Kapachino

Day Off?

I worked all weekend, then had a frantically busy day yesterday. Last night I was tired through and through, but could I rest? No, there were cake consultations to attend and invitations to design. Luckily I had today off, so I could get rested (or so I thought).

Despite being an emotional wreck for most of the day, I did manage to accomplish some things. First, I got fitted for undergarments at Nordstrom and OH MY WORD if you haven’t done that, go. It will change your life. Purchased all my underwear for the wedding and then some.

Second, I finally found a paper store that had what I wanted: plain white, smooth finish, thick paper without a watermark. You would think that such a product would be easy to find, but you would be wrong. The store is FasClampitt and today I am in love with it. We also got envelopes there.

Third, went shopping with my mother-in-law-to-be and found her a beautiful outfit to wear to the wedding, then took it to be altered.

Fourth, to kill time I stopped by Old Navy and bought a cheap swimsuit for our honeymoon.

Fifth, I met David at the jewelry store where he bought my engagement ring and discussed wedding band options. It seems that if I want the band to fit against the ring and look like a set I will have to get it custom made, which will cost $400-500. If I don’t do that, I will be wearing two mis-matched rings. What would you do?

Finally, David and I had dinner at Mama’s Cafe, and it was very good. And when I said goodbye to him (since we were in separate cars) I almost cried because we hardly ever get to see each other, and I have another looooong day of work and errands tomorrow. That would have made about the tenth time I cried today (only slightly exaggerating). See? Emotional wreck.

It’s not my impending marriage that is doing this to me, though - it’s the combination of hormones (the perfect scapegoat), wedding planning, and above all: MY JOB. Are there any new nurses out there who can empathize with me? I seriously love it and wouldn’t want to be doing anything else, but I just can’t explain how physically and mentally draining it is. I know I’ll get used to it, but I haven’t yet.

Anyway, if I’m going to be asleep by 8 p.m. I better get going.

Another Nursing Incident

I wasn’t going to bore you with stories from work again, but again something happened. Yesterday I was taking care of the same patient that I have had for at least a week now. And every day, her potassium is low. Every day the doctor makes rounds in the morning, sees that it is low, and orders us to replace the potassium through her IV. Yesterday her potassium was 1.5 (normal is 3.5 to 5.0), which is a critical level because abnormal potassium can cause life-threatening heart rhythm problems. Nurses worry when it drops below 3.

The day before, her potassium had been 1.8. I was with my preceptor that day, and she informed me that although it was low, it was best if we just waited for the doctor to make his rounds instead of calling him. She said that he is very particular and hates to be called about things like low electrolytes which he can take care of on rounds. Yesterday, my preceptor wasn’t there and so I was more or less on my own. I waited for awhile for the doctor to make rounds, but he didn’t come. Finally I consulted another nurse. She also told me not to call the doctor for low electrolytes. So I didn’t.

I recorded my report, and in it I said that her potassium was 1.5 and so the next shift should keep an eye out for the doctor. When the nurse from the next shift heard my report, she came flying out of the room. She asked someone, “Is her potassium really 1.5 and nothing has been done about it all day? Did I hear that right?” And all of a sudden I was being bombarded by nurses asking me what was going on and why I hadn’t done anything about it.

I told them what my preceptor had said to me the day before, and what the other nurse had told me that day. Apparently I asked the wrong person. They wanted to do a formal patient safety report, so they went and talked to the nurse who gave me the advice. I was really upset because I like her, have to work with her frequently, and it was not my intention to get her in trouble. I was also given a “talking to” by more than one person.

They ended up asking the nurse practitioner on our floor to write an order for potassium replacement. The nurse who gave me the advice caught me before I left and said that she had put the patient safety report in her name. She said, “I personally still wouldn’t have called him. That’s my professional judgment. Reason being her potassium is low every day, the doctor is aware of it, and he is expecting it to be low again today. But anyway, I’ve been a nurse for 12 years and I can take the heat. Don’t worry about it.”

Everything ended up being ok, but it was very frustrating to have such an incident happen to me right at the end of my shift, when I thought I had had a good day. But I learned to never take one person’s advice if I’m not comfortable with it, and to always be an advocate for the patient even in the face of grumpy doctors.

Today her potassium is 1.6 and I had someone else call the doctor for me!

These Days Will Happen

I had a wonderful weekend, slept great, and was refreshed all day Sunday. I was ready to start the week.

Well, last night I could not fall asleep for hours. My parents keep the house way too hot to be sleeping upstairs, and yet for some reason I didn’t think to go down and lower the thermostat. Therefore I tossed and turned, kicked covers and twisted sheets. Cleo was restless too; someone somewhere was setting off remnants of Independence Day firecrackers, and that got her trembling and needy for my attention. 

I think that today wouldn’t have seemed so bad if I weren’t so tired the whole time. But I was and it did. It was the first day at this job when I actually felt inadequate, and thought, “What have I gotten myself into?”

First, I made a mistake by not flushing a patient’s PEG tube when I unhooked it for him to take a shower, because then it got quite clogged and my preceptor had to work long and hard to fix it. (Sorry for the jargon, I’m too tired to explain.)

Later I was helping transfer a patient to a stretcher and the Patient Care Assistant (PCA - like a nurse’s assistant) told me that she had better take my place because I wouldn’t do a good job. Now, I know I’m small and don’t look strong, and no I haven’t had years of experience like she has, but that doesn’t automatically mean that I don’t know what I’m doing or I won’t do a good job. I don’t enjoy being looked down on.

Then, about an hour before the end of the shift, one of my patients had a period of unresponsiveness, change in vital signs, and copious amounts of bloody stool. I am leaving out many other details that I’m sure you don’t want to hear about. We were in a frenzy taking care of him, so I didn’t have time to get my thoughts together before giving report to the next shift. On our unit, we tape record our reports. I hate doing it in the first place, because I picture all the nurses sitting around listening to my voice and whatever stupid thing comes out of my mouth. But giving report isn’t something you’re really trained to do in nursing school, and I always feel like I’m just bumbling through. If I have time, I like to write down everything I’m going to say. But a crashing patient equals no time, which equals a really embarrassing report.

After the long bus ride home, I finally had a few hours to myself. I wanted to get some things done, but I couldn’t move myself from the couch. David stopped by to see me on his way home from playing golf, and we hung out for a total of 15 minutes. Then I told him he had to leave because I need to go to sleep (hopefully) in order to do this all over again.

My days aren’t all like this, and I hope that tomorrow is better. Sometimes I do wonder why I didn’t choose something easier. I think I have a pretty good idea, though. It’s going to be worth it.

Looking Forward

It’s good to have things to look forward to. For example: the weekend, seeing friends from out of town, a good vacation, heaven, blah blah blah. I think that one of the main reasons that I can usually stay so positive is because I always find something to look forward to, whether it’s little or big. People who have a hard time with this sometimes start negative habits just because it gives them something to look forward to.

I was thinking about this concept this morning as I dragged myself out of bed. There are certain things that make it a little bit easier on me to wake up at 4 a.m. For example, when my alarm goes off I look forward to a shower and eating breakfast. When I leave, I look forward to the nap I will get to take on the long bus ride to work. After I arrive at the hospital (20 minutes early every day), I look forward to the nap I will get to take sitting in a chair in the lobby. When it’s time to head up to the unit, I look forward to a cup of coffee. And if I can get that far, I can usually make it!

This post could become an essay on the power of hope, except that right now I am very much looking forward to going to sleep, and that is much more powerful than anything else at the moment. So, what are you currently looking forward to?

How I Spent My First Month’s Pay

• Gave my tithe to my church
• Paid a huge chunk of money on my credit card bill
• Car insurance and phone bills
• Miscellaneous gas and food
• Donated to my four monthly charities (Compassion, Tabor College, support for two friends who are missionaries)
• Bought my cousin’s wife a baby shower gift
• Bought the CD Ampersand by Derek Webb and Sandra McCracken
• Paid to have my address changed on my driver’s license
• Premarital counseling

• Bought Coldplay tickets. Yes!

Still have some to spare! I’m liking this “real job” thing. Even though it does wear me out, it’s also very fulfilling. I had the option of taking the holiday off, but I chose instead to work to save up more personal time. I was a little jealous when David texted me at 11 a.m. saying he had just woken up. I responded, “Do you realize that you’ve had a full night’s sleep since I got up this morning?” I didn’t have much sympathy when he told me he was still tired!

Busy weekend ahead of me, and I hope to have much to report at the end of it!

Early Monday

I was woken up at 3:45 a.m. by the two 100+ pound dogs that I’m taking care of this week, Teak and Riley. They wanted to be fed, and there is no more sleeping when they want to be fed. So I got up and did just that, and then I stayed awake because my alarm was scheduled to go off at four. It’s only fifteen minutes, you may say, but when that fifteen minutes comes as early as it does it makes a big difference. So I was annoyed.

But, as usual, I got to work and everything was great. Two cups of coffee and I didn’t feel the sleep I was missing until about 1 p.m. when we had an inservice. Today I was assigned a patient all to myself, and I think I did pretty well. Although I must admit, she was not demanding at all. I spent the majority of my time today with my mind wandering to wedding plans.

On the way home I stopped at the grocery store, and I was strolling the aisles in my own little world. The song “Jack and Diane” was playing on the loudspeaker, and I was singing along to myself. As I rounded a corner and looked up, there was an older woman coming towards me, an employee, and at that moment we were both audibly singing, “Oh yeah, life goes on…” when our eyes locked. We could have been embarrassed, but instead we just smiled and walked on.

I Want My Normal Life Back

Hey everyone, I’m returning to the internet world. I’ve been almost completely cut off, only able to briefly check my e-mail at work. I have to say, this past week has been pretty depressing. Not because of the lack of internet, but because my life is in upheaval. My roommate Amanda moved out last week, taking all of her furniture and dishes with her. Courtney and I lived the whole week in a bare apartment, with no TV, no internet, barely any food, no plates or bowls, etc. It was a lonely place. I did a lot of reading.

Also, I am still getting used to my work schedule. I love my job, but there are times when I despair over waking up at 4:30 a.m. and going to sleep at 8:30 p.m. I have only a few hours in the evening to myself, and although there are so many things I want to be doing with that time (being with David, planning the wedding, working out, playing tennis) I rarely have the energy for any of it. I’m hoping that things will get better the longer I go.

And then finally yesterday I moved out of my apartment. My amazing fiance, parents, and soon-to-be parents-in-law helped me out immensely. My furniture is being stored at a friend’s house for the time being, and all of my stuff is now piled in an extremely disorganized fashion in the guest room at my parents’ house, where I will be living for the next few months. I’m house-sitting this week, and I am trying my best not to think about this:

Some people may have an anxiety attack when they lose control of a situation, others when they are forced to throw things away, but I lose it when my life becomes extremely disorganized. I’m barely holding it together here!

Also, I injured my toenails again. First week I played outdoor soccer this happened:

Beautiful, right? And I’m sure it won’t be gone in time for the wedding. Oh well, that’s my life. And by the way, outdoor soccer during the summer in Houston? Is pretty much hot as hell, but with a lot more humidity.

To end on a positive note, here is a picture of my handsome fiance with our pastor’s son Isaiah. We went out to eat with their family this afternoon, and I think I only caught about half of the conversation because Isaiah insisted that I sit by him and he talked to me the entire time. I’m not complaining, I want one just like him!

The Week So Far

On Monday night I went out and bought a bunch of pairs of scrubs in Caribbean blue, our required color. This is not a popular color for scrubs, but I found it at an awesome store in Katy. There was a friendly Indian woman there who owns and runs the place, and by the end of my shopping experience she was giving me marriage advice and showing me all of her receipts for the day.

On Tuesday my preceptor was off and my backup preceptor was late, so I ended up working with a girl who has only been a nurse since January. Although she was very nice, she was also extremely disorganized and I did not much enjoy working with her. That night David and I went and spent some time with our good friends Megan and Peter, who were in town for a wedding. The highlight of the night involved Megan and I getting completely made fun of for the fact that in high school we listened to ska music and skanked. Don’t know what that is? You’re cooler than I am.

Wednesday my preceptor was off again and I sat with the unit secretary. It was boring, but at least I got to sit down. That night David and I went to visit his aunt and uncle in Sealy. David is very close to them, and his aunt has pancreatic cancer and is not doing well. It was good that we went.

Today my preceptor, Christy, was back and we had a good day. She is allowing me to do more things now. Tonight I am returning to my apartment. I have been away for over a week house- and pet-sitting. I miss Cleo and my bed.

I am really exhausted. 4:30 a.m. comes really early.

NCLEX Run-down

I couldn’t sleep last night. I was in bed at 9:30 p.m. but I just tossed and turned. I guess I finally drifted off eventually, but I was awoken at 3 a.m. by Teak and Riley, who I am pet-sitting, because they had to go outside. Then my alarm went off seemingly ages later at 5 a.m. I was restless, so I got out of bed right away. As I was getting ready I kept thinking, “I can’t believe I’m going to take this test today.” I was so nervous my stomach was doing flips. I can’t remember the last time I was that nervous about anything.

I got to the testing center half an hour early. My car was the only one in the parking lot.

So I went and sat on a bench outside of the building, and just tried to calm myself down mentally.

After a few minutes my friend Lauren walked up, and we talked until it was time to go in the building. We had to wait until exactly 7:30 a.m. before they would let us in the suite. We each took a number, and that was the order we were checked in. I took number 3. I showed them my ID, my authorization to test, signed a signature pad, had my picture taken, and was fingerprinted. I put all of my stuff in a locker, except a sweater that they let me take in. Then I was given a dry erase board and a set of earplugs and was led to a little cubicle. I ran through a tutorial of how the test would be given, and then my first question popped up.

I’m not allowed to talk about the exact questions I got, but I do know that I got 6 questions about pediatrics, 2 about OB, 9 regarding specific drugs, 1 calculation, and 14 “alternate item” questions that were “select all that apply” rather than multiple choice. The rest were mainly a mixture of med-surg, delegation, and teaching questions. I had 75 questions total, the minimum amount. It took me an hour and a half.

My impression? It was hard. REALLY hard. If it were a test in nursing school I would be extremely upset and just know I failed. BUT, the NCLEX is not scored on a percentage; you just have to get more right than wrong. It was very similar to the practice tests I had been taking, and I passed all of those. So, I honestly feel pretty good about it.

The results will be ready for me to view on Friday, but I will be at work. I could check them there, but if I happen to fail that would be extremely embarrassing because everyone in my orientation group will ask me about it. So I’ve decided that I’m going to wait until I get home that evening and I’m with my fiance David to check it. I want to be with him either way it turns out.

I feel exhausted for one, and a little numb to it all. I also feel apprehensive, because I can’t quite relax yet. But it’s nice to have the rest of the day off. After I finished the test I immediately went to get a manicure and pedicure. Then I met David for lunch, and now I’m going to take a short nap before going to meet David again for dinner and a movie.

If you prayed, thank you. I can’t tell you how much it comforted me to think about all the people that were praying for me. Now if you could just pray for two more days until I find out my results, that would be great!

Whew

I have successfully completed my first week of work, and I have determined that new nurse orientation is way worse than school. Except for the fact that I am getting paid good money for it, which makes it bearable.

Basically I have been sitting in lectures. They cover a variety of topics, from why Methodist is considered a magnet hospital, to wound care, to cultural competency (as if I haven’t had that drilled into my head a million times by now), to operating an AED. I have also been doing a thousand computer-based training modules. These are better than the lectures, but after the 999th one they get pretty old. (You may notice that I’m prone to hyperbole today.)

Next week doesn’t look much better. In fact, it looks worse because I finished all my computer modules and now I mainly have only lectures to look forward to. Except Wednesday, which is, if you remember, the day I am taking the most important test of my LIFE.

Speaking of that, I guess it’s another reason I feel so drained. I come home from work and I study, that’s what I do. I managed to hurt my back in the process somehow, maybe from all that strenuous sitting I’ve been doing. But seriously, if it doesn’t start feeling better soon I’m going to have to go to a doctor. David and I have barely seen each other this week, which is no fun for either of us. I’m not trying to be a complainer, I’m just trying to express how much I can’t WAIT to get that test over with and start a normal life!

So, I’m taking the evening off to hang out with my parents. David is going to see the Astros with my brothers, so my mom and I are going to go for a short shopping trip. Perhaps I can get some studying in later tonight, but if I can’t, eh. I have the whole weekend for that.