it's been a fiasco. Then here I come along and she's had some relief and then I go and take another job. I'm sure she is ok with it but I know there's a bit where she feels a little down.
On the other hand I'm a bit done with that unit and some of the bureaucracy the medicine units have to deal with. I'm sure there will be just as much of the same crap in the ER but it'll be different similar crap.
Well here's hoping I have more to write about later in the week!
I'm so happy to not have to wash my own scrubs anymore. That in itself is worth it! I am a bit nervous about the job but I think once I get into it more it'll be ok. It's also a new hospital and I don't know my way around it but then again I didn't know half of the old hospital either. I almost got lost trying to find ultrasound on the weekend with half the lights off.
Leaving my old job was a bit sad, and I know the other RN on my team felt a tad hurt. She's been having to be charge a lot since her last RN partner retired a year ago and she's been burning out. They didn't post the job until 6 months later and even then it's been a fiasco. Then here I come along and she's had some relief and then I go and take another job. I'm sure she is ok with it but I know there's a bit where she feels a little down.
On the other hand I'm a bit done with that unit and some of the bureaucracy the medicine units have to deal with. I'm sure there will be just as much of the same crap in the ER but it'll be different similar crap.
Well here's hoping I have more to write about later in the week!
Monday, June 2, 2014
Counting Down the Shifts
Well I did my last run of three twelve hour shifts at my current job over the weekend. I changed the assignment sheet on Friday so that I would get the undergraduate nursing employee who is orientating to the unit. We really didn't have a heavy patient load so I let her do everything. I find my biggest issue with new grads and students is that I don't have the patience when they are slow at doing initial assessments and vital signs. I do let them fall behind as it's important for them to recognize where they have to improve but it's hard for me to stand by and not get things done for them.
One of out patients is a recurrent ETOH cirrhosis guy who has Pickled Brain Syndrome, and unfortunately is MRSA/VRE positive but cannot understand the precautions he needs to take to leave his room. It's a constant source of tension among the staff because some people let him use the phone if he's properly attired and some people think he shouldn't be allowed to come anywhere near us.
This guy also has a history of AMA'ing though the current attending seems to think he becomes encephalopathic and we don't realize it and are way too eager to let him sign the form. So he had the patient sign a letter which his sister witnessed that says he is competent enough right now to know he shouldn't leave and we as staff are not to let him sign the waiver. I'm assuming that if he did try we would just call security and the team to have him formed but I can already see it becoming a huge deal down the road.
Either way this guy is a pain but it's part of the job right? Sadly I know I'll be dealing with many of his like in the ER but at least I won't have to deal with the same patient three days in a row.
Granted I was at the desk for Sat and Sun but his room is right across the hallway so he often brings his problems to me.
Anyway, the staff are all giving me a jokingly hard time for leaving though I know some of them really are a bit hurt about it. But I can't let it get to me, since I have to do what I feel is right for me.
One of out patients is a recurrent ETOH cirrhosis guy who has Pickled Brain Syndrome, and unfortunately is MRSA/VRE positive but cannot understand the precautions he needs to take to leave his room. It's a constant source of tension among the staff because some people let him use the phone if he's properly attired and some people think he shouldn't be allowed to come anywhere near us.
This guy also has a history of AMA'ing though the current attending seems to think he becomes encephalopathic and we don't realize it and are way too eager to let him sign the form. So he had the patient sign a letter which his sister witnessed that says he is competent enough right now to know he shouldn't leave and we as staff are not to let him sign the waiver. I'm assuming that if he did try we would just call security and the team to have him formed but I can already see it becoming a huge deal down the road.
Either way this guy is a pain but it's part of the job right? Sadly I know I'll be dealing with many of his like in the ER but at least I won't have to deal with the same patient three days in a row.
Granted I was at the desk for Sat and Sun but his room is right across the hallway so he often brings his problems to me.
Anyway, the staff are all giving me a jokingly hard time for leaving though I know some of them really are a bit hurt about it. But I can't let it get to me, since I have to do what I feel is right for me.
Thursday, May 29, 2014
Wednesday, May 28, 2014
This....is why everyone has VRE
When an isolation room is chock full of family members not wearing precautions
What to Look Forward To
In anticipation for my new job, I tend to be reminiscing about certain patients I had when I was in my final placement at Small Community Hospital. SCH was NOT a trauma centre so we didn't see a lot of craziness injuries, but it was the closest healthcare centre to some of the outlying burbs which were known for heavy partying.
#1 - A twenty-something dude came in with decreased LOC, probably a GCS of 8/15, was already intubated and high on god knows what. He was quickly taken to the Resuscitation Rooms just in case. We knew his name and that he was from "Province whose main language English was not" but otherwise nothing else. EMS stated his friends thought he was drunk and high on cocaine/THC. He was mostly stable but would spike his GCS and become alert enough to thrash and pull at his ETT so restraints were quickly fitted. To me it looked like he was regressing to a more primordial thought process as his primal self came through. Lucky me got to place my first OG tube, and foley the messed up yet "prime" specimen that was on the table.
This happened right at the beginning of my shift, and by the time I left 12 hours later he was alert and speaking in his dreamy Non-English Province accent. That was the first time I really saw the difference between completely corked out and normal in a patient.
#2 - This was a bipolar woman who had the benefit of being secured in a room with sliding glass doors that could be locked. She would yell and rant that she was fine and that everyone else had a problem because she could only speak Celtic (which is not a language) and the issue was just a lack of communication. Well we could understand her JUST fine.
But my favourite moment was when she was taken to the bathroom and had spent a little too much time in there, so one of the nurses asked if she needed any help. The door swung open, she yelled "Come right in!" and walked out into the centre of the acute area completely shirtless with her gravity affected mammaries swinging everywhere. As nurses scrambled to cover her up, I thought to myself while laughing uncontrollably, "I love it here!"
#3 - Then there was my first incoming Code Blue. I was in awe at how the staff worked together, though the code itself wasn't very eventful or long. The guy had suffered an asthma attack in the cold without his puffers and dropped. He had been down for too long and nothing was going to work. But the more memorable part was when his sister showed up and we had to break the news. I don't think that's something that will every be easier to hear.
#1 - A twenty-something dude came in with decreased LOC, probably a GCS of 8/15, was already intubated and high on god knows what. He was quickly taken to the Resuscitation Rooms just in case. We knew his name and that he was from "Province whose main language English was not" but otherwise nothing else. EMS stated his friends thought he was drunk and high on cocaine/THC. He was mostly stable but would spike his GCS and become alert enough to thrash and pull at his ETT so restraints were quickly fitted. To me it looked like he was regressing to a more primordial thought process as his primal self came through. Lucky me got to place my first OG tube, and foley the messed up yet "prime" specimen that was on the table.
This happened right at the beginning of my shift, and by the time I left 12 hours later he was alert and speaking in his dreamy Non-English Province accent. That was the first time I really saw the difference between completely corked out and normal in a patient.
#2 - This was a bipolar woman who had the benefit of being secured in a room with sliding glass doors that could be locked. She would yell and rant that she was fine and that everyone else had a problem because she could only speak Celtic (which is not a language) and the issue was just a lack of communication. Well we could understand her JUST fine.
But my favourite moment was when she was taken to the bathroom and had spent a little too much time in there, so one of the nurses asked if she needed any help. The door swung open, she yelled "Come right in!" and walked out into the centre of the acute area completely shirtless with her gravity affected mammaries swinging everywhere. As nurses scrambled to cover her up, I thought to myself while laughing uncontrollably, "I love it here!"
#3 - Then there was my first incoming Code Blue. I was in awe at how the staff worked together, though the code itself wasn't very eventful or long. The guy had suffered an asthma attack in the cold without his puffers and dropped. He had been down for too long and nothing was going to work. But the more memorable part was when his sister showed up and we had to break the news. I don't think that's something that will every be easier to hear.
Tuesday, May 27, 2014
It Begins!
At long last I have been hired into an ER job. Yes, yes, they say you need to pay your dues before you can start getting what you want, but after applying to 5 16 29 37 job postings in a year, I am thrilled to pieces!
Actually, I went for an interview at this same hospital (Our Mother of Mercy Ghetto Hospital) about a month and half ago, and they offered me a temporary position that was only going to last five months. Sadly I had to turn it down because the Gods of Poor Timing saw fit to have my current unit (at what we shall call Other Big Hospital, which I had worked at in a year long mat leave) offer me a permanent position the day before. One might say "It's only five months, but you would probably be able to get something soon after". But I was recently recovering from Stressballitis, as I had gone 6 weeks of technical unemployment prior to this offer. I couldn't risk being unemployed again. So I took the job with all the bells and whistles a permanent position could offer.
Five weeks later, Other Big Hospital calls to schedule an interview. I light up like a fabulous fantastic Christmas Tree full of neon fireflies. Sadly I'm on nights during the first week of interviews so I have to book one the following week. During this said week of nights, OMMGH calls to say they used my same interview for another posting I applied on and are offering a full time year long temporary position. Oh Gods of Poor Timing, yet again you seek to make conflict and force me to make hard decisions. Well, I went for the interview yesterday at Other Big Hospital but accepted the temp position at OMMGH. I will literally die if OBH offers me a permanent job, but my manager has already posted my position as a temp so I'm a bit locked into it.
EITHER WAY....I'm starting in the ER. At OMMGH where I'll be over run with drunks and druggies. Yay.
But...it's only a year and the experience will no doubt make it super easy to get into OBH down the road.
The first couple of weeks will be in-class education with computer modules (secretly I'm glad there will actually be computer modules), but I'm over the moon excited nonetheless. I'm vibrating down to my toes with anticipation.
*Bouncing around the room in case you didn't notice*
Actually, I went for an interview at this same hospital (Our Mother of Mercy Ghetto Hospital) about a month and half ago, and they offered me a temporary position that was only going to last five months. Sadly I had to turn it down because the Gods of Poor Timing saw fit to have my current unit (at what we shall call Other Big Hospital, which I had worked at in a year long mat leave) offer me a permanent position the day before. One might say "It's only five months, but you would probably be able to get something soon after". But I was recently recovering from Stressballitis, as I had gone 6 weeks of technical unemployment prior to this offer. I couldn't risk being unemployed again. So I took the job with all the bells and whistles a permanent position could offer.
Five weeks later, Other Big Hospital calls to schedule an interview. I light up like a fabulous fantastic Christmas Tree full of neon fireflies. Sadly I'm on nights during the first week of interviews so I have to book one the following week. During this said week of nights, OMMGH calls to say they used my same interview for another posting I applied on and are offering a full time year long temporary position. Oh Gods of Poor Timing, yet again you seek to make conflict and force me to make hard decisions. Well, I went for the interview yesterday at Other Big Hospital but accepted the temp position at OMMGH. I will literally die if OBH offers me a permanent job, but my manager has already posted my position as a temp so I'm a bit locked into it.
EITHER WAY....I'm starting in the ER. At OMMGH where I'll be over run with drunks and druggies. Yay.
But...it's only a year and the experience will no doubt make it super easy to get into OBH down the road.
The first couple of weeks will be in-class education with computer modules (secretly I'm glad there will actually be computer modules), but I'm over the moon excited nonetheless. I'm vibrating down to my toes with anticipation.
*Bouncing around the room in case you didn't notice*
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