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.

Full Moon Madness

It's been 2-3 nights since the huge full moon occurred. Regardless, the children in the Big House have not gotten said memo. I only had two babies last night and they were being so naughty!!!

I was running behind all night long and not for lack of trying. One kid takes frickin forever to assess and feed because there are often unforseen complications such as him puking every. single. assessment. because he gets so worked up and upset that he doesn't even make sound when crying and thus provides enough pressure on his stomach to then throw up. *Ugh, buddy, let's talk about this!* This phrase is uttered more times than should be allowed in an attempt to get him to chill out. Surprisingly, he's more cooperative for me than for anyone else. *facepalm*

My other kid was on a vent, but absolutely delightful. He's so sweet and his family is so kind and calm. I adore this family/kid. However, he's getting sick. So, after being late from my first kid taking waaaaaay too long to eat and not having a tube to be able to tube the rest of the feed, I started in on this kid. Shortly after sitting down to begin charting on both little pip-squeaks, the NNP came in and I got informed the kid needed blood cultures taken stat. Which means IV sticks to get a totally sterile sample of blood, besides whatever terrible thing has decided to begin growing in this poor little kid's body. First IV got placed no problem, but no blood return to be able to get for cultures. So on to second IV. Got that, no problem and got blood. Antibiotics started and I'm already late for the first kid's second assessment/feeding.

*sigh*

The whole night ran behind after that. Try as I might, I could not get caught up on charting completely until day shift arrived. I was 10 minutes to clock out so that I could chart everything that happened.



I finally got home, got showered, and dressed into new pj's straight out of the dryer. Called in my puppy to sleep with me for the day and as soon as I laid down and petted her, I realized she was covered in some mysterious, dried, likely-dead-animal's guts type substance. So, at 10 a.m. after a frustrating night-shift, I walked my backyard twice in hopes of finding whatever it is she rolled in. Then proceeded to give her a bath. She was pissed, but hey, I'm not letting her gallivant about in my house and all over my bed in some dead creatures guts. GROSS!

Dog's bath done, another change of pajamas, scrubbing my arms up to my elbows and aromatherapy diffuser turned on, I fell asleep.

I woke up 5 hours later, and 2 hours earlier than I needed to, because of nightmares. Nightmares about work, nightmares about family, nightmares about past events. My subconscious must be trying to tell me something, but I'm not getting overworked. I think it was just a stressful shift, my family all bailed on me (except for mom) in every way possible (Thanksgiving, both rape cases, you name it), and I'm still battling memories of exboyfriend and exfiance. I would have worded the last few sentences differently, I don't normally use rape in such a blunt term when talking about those two assholes and the countless number of times I have been abused at their hands, but I'm in a no-nonsense kind of mood right now.

Tomorrow night is Newbie's Night Out with the other new girls on my unit. I'm so excited I can't even tell you! I've been looking forward to this night, and attempting to plan it for months. I kid you not. So, for it to be so close is a wonderful feeling. I'll let you know how it goes!

Good news about last night's shift is that I have made friends (work friend status) with the respiratory therapists, many of the NNP's, and so many others besides the regular nurses. Plus, I got to have my favorite charge nurse on last night!!! I tell you what, she makes the shift so much better, just by being there. But she listens when I have concerns, she believes my "nursing judgement" which is little more than babysitter judgement at this point, and she helps us out. She agreed to help me out with tonight's assignments and not putting my two kids together until first kid learns to not take so long and second kid starts to feel better. I wish she were charge again tonight... ah well, I'm making friends with people the other "regular" staff has difficulties with. Thing is, they have difficulties with a lot of people, and I think it's because of the "regular" staff, not the others. Ya know what I mean? That's how it rolls with a clique mentality. Meanwhile, I'll be friends with everyone and people on other units have already begun requesting me by name. So I'm good with that.

Comedic Relief?

I got a friend request on Facebook the other day from someone I didn't recognize. Looking through the little bit that was shown on their profile without us being friends, left me still confused as to who this person was.

I looked at the birthday and it matched Exfiance's birthday day, but it showed a different year... I looked at the name and the first name was his, but the last had been changed... There was only a profile picture taken through a windshield looking out onto fields of wild grass, and a cover photo of a motorcycle. I did not recognize the vehicle in the profile picture, nor did I recognize the motor cycle.

Something about the friend request struck me as odd, from the very beginning. As I did my short little search, more and more pointed to this being an obviously fake account, likely set up by A**hole Exfiance.

I never imagined his search for me would ever cease. I'm sure he's curious about what I'm doing, where I am, and how I'm doing without him.

You know what? I'm doing just fine right now, besides the stress of the fucking flu shot and minor stresses that plague every newly graduated college student (bills, chores, student loans, new job, etc). I have bouts of memories, but the L-rd brings me peace. I have struggles with insecurities, still, but I am also more confident than I think I've been in my whole life.

G-d is restoring me from the shell of a person I was a mere year ago, or even 4 months ago. He is filling in the cracks with gold and showing the bits of value I always had.

Praise the L-rd I'm smarter than I look. I can't believe he thought I would be so stupid that I would accept a friend request from 1) someone I didn't know, 2) that someone has his same first name and birthday and 3) pictures that do not show who the account is for... for real dumbass? You think I'm that dumb? After I went to the police, around your back, filed the report, called you on a recorded line, and broke up with you 4 times... while learning how to block you on every communication line you thought you could use. After all of that you think I'm going to be dumb enough to accept your dumbass, non-creative, completely unhidden friend request just because it has a different last name and different birth year?

Good heavens.

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.

"Just wait 5 more days..."

I called 12-15 times today to talk with BON, but the automated system just says they are experiencing "high call volumes and cannot take my call at this time" after which it hangs up on you.

So, I began emailing everyone I could at said BON. I finally got a call back from a lady there who told me to wait another 5 days because there are so many graduations all at the same time they are swamped.

WHO DO I CALL TO COMPLAIN ABOUT THE FRICKIN' BON???

Seriously, this is ridiculous. I've been waiting on them for 2 months. They have lost my paperwork and they are not keeping their promise about finishing each step in 10 business days. Seriously people, you know graduations happen at least 2 times a year... HIRE MORE PEOPLE!!!

Honestly, you know how it gets, so why is now the normal time to be "understaffed" but not do anything about it. Get more people on the phones, get more people processing mail, get more people processing licenses and permits. For goodness sake, double your staff for 2 months around May graduations and another 2 months during December graduation and your life will not suck so bad when said graduation times come around.

For the love of Pete, somebody find the person I'm supposed to complain to so that I can get shit done for the people coming after me because this is COMPLETELY unacceptable.

My "cousin" (mom's cousin's daughter-in-law) had to wait 3 months for my state's regulatory agency to process her radiation tech licensing because they were moving buildings and took their sweet-ass time while also putting everyone else's life on hold who is depending on the agency to process their paperwork in order to start making a living. Seriously, there is no way to be able to prepare for this stuff besides hope that you have enough life savings to deal with the bullshit that is dealing with governmental agencies.

Today I need a Haldol...

Oh the beach!

Y'all, I just got back last night from a 2 week vacation and it was amazing! Sorry about the extended radio silence. A week at the beach and a week (split into two little pieces) of visiting with my family that lives in the south. Oh man, they are funny and boy can they cook.

We drove home to Home State and got in at about 0400 time there. I could have been dropped off at my new home, but I wanted to go back to get my dog. So, mom let me come to Home State, pick up the puppy (she's about 9 now) and then mom drove puppy and I back to Small Town yesterday. Actually, I drove but she was there. She just left here for Home State about an hour ago. I miss her terribly already...

Paperwork finally went through and I got to register for my NCLEX! *screams silently in head* I'm terrified. This is scary!!! What if I fail? Then I have to pay to take it again and my nursing permit will be revoked so I will be out of work until I pass it. Oh goodness, how could I handle that? How could I handle another thing wrong, I still feel like I'm on a constant teeter-totter and could fall into a pit that I'll never be able to get out of. I feel like I could drown at any moment and just not take another breath because of sheer exhaustion of surviving. Anyway, since the paperwork is in and I registered for the NCLEX, it'll take up to 10 business days from the day they processed it for me to get my permit so I can start working. Hopefully it happens sooner than that because I'd really like to begin working. Mema says they have babies again which is good for me but scary for the poor parents. It's one of those double-edged swords that makes nursing difficult.

So, it's just me a Puppy figuring out how to live in Small Town and getting our schedules back in order. Praise the L-rd for His timing and His provisions. I'm just barely making it, with loans from my parents and my one credit card nearly maxed out (and hardly any money in the bank). Money is tighter right now than it was when I was in college! Ah well, I'm hoping everything will get settled here shortly.

Life As a New Grad Nurse...???

There are seasons in my life where everything seems to be going wrong. When I say "wrong" I mean, life suffocates me and it's all I can do to crawl to the bathroom in the event that I have to pee. I spend days in bed sleeping, don't need to eat, drinking something like water only happens to get down the pills, and I am paralyzed.

There are other seasons, where, for the first time in a very long time, I will have weeks of good days and I may be excited about life for awhile. Times when I see the fruition of the L-rd's work and I suddenly believe that life will work out and cooperate for a bit.

Then, there are days like today... My short bit of life right before and following graduation were wonderful. I was full of hope, some anxiety but it was more nervous excitement than true anxiety, I was able to smile, I felt lighter, I was graduating nursing school! I had a job! I was moving to Small Town and I'm getting away from the town that has produced nothing but pain for me the past year or two. I was leaving the boys that destroyed my sense of self and I would not have to worry about seeing their trucks on the road any longer. I don't have to worry about seeing them at a bar or when I go out to supper with friends. I don't have to be concerned that I'll bump into one of their friends when I go out bowling or to the grocery store. There was a light at the end of my deep, dark, looooooooong tunnel and I was nearing it!

I am nearer to the light, but it's gotten a bit dim today. I haven't started work and I've been down here for nearly two weeks. I've been graduated from nursing school for over a month and still no money coming in. Without work, I haven't been able to meet new people. A highlight in my day involves going to the grocery store across the street because they help every single customer out to their car so I get to talk to the person that helps me out. This is my socialization. I've spent time with my Mema and other family who is down here, but everyone seems to be so busy! They keep asking me how my license is coming and it's irritating to only be able to say that I'm still waiting on the board of nursing for the state. I JUST WANT TO START WORKING!!!

I go on vacation in about a week and a half and really want to work before I go on that vacation.



Through nursing school, everyone tells you how scary it is to wait to take the NCLEX. They tell you how scary it is waiting for the results. They tell you how hard the first year of nursing is, but they explain that it will still be rewarding and exciting.

Nobody tells you about the month or two in between nursing school and the NCLEX/working where life seems to stand still. It's a struggle if you do have a job because you are now college educated, working your college job... Or, you might be like me, who took a semester off of work for various reasons, and now you're waiting on the governmental agency to get their shit together so that you can begin your life!!! I'm going nuts!

Thing is, I've had so many friends text me disappointed about not having a job yet, not being able to work, being scared about how they will pay their bills, worried that they aren't good enough to be a nurse because the local hospitals won't hire them because of the mass influx in new grads, and we're all terrified. Nobody told us about this season of self-doubt, depression, anxiousness, feelings of failure, frustration at the system, and disappointment in ourselves for even feeling these things.

Most of us are having a terribly difficult time. I slept until 12:30 p.m. today and haven't left my bed yet because I have no motivation to do anything. I don't feel needed, I don't have friends to be able to see, I don't have money to be able to go do anything, and I can't see a purpose to get dressed or complete any task. Couple that with my nightmare I had last night (I'll tell you about it in my next post) and the flashbacks that are coming back in full force, I'm struggling. Now, I'm not as bad as I have been. This is the point where I can still turn my depressive episode around. All I have to do is find the energy and desire.