Thought I was done with Charge

I showed up to work yesterday a little early. I had spent the night at my cousin's home in Virginia so I had left a little earlier than normal to be sure I would not be late to work. I showed up on my floor at 0620 to the question of "Are you going to be Charge today?" The nurse who was scheduled to be charge had car trouble and would not be able to make it in. (He was fine, his car would not start.) My biggest concern was then getting an extra nurse floated over to the my floor to cover some of the patients. There were three nurses on the floor, one nurse at the telemetry monitor, and one CNA on the floor. We have rather high acuity (lots of physical needs) patients on the floor and the charge nurse is only supposed to take two patients at the most preferably take none. We all started out the morning with four patients, no big deal. But thankfully the supervisor was able to get me an extra nurse from one of our ICUs to come take a patient from each one of us. By the end of the day, we had transferred one patient upstairs to a surgical ward and did not receive any admissions or transfers in. It ended up being a great day on the floor. Since we all worked so well together as a team we all had some down time to hangout and talk. I really like those rare moments when we are able to get to know each other a little more. We were so on top of things we were all able to leave early. We are supposed to be there until 1915, but the next shift of nurses all came on time and got report done so we could leave. It was wonderful! I hope to have more days like that one giving me time to get to know those I work with a little better. Plus, I feel like I had earned an easier day after the past week I had on the floor.

Fighting for your patients

Sometimes we win and sometimes we lose. When the Intern is telling you he does not care when you call repeated times, you feel like you are failing your patient. When the Intern's Attending steps in 10 hours later and proves that the lowly 2LT RN was correct, you feel a brief moment of success, a moment of victory over the system...but you realize it took 10 hours. Ten hours in my book is still failing my patient. Close to the end of my shift the patient was finally taken care of and the Attending came to my floor to pull me into a empty room to discuss my actions that day. I was scared. But he was nothing but complimentary. He thanked me for fighting as hard as I did. He encouraged me to keep fighting for my patients and said that he wouldn't mind if I took his patients everytime they were admitted or transferred to my floor. A civilian nurse who I very much respect helped debrief me but I still took it home with me.

We fight everyday for our patients, and we often bring it home with us. How am I, rather how are we to last 20 years of patient care when we so often bring our work home with us?

Finished with Charge for the month!

And thank the Lord for being done! So far this month (my first month on my own as a new RN) I have worked eight 12-hour shifts. Five of those shifts have been as the Charge Nurse. First time was a little scary but the next few not so bad. This Wednesday was rough as the patient acuity was pretty high and we had a patient receiving many VIP visitors. The nursing staff was great, but wow! were we busy. During lunch our Assistant Head Nurse called a mock-code for me to run along with another new nurse. Our dummy made it, but it was a little crazy. Thursday there were some awesome nurses on the floor that I got to work with plus we were able to discharge and transfer out a few patients in the afternoon. I am really glad that I learned along time ago not to sweat the small stuff and to focus all my energy on the patients and fellow staff on the floor.

Only four more shifts this month! My hours rock!

Seeing the sights with friends!

Two friends I met while at APU took their Spring Break to come out to visit the DC area and see the sights. Hi Heather! Hi Kristi! I worked most of the time they were here but was able to hang out with them for a day and a half. It was so great to be reminded how fun life was in school. We went to Montecello (he lived pretty far outside the city) and to the Kennedy Center. The concert at the Kennedy Center was awesome! It was a Pops Diva show. I loved it! I really do miss going to see shows. Looks like I will have to start that up again.

Charge Nurse with success!

Yup, it is true. Today is the seventh day since my final day of orientation. (Not the seventh day of work since orientation, simply the seventh day.) Yesterday, I was the Charge Nurse. I started my morning checking the crash carts and supplies at 0600. I then had to get report and make the assignments for the day. I had 4 RNs on the floor and one sit tele. So at 0645 we all sat down for report. Two RNs started with 3 patients while the other one and I started with two. I was the "clean" nurse as we thought we were going to get a patient following cardiac surgery but we found out early that the patient would not be coming back to us that day.

The House Supervisor came by about 9am for report. On my floor every RN is supposed to have a general idea about each patient so we can cover when things happen, but when you are charge you have to know everything. It is crazy!

I transferred one by lunch so I took a patient from one of the RNs with three. About 3pm I finally discharged one that should have been gone at lunch when I transferred my other one. So I was down to one patient again. The Hosue Supervisor came by again for a second report, thankfully I only had to give her updates.

At about 4pm we started getting hit. One transferring from the Internediate Care Unit, one admit from the ER, and a transfer from the fifth floor. The patient I admitted from the ER was very quickly taken to the PACU to be preped for a quick procedure. The MD team was so eager to treat her that they hadn't even gotten a signed consent or picked up the chart before they were trying to take her off the floor. I literally had to run down the hallway after them to get my tele box off the patient as they simply wheeled the patient away without telling any of the staff on the floor. (Sometimes the Interns drive me nuts!)

By the end of the shift everyone was still breathing and more importantly everyone was in better shape than when we arrived for the day. One day as charge nurse down, only four more this month...

The Blooming City

The Cherry Blossoms are out in full force! It is a beautiful site to see when walking through downtown DC. Even the weather has been in agreement with those of us out enjoying the sites and fresh flower smell coming from the trees. My roommate and I went for a bike ride through the city so we could see the trees. It was a blast! I wish everyone could come out and see this at least once. (Yeah for Heather and Kristi for coming soon to see the city!)

First Day On My Own

Every new RN should be as blessed as I was today. Today was my first day on my own (off orientation). I was kind of dredding it as I was sure the board would be full and we would be under staffed as usual. But to my surprise, we had 3 RNs on the floor, 1 to sit Tele, and 1 who was placed on-call. A full staff! But even better, we were able to place our LPN on-call because we only had 6 patients! We are a 14-bed unit that is usually packed. Transfer one out or discharge someone home, and within 2 hours the bed will be full again. Each RN on the floor was assigned 2 patients for the day. My two were awesome! I discharged one to home at lunch (putting me up for the first admission) and my second one went to the Fischer House on pass to hangout with his family. So for four hours in the afternoon I had no patients! As I will be Charge this Friday, the current charge nurse allowed me to shadow her a little more to be sure I knew all the little tasks I would need to complete. I actually had time to sit and talk with one of our agency nurses and get to know her. It was great! A rare day on my floor. But a welcome one!

Easter Egg Time

My cousin Allison invited me over for an afternoon of Easter Egg Dyeing. It was a blast. I think both of our moms would be proud to know that we did not make a huge mess as we were brave enough to dye the eggs inside and not have to sit in the garage or the back deck for the activity!