C=RN

So, I finally went to bed at midnight and spent about 35 minutes decompressing from my rather bad day in the ICU. I finally started dropping off to sleep, and my eyes snapped open like windowshades! I forgot to waste 75 mcg of fentanyl in the Pyxis during my shift.

Got up, called the charge nurse, told her about it. She said it would be ok and we could waste it the next time I worked

I am really stupid and I had better not make that a habit or someone will think I am stealing drugs.

http://allnurses.com/forums/f8/doctor-helps-children-change-their-gender-298601.html#post2798435

All I can say is, "Thank you, Doctor"

So, I am a big, bad ICU Nurse, right? ;) I don't care about your psychosocial issues, I only care about your hemodynamic status. I could not possibly care less if your family is upset. I have to worry about whether or not you are oxygenating. Get out of my way, I am here to save your ass, not kiss it. *points at avatar desperately*

So, that's turned into another huge lie.


I had a patient who was possibly the saddest case ever. The patient drank herself to death over a period of 20 years or so. she was only in her mid-50's. She was like....third world country malnourished. (Total protein of 4, albumin of *1*) Anasarca, asterixis, ammonia level in the 150's, came in for decreased LOC. You guessed it, nurse friends...hepatic encephalopathy.

It's a death sentence for her. She was nearly dead when we got her, so there was not much we could do to reverse it. I won't go through the disease process here. Half of you know it and half of you will not care.

I spoke with her daughter for quite awhile after we had to emergently intubate her. She was a lovely girl, and had her life together despite being raised by a severe alcoholic. She started to blame herself for not being able to get her mother to stop drinking, and I had to intervene. I told her that she could not take ownership of her mother's addiction, and that it was between her mother and God now. I told her that people make their own choices, and that we cannot force adults to do as we wish. I held her, and she cried. She thanked me for helping her.

I hug people now. I actually talk to them about their psychosocial issues. lol....a year ago I would have considered this a weakness. ;)

** Update. This woman is actually ALIVE. Brain is somewhat scrambled, but she is breathing by herself.....as we speak. Talk about the miracles of modern medicine.

During my two years of nursing school, I 'lost' a few friends along the way. There were people who did not make it who were good friends of mine. I remember the days when I had to say 'goodbye' to friends that didn't quite make it. Today, two of those people became (with the exception of preceptorship)graduate nurses.

They had certain things in common. They were both intelligent, sensitive people. They both had many things going on in their lives that influenced their progress in nursing school. they were both great clinically, but occasionally had a problem with test anxiety, or becoming distracted during noisy exams. I was close to both of them, and felt the loss when they were no longer there to share the joys and stresses of the craziest time of our lives. I remained close with them and tried to be encouraging. They were also both guys. :)

So, congrats Mike and Steve. Welcome to the other side.

I love you both.

My preceptor says that it is time for me to come out of orientation. I technically have 3 weeks left.

She said, "I have not done anything in weeks. You are ready to take care of your own patients now. I am here if you need questions answered, but you are ready"

I am afraid.

This is an ICU. The patients are SICK. Like..really sick. Intubated, ventilated, on drips to keep their blood pressure up; SICK.

What if I am not ready and miss something critical? I mean....I feel reasonably confident but I am still afraid.

Sigh

I have a love/hate relationship with nursing.

Brilliant


http://youtube.com/watch?v=OVx2mjjBvis

Nuff said

On Sunday at about 7:30 pm, I signed my name as "RN" for the first time on a legal document. It was pretty cool. ;)

I mentioned it to one of my co-workers, who said "AWWWWWW!" like you would coo at a child's accomplishments. She was delighted, and mentioned it to someone else. They grinned from ear to ear, and it was obvious that they remembered a similar moment in their own lives.

And last night...

I had to quietly tell a man that his wife was unable to respond to him, no matter what it looked like. I had to tell him that the brain bleed she had suffered was so large, that she would never respond to anything again. The doctor had already explained this very thoroughly. He was not ready to believe it, and was waiting for the miracle that would keep her with him. I was as gentle as I could manage, but inspiring false hope is cruel and wrong. He said, "It's just so hard to believe that she isn't in there anymore".

I sat and held his hand for quite awhile, outwardly calm, but wracking my brain trying to come up with something that would help relieve his pain. I finally decided to just be there and let him have some quiet human companionship. After quite awhile, he said a few things that made me understand that he was seeking approval to go home for the night. He was emotionally bereft and physically exhausted.

I took my cue and told him that he needed to go home and rest. I promised to take good care of her, and promised to call him if anything changed. I told him what time I would be going off shift, and that a wonderful nurse was scheduled to take care of her the next morning, so he should try to get as much sleep as he could. (I had no idea who was even on the schedule)

He gratefully left the unit. He knew somewhere inside him that this was the place where his beloved wife would die. He did not know exactly when, but he knew that he was standing in the last place her heart would ever beat. I hope I was comforting to him.

What I discovered today was that writing "RN" is pale and insignificant compared to the awesome responsibility. I was his caregiver as well as hers. I assisted him in getting ready to say goodbye. The hour I spent with my patient's husband made me finally feel like a nurse.

I passed.

I cried, I threw up, then I started making phone calls.

Janie, RN

Your exam results are not available at this time.

'nuff said

I took my state boards today.

I walked out shaking, crying and nearly vomited. I didn't feel like I knew any of the answers. I got like a SHIT TON of urinary and infection control. I forgot what MS was and answered the questions wrong.

Kill me now

You have to click the picture twice to get it big enough to read it.

Today, the father of Roleplaying rolled a critical failure and tore up his last character sheet.

Once, a nerdy seven year old girl visited her cousins in Texas. They had a set of books in a box that held open a door to a new place. In this world of fantasy, the shy little bookworm could be anything she wanted to be.

So, back when 'Elf' was a class, and DDO didn't exist, children loved to read because of Gary Gygax. We used our imaginations and made up worlds, became heroes, and died bravely. Eventually, we learned why screwing around with the wish spell was a bad idea, and that pulling cards from the Deck of Many Things wasn't all it was cracked up to be. We also learned to work together, read at a much higher grade level, and made lifelong friends in our little D&D groups all over the country.

Fundamentalist Christians all over the world tried to squelch our creativity and denounce our beloved Dungeons and Dragons as 'evil'. I am proud to say that my children are D&D fans, and that my 14 year old has also been Roleplaying since the age of 7. He's a chip off the old mom ;). He also reads a book a week.

So, Thanks for the memories, Gary..... I hope you are proud to know that you touched the lives of multiple generations. You will be missed.

So, to get a nursing license in the state of Missouri, you must do electronic fingerprints through a private company, who forwards them to the highway patrol.

You can't actually go to the highway patrol and do your fingerprints....cause spending 40 bucks to do computer fingerprints is like...too cool for MO to pass on. WE LOVE THE MIDDLEMAN!

So they took my fingerprints, and sent them to the board of PHARMACY, which is why I have not received an authorization to test. One of the dorks in their office put the wrong ORI number on them and sent them to the wrong board. If I don't have a license by Mar 18, I LOSE MY JOB.

Needless to say, I was hysterical when I found out...they weren't going to tell me what happened, cause LYING to me was more fun. I had to drag it out of one of the supervisors. I forced him to write me a letter for my boss, sent via email and snail mail.

If I lose my job, I am suing them for lost wages.

Wood type: birch Length: 11 inches Core: Dragon Heartstring get your own wand!

( Grad vs experience nurse )

I adore being out of school.....except I am still in school ;)


I have been in orientation for 3 days. Read that as 24 hours of lecture :) Tomorrow I do 4 hours of lecture and 4 hours of CPR.

Essentially, all of the lectures are about how JCAHO (joint commission...which is our national hospital regulatory department for all you Brits) can make your life miserable. I am totally into patient safety, I am committed to excellent care. I am just SICK of hearing about all the fines we are going to get for forgetting to chart a time or a re-check of someones pain score....lol

I think they should give you the JCAHO crap in small doses.... It's enough to make you afraid to be a nurse.


Other than that...I love it. They are PAYING me to go to those lectures. WOOT!

I start my new job on Monday!

I am pretty nervous, and really excited. No NCLEX test date yet.


I am changing the title of my journal.....:)

More loot....

Pink nylon kate spade bag...the claire :) from mom

I graduate tomorrow.

If you happen to be reading this at 7pm CST December 13, my pinning ceremony will have just started.

nuff said

I got my graduation present today. From Paul....the most awesomely wonderful husband on the planet.

Large, camel-colored, all leather....Coach Hobo bag :)

Damnit, it's gorgeous!

I love it.....lovelovelove