Didn't think it could get any worse... And then IT DID!

Oh. My. Goodness. *breathe* My past few weeks have been awful.

Last week was my first week off of L&D orientation. Sucked! Day 1, thought I was doing okay. Can't remember exactly what happened, but it wasn't terrible. Day 2, I had 2 labor patients, not good, but I handled it. Day 3, I came back, and found out that 1 of my patients that I thought was a 4, was actually not even 1 c.m. dilated and my other lady who was a 4 turned out to be a C section for being breech.

*breathe*

I turned in my application for a Nurse Midwifery program here in-state. 3-4 days after the deadline, I got an email saying that my application would not be turned in because I was missing transcripts for my transferred credit. I probably wasted $70 on the application, and it'll never even get in front of the admission board for them to decide whether they like me or not.

*just try to breathe*

Then I go to NICU and can't seem to do anything right when I'm there, so day shift is always yelling at me because they do things differently, but I was just following what the previous day shifter told me to do.

*frickin' breathe*

Yesterday I slept through my alarm and my poor counselor texted me 20 minutes into when I was supposed to be there and I didn't call back until 20 minutes after that! Oh my gosh, I feel just so awful. She's so sweet and understanding, but I hate hate hate wasting people's time and it's the holidays. I'm sure she could have been with her family or at home or doing anything else except for waiting for ridiculous me who couldn't even wake up for my 2 alarms.

*just fuckin' take a breath*

Last night, after missing my much needed counseling appointment, I kept tearing up in the middle of feeds. My babies were being difficult (I know, it's not their fault, they're learning how to be alive and eat and manage both at the same time. Lots of work and coordination! Plus parents yell at me on the regular here because of the way the doctors/practitioners change the plan of care all the time.) Regardless, babies can be frustrating and NICU work can be very stressful, even when you only have "feeder growers" because they don't want to feed and growing is even optional. So, between not feeling okay in my NICU knowledge at this hospital, not feeling at all okay in L&D, missing my appointment, being a general thorn in everyone's side, and the myriad of other reasons why I suck as a person... I just couldn't seem to get it together.

Fast forward to 2 hours before my shift was supposed to be up and: my rooming in mom hadn't woken up and she was 30-45 minutes late with her feed, one kid was taking for-frickin-ever to bottle feed and then threw up all over my lap, and my last kid was over in his bed screaming his head off in his inconsolable state.

Maybe I need to just quit breathing at this point and all of the frustrations of life would fade away...

I don't want to be a thorn in anyone's side. Yet, I find myself in a season of being a thorn in EVERYONE'S side, even my poor counselor!



I got to thinking and it's worth note that I cannot plan a wedding. Pinterest has all sorts of cute wedding things, and one of my counseling homework assignments was to make a wedding board on Pinterest of the things I would like to have at my wedding. I don't know what I want for a wedding. I'm not particularly emotionally invested in anything with that. I do, however, have my funeral planned out to a "t". I've had my funeral planned since I was 10 or 12. I know that I was a simple casket, to be buried in gray because I don't feel worthy of being buried in white. I know that I want to be buried in the most simple casket anyone can build, under a weaping willow or some type of large tree. I don't want people dressed up and the reception should be a simple bonfire, with music, and beers. If anyone goes, it would be nice for them to share stories, but having people there doesn't seem realistic, let alone getting anyone to tell stories or even know that I died or to care that I passed. I know that, at 23, I have been a DNR for years.

Last night, I found myself in a position of longing that G-d would let me be done with life. I haven't been here in a long time. Chalk it up to being tired, stressed with so much newness with working L&D, or blame it on me not being able to make it in life without the wonderful support of a counselor because I'm just too weak; but this is not a good place to be. I don't like wanting to be gone and yet being stuck on this earth, in this body, with this life. I can't imaging a bright future. I don't know what it will look like. Not even one little bit.

Will I go on to get my Master's? Doctorate? PhD?
Will I have a husband or family? Will I die alone?
Will I be happy? Or forever chasing happiness, but never able to reach it?

I have no clue what is going to happen. I pray that there are more good things than bad to await me in the future, but I feel like I'm 89 and looking back on my life where I have a hard time understanding my purpose on this earth.



You know when circumstances get so bad that all you can do is either laugh or cry? What does it mean when you do both? But the crying isn't from laughing too hard, it's all from just being utterly overwhelmed with life.

Trial and Error

Ugh, the amount of high's and low's I experience per shift in L&D has given me a terrible case of whip lash. One shift goes great, while the very next night is absolute hell and I can't seem to do anything right.

Last night's shift was a crazy combination of both.

I admitted a patient who was there for an elective induction, but did not want any of the meds to get labor started...

Then I immediately got another pt who needed an epidural pronto and then her blood pressures bottomed out and she went from a 5 to a 10 and delivered in 1.5 hours.

About 3 hours after the delivery, as I was getting caught up on charting, my preceptor came to me and asked if I minded taking ice water into the delivered patient, and asking what they decided to name the baby since they had waited until after the birth to pick a name. I went in, asked what the name was and you know what? They named their baby after me! I was with them for a total of maybe 5 hours, missed her whole recovery because of my other pt, and they honored me by naming their baby after me. Yes, I happy cried and teared up in the room. I don't think I have ever been so honored by anyone, let alone someone that I barely knew.

I came out and sat down to chart when my other pt pressed her call light. I went in and she said she thought her water broke. Okay, so normally we are supposed to check them when that happens so that I could report to the doctor. Well, this particular doctor was planning to come in and check her and break her water about 30 minutes after when she SROM'd. So, I figured I would check her (as normal) and go let him know. Well, I got REAMED for that because apparently he likes to check his own patients when he is at the hospital. I had been told this at the beginning of my orientation, but I am still in the task-oriented phase of learning and I did what would normally be done.

I'm trying to let it roll off my shoulders and just learn for next time, but it's still frustrating to me that we bend over backwards for doctors, and yet they yell at us for something so small as a preference. Nobody was hurt, nothing bad happened, and it didn't change the course of treatment at all...

I will do it differently next time. I will do my best to remember the little nuances and remember every doctor's preferences as best I can... but I'm still going to complain about the way that we are chewed out for stupid shit every day, just because the doctor is having a bad day or likes some random things done a very specific way.



Deep breaths. He'll be mad at me for the next several weeks and I will have months of proving myself to him and the other doctors. I hate this part, but I am also the most motivated when I feel like people are expecting me to fail, so I guess we'll see how it goes. L-rd willing, I don't struggle too bad.

Because I'm An Idiot

Let's preface this with the fact that we had a recent baby boom and are busting at the seems.

I keep making stupid newbie mistakes. Now, is this because I'm not paying attention? Not really. Mostly, I'm making mistakes without even knowing I'm making them because these are things that I was not taught in orientation. Now that I am on my own, I get in trouble for making said mistakes because I am now responsible for the actions I do, whether I know it is against the rules or not.

This was brought about by getting "in trouble" (my words, not theirs) for overfeeding my kid. In our unit, children can go to ad lib and/or on demand. This, to me, means they can eat however much they want (ad lib) whenever they wake up and start fussing (on demand). Nobody taught me otherwise, until today.

I had my charge nurse feed one of my kids because I was crazy busy and also way late on charting. Well, she ended up looking at my charting and told me I was way overfeeding my kid. Apparently it is an unspoken rule that ad lib actually means 160-200 mL/kg/day. Now, average this out by how long the kid goes between feedings (2-4 hours) and you get your ad lib ranges of what to feed depending on how long they slept. Who knew? Well, I guess everyone did... except me. So, this kid's max was 100 (actually  this is only for going 3 hours in between, for 4 hours it's 133 mL) and I was letting him take as much as he wanted, in the ball parks of 120-150. So, not too much over, and I admitted my mistake to day shift during report, to my friends, and to our unit manager. However, I still feel like a complete dumb ass because I just know this is going to end up being a thing that gets talked about for weeks. The doctor is going to be upset, I'm going to get a lecture, maybe a group email, and it'll be because of me and because I have no clue what the hell I'm doing. Some kids do get ordered to be ad lib with no max. Apparently this is something that is uncommon and ad lib means 160-200.

Ya live and learn, I guess. Poor day shift must think I'm a complete moron because I know the other girls on night shift think I am.



In other news we got our yearly reviews done... everyone is pissed. We have a peer review system, but not everyone fills out reviews for other employees. Plus, the reviews from the employees are used as the sole summation of your work on the unit. So, there is a lot of bias. If you get your review "randomly" (I don't think they were all random) put into a folder to be reviewed by someone on our unit who doesn't like you, your raise will depend on how mean they felt that day. On the flip side, we have some employees who don't do well at work and cut corners who get reviewed by their friends and end up getting raises that they maybe shouldn't have gotten as well as better reviews than they worked for. So, no matter what, you get screwed. So, I got an okay eval, but my friends did not. Their evals went to a girl who is not nice to us and clearly does not like any of us new girls. Therefore, my friends had terrible reviews and did not get the same type of raise I did. It might be by just a few cents, but the reviews are on file for the rest of their career at this hospital. They are not getting good marks because their "grader" is spiteful, rude, mad at us for going to HR about her, and biased.

Add in that I'm tired, probably PMS'ing, and cannot seem to have a good night, and even though I'm sleep deprived, I will probably end up not sleeping well. That sucks because I have been at work every night for a week and still have another 4 days to go. I kid you not, I will have 13 days clocked, in a row because I'm stupid and kept coming in "for just one more night" because we were slammed with kids.

Sometimes I do dumb things.

Mostly, I do dumb things regularly. It's a wonder my review didn't turn out worse than the most negative things being written is that "she gets frustrated". Well no shit. I'm a new grad, I've been on my own for 3 months (out of orientation), and I get frustrating assignments because they are trying to get me experiences with tougher assignments. They say that in the review. Half of our staff is frustrated and frazzled most of their nights at work because they are 1) high strung on their good days and completely out of control on a mediocre day or 2) assignments are not given to be balanced so that stress is evenly distributed across the entirety of the staff for the shift. Assignments are given with no regards to patient needs and nurse responsibilities.



On a more positive note. I emailed the nurse midwifery program I want to attend. They emailed back quickly and asked if I wanted to start in August 2017... I can't move yet, but I kind of want to start school so I'll graduate in 2020. It's a happy year especially with high school graduation being 2012, college graduation being 2016; 2020 fits my little trend!

The only thing I can think is: I can't even be a nurse and do things correctly on a regular basis, what makes me think I can be a practitioner and write orders as opposed to simply following practitioner orders? Everything takes practice and experience, but it's scary!



Ah well. I'm off to sleep so that I can show up to struggle through another crazy shift.

Let's not even talk about my new desire for a kid. I keep getting attached to my little patients that  I tear up when they get to go home. It's bitter sweet, but I love these kids more than I should be loving patients. Then I want a kid, but then I'm over-come with dread and fear of the things they could/might go through in life. Then I start crying because I get scared thinking about what it would be like to have to go through meeting a guy and hoping he won't be evil to me like the other guys have been. And, if he's not evil, then I am scared to tell him the evils I've survived and I'll have to delve into why I don't think I'm pure... and... and... and...

I think I just need some sleep. I'll catch up with y'all later.