Utterly Exhausted

For those of you that don't know, I am currently in the process of orienting to 2 hospitals. 1 hospital, I interviewed for L&D but got told that I would need to work Mom/Baby for awhile. The other hospital was scheduled for an interview the day I got the Mom/Baby offer, and that was for the NICU. Me, being my greedy self of not being able to see myself stay in Mom/Baby with no NICU baby interaction, I decided to propose working part-time at both places to the managers. Well... they accepted that bargain.

The manager for Mom/Baby told me I would work in that department for a year before being able to switch over, I told her that was absolutely too long. She countered with saying it might just be a few months (like 3-6ish months). This didn't sound great, but it sounded do-able with me also keeping my NICU critical care skills up to par.

Well, Tomorrow is finally my last day of charting class, a.k.a. my last orientation piece before going to total floor orientation. I can do floor orientation all the day long! It's the classroom nonsense that'll kill ya... slowly...

Well, I went to talk with my Mom/Baby manager about some scheduling troubles, and she offered me a L&D position, starting at the end of the month!!! OH. MY. GOSH!!! Thing is, it'll be full time instead of part time. My insurance is through the other hospital, and I can't leave the NICU, I just can't. So, am I crazy for thinking I can do 5 days a week between 2 critical care areas? Plus, the on-call shifts taking me up to 6-7 days each week!

I'm sustaining this crazy 6 days a week schedule right now, but I'm working days. I already know that working nights is a much bigger challenge when working so many "days" (shifts) in a row. That messed up circadian rhythm will actually slowly start to kill you.

I just don't know if I can do it. But I sure want to try it for awhile. Worst case scenario is that I go to PRN for NICU and keep full-time with L&D. Plus, I don't have on-call days for L&D until I complete the 3+ months of training required to begin in L&D. So, that helps for a few months to get my feet under me and my schedule ironed out a little bit.

I guess we'll see how it goes when I talk to the Mom/Baby slash L&D manager on Tuesday. She seems pretty excited to get me over to training in the field I actually wanted to be in an originally interviewed for. She actually took a similar road to me and started in Peds/PICU and transferred to L&D, but she worked both jobs at the same time for about a year or so! I think she liked that I was trying to do that and she understands the whole process and desire to do that "double specialty" type of nursing. It's like double majoring in college, except everybody thinks you're insane and you get even less sleep.



Problem is, I've been trying to find a house to rent so I can bring my dog with me. I would also need a roommate (or 2), so that my dog would have a friend while I'm working. She is currently staying with a friend of my mom's, who has another dog. This lady takes my dog for walks with her dog every day. She has a roommate that is home most of the time, except for maybe 3 hours a week (it seems like anyway, he doesn't work I don't think...). So, my dog has friends and another dog to hang out with all the time! Sometimes she even gets to go on a "field trip" to the lady's son's office because he owns his own business and hardly has customers to the office, he mostly goes out to remote locations for quotes and stuff.

So she has a really good set-up, compared to living with a night-shift nurse, who's exceedingly lazy on her days off and doesn't even get to play with her dog because she's too tired. I really feel like the worst puppy mom in the world! But I also feel terrible for leaving her at another person's house because I don't want her to feel abandoned. She gets so excited when we come to visit her! And then she goes into a depression when we leave again!!! It's too much for me to handle.

Times like these, I start to get upset that my parents aren't living together and able to house her and my brother. I get it, they were having lots of problems and it's not economical to afford a house with a backyard, just for the dog. But still, she's my dog. I picked her out, I have cared for her. She's been my best buddy since I was about 10 and I'm now 23 1/2.



I guess I'll talk it over with the lady keeping her, and I'll try to work it out with all of my managers to see what will happen. Mostly, it's a wait-and-see type of situation. The lady keeping my dog says she loves having my dog with her dog and it's not much different than her normal routine to have an extra puppy around. Plus, she appreciates the extra money every month. My current living situation is wonderful and is great while I am working so many crazy hours, and I don't have to do much since I have a roommate that does most everything around his house.



My heart says YES!!! My brain says I could probably make it work, but I'll be beyond exhausted, but I need the experience and my resume will be beyond great! My body says are you insane? I'm barely running as it is, AND WE'RE ON DAYS!!! So, mostly, I'm leaning towards the hard YES!!!!!!!!!!! But I'll talk with my manager Tuesday and discuss it a bit more.






Time to go pray! This will be quite the interesting adventure, should I choose to embark.

Rebuilding Life

As I've had the past couple weeks "off", I have noted that the month of June/July is not a good month for me as far as life/working goes. For the past several years, this has been a time of the year where I am trying to start jobs, find housing, and otherwise "homeless" and bouncing between both of my parent's houses.

Both orientations are proving to be a bigger pain in the a$$ than initially expected. Between both hospital's HR people contacting me, educators calling, appointments for paperwork and health screenings, and the slew of other things I have to get done while living an hour and a half away from where I need to be, I'm frustrated. Just breathe. I know that everything will get done and even if I was only trying to figure out this process for one hospital, it would still be annoying. It'll get done soon, I'm just looking forward to being done with hospital orientations and floor orientations, so I can just start working.

Praise the L-rd I've got decent amounts of experience in NICU and some post partum/baby experience. Hopefully I get to learn some new valuable things during orientation!!!

I'll be going through the same charting class twice in the next couple of weeks, and it's a class I went through 2-3 times throughout nursing school. I should be working directly for the company by this point, but that didn't seem to happen.

No housing has become available in order for me to be able to move down to College town anytime soon. Maybe it's because I sound like a child on the phone? Maybe it's because everybody and their cousin is moving to this damn state and snatching up any hopes of having a house I had. House prices are skyrocketing, rent prices are ridiculous, new houses are being built all over the place, and I predict another economy crash here in the near future. I can see the crash of 2008 happening again... soon. Until then, I'll be trying to find a place for me and the puppy to live.

This baby nurse is struggling.



How is your guys' summer shaping up?

NIghtshift Begins

I worked night shift as a CNA for a year and a half through nursing school. I was a patient sitter, who sat with 1-4 patients on the nights I worked. 12 hours, in a dark, chilly hospital room, trying to get a patient to sleep is difficult work. You may think it's easy or lazy work, which leads me to say: "You do it!" I have had multiple patients grab, kick, punch, and hit me. Yelling doesn't even count as attacks anymore, but some people come up with some nasty things to say when they are on CIWA (edited from AWA, I don't know what AWA is but I wrote this while tired... my bad) (alcohol withdrawal) precautions and need themselves a little buddy for their hospital stay. I have had to stand in the way of elevator doors and hand on for dear life as a dementia patient was pulling me in then pushing me out in hopes that he could get the elevator to work so he could go home.

It may not sound like much, but I have sat with suicidal 15 year-olds, patients suffering from paranoid schizophrenia, CIWA people, dementia sufferers simply wanting to go home, and with so many confused patients that even the nurse refuses to come into the room because of the tension and stress the patient causes for the patient. And yes, they charted that they had done their assessment... I saw it in the charting system but never once saw the damn nurse come into the room (I would know, I was in that stupid room all night, without a break).

Anywho, I predicted that working nights in the NICU would be slightly smoother and a little less difficult to stay awake during. I was correct... for the time-being. I haven't needed mid-shift caffeine boluses (for myself, we started a couple on the kiddos) just yet, nor have I been nodding off while charting. Granted, I just worked my second night shift last night and I'm still working on staying on-time with meds, labs, and feedings, so I stay pretty busy most of my shift.

First Night in NICU: I show up, bright-eyed and bushy tailed for the first day of night orientation. We get report on our two sweet babies and get started. Everything is chugging along with on kid that was admitted a couple hours before we got them (so they required a lot of extra help), and another little punkin that fought feedings with everything the kid had. My gosh, the baby would cry when not being fed, but refuse to eat when we finally gave the bottle. Hahaha, it happens, in my short amount of working, I have seen a few kids do that. So, we got through to about midnight and got notice that we would be getting another child to our assignment. Praise the L-rd I had a preceptor because I didn't even help with our third baby. Then, around 0430, we got a call that our already short-staffed unit would be receiving another little bundle of joy via surprise c-section! Seeing as I'm still learning, and two... one and a quarter nurses are better than none at said delivery... off we ran not even ten minutes later to a delivery that proceeded much more quickly than we were warned about.

When all the day nurses that had been teaching me for  the past several months asked how my first night-shift was, all I could do was allow my eyes to get really wide and say, "Well, I learned a lot." That's it! My gosh, I did learn a lot and the nurses learned that I could be counted on to do their assessments if I happened to not be crazy busy while one of their little patients decided to go meet Jesus as an inopportune time for us. I know it's all about working with the babies and their schedule, but them leaving us to "go towards the light" is not something we take kindly to.

Plus, I realized at about 0200 that it was the Harvest Moon, which is a full moon that packs in EXTRA "excitement" (edited from crazy, because that's a mean word to use), obviously. The labor board was chalked full, our NICU is full to bursting, and all of the babies (both earth-side and those still earth-bound) were in cahoots. The ones we had were mostly trying to die or crying their little lungs out. While the kiddos still cooking in mamas decided that it's about time they join in with our fun. Well, normally I'm all for lots of babies, but when said babies are just a couple weeks over halfway baked, it causes a bit of stress for the medical professionals committed to trying to make sure living humans remains living.

NICU Night #2: We started with two infants and gave report on only those two infants. Oh my gosh, it was glorious. We had time to help other nurses that were crazy busy, and all of us went home and clocked out on time! Charting completed, meds given, learning opportunities utilized, IV placed on child, and teachings done!

When day-shift nurses came on and asked how my shift went, I couldn't help but beam with excitement. I stayed on-timeish (minus getting behind for pulling an umbilical arterial line (scary) and doing labs at 0500. Besides that, the shift went fairly well. My gosh, I have been so incredibly blessed with good preceptors and my night-shift preceptor is no exception. She is a wonderful nurse, a great teacher, and a really sweet lady. I am very glad to be able to get to learn from her and know that I can count on her when I am on my own drowning in the future.



My orientation is technically over in 4 shifts. That completes my 12 weeks of training and preceptorship and the more I work the more under-qualified I feel. I'm not a parent. I've never breastfed. I am a brand-new nurse that has a college degree essentially giving me permission to begin on-the-job training. In a field that is life and death, that is freakin' terrifying. Throw into the mix that the life-or-death circumstances belongs to people's literal babies, and I'm plumb scared off my rocker.

Between being scared of breaking or killing somebody else's child and being terrified that they think I'm gonna be okay to be on my own soon, there is also the worry of the night shift staff. So many of them are girls that are a year or two out of college, but already thinking they should be charge nurse. However, these girls don't even keep up with the responsibilities they have to keep their babies clean, fed, and organized. I'm so sick of my generation thinking that they are better than other, they are entitled, or that they can climb the ladder just by sucking up to those in management positions while degrading and bullying those of us perceived to be "less than" them. Why am I "less than" you might ask? I don't know. These girls won't acknowledge me, look at me, speak to me, help me, or otherwise respect me as a living being. The only thing that shows that they can actually see me, is that us "less than's" tend to be tucked into various jokes. At least I provide comedic relief to somebody! I'm constantly laughing at myself, but it's nice to know somebody else can laugh with me too.

Struggle of This New Nurse

As my orientation season begins to wrap up, I can't help but think about how I felt when I started, and also how I'm not sure I can do it on my own. So far I can get the basics down, but there is always someone watching me and right next to me.

When I need another syringe, they are right there supervising and will run and get it. They are there to answer my millions of questions, without me ever having to leave the baby's bedside. They help one mom breastfeed as I assess and situate the next baby on my assignment list. They make milk, give baths, and do all of the cares that I cannot seem to fit into my work list because I am still slow in the tasks I do as I begin to figure out my muscle memory and routines. They help remind me when I have a med to give, I need to look at labs, and they help me be able to talk to the providers (NNP and neonatalogists) so that I do not get eaten alive just yet.

As I begin to get down the basics, I'm finding more and more that I am so far from knowing how to be a nurse on my own. Orientation for me ends at the end of September. I finished my last day shift orientation yesterday and I begin night shift orientation on Sunday...

To say "the struggle is real" is an understatement.

As I go about learning the ins and outs of a "typical" day, I have found some serious things I struggle with:

1. Breastfeeding. I don't have children. I don't know what it is like to breastfeed. I try to learn what I can from the nurses I am precepting under, but I feel terribly unqualified. When parents and grandparents of the babies ask if I have kids, I have to shamefully respond that I do not. That is followed with them asking how old I am and how much schooling I have left... Apparently the make-up I decided to start wearing so parents wouldn't be freaked out with how young I am, isn't working at all.
2. Families. The baby's families scare me. For every sweet, loving, adoring, easy family, there is an equally "different" family just down the hall. The kind of family that tells you they were a NICU nurse at the hospital I work at, but after further investigation you learn they were in the float pool and only floated the NICU one night to act as our unit secretary because we were severely short-staffed. There are families where we worry if the parents are on too many pain killers because they are falling asleep holding their 3 pound baby and asking the same question over and over. There are the families that we wonder about the safety of the mom because the dad is overbearing and there are signs of domestic violence. Parents who don't seem interested in the child. Women who tell the staff they will be adopting a baby that is in our NICU, throw a fit when they are not allowed to see said baby because we have no paperwork to say they will be the kid's guardian, and then we find out later there was never a plan for this lady to ever be involved in the care of the kid. Now, many of these situations are simply the stories from the nurses I've worked with, but I have experienced some of them between the few hospitals I worked at in Home State and now Small Town Hospital. Parents/family members scare me!  They blame us for what has happened to the baby even when the kid would have died if we didn't come help. They get upset with us for a positive drug screen in a 2 hour old infant, but I know we aren't the ones doing drugs through the pregnancy... I get that many of them are scare, and coping (though not always effectively coping), and they are in a situation that was unexpected and stressful. I get that. But I need serious practice with the parents and family members.
3. Time management. As soon as I feel like I get caught up, a kid pukes, poops, pees, or the family comes in and puts me right back to being behind. Through in a child needing a bath and bed change and I don't know how I will ever do it without having my preceptor there to help me out.
4. Remembering all of the "little" things. Little things like checking the med list for the babies every time I do an assessment so that I'm not late with antibiotics. Knowing how to give certain medications... Knowing who to ask for, how to ask, and what to do when I am needing a certain supply. Remembering the normal vital ranges and care tasks for babies when I am still so used to adult numbers and cares. 
5. Staying out of the cliques. Now, this one is a little different for me because I already have a target on my back. My grandmother (Mema) works in the NICU at my hospital. She has been there for years and years and years. My great aunt (Mema's sister) is the DON of the floor containing the NICU, L&D, the women's med/surg specialty floor, newborn nursery, and other various similar care departments. She is also the one who does the hiring and runs the meetings... So, you can see how many of the girls on the floor could be concerned and upset with me working there. Throw in the fact that night-shift NICU crew is known throughout the hospital for being ridiculously "cliquey" and I already starting with a handful of major disadvantages. So, while I need to work on time-management and all of these other things so that I can be "on-time" with all of the tasks I need to do, I am so very grateful that I am slow and always having something to do to stay busy because it keeps me from even being in a place where I could have downtime to have to talk with the girls. Maybe, by the time I get to a place where I am okay at being a NICU nurse, I will be so used to being busy that I will remain out of the clique scene all-together and nobody will ever know that there is another way for it to be.

So, here I am, about to be pushed off a cliff. Time to see if I will sink or swim.